Association of Osteoporosis and periodontitis is well documented. Osteopenia being the initial state of bone loss prior to osteoporosis; finding its correlation with clinical attachment loss holds significance in the process of establishing early reduction in BMD as a risk factor for periodontitis. Objectives: The present cross sectional study aimed to explore the association of osteopenia with serum high sensitivity C-reactive protein (hsCRP) levels, and periodontal parameters in narrow age range postmenopausal (PM) women. Methods: 112 participants in this single centred cross sectional study were bifurcated into test group: osteopenic PM women [n=62], and control group: normal bone mineral density [BMD] PM women [n=50]. BMD, serum levels of hsCRP, and periodontal parameters were recorded. Results: Clinical attachment loss [CAL] and hsCRP were found to be significantly higher in the osteopenic PM group. Conclusion: An association of osteopenia with increased CAL in PM women was found, implicating postmenopausal osteopenia associated with increased risk of periodontitis. The present study hints towards the comprehensive management of Periodontitis and osteopenia in postmenopausal women by maintaining a good coordination between the physicians and dentists.


  1. Page RC. The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res. 1991;26:230-42.
  2. Bergström J, Preber H. Tobacco use as a risk factor. J Periodontol. 1994;65:545-50.
  3. Singh A, Sharma RK, Siwach RC, Tewari S, Narula SC. Association of bone mineral density with periodontal status in postmenopausal women. J Investig Clin Dent. 2014;5:275-82.
  4. Gondim V, Aun J, Fukuda CT, Takayama L, Latorre MD, Pannuti CM, et al. Severe loss of clinical attachment level: an independent association with low hip bone mineral density in postmenopausal females. J Periodontol. 2013;84:352-9.
  5. Wactawski-Wende J, Hausmann E, Hovey K, Trevisan M, Grossi S, Genco RJ. The association between osteoporosis and alveolar crestal height in postmenopausal women. J Periodontol. 2005;76:2116-24.
  6. Sultan N, Rao J. Association between periodontal disease and bone mineral density in postmenopausal women: a cross sectional study. Med Oral Patol Oral Cir Bucal. 2011 1;16:440-7.
  7. Tezal M, Wactawski-Wende J, Grossi SG, Ho AW, Dunford R, Genco RJ. The relationship between bone mineral density and periodontitis in postmenopausal women. J Periodontol. 2000;71:1492-8.
  8. de Pablo P, Cooper MS, Buckley CD. Association between bone mineral density and C-reactive protein in a large population-based sample. Arthritis Rheum. 2012;64:2624-31.
  9. Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, De Nardin E. Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001;72:1221-7.
  10. Abdellatif HM, Burt BA. An epidemiological investigation into the relative importance of age and oral hygiene status as determinants of periodontitis. J Dent Research. 1987;66:13-8.
  11. Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton L3. Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis. Journal Clin Investig. 1981 1;67:328- 35.
  12. Passos JS, Vianna MI, Gomes-Filho IS, Cruz SS, Barreto ML, Adan L, et al. Osteoporosis/ osteopenia as an independent factor associated with periodontitis in postmenopausal women: a case–control study. Osteoporos Int. 2013 1;24:1275-83.
  13. Bor rell LN, Papapanou PN. Analyt ical epidemiology of periodontitis. J Clin Periodontol. 2005;32:132-58.
  14. Mashalkar VN, Suragimath G, Zope SA, Varma SA. A cross-sectional study to assess and correlate osteoporosis and periodontitis among postmenopausal women: a dual energy X-ray absorptiometry study. J Mid-Life Health. 2018;9:2.
  15. World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO study group [meeting held in Rome from 22 to 25 June 1992].
  16. Gomes-Filho IS, Freitas Coelho JM, da Cruz SS, Passos JS, Teixeira de Freitas CO, AragãoFarias NS, et al. Chronic periodontitis and C-reactive protein levels. J Periodontol. 2011;82:969-78.
  17. Silness J, Löe H. Per iodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121-35.
  18. Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;2:533-51.
  19. Lang NP, Adler R, Joss A, Nyman S. Absence of bleeding on probing an indicator of periodontal stability. J Clin Periodontol. 1990;17(10):714-21.
  20. Inagaki K, Kurosu Y, Kamiya T, Kondo F, Yoshinari N, Noguchi T, et al. Low metacarpal bone density, tooth loss, and periodontal disease in Japanese women. J Dent Res. 2001 Sep;80(9):1818- 22.
  21. Mohammad AR, Hooper DA, Vermilyea SG, Mariotti A, Preshaw PM. An investigation of the relationship between systemic bone density and clinical periodontal status in post-menopausal Asian-American women. Int Dent J. 2003;53:121-5
  22. Xu S, Zhang G, Guo JF, Tan YH. Associations between osteoporosis and risk of periodontitis: A pooled analysis of observational studies. Oral Dis. 2021;27:357-69.
  23. Hreshchyshyn MM, Hopkins A, Zylstra SA, Anbar M. Effects of natural menopause, hysterectomy, and oophorectomy on lumbar spine and femoral neck bone densities. Obstet Gynecol. 1988;72:631- 8.
  24. Gallagher JC, Goldgar D, Moy A. Total bone calcium in normal women: effect of age and menopause status. J Bone Miner Res. 1987;2:491-6.
  25. Hildebolt CF, Pilgram TK, Dotson M, Yokoyama- Crothers N, Muckerman J, Mauser J., et al. Attachment loss with postmenopausal age and smoking. J Periodontal Res. 1997;32:619-25.
  26. Baldodia A, Sharma RK, Tewari S, Narula SC. Effect of periodontitis on bone mineral density in postmenopausal women: A non-randomized interventional study. Quintessence Int. 2017;48:113-22.
  27. Koh JM, Khang YH, Jung CH, Bae S, Kim DJ, Chung YE, et al. Higher circulating hsCRP levels are associated with lower bone mineral density in healthy pre-and postmenopausal women: evidence for a link between systemic inflammation and osteoporosis. Osteoporos Int. 2005;16:1263-71.
  28. Lerner UH. Inf lammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis. J Dent Res. 2006;85:596-607.
  29. Yoshihara A, Seida Y, Hanada N, Miyazaki H. A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults. J Clin Periodontol. 2004;31:680-4
  30. Ayed MS, Alsharif AF, Divakar DD, Jhugroo C, Alosaimi B, Mustafa M. Evaluating the possible association between systemic osteoporosis and periodontal disease progression in postmenopausal women. Dis-Mon. 2019;65:193-215.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.