title: Periodontal Health in Women With Early-Stage Postmenopausal Breast Cancer Newly on Aromatase Inhibitors: A Pilot Study.
abstract: BACKGROUND
  Aromatase inhibitor (AI) use results in low estrogen levels, which in turn affect bone mineral density (BMD). Periodontitis, alveolar bone loss, and tooth loss are associated with low BMD. The goal of this study is to assess the prevalence of periodontitis and perceived oral health and evaluate salivary biomarkers in postmenopausal women who are survivors of early-stage (I to IIIA) breast cancer (BCa) and receive adjuvant AI therapy.
  
  
  METHODS
  Participants included 58 postmenopausal women: 29 with BCa on AIs and 29 controls without BCa diagnoses. Baseline periodontal status was assessed with: 1) periodontal probing depth (PD); 2) bleeding on probing (BOP); and 3) attachment loss (AL). Demographic and dental utilization information was gathered by questionnaire. Linear regression modeling was used to analyze the outcomes.
  
  
  RESULTS
  No differences were found in mean PD or number of teeth. The AI group had significantly more sites with BOP (27.8 versus 16.7; P = 0.02), higher worst-site AL (5.2 versus 4.0 mm; P <0.01), and more sites with dental calculus (18.2 versus 6.4; P <0.001) than controls. Linear regression adjusted for income, tobacco use, dental insurance, and previous radiation and chemotherapy exposure demonstrated that AI use increased AL by >2 mm (95% confidence interval, 0.46 to 3.92). Median salivary osteocalcin and tumor necrosis factor-α levels were significantly higher in the AI group than the control group.
  
  
  CONCLUSIONS
  This first investigation of the periodontal status of women initiating adjuvant AI therapy identifies this population as having an increased risk for periodontitis.
authors: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.
authors: L Susan
authors: LS
authors: Taichman
authors: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.|Department of Psychology; College of Literature, Science, and the Arts; University of Michigan.
authors: Marita R
authors: MR
authors: Inglehart
authors: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.
authors: William V
authors: WV
authors: Giannobile
authors: Department of Biostatistics, School of Public Health, University of Michigan.
authors: Thomas
authors: T
authors: Braun
authors: Center for Statistical Consultation and Research, University of Michigan.
authors: Giselle
authors: G
authors: Kolenic
authors: Department of Internal Medicine, Hematology and Oncology Division, University of Michigan.
authors: Catherine
authors: C
authors: Van Poznak
mesh_terms: D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis; D001943:Breast Neoplasms / Q000188:drug therapy*; D003728:Dental Calculus / Q000145:classification; D003774:Dental Plaque Index; D005260:Female; D005889:Gingival Recession / Q000145:classification; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009909:Oral Health; D015675:Osteocalcin / Q000032:analysis; D017622:Periodontal Attachment Loss / Q000145:classification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D010518:Periodontitis / Q000145:classification; D010865:Pilot Projects; D017698:Postmenopause; D016300:Radiography, Bitewing / Q000379:methods; D012463:Saliva / Q000737:chemistry; D016388:Tooth Loss / Q000145:classification; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; D015675:Osteocalcin
keywords: Aromatase inhibitors; biological markers; breast neoplasms; periodontal attachment loss; postmenopause; women’s health