Is there any association between systemic bone mineral density and clinical manifestations of periodontal disease?

Background and aims. The aim of the present study was to assess the hypothesis that an osteopenic diathesis may accelerate or exaggerate periodontal disease via evaluation of the clinical association between systemic bone mineral density and periodontal disease.Materials and methods. The subjects included 150 patients (mean age ≥ 45 years old) who were referred for evaluation of bone mineral density. After measurement of body mass index, skeletal bone mineral density (BMD) was assessed by Dual energy X-ray Absorptiometry (DXA) at femur and lumbar spines. Seventy five patients with lower than normal BMD values (49: Osteopenic, 26: Osteoporotic) were allocated into the case group and the rest of the subjects with normal BMD were allocated into the control group. Periodontal examination involved clinical probing depth (CPD), clinical attachment level (CAL), bleeding on probing (BOP), tooth mobility and the number of remaining teeth. The data were analyzed using chi-square test and student’s t-test.Results. There was no significant difference with respect to CPD, BOP, the number of remaining teeth, and tooth mobility between case and control groups. However, clinical attachment loss in subjects of the case group was significantly higher than the control group.Conclusion. Although it was not possible to demonstrate a causal relationship between bone mineral density and clinical attachment loss in the periodontium, it appears that these two parameters are strongly correlated.