title: A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults.
abstract: OBJECTIVE
  Bone loss is a common feature of periodontitis and osteoporosis. Both diseases may share common etiologic agents which may either affect or modulate the process of both diseases. The purpose of this study was to evaluate the relationship between systemic bone mineral density (BMD) and periodontal disease among older people.
  
  
  METHODS
  Among all 4,542 inhabitants aged 70 years according to a registry of residents in Niigata city in Japan, 600 people were selected randomly. One hundred and eighty-four subjects who did not have diabetes mellitus, whose blood sugar was <140 mg/dl, who had more than 20 teeth, who were non-smokers, and who did not take medication for osteoporosis, were included in the study. Four dentists performed clinical evaluations on probing attachment level (PAL). We also utilized the data on BMD of the heel, which we measured using an ultrasound bone densitometer. Follow-up clinical surveys were done by measuring PAL after 3 years. Finally, 179 subjects who could participate in both the baseline and the follow-up examinations were included in the analysis. After dividing the subjects into an osteopenia group (OG) and non-osteopenia group (NOG), we evaluated the relationship between BMD and the number of progressive sites which had > or =3 mm additional attachment loss during 3 years after controlling the known confounding factors.
  
  
  RESULTS
  The mean number of progressive sites for the OG and the NOG, respectively, were 4.65+/-5.51 and 3.26+/-3.01 in females and 6.88+/-9.41 and 3.41+/-2.79 in males. Two-way analysis of variance was performed to discriminate among effects of gender, BMD, and gender-BMD interaction. A significant effect of BMD (OG or NOG, p=0.043) with a significant interaction (p=0.038) was observed. Furthermore, BMD was associated with the number of progressive sites which had > or =3 mm additional attachment loss during the 3 years (p=0.001) by multiple linear regression analysis.
  
  
  CONCLUSIONS
  This study suggested that there was a significant relationship between periodontal disease and general BMD.
authors.affiliation: Division of Preventive Dentistry, Department of Oral Health Science, Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-Dori, Niigata 951-8514, Japan. akihiro@dent.niigata-u.ac.jp
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshihara
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Seida
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Hanada
authors.forename: Hideo
authors.initials: H
authors.lastname: Miyazaki
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications* / Q000503:physiopathology; D035061:Control Groups; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000503:physiopathology; D010510:Periodontal Diseases / Q000150:complications* / Q000503:physiopathology