Relationship of lumbar spine bone mineral density and oral dryness feeling in menopause

Osteoprotegerin changes in saliva and serum of patients with knee osteoarthritis

OBJECTIVE

The scope of this study was to assess salivary and serum osteoprotegerin (OPG) levels in knee osteoarthritis (OA).

METHODS

Serum and saliva OPG levels of 30 knee OA and 30 matched healthy controls in this cross-sectional study was assessed by ELISA. Knee pain was assessed by WOMAC. Data were analyzed by Student's t-test, Spearman correlation test and ROC.

RESULTS

The mean serum but not saliva OPG level was lower in knee OA than that of the healthy group. WOMAC negatively correlated with serum OPG (r=-0.501; P=0.000). The serum OPG cutoff value was 237.5pg/ml for the diagnosis of knee OA.

CONCLUSIONS

As serum OPG was lower in knee OA and negatively correlated with WOMAC, it seems that detection of OPG in serum but not in saliva may be a probable marker to the diagnosis of knee OA.

KEY MESSAGES

Osteoprotegerin decreases in knee osteoarthritis.

Increased Plasma Osteocalcin, Oral Disease, and Altered Mandibular Bone Density in Postmenopausal Women

An association between oral diseases and postmenopausal status has been recognized. However, the relationship between all oral disease, mandibular bone density, health status, and osteocalcin (OCN) bone markers in postmenopausal dental patients has not been reported. This study was therefore to verify the differences in plasma OCN levels, dental, periodontal, and oral mucosal disease, and mandibular bone density alterations from panoramic radiograph and systemic parameters in postmenopausal women, compared to premenopausal women. Oral, radiographic, and blood examination were performed in 92 females. Dental, periodontal, and oral mucosal statuses were recorded. Health profile parameters were collected from medical charts. Plasma OCN was evaluated by enzyme-linked immunosorbent assay. Forty-two (45.7%) participants were postmenopausal with a higher median age (55 (51, 62) years) than the premenopausal group (43 (38, 45) years). Overweight or obesity, hypercholesterolemia, and impaired fasting blood sugar were more prevalent in postmenopause. The average postmenopausal OCN level (425.62 ng/mL) was significantly higher than the premenopausal group (234.77 ng/mL, p < 0.001). The average number of missing teeth, mean attachment loss, alveolar bone loss, periapical lesion count, and clinical oral dryness score were also significantly higher in postmenopause (p=0.008,   < 0.001,  0.031,  0.006,  and 0.005, respectively). However, mandibular bone density determined by mandibular cortical index was lower in postmenopause (p < 0.001). The panoramic mandibular index, mandibular cortical width, fractal dimension, and other oral mucosal disease did not differ between the groups. Postmenopause was associated with elevated plasma OCN (β = 0.504, p < 0.001) when related covariates were adjusted. Elevated plasma OCN, oral mucosal dryness, high number of periapical radiolucencies and missing teeth, and lower mandibular bone density from panoramic radiograph were prevalent in postmenopausal women. Dentists should suspect an increased risk of low bone mineral density in postmenopausal patients who display these clinical and radiographic findings, and they should be referred for further examination. Plasma OCN may interconnect a relationship between postmenopausal status and the low mandibular bone density.

Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis

BACKGROUND

One of the most common causes of hypothyroidism is Hashimoto's Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren's syndrome.

MATERIAL AND METHODS

HT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute.

RESULTS

Xerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant.

CONCLUSIONS

The patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions.

Menopause and oral health

Different phases of a woman's life: Puberty, menses, pregnancy, and menopause have varied influence on her oral health. During the menopause, women go through biological and endocrine changes, particularly in their sex steroid hormone production, affecting their health. Because the oral mucosa contains estrogen receptors, variations in hormone levels directly affect the oral cavity. A few oral conditions and or diseases are seen more frequently during post menopausal years. Role of hormones affecting the health of oro-dental tissues, as well as treatment by HRT in ameliorating these conditions is not clear. There is paucity of randomized controlled trials in this field and more data is needed, before the recommendations for oral health care in post menopausal women can be made. A gynecologist sitting in menopausal clinic should be aware of oral changes happening during this period, and dental needs of these women and should refer them to the dental specialists accordingly. On the other hand, a dentist should also be sensitized about the menopausal status of the woman, her HRT status and special preventive and treatment needs.

Evaluation of serum calcium and serum parathyroid levels in post-menopausal women with and without oral dryness

OBJECTIVE

The primary objective of this study was to estimate and secondary objective was to compare the serum calcium levels and serum parathyroid hormone (PTH) levels in post-menopausal women with and without oral dryness (OD).

MATERIALS AND METHODS

A case-control study was carried out on 80 selected post-menopausal women. Salivary flow was assessed by flow rate; serum calcium concentrations were assessed through Semi Autoanalyzer by Arsenazo III reaction. The serum PTH concentration was measured by the enzyme-linked immunosorbent assay. Severity of OD was assessed by a questionnaire through which the xerostomia inventory (XI) score could be measured. Statistical analysis of Student's t-test, Mann-Whitney test and Pearson's correlation was used.

RESULTS

There was a significant difference in mean values of both serum PTH concentration and XI score in post-menopausal women with/without OD (p < 0.001). No statistically significant difference (p = 0.354) was found in salivary flow rate and serum calcium levels in post-menopausal women in both groups. A positive correlation was found between the serum PTH and XI score in both case and control groups (p < 0.05).

CONCLUSION

Severity of oral dryness in post-menopausal women is associated with the high levels of serum PTH. However, the correlation of severity of OD with serum calcium could not be established.

Salivary flow, testosterone, and femur bone mineral density in menopausal women with oral dryness feeling

OBJECTIVES

We compared salivary flow, serum and saliva testosterone, and femur bone mineral density (BMD) of menopausal women with or without xerostomia.

STUDY DESIGN

A case/control study was performed on 60 selected menopausal women with or without xerostomia. BMD and testosterone concentration were measured by a dual-energy x-ray absorptiometry system and enzyme-linked immunosorbent assay method, respectively.

RESULTS

Multinomial logistic regression demonstrated that low saliva flow rate (odds ratio [OR] = 22.8, 95% confidence interval [CI]: 5.4, 96.8), low femur BMD (OR = 6.0, CI: 1.8, 20.0), high stimulated saliva testosterone (OR = 5.2, CI: 2.0, 18.9), high unstimulated saliva testosterone (OR = 3.8, 95% CI: 1.6, 12.3), and high serum testosterone (OR = 2.7, CI: 1.1, 7.2) were associated with an increased risk of xerostomia in menopausal women.

CONCLUSIONS

High serum and salivary testosterone and low femur BMD and saliva flow were associated with xerostomia. Of these factors, low salivary flow seems to be the most important element in the perception of dry mouth.

Unstimulated saliva 17β-estradiol and xerostomia in menopause

One of the most common oral manifestations of menopause is xerostomia. As gingival tissue is sensitive to changes in the female sex steroids; the aim of this study was to evaluate the relationship between saliva 17β-estradiol and severity of xerostomia. A case-control study was carried out in 64 selected menopausal women aged 42-75 years with or without xerostomia (32 as case and 32 as control) conducted at the Clinic of Oral Medicine, Tehran university of medical sciences. Xerostomia inventory (XI) score was used as an index of xerostomia severity. The saliva 17β-estradiol was measured by an enzyme immunoassay kit. The mean unstimulated saliva flow rate and concentration of 17β-estradiol were significantly lower in case than control. There were significant negative correlation between XI score and unstimulated whole saliva flow rate and also concentration of 17β-estradiol in menopausal women. It seems that there is a negative correlation between xerostomia severity and saliva 17β-estradiol in menopausal women.

Serum and saliva magnesium in postmenopausal women with xerostomia

OBJECTIVES

The aim of this study was to investigate serum, stimulated and unstimulated salivary magnesium in postmenopausal women with xerostomia.

MATERIALS

A case-control study was carried out on 60 selected postmenopausal women aged 41-77 years with or without xerostomia (30 as cases with xerostomia and 30 as controls without xerostomia), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Unstimulated and paraffin-stimulated saliva samples were obtained by expectoration. Magnesium concentration was determined by the spectrophotometer method. Statistical analysis was carried out using Student's t-test.

RESULTS

The mean serum concentration, but not stimulated and unstimulated whole saliva magnesium concentrations, was significantly higher in the cases than in the controls.

CONCLUSION

Serum magnesium level appears to be associated with xerostomia in menopause.

Unstimulated whole saliva parathyroid hormone in postmenopausal women with xerostomia

OBJECTIVE

The aim of this study was to evaluate the correlation of xerostomia severity with unstimulated saliva parathyroid hormone (PTH) and to compare unstimulated whole saliva PTH between postmenopausal women with/without xerostomia.

METHODS

A case-control study was carried out in 60 (30 as case and 30 as control) selected postmenopausal women with/ without xerostomia conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Xerostomia inventory (XI) score was also used as an index of xerostomia severity. PTH concentration was analyzed by enzyme-linked immunosorbent assay (ELISA). Statistical analysis of Student's t-test and Spearman correlation was used.

RESULTS

The mean unstimulated saliva PTH concentration was significantly higher but flow rate was lower in the case group compared with control. XI score correlated significantly with saliva PTH (r = 0.688, p = 0.001) and flow rate (r = - 0.529, p = 0.001).

CONCLUSION

Xerostomia severity correlated positively with unstimulated whole saliva PTH and negatively with saliva flow rate in this group of postmenopausal women. Thus, salivary flow rate and PTH levels appear associated with xerostomia and menopause.

CLINICAL SIGNIFICANCE

Salivary PTH level appears to be associated with xerostomia and menopause.