The association of cigarette smoking with alveolar bone loss in postmenopausal females.
OBJECTIVE
The purpose of this 2-year longitudinal clinical study was to determine the impact of smoking on alveolar bone height and density changes in postmenopausal females.


METHODS
59 postmenopausal women completed this study, including 38 non-smokers and 21 smokers. All subjects had a history of periodontitis, participated in 3- to 4-month periodontal maintenance programs and were within 5 years of menopause at the study outset. 4 vertical bite-wing radiographs of posterior sextants were taken at baseline and 2-year visits. Radiographs were evaluated using computer-assisted densitometric image analysis (CADIA); changes in interproximal alveolar bone density and changes in alveolar bone height were determined. Relative clinical attachment levels (RCAL) and presence/absence of plaque and bleeding on probing were recorded.


RESULTS
Smokers exhibited a higher frequency of alveolar bone height loss (p<0.05) and crestal (p<0.03) and subcrestal (p<0.02) density loss relative to non-smokers. Smokers exhibited a trend (p<0.08) toward a higher frequency of > or =2.0 mm RCAL loss over the 2-year period. Plaque and bleeding on probing did not differ between smokers and non-smokers. A significant interaction, determined by repeated measures ANOVA, was noted between systemic bone mineral density (BMD) at the lumbar spine and smoking on alveolar bone density change (p<0.05). Only non-smoking patients with normal BMD realized a mean net gain in alveolar bone density; osteoporotic/osteopenic subjects (n=25) and smokers lost alveolar bone density.


CONCLUSIONS
Postmenopausal female smokers were more likely to lose alveolar bone height and density than non-smokers with a similar periodontitis, plaque and gingival bleeding experience. In addition, both smoking and osteoporosis/osteopenia provided a negative influence on alveolar bone.
Payne
J B
JB
Department of Surgical Specialties, University of Nebraska Medical Center, College of Dentistry, Lincoln 68583-0757, USA. jbpayne@unmc.edu
Reinhardt
R A
RA
Nummikoski
P V
PV
Dunning
D G
DG
Patil
K D
KD
D015502:Absorptiometry, Photon / Q000379:methods; D016301:Alveolar Bone Loss / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000473:pathology; D000704:Analysis of Variance; D015519:Bone Density; D003774:Dental Plaque Index; D004967:Estrogens / Q000097:blood; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D010519:Periodontium / Q000000981:diagnostic imaging / Q000473:pathology; D012907:Smoking / Q000009:adverse effects* / Q000097:blood / Q000473:pathology
D004967:Estrogens