Bidirectional relationship of periodontitis with osteoporosis
Keywords:
periodontitis, osteoporosis, cytokines, bone resorptionAbstract
Periodontitis is an inflammatory disease that affects periodontal tissue, triggering immune responses with the release of pro-inflammatory cytokines and contributing to bone imbalance. In addition, this disease is associated with various systemic pathologies, osteoporosis among them. Osteoporosis is characterized by loss of bone density, which can influence the severity of periodontal destruction and alter responses to cytokines generated by periodontal infections. Although the bidirectional relationship between periodontitis and osteoporosis has not been conclusively established, both share risk factors such as age, gender, genetics and hormonal change. The need for further research to better understand the relationship and its clinical implications is highlighted.
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References
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30. Lin TH, Lung CC, Su HP, et al. Association between periodontal disease and osteoporosis by gender: a nationwide population-based cohort study. Medicine (Baltimore). 2015;94(7):e553. DOI: 10.1097/MD.0000000000000553.
2. Goyal L, Goyal T, Gupta ND. Osteoporosis and Periodontitis in Postmenopausal Women: A Systematic Review. J Midlife Health. 2017;8(4):151-8. DOI: 10.4103/jmh.JMH_55_17.
3. Vargas-Sanchez PK, Fernandes RR, Furlaneto FAC, et al. Osteoporosis Affects Functional Activity and Gene Expression of Osteoblastic Cells Derived from Rat Alveolar Bone. Braz Dent J. 2020;31(6):617-22. DOI: 10.1590/0103-6440202003068.
4. Yu B, Wang C-Y. Osteoporosis and periodontal diseases – An update on their association and mechanistic links. Periodontol 2000. 2022;89(1):99-113. DOI: 10.1111/prd.12422.
5. Chou HH, Lu SL, Wang ST, et al. The Association between Bone Mineral Density and Periodontal Disease in Middle-Aged Adults. Int J Environ Res Public Health. 2021;18(6):3321. DOI: 10.3390/ijerph18063321.
6. Hong SJ, Yang BE, Yoo DM, et al. Analysis of the relationship between periodontitis and osteoporosis/fractures: a cross-sectional study. BMC Oral Health. 2021;21(1):125. DOI: 10.1186/s12903-021-01496-1.
7. Marjanovic EJ, Southern HN, Coates P, et al. Do patients with osteoporosis have an increased prevalence of periodontal disease? A cross-sectional study. Osteoporos Int. 2013;24(7):1973-9. DOI: 10.1007/s00198-012-2246-9.
8. Darcey J, Devlin H, Lai D, et al. An observational study to assess the association between osteoporosis and periodontal disease. Br Dent J. 2013;215(12):617-21. DOI: 10.1038/sj.bdj.2013.1191.
9. Kitaura H, Marahleh A, Ohori F, et al. Osteocyte-Related Cytokines Regulate Osteoclast Formation and Bone Resorption. Int J Mol Sci. 2020;21(14):5169. DOI: 10.3390/ijms21145169.
10. Yang TL, Shen H, Liu A, et al. A road map for understanding molecular and genetic determinants of osteoporosis. Nat Rev Endocrinol. 2020;16(2):91-103. DOI: 10.1038/s41574-019-0282-7.
11. Xu S, Zhang G, Guo JF, et al. Associations between osteoporosis and risk of periodontitis: A pooled analysis of observational studies. Oral Dis. 2021;27(2):357-69. DOI: 10.1111/odi.13531.
12. Nazir M, Al-Ansari A, Al-Khalifa K, et al. Global Prevalence of Periodontal Disease and Lack of Its Surveillance. Sci World J. 2020;2020:2146160. DOI: 10.1155/2020/2146160.
13. Hajishengallis G. Interconnection of periodontal disease and comorbidities: evidence, mechanisms, and implications. Periodontol 2000. 2022;89(1):9-18. DOI: 10.1111/prd.12430.
14. Ma Z, Li S, Sun Y. Effect of enhanced masticatory force on OPG, RANKL and MGF in alveolar bone of ovariectomized rats. J Appl Oral Sci. 2020;28:e20190409. DOI: 10.1590/1678-7757-2019-0409.
15. Wang LT, Chen LR, Chen KH. Hormone-Related and Drug-Induced Osteoporosis: A Cellular and Molecular Overview. Int J Mol Sci. 2023;24(6):5814. DOI: 10.3390/ijms24065814.
16. Calixto RD, Ayumi Omory M, Ramazzotto LA, et al. The role of hypoestrogenism on Mmp-8 and Mmp-13 gene expression in maxilla and mandible’s growth sites. Clin Investig Orthod. 2022;81(1):50-7. DOI: 10.1080/13440241.2022.2041353.
17. Ursarescu IG, Martu-Stefanache MA, Solomon SM, et al. The Assessment of IL-6 and Rankl in the Association between Chronic Periodontitis and Osteoporosis. Rev Chim [Internet]. 2016 [citado 26/11/2021];67(2). Disponible en: https://revistadechimie.ro/Articles.asp?ID=4882
18. Luo K, Ma S, Guo J, et al. Association between postmenopausal osteoporosis and experimental periodontitis. Biomed Res Int. 2014;2014:316134. DOI: 10.1155/2014/316134.
19. Xu XC, Chen H, Zhang X, et al. Effects of oestrogen deficiency on the alveolar bone of rats with experimental periodontitis. Mol Med Rep. 2015;12(3):3494-502. DOI: 10.3892/mmr.2015.3875.
20. Xu J, Yu L, Liu F, et al. The effect of cytokines on osteoblasts and osteoclasts in bone remodeling in osteoporosis: a review. Front Immunol. 2023;14:1222129. DOI: 10.3389/fimmu.2023.1222129.
21. Ramadan DE, Hariyani N, Indrawati R, et al. Cytokines and Chemokines in Periodontitis. Eur J Dent. 2020;14(3):483-95. DOI: 10.1055/s-0040-1712718.
22. Robinson JL, Johnson PM, Kister K, et al. Estrogen signaling impacts temporomandibular joint and periodontal disease pathology. Odontology. 2020;108(2):153-65. DOI: 10.1007/s10266-019-00439-1.
23. Fischer V, Haffner-Luntzer M. Interaction between bone and immune cells: Implications for postmenopausal osteoporosis. Semin Cell Dev Biol. 2022;123:14-21. DOI: 10.1016/j.semcdb.2021.05.014.
24. Chang X, Xu S, Zhang H. Regulation of bone health through physical exercise: Mechanisms and types. Front Endocrinol. 2022;13:1029475. DOI: 10.3389/fendo.2022.1029475.
25. Lohana M, Suragimath G, Abbayya K, et al. A Study to Assess and Correlate Osteoporosis and Periodontitis in Selected Population of Maharashtra. J Clin Diagn Res. 2015;9(6):ZC46-50. DOI: 10.7860/JCDR/2015/13725.6116.
26. Passos JS, Vianna MI, Gomes-Filho IS, et al. Osteoporosis/osteopenia as an independent factor associated with periodontitis in postmenopausal women: a case-control study. Osteoporos Int. 2013;24(4):1275-83. DOI: 10.1007/s00198-012-2130-7.
27. Ayed MS, Alsharif AF, Divakar DD, et al. Evaluating the possible association between systemic osteoporosis and periodontal disease progression in postmenopausal women. Dis Mon. 2019;65(6):193-215. DOI: 10.1016/j.disamonth.2018.11.001.
28. Renvert S, Berglund J, Persson RE, et al. Osteoporosis and periodontitis in older subjects participating in the Swedish National Survey on Aging and Care (SNAC-Blekinge). Acta Odontol Scand. 2011;69(4):201-7. DOI: 10.3109/00016357.2010.549501.
29. Choi JK, Kim YT, Kweon HI, et al. Effect of periodontitis on the development of osteoporosis: results from a nationwide population-based cohort study (2003-2013). BMC Womens Health. 2017;17(1):77. DOI: 10.1186/s12905-017-0440-9.
30. Lin TH, Lung CC, Su HP, et al. Association between periodontal disease and osteoporosis by gender: a nationwide population-based cohort study. Medicine (Baltimore). 2015;94(7):e553. DOI: 10.1097/MD.0000000000000553.
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Published
2024-11-20
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de-la-Cruz-Rodríguez RA, Sernaque-Roca K, Aguirre-Siancas E. Bidirectional relationship of periodontitis with osteoporosis. Rev Méd Electrón [Internet]. 2024 Nov. 20 [cited 2025 Jun. 23];46:e5748. Available from: https://revmedicaelectronica.sld.cu/index.php/rme/article/view/5748
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