Oral health in patients on inhaled corticosteroid treatment.
OBJECTIVE
The aim of this study was to investigate the effects of long-term inhaled corticosteroids on bone mineral density (BMD) of the mandible in relation with the tooth loss.


METHODS
Cross sectional analytic study.


METHODS
Patients (n = 30) with chronic obstructive pulmonary disease under inhaled corticosteroid therapy for at least 1 year were compared with sex- and age-matched healthy controls (n = 30). BMD of the mandible was measured by dual-energy X-ray absorptiometry. The clinical examination included recording the number of teeth present together with periodontal condition. Levels of serum osteocalcin, alkaline phosphatase, calcium, phosphorus and cortisol were also assessed.


RESULTS
BMD of the mandible in patients on corticosteroid treatment was significantly lower than that in the control group (P = 0.001). Patients under treatment had more missing teeth than the control group but the difference did not reach statistical significance. The two groups exhibited similar clinical parameters of periodontal condition. Significantly lower levels of osteocalcin (P < 0.0001), calcium (P = 0.004) and cortisol (P = 0.03) were observed in the patients on corticosteroid treatment.


CONCLUSIONS
Long-term use of inhaled corticosteroids may impair bone metabolism and lead to a marked decrease in the mandibular BMD.
Komerik
N
N
Department of Oral Surgery, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey. nkomerik@med.sdu.edu.tr
Akkaya
A
A
Yildiz
M
M
Buyukkaplan
U S
US
Kuru
L
L
D015502:Absorptiometry, Photon; D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D000368:Aged; D016301:Alveolar Bone Loss / Q000097:blood / Q000139:chemically induced*; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D015519:Bone Density; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D000068298:Fluticasone; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008334:Mandible / Q000473:pathology; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010512:Periodontal Index; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy; D018709:Statistics, Nonparametric; D016388:Tooth Loss / Q000139:chemically induced*
D000305:Adrenal Cortex Hormones; D000730:Androstadienes; D000893:Anti-Inflammatory Agents; D015675:Osteocalcin; D019819:Budesonide; D000068298:Fluticasone; D002118:Calcium; D006854:Hydrocortisone