The pattern of alveolar crest height change in healthy postmenopausal women after 3 years of hormone/estrogen replacement therapy.
BACKGROUND
The loss of ovarian function at menopause is associated with loss of postcranial and oral bone. Hormone/estrogen replacement therapy (HRT/ERT) has a positive effect on both postcranial and oral bone. The objective of the study was to determine if the positive effect of HRT/ERT on alveolar crest height (ACH) is generalized or site specific.


METHODS
The sample consisted of 49 women who completed a 3-year, HRT/ERT prospective study. Cemento-enamel junction distances (ACH) were measured on digitized images of bitewing radiographs. Lumbar spine and proximal femur bone mineral densities (BMDs) were determined with dual-energy x-ray absorptiometric scans. Measurements were made at baseline and at the end of year 3. For the 3-year study period, mean change in ACH was determined for each patient. In addition, the sites with the greatest, second and third greatest ACH changes were determined for each patient. Correlations between changes in ACH (as determined by the various methods) and postcranial BMD were determined.


RESULTS
Mean ACH changes had an average correlation (r) of -0.24 with femoral and lumbar spine BMDs. Although the largest site-specific change in ACH resulted in a mean correlation of -0.21, the correlations for the second and third largest changes in ACH dropped to -0.15 and -0.12. Overall, the correlations for site-specific changes were substantively smaller than those for generalized change.


CONCLUSIONS
The data of this study indicate that ACH change attributable to HRT/ERT is generalized rather than site specific. Studies of the effect of HRT/ERT on ACH should employ multiple measurements to minimize measurement errors associated with site-specific measurements.
Hildebolt
Charles F
CF
Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA. hildeboltc@mir.wustl.edu
Pilgram
Thomas K
TK
Yokoyama-Crothers
Naoko
N
Vannier
Michael W
MW
Dotson
Mary
M
Muckerman
Jane
J
Armamento-Villareal
Reina
R
Hauser
Jay
J
Cohen
Sheldon
S
Kardaris
E Eugenia
EE
Hanes
Philip
P
Shrout
Michael K
MK
Civitelli
Roberto
R
D015502:Absorptiometry, Photon; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015519:Bone Density / Q000187:drug effects*; D001861:Bone Regeneration / Q000187:drug effects*; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000008:administration & dosage; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects; D008525:Medroxyprogesterone / Q000008:administration & dosage; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000503:physiopathology; D017698:Postmenopause / Q000502:physiology; D011446:Prospective Studies; D016300:Radiography, Bitewing
D004967:Estrogens; D008525:Medroxyprogesterone