Trabecular bone score, a new bone quality index, is associated with severe periodontitis.
bone
epidemiologic studies
oral hygiene
osteoporosis
periodontitis
trabecular bone
Journal
Journal of periodontology
ISSN: 1943-3670
Titre abrégé: J Periodontol
Pays: United States
ID NLM: 8000345
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
05
10
2019
revised:
20
01
2020
accepted:
01
02
2020
pubmed:
27
2
2020
medline:
18
11
2020
entrez:
27
2
2020
Statut:
ppublish
Résumé
The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. Therefore, this cross-sectional study investigated the association between TBS and severe periodontitis. Eight hundred and five Thai participants, aged 30 to 82 years, underwent bone quality assessment. Their mean TBS was calculated from dual-energy X-ray absorptiometry images at the L1 to L4 lumbar spine using TBS software. Each participant was classified as normal, partially degraded, or degraded TBS. Full-mouth periodontal examinations determined plaque score, probing depth, clinical attachment level (CAL), and the number of remaining teeth. The participants were classified as non-severe or severe periodontitis. Differences in periodontal parameters between the TBS groups were analyzed using one-way ANOVA. The association between TBS and severe periodontitis was assessed with multivariate binary logistic regression. For severe periodontitis, the additive interaction between TBS and oral hygiene status was also analyzed. The mean CAL was 0.9-mm higher in the degraded TBS group compared with the normal TBS group. Degraded TBS was associated with severe periodontitis with an adjusted odds ratio (OR) of 2.10 (95% confidence interval [CI] = 1.03 to 4.26). The combination of degraded TBS and plaque score ≥80% increased the adjusted OR to 5.71 (95% CI = 1.15 to 28.43). Degraded TBS is associated with severe periodontitis and has a synergistic effect with poor oral hygiene, suggesting monitoring decreased bone quality and good oral hygiene for promoting the periodontal-systemic health of these individuals.
Sections du résumé
BACKGROUND
The association between systemic bone loss and periodontitis remains unresolved; and the trabecular bone score (TBS) is a new index for assessing decreased bone quality. Therefore, this cross-sectional study investigated the association between TBS and severe periodontitis.
METHODS
Eight hundred and five Thai participants, aged 30 to 82 years, underwent bone quality assessment. Their mean TBS was calculated from dual-energy X-ray absorptiometry images at the L1 to L4 lumbar spine using TBS software. Each participant was classified as normal, partially degraded, or degraded TBS. Full-mouth periodontal examinations determined plaque score, probing depth, clinical attachment level (CAL), and the number of remaining teeth. The participants were classified as non-severe or severe periodontitis. Differences in periodontal parameters between the TBS groups were analyzed using one-way ANOVA. The association between TBS and severe periodontitis was assessed with multivariate binary logistic regression. For severe periodontitis, the additive interaction between TBS and oral hygiene status was also analyzed.
RESULTS
The mean CAL was 0.9-mm higher in the degraded TBS group compared with the normal TBS group. Degraded TBS was associated with severe periodontitis with an adjusted odds ratio (OR) of 2.10 (95% confidence interval [CI] = 1.03 to 4.26). The combination of degraded TBS and plaque score ≥80% increased the adjusted OR to 5.71 (95% CI = 1.15 to 28.43).
CONCLUSIONS
Degraded TBS is associated with severe periodontitis and has a synergistic effect with poor oral hygiene, suggesting monitoring decreased bone quality and good oral hygiene for promoting the periodontal-systemic health of these individuals.
Identifiants
pubmed: 32100286
doi: 10.1002/JPER.19-0580
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1264-1273Informations de copyright
© 2020 American Academy of Periodontology.
Références
Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89:S173-S182.
Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: case definitions and diagnostic considerations. J Periodontol. 2018;89:S183-S203.
Barbour KE, Lui LY, Ensrud KE, et al. Inflammatory markers and risk of hip fracture in older white women: the study of osteoporotic fractures. J Bone Miner Res. 2014;29:2057-2064.
Guiglia R, Di Fede O, Lo Russo L, Sprini D, Rini GB, Campisi G. Osteoporosis, jawbones and periodontal disease. Med Oral Patol Oral Cir Bucal. 2013;18:e93-e99. https://doi.org/10.4317/medoral.18298.
Wang CJ, McCauley LK. Osteoporosis and periodontitis. Curr Osteoporos Rep. 2016;14:284-291.
Al Habashneh R, Alchalabi H, Khader YS, Hazza'a AM, Odat Z, Johnson GK. Association between periodontal disease and osteoporosis in postmenopausal women in Jordan. J Periodontol. 2010;81:1613-1621.
Brennan RM, Genco RJ, Hovey KM, Trevisan M, Wactawski-Wende J. Clinical attachment loss, systemic bone density, and subgingival calculus in postmenopausal women. J Periodontol. 2007;78:2104-2111.
Gondim V, Aun J, Fukuda CT, et al. Severe loss of clinical attachment level: an independent association with low hip bone mineral density in postmenopausal females. J Periodontol. 2013;84:352-359.
Iwasaki M, Taylor GW, Nakamura K, Yoshihara A, Miyazaki H. Association between low bone mineral density and clinical attachment loss in Japanese postmenopausal females. J Periodontol. 2013;84:1708-1716.
Penoni DC, Torres SR, Farias ML, Fernandes TM, Luiz RR, Leao AT. Association of osteoporosis and bone medication with the periodontal condition in elderly women. Osteoporos Int. 2016;27:1887-1896.
Ronderos M, Jacobs DR, Himes JH, Pihlstrom BL. Associations of periodontal disease with femoral bone mineral density and estrogen replacement therapy: cross-sectional evaluation of US adults from NHANES III. J Clin Periodontol. 2000;27:778-786.
Gomes-Filho IS, Passos Jde S, Cruz SS, et al. The association between postmenopausal osteoporosis and periodontal disease. J Periodontol. 2007;78:1731-1740.
Passos JS, Vianna MI, Gomes-Filho IS, et al. Osteoporosis/osteopenia as an independent factor associated with periodontitis in postmenopausal women: a case-control study. Osteoporos Int. 2013;24:1275-1283.
Iwasaki M, Nakamura K, Yoshihara A, Miyazaki H. Change in bone mineral density and tooth loss in Japanese community-dwelling postmenopausal women: a 5-year cohort study. J Bone Miner Metab. 2012;30:447-453.
Jang KM, Cho KH, Lee SH, Han SB, Han KD, Kim YH. Tooth loss and bone mineral density in postmenopausal South Korean women: the 2008-2010 Korea National Health and Nutrition Examination Survey. Maturitas. 2015;82:360-364.
Darcey J, Devlin H, Lai D, et al. An observational study to assess the association between osteoporosis and periodontal disease. Br Dent J. 2013;215:617-621.
Famili P, Cauley J, Suzuki JB, Weyant R. Longitudinal study of periodontal disease and edentulism with rates of bone loss in older women. J Periodontol. 2005;76:11-15.
Hattatoglu-Sonmez E, Ozcakar L, Gokce-Kutsal Y, Karaagaoglu E, Demiralp B, Nazliel-Erverdi H. No alteration in bone mineral density in patients with periodontitis. J Dent Res. 2008;87:79-83.
Marjanovic EJ, Southern HN, Coates P, et al. Do patients with osteoporosis have an increased prevalence of periodontal disease? A cross-sectional study. Osteoporos Int. 2013;24:1973-1979.
Phipps KR, Chan BKS, Madden TE, et al. Longitudinal study of bone density and periodontal disease in men. J Dent Res. 2007;86:1110-1114.
Bousson V, Bergot C, Sutter B, Levitz P, Cortet B. Trabecular bone score (TBS): available knowledge, clinical relevance, and future prospects. Osteoporos Int. 2012;23:1489-1501.
Persson GR, Berglund J, Persson RE, Renvert S. Prediction of hip and hand fractures in older persons with or without a diagnosis of periodontitis. Bone. 2011;48:552-556.
Silva BC, Leslie WD, Resch H, et al. Trabecular bone score: a noninvasive analytical method based upon the DXA image. J Bone Miner Res. 2014;29:518-530.
Vathesatogkit P, Woodward M, Tanomsup S, et al. Cohort profile: the electricity generating authority of Thailand study. Int J Epidemiol. 2012;41:359-365.
Mongkornkarn S, Suthasinekul R, Sritara C, Lertpimonchai A, Tamsailom S, Udomsak A. Significant association between skeletal bone mineral density and moderate to severe periodontitis in fair oral hygiene individuals. J Investig Clin Dent. 2019;0:e12441. https://doi.org/10.1111/jicd.12441.
World Health Organization Regionl office for the Western Pacific. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Sydney: Health Communications Australia; 2000:18. http://iris.wpro.who.int/handle/10665.1/5379.
American Diabetes Association. 6. Glycemic targets: standards of medical care in diabetes-2019. Diabetes Care. 2019;42:S61-S70.
Sritara C, Thakkinstian A, Ongphiphadhanakul B, et al. Age-adjusted dual x-ray absorptiometry-derived trabecular bone score curve for the lumbar spine in Thai females and males. J Clin Densitom. 2016;19:494-501.
Baim S, Binkley N, Bilezikian JP, et al. Official positions of the International Society for Clinical Densitometry and executive summary of the 2007 ISCD Position Development Conference. J Clin Densitom. 2008;11:75-91.
Cormier C, Lamy O, Poriau S. TBS in Routine Clinial Practice: Proposals of Use. Plan-les-Outes, Switzerland: Medimaps Group; 2012:1-14.
O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43:38.
Eke PI, Page RC, Wei L, Thornton-Evans G, Genco RJ. Update of the case definitions for population-based surveillance of periodontitis. J Periodontol. 2012;83:1449-1454.
Torrungruang K, Tamsailom S, Rojanasomsith K, et al. Risk indicators of periodontal disease in older Thai adults. J Periodontol. 2005;76:558-565.
VanderWeele TJ, Shpitser I. A new criterion for confounder selection. Biometrics. 2011;67:1406-1413.
Albandar JM. Periodontal disease surveillance. J Periodontol. 2007;78:1179-1181.
Knol MJ, VanderWeele TJ. Recommendations for presenting analyses of effect modification and interaction. Int J Epidemiol. 2012;41:514-520.
Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009-2014. J Am Dent Assoc. 2018;149:576-588.
Passos-Soares JS, Vianna MIP, Gomes-Filho IS, et al. Association between osteoporosis treatment and severe periodontitis in postmenopausal women. Menopause. 2017;24:789-795.
Buchwald S, Kocher T, Biffar R, Harb A, Holtfreter B, Meisel P. Tooth loss and periodontitis by socio-economic status and inflammation in a longitudinal population-based study. J Clin Periodontol. 2013;40:203-211.
Chaffee BW, Weston SJ. Association between chronic periodontal disease and obesity: a systematic review and meta-analysis. J Periodontol. 2010;81:1708-1724.
Needleman I, Garcia R, Gkranias N, et al. Mean annual attachment, bone level, and tooth loss: a systematic review. J Clin Periodontol. 2018;45:S112-S129.
Penoni DC, Fidalgo TK, Torres SR, et al. Bone density and clinical periodontal attachment in postmenopausal women: a systematic review and meta-analysis. J Dent Res. 2017;96:261-269.
Anderson KB, Holloway-Kew KL, Mohebbi M, Kotowicz MA, Hans D, Pasco JA. Is trabecular bone score less affected by degenerative-changes at the spine than lumbar spine BMD. Arch Osteoporos. 2018;13:1-9.
Padlina I, Gonzalez-Rodriguez E, Hans D, et al. The lumbar spine age-related degenerative disease influences the BMD not the TBS: the Osteolaus cohort. Osteoporos Int. 2017;28:909-915.
Lee JE, Kim KM, Kim LK, et al. Comparisons of TBS and lumbar spine BMD in the associations with vertebral fractures according to the T-scores: a cross-sectional observation. Bone. 2017;105:269-275.
Briot K, Paternotte S, Kolta S, et al. Added value of trabecular bone score to bone mineral density for prediction of osteoporotic fractures in postmenopausal women: the OPUS study. Bone. 2013;57:232-236.
Hans D, Goertzen AL, Krieg MA, Leslie WD. Bone microarchitecture assessed by TBS predicts osteoporotic fractures independent of bone density: the Manitoba study. J Bone Miner Res. 2011;26:2762-2769.
Popp AW, Meer S, Krieg MA, Perrelet R, Hans D, Lippuner K. Bone mineral density (BMD) and vertebral trabecular bone score (TBS) for the identification of elderly women at high risk for fracture: the SEMOF cohort study. Eur Spine J. 2016;25:3432-3438.
McCloskey EV, Oden A, Harvey NC, et al. A meta-analysis of trabecular bone score in fracture risk prediction and its relationship to FRAX. J Bone Miner Res. 2016;31:940-948.
Winzenrieth R, Dufour R, Pothuaud L, Hans D. A retrospective case-control study assessing the role of trabecular bone score in postmenopausal Caucasian women with osteopenia: analyzing the odds of vertebral fracture. Calcif Tissue Int. 2010;86:104-109.