Email Alert | RSS

北京大学学报（医学版） ›› 2019, Vol. 51 ›› Issue (6): 1115-1118. doi: 10.19723/j.issn.1671-167X.2019.06.024

• 论著 • 上一篇    下一篇

绝经期妇女牙周状况与骨质密度的相关性分析

朱洁1,李建红2,袁婷婷2,和璐3,梁宇红1,△()   

  1. 1. 北京大学国际医院口腔科,北京 102206
    2. 北京大学国际医院核医学科,北京 102206
    3. 北京大学口腔医学院·口腔医院,牙周科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081
    4. 北京大学口腔医学院·口腔医院牙体牙髓科,北京 100081
  • 收稿日期:2017-10-10 出版日期:2019-12-18 发布日期:2019-12-19
  • 通讯作者: 梁宇红 E-mail:leungyuhong@sina.com
  • 基金资助:
    中华口腔医学会“口腔疾病与全身疾病关系研究专项基金”(CSA-Y2015-05)

Relationship between periodontitis and osteoporosis in postmenopausal women

Jie ZHU1,Jian-hong LI2,Ting-ting YUAN2,Lu He3,Yu-hong LIANG1,△()   

  1. 1. Department of Stomatology, Peking University International Hospital, Beijing, 102206, China
    2. Department of Nuclear Medicine, Peking University International Hospital, Beijing, 102206, China
    3. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    4. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China
  • Received:2017-10-10 Online:2019-12-18 Published:2019-12-19
  • Contact: Yu-hong LIANG E-mail:leungyuhong@sina.com
  • Supported by:
    Supported by “Association between Oral Disease and Systemic Disease” Research Program of Chinese Stomatological Association(CSA-Y2015-05)

RICH HTML

   

PDF (PC)

摘要：

目的 检查绝经期妇女的牙周状况、颏孔处皮质骨厚度以及全身骨密度的情况,探索它们之间是否存在相关关系。方法 采用报名招募的方式,选择2017年3月至11月在北京大学国际医院报名的符合条件的50~65岁绝经期妇女98名纳入研究,记录患者的一般情况,包括年龄、绝经时间、绝经年龄、体重指数等。检查并记录简化口腔卫生指数、探诊深度、临床附着丧失、牙龈退缩、探诊后出血百分比等反映牙周状况的指标;拍摄曲面断层片并在曲断图像中测量下颌骨下缘颏孔处对应的皮质骨厚度。检查者和测量者均通过一致性检验。利用双能X线骨密度测量仪测量左侧髋部和腰椎的骨密度,根据世界卫生组织的标准,按照T值(测得的骨质密度与年轻白人女性的平均峰值骨量的标准差)分为骨质疏松组(T值<-2.5)和非骨质疏松组(T值≥-2.5),比较两组间的牙周指标和曲面断层片中测量的颏孔处皮质骨厚度间是否存在差异。结果 98名受试者中,共检查出骨质疏松者47例,所占比例为47.96%。骨质疏松组与非骨质疏松组间的年龄和绝经时间差异有统计学意义。骨质疏松组的年龄更大[(59.64±4.58) 岁 vs. (56.94 ± 4.26) 岁,P<0.05]、绝经时间更长[(10.17± 5.37) 年 vs. (6.02 ±4.48) 年,P<0.05];绝经年龄和体重指数两组间差异无统计学意义。探诊后出血阳性比例分别为21.43%±17.09%(非骨质疏松组)和29.43%±21.12%(骨质疏松组),差异有统计学意义(P=0.046);而简化口腔卫生指数、探诊深度、临床附着丧失、牙龈退缩等牙周指标差异无统计学意义;颏孔处的皮质骨厚度随着全身骨质密度减低而减少,均值分别为(4.25±0.77) mm(非骨质疏松组)和(3.61±1.04) mm(骨质疏松组),差异有统计学意义(P=0.001)。结论 绝经期妇女的牙周状况与全身骨质密度间无相关性,但曲面断层片中测得的颏孔处的皮质骨厚度与全身骨密度相关,这提示可利用颌面部影像显示的颌骨皮质骨厚度来推断全身骨密度的可能性。

关键词: 绝经期妇女, 骨质疏松, 牙周炎, 皮质骨厚度

Abstract:

Objective: To explore the relationships of periodontal parameters, cortical width on mental foramen and osteoporotic condition in postmenopausal women.Methods: Ninety-eight postmenopausal women between 50 to 65 years old were recruited. General conditions, such as age, menopausal age, duration of menopause, and body mass index (BMI) were recorded. Periodontal parameters were examined, including oral hygiene index simplified (OHI-S), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR) and bleeding on probing (BOP). Panoramic radiograph was taken and the cortical width (CW) of mental foramen was measured on images. The examiner was celebrated. Bone mass density (BMD) of left hip and lumbar spine was assessed using standardized dual energy X-ray absorptiometry. According to World Health Organization, based on the T-score of BMD(difference of the measured BMD and the mean value of young white women in terms of standard deviations), the subjects were divided into osteoporotic group (T-score<-2.5) and non-osteoporotic group (T-score≥-2.5). These parameters were compared between the groups.Results: The number of osteoporotic group was 47 (47.96%). Ages and duration of menopause were significantly different between the groups. Osteoporotic group presented older ages [(59.64±4.58) years vs. (56.94 ± 4.26) years, P<0.05], and longer duration of menopause [(10.17± 5.37) years vs. (6.02 ±4.48) years, P<0.05]. There was no significant difference in menopausal age and BMI between the groups. BOP% was statistically significantly higher in osteoporotic group (29.43±21.12) than in non-osteoporotic group (21.43±17.09), with a P-value of 0.046. The other periodontal parameters, including OHI-S, PD, CAL, and GR were not statistically significantly different in the groups. The CWs were statistically significantly lower in osteoporotic group compared with non-osteoporotic group, with a P-value of 0.001. The mean values of CWs were (3.61±1.04) mm (osteoporotic group) and (4.25±0.77) mm (non-osteoporotic group), respectively.Conclusion: The study demonstrated absence of a significant association between periodontal parameters and BMD. However, the CWs were found to be related with the BMD, which may be used to detect BMD abnormal in maxillofacial imaging. The dentists should pay attention not only to the oral health, but also to the general bone mass density, which may be detected on panoramic images.

Key words: Postmenopausal, Osteoporosis, Periodontitis, Cortical width

中图分类号: 

  • R781.4

表1

各组间一般情况的比较"

Parameters Non-osteoprosis
(n=51)		 Osteoprosis
(n=47)		 P
Age/years, x?±s 56.94±4.26 59.64±4.58 0.003
Menopausal age/years, x?±s 51.08±3.24 50.02±3.64 0.131
Duration of menopause/years, x?±s 6.02±4.48 10.17±5.37 0.000
BMI/(kg/m2), x?±s 23.52±2.77 22.55±2.93 0.095

表2

各组间牙周指标的比较"

Parameters Non-osteoprosis
(n=51)		 Osteoprosis
(n=47)		 P
OHI-S, x?±s 2.27±0.95 2.52±0.95 0.186
PD/mm, x?±s 2.52±0.52 2.72±0.57 0.074
CAL/mm, x?±s 2.32±1.03 2.60±1.27 0.222
GR/mm, x?±s 0.58±0.47 0.69±0.57 0.329
BOP/%, x?±s 21.43±17.09 29.24±21.12 0.046

图1

不同分组的CW值箱图"

[1] Lerner UH . Inflammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis[J]. J Dent Res, 2006,85(7):596-607.
[2] Greene JC, Vermillion JR . The simplified oral hygiene index[J]. J Am Dent Assoc, 1964,68:7-13.
[3] Luo K, Ma S, Guo J, et al. Association between postmenopausal osteoporosis and experimental periodontitis [J/OL]. Biomed Res Int, 2014,2014(5):316134[2017-10- 01]. .
[4] Jabbar S, Drury J, Fordham J , et al. Plasma vitamin D and cytokines in periodontal disease and postmenopausal osteoporosis[J]. J Periodontal Res, 2011,46(1):97-104.
[5] Mau LP, Kuan YC, Tsai YC , et al. Patients with chronic periodontitis present increased risk for osteoporosis: a population-based cohort study in Taiwan[J]. J Periodontal Res, 2017,52(5):922-929.
[6] Chang WP, Chang WC, Wu MS , et al. Population-based 5-year follow-up study in Taiwan of osteoporosis and risk of periodontitis[J]. J Periodontol, 2014,85(3):e24-30.
[7] Penoni DC, Torres SR, Farias ML , et al. Association of osteoporosis and bone medication with the periodontal condition in elderly women[J]. Osteoporos Int, 2016,27(5):1887-1896.
[8] Iwasaki M, Taylor GW, Nakamura K , et al. Association between low bone mineral density and clinical attachment loss in Japanese postmenopausal females[J]. J Periodontol, 2013,84(12):1708-1716.
[9] Gondim V, Aun J, Fukuda CT , et al. Severe loss of clinical attachment level: an independent association with low hip bone mineral density in postmenopausal females[J]. J Periodontol, 2013,84(3):352-359.
[10] Weyant RJ, Pearlstein ME, Churak AP , et al. The association between osteopenia and periodontal attachment loss in older women[J]. J Periodontol, 1999,70(9):982-991.
[11] Famili P, Cauley J, Suzuki JB , et al. Longitudinal study of periodontal disease and edentulism with rates of bone loss in older women[J]. J Periodontol, 2005,76(1):11-15.
[12] Hildebolt CF, Pilgram TK, Dotson M , et al. Attachment loss with postmenopausal age and smoking[J]. J Periodontal Res, 1997,32(7):619-625.
[13] 张智海, 刘忠厚, 石少辉 , 等. 中国大陆地区以-2.5SD为诊断的骨质疏松症发病率文献回顾性研究[J]. 中国骨质疏松杂志, 2015,21(1):1-7.
[14] Taguchi A, Suei Y, Ohtsuka M , et al. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible[J]. Dentomaxillofac Radiol, 1996,25(5):263-267.
[1] 潘莲菲, 李文静, 王瑞洋, 焦剑, 曹战强, 高丽, 释栋. 口服抗生素辅助牙周机械治疗对重度牙周炎的短期疗效及影响因素[J]. 北京大学学报（医学版）, 2026, 58(1): 30-36.
[2] 张斯巧, 刘建, 徐涛, 胡文杰, 张浩筠, 危伊萍. 异种骨与人工合成骨在磨牙拔牙同期微翻瓣牙槽嵴保存术中的临床效果比较[J]. 北京大学学报（医学版）, 2026, 58(1): 74-83.
[3] 马保金, 李建华, 桑元华, 于洋, 仇吉川, 邵金龙, 李凯, 刘世岳, 杜密, 商玲玲, 葛少华. 基于微环境和干细胞调控的牙周组织再生关键技术的建立与应用[J]. 北京大学学报（医学版）, 2025, 57(5): 841-846.
[4] 曹沛, 栾庆先. 牙周炎与全身系统性疾病的思考与探索[J]. 北京大学学报（医学版）, 2025, 57(5): 852-858.
[5] 包振英, 王雅杰. 炎症指标和细胞因子联合检测在慢性牙周炎中的应用[J]. 北京大学学报（医学版）, 2025, 57(4): 772-778.
[6] 盛春辉, 张晓, 吕珑薇, 周永胜. 人脂肪间充质干细胞外泌体对去势小鼠骨质疏松的预防[J]. 北京大学学报（医学版）, 2025, 57(2): 217-226.
[7] 杨菊, 刘玥, 曲春娜, 孙健斌, 李天英, 石连杰. 双膦酸盐相关性颌骨坏死1例[J]. 北京大学学报（医学版）, 2025, 57(2): 388-392.
[8] 石宇彤, 危伊萍, 胡文杰, 徐涛, 张浩筠. 罹患重度牙周炎下颌磨牙拔牙微翻瓣牙槽嵴保存效果评价[J]. 北京大学学报（医学版）, 2025, 57(1): 33-41.
[9] 李敬谦, 朱子璐, 焦剑, 施捷. 隐形矫治重度牙周炎患者前牙区病理性移位患牙的临床疗效[J]. 北京大学学报（医学版）, 2025, 57(1): 51-56.
[10] 白心竹,何金徽,陆松松,李春,王依林,熊建. 椎体骨折合并活化部分凝血活酶时间延长1例[J]. 北京大学学报（医学版）, 2024, 56(2): 371-374.
[11] 胡玉如,刘娟,李文静,赵亦兵,李启强,路瑞芳,孟焕新. Ⅲ期或Ⅳ期牙周炎患者龈沟液中有机酸浓度与牙周炎的关系[J]. 北京大学学报（医学版）, 2024, 56(2): 332-337.
[12] 张晗,秦亦瑄,韦帝远,韩劼. 牙周炎患者种植修复维护治疗依从性的影响因素[J]. 北京大学学报（医学版）, 2024, 56(1): 39-44.
[13] 殳畅,韩烨,孙雨哲,杨再目,侯建霞. Ⅲ期牙周炎患者牙周基础治疗前后炎症性贫血相关指标的变化[J]. 北京大学学报（医学版）, 2024, 56(1): 45-50.
[14] 汪大伟,王华东,李利,尹欣,黄伟,郭继东,杨亚锋,刘义灏,郑扬. 自体下关节突骨块应用于骨质疏松患者腰椎椎间融合术的疗效分析[J]. 北京大学学报（医学版）, 2023, 55(5): 899-909.
[15] 裴喜燕,阳雯,欧阳翔英,孙凤. 牙周内窥镜下根面清创与牙周翻瓣术疗效比较[J]. 北京大学学报（医学版）, 2023, 55(4): 716-720.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
ISSN 1671-167X
CN 11-4691/R
主管单位：中华人民共和国教育部
主办单位：北京大学
地址： 北京市海淀区学院路38号 北京大学医学部 《北京大学学报（医学版）》
邮编：100191
电话：010-82801551
Email： xbbjb2@bjmu.edu.cn

《北京大学学报（医学版）》
微信公众号
版权所有 © 2018 《北京大学学报（医学版）》编辑部