The association between estrogen status and alveolar bone density changes in postmenopausal women with a history of periodontitis

WHILE NUMEROUS STUDIES HAVE DEMONSTRATED a relationship between 17-beta-estradiol (E(2)) deficiencies and skeletal bone loss in postmenopausal females, the influence of E(2) deficiency on alveolar bone resorption is poorly understood. The purpose of this study was to examine the association between the estrogen status of postmenopausal women and alveolar bone density changes in a 1-year longitudinal study. Twenty-four postmenopausal women,within 7 years of menopause, were divided into 2 groups, E(2)-sufficient (n = 10) and E(2)-deficient (n = 14). Venous blood samples were taken at baseline, 6 months, and 1 year for radioimmunoassay determination of serum E(2) levels, At baseline and 1 year, 4 vertical bite-wing radiographs were taken for computer-assisted densitometric image analysis (CADIA). Areas of interest (AOIs) for CADIA were crestal and subcrestal regions of posterior interproximal alveolar bone. Serum E(2) levels were significantly higher at all 3 time points in the E(2)-sufficient subjects (P < 0.002, repeated measures ANOVA), Overall, mean CADIA values (0.30 +/- 0.07 for the E(2)-sufficient women and -0.44 +/- 0.07 for the E(2)-deficient women) were statistically different between groups (P < 0.001, repeated measures ANOVA), indicating that the E(2)-sufficient women displayed a mean net gain in alveolar bone density and the E(2)-deficient women displayed a mean net loss in alveolar bone density. Furthermore, the E(2)-sufficient women exhibited a higher frequency of sites demonstrating a gain in alveolar bone density. These data suggest that estrogen status may influence alveolar bone density changes as demonstrated with CADIA.