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      Comparative evaluation of periodontal health status of pre and postmenopausal females

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          Abstract

          BACKGROUND:

          Menopause in females is a corporeal stage that gives rise to a number of adaptive changes both at systemic and oral levels, prototypically occurring in the late fourth or fifth decade of life. Though physiological aging affects the oral tissue, the hormonal changes due to menopause also act as a major contributing factor in deteriorating the health of oral tissues. Thus, the main aim of our study was to compare the overall periodontal status and alkaline phosphatase levels in the saliva of females in their pre and postmenopausal ages.

          MATERIAL AND METHODS:

          This study was conducted on 200 female subjects coming to the Department of Periodontology at Rajendra Institute of Medical Science for oral prophylaxis. The subjects were arbitrarily selected in the age group ranging from 15 to 70 years and were further divided based on the inclusion criteria. Group A included 100 subjects with age ranging from 15 to 45 years, and group B, 100 subjects with age 54 to 70 years. Signs of periodontitis including clinical attachment loss, furcation involvement, and probing depth and salivary alkaline levels were obtained, evaluated, compared, and analyzed.

          RESULTS:

          In group A 65% of patients had grade 0 and 28% had grade 1 of clinical attachment level. Similarly in group B, 44% of the total had grade 0 of clinical attachment loss, 38% had grade 1, and 18% were of grade 2. On evaluating grades of furcation involvement, around 45% of the total patients in group A were grade 1 (incipient, pocket formation), while in group B, 51% of the total patients were grade 1. At least 46% in group A and only 20% in group B had no signs of furcation involvement. Salivary alkaline phosphatase levels in pre and postmenopausal patients showed a significant difference between the two groups was obtained.

          CONCLUSION:

          The study concluded a major difference in the periodontal health of pre and postmenopausal women with many influencing factors apart from menopause itself.

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          Most cited references20

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          Estrogens and Androgens in Skeletal Physiology and Pathophysiology.

          Maria Almeida, Michaël R Laurent, Vanessa Dubois … (2017)
          Estrogens and androgens influence the growth and maintenance of the mammalian skeleton and are responsible for its sexual dimorphism. Estrogen deficiency at menopause or loss of both estrogens and androgens in elderly men contribute to the development of osteoporosis, one of the most common and impactful metabolic diseases of old age. In the last 20 years, basic and clinical research advances, genetic insights from humans and rodents, and newer imaging technologies have changed considerably the landscape of our understanding of bone biology as well as the relationship between sex steroids and the physiology and pathophysiology of bone metabolism. Together with the appreciation of the side effects of estrogen-related therapies on breast cancer and cardiovascular diseases, these advances have also drastically altered the treatment of osteoporosis. In this article, we provide a comprehensive review of the molecular and cellular mechanisms of action of estrogens and androgens on bone, their influences on skeletal homeostasis during growth and adulthood, the pathogenetic mechanisms of the adverse effects of their deficiency on the female and male skeleton, as well as the role of natural and synthetic estrogenic or androgenic compounds in the pharmacotherapy of osteoporosis. We highlight latest advances on the crosstalk between hormonal and mechanical signals, the relevance of the antioxidant properties of estrogens and androgens, the difference of their cellular targets in different bone envelopes, the role of estrogen deficiency in male osteoporosis, and the contribution of estrogen or androgen deficiency to the monomorphic effects of aging on skeletal involution.
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            Inflammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis.

            U Lerner (2006)
            During physiological conditions, the skeleton is remodeled in so-called bone multi-cellular units. Such units have been estimated to exist at 1-2 x 10(6) sites in the adult skeleton. The number and activities of these units are regulated by a variety of hormones and cytokines. In post-menopausal osteoporosis, lack of estrogen leads to increased numbers of bone multi-cellular units and to uncoupling of bone formation and bone resorption, resulting in too little bone laid down by osteoblasts compared with the amount of bone resorbed by osteoclasts. Inflammatory processes in the vicinity of the skeleton, e.g., marginal and apical periodontitis, will affect the remodeling of the nearby bone tissue in such a way that, in most patients, the amount of bone resorbed exceeds that being formed, resulting in net bone loss (inflammation-induced osteolysis). In some patients, however, inflammation-induced bone formation exceeds resorption, and a sclerotic lesion will develop. The cellular and molecular pathogenetic mechanisms in inflammation-induced osteolysis and sclerosis are discussed in the present review. The cytokines believed to be involved in inflammation-induced remodeling are very similar to those suggested to play crucial roles in post-menopausal osteoporosis. In patients with periodontal disease and concomitant post-menopausal osteoporosis, the possibility exists that the lack of estrogen influences the activities of bone cells and immune cells in such a way that the progression of alveolar bone loss will be enhanced. In the present paper, the evidence for and against this hypothesis is presented.
            Article 0 comments Cited 60 times – based on 0 reviews     Review now
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              Advances in periodontal disease markers.

              Nurdan Ozmeric (2004)
              A computer-assisted medline search was conducted to find the relevant articles concerning the periodontal disease markers in gingival crevicular fluid (GCF) and saliva published during the 10-year period from 1993 to July 2003. This review suggests that certain diagnostic uses of saliva and GCF show promise. Although both fluids have been used to evaluate the risk for an individual to develop periodontal disease and to monitor of the host response to periodontal therapy, GCF has the chance of being closely approximated to the periodontal tissues where periodontal disease begins. The enzymes contributed to extracellular matrix (ECM) molecules and non-ECM molecules degradation and markers for polymorphonuclear leukocytes (PMN) activity and influx into the gingival tissue seem to provide valuable information regarding the periodontal disease diagnosis and prognosis. There is also an increasing evidence implicating reactive oxygen species and nitric oxide pathway in the pathogenesis of periodontal diseases. Although promising results have been achieved with the assays evaluating the markers in assessment of periodontal disease status, up to now, none of these tests are used routinely. Further, one commercially available genetic test has been reported to have the potential to be used to predict the periodontal disease, but there are controversial reports on this genetic susceptibility test.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Educ Health Promot
                Journal ID (iso-abbrev): J Educ Health Promot
                Journal ID (publisher-id): JEHP
                Title: Journal of Education and Health Promotion
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 2277-9531
                ISSN (Electronic): 2319-6440
                Publication date Collection: 2023
                Publication date (Electronic): 30 June 2023
                Volume: 12
                Electronic Location Identifier: 211
                Affiliations
                [1] Department of Periodontology and Oral Implantology, Dental College, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
                [1 ] Department of Dentistry, MGM Medical College and Hospital, Jamshedpur, India
                [2 ] Department of Orthodontic and Dentofacial Orthopedic, Dental College, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
                [3 ] Department of Conservative Dentistry and Endodontics, Dental College, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
                Author notes
                Address for correspondence: Dr. Santosh Kumar Verma, Department of Periodontology and Oral Implantology, Dental College, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. E-mail: santoshvermakr@ 123456gmail.com
                Article
                Publisher ID: JEHP-12-211
                DOI: 10.4103/jehp.jehp_15_23
                PMC ID: 10402798
                SO-VID: e7fa1ea9-3f97-46a3-b482-dc53330df584
                Copyright © Copyright: © 2023 Journal of Education and Health Promotion
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 04 January 2023
                Date accepted : 24 February 2023
                Categories
                Subject: Original Article

                Keywords: alkaline phosphate,furcation involvement,menopause,periodontitis
                Data availability:
                Keywords: alkaline phosphate, furcation involvement, menopause, periodontitis

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