Marginal Bone Levels and Trabecular Bone Structure: A Longitudinal Population Study of Women - Marginal Bone Levels and Trabecular Bone Structure: A Longitudinal Population Study of Women - Open Access Pub

Bone quality is difficult to assess but the skeletal bone condition is reflected in mandibular trabecular bone, which is well imaged in periapical dental radiographs. The aim of this 12-year prospective cohort study was to test if marginal mandibular bone loss differs in women with varying trabecular bone structure. The sample consisted of 460 women (aged 38, 46, and 54 years) from the prospective population study of women in Gothenburg, Sweden. Marginal bone loss was assessed according to a five-graded scale in two surveys 12 years apart, and the mandibular bone structure was evaluated visually as sparse, mixed, and dense. The results showed that marginal bone loss was significantly correlated to mandibular bone structure (r= 0.20; p<0.001 at baseline, and r= 0.17; p<0.001 after 12 years). Significant differences in marginal bone loss between trabeculation groups were found, with the largest loss in the group with dense trabeculation. Age, smoking, number of missing teeth and trabecular bone structure explained 20-28% of the variation in marginal bone loss. The conclusion was that women with dense trabecular bone in the mandible suffered a stronger periodontal bone destruction when negative events occur, than the women with sparser trabeculation. DOI10.14302/issn.2474-7785.jarh-16-1275 Periodontitis is a chronic bacterial infection caused by dental biofilms. Bacterial virulence triggers immune-pathologic host responses which in turn may lead to periodontal hard and soft tissue destruction and sometimes loss of teeth.1 The host response to infection determines to a certain degree the extent and severity of the disease, and increased prevalence and severity may be associated with certain systemic diseases.2 Osteoporosis may have an impact on the host response but the association between periodontitis and osteoporosis is not fully elucidated. Periodontitis and osteoporosis both progress with advancing age, smoking, estrogen deficiency, and heredity.3Thus,many risk factors are common for the two conditions although infection is the unique feature of periodontitis.3 Most adults in Western countries visit their dentists regularly, and radiographs are taken. The trabecular structure is well imaged in intra-oral and extra-oral radiographs, but normally not assessed in the clinic. However, mandibular sparse trabeculation is associated with osteopenia,4,5 and a serious risk factor for fracture identifying women at high risk for future fractures many years before the first fracture occurs.6,7 As much as 71-78% of women with sparse trabeculation would sustain