RESUMO
In post-menopausal osteoporosis, lack of estrogen will affect the remodeling of the bone tissue in such a way that, in most patients with periodontitis, the amount of bone resorbed exceeds that being formed, resulting in net bone loss. Osteoporosis can be treated by a variety of methods, the hormone replacement therapy (HRT), the selective estrogen receptor modulators (SERM) and the bisphosphonates. The HRT or bisphosphonates treatments improve the clinical outcome of periodontal disease and may be an adjunctive treatment to preserve periodontal bone mass. This paper reviews the current evidence on the mechanism of periodontal breakdown after menopause and the benefit to oral health by treatments for osteoporosis.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Osteoporose Pós-Menopausa/complicações , Osteoporose Pós-Menopausa/tratamento farmacológico , Doenças Periodontais/etiologia , Conservadores da Densidade Óssea/uso terapêutico , Doença Crônica , Difosfonatos/uso terapêutico , Terapia de Reposição de Estrogênios , Estrogênios/deficiência , Estrogênios/fisiologia , Feminino , Humanos , Doenças Periodontais/prevenção & controle , Moduladores Seletivos de Receptor Estrogênico/uso terapêuticoRESUMO
Many studies have attempted to define the relationship between postmenopausal osteoporosis and periodontal disease. Most studies support a positive association between these common diseases; however, many are cross-sectional in nature, include relatively small sample sizes, and have inadequate control of potential confounding factors, such as age, gender, hormone intake, race, and smoking, limiting our understanding of the nature of the relationship between these diseases. Clinical conditions causing low estrogen environments in postmenopausal women allow T- and B-cell abnormalities, increased local production of the bone-active cytokines (i.e., Interleukin-1, -6 and -8, tumor necrosis factor [TNF]-alpha) and a rise in prostaglandin E(2), resulting in the progression of periodontitis.
Assuntos
Osteoporose Pós-Menopausa/complicações , Feminino , Humanos , Osteoporose Pós-Menopausa/fisiopatologia , Doenças Periodontais/etiologiaRESUMO
Many studies have attempted to define the relationship between postmenopausal osteoporosis and periodontal disease. Most studies support a positive association between these common diseases; however, many are cross-sectional in nature, include relatively small sample sizes, and have inadequate control of potential confounding factors, such as age, gender, hormone intake, race, and smoking, limiting our understanding of the nature of the relationship between these diseases. Clinical conditions causing low estrogen environments in postmenopausal women allow increased local production of the bone-active cytokine and the progression of periodontal disease. Prospective studies are needed to confirm or refute a causal relation.
