The influence of alveolar structures on the torsional strain field in a gorilla corporeal cross-section

Anthropologists have often used mandibular torsional properties to make inferences about primate dietary adaptations. Most of the methods employed are based on assumptions related to periodontal and alveolar properties. This study uses the finite element method to evaluate some of these assumptions with a cross-section through the third molar of a gorilla. Results indicate that the properties of alveolar bone play an important role in determining the strain field. In comparison, the exact stiffness values of the periodontal ligaments seem to have a much smaller impact. Replacing the dental roots and periodontal ligaments with alveolar bone, however, has a significant influence on the strain field. It underestimates the maximum shear strain by about 28% along its periosteal aspect when alveoli are modeled as cortical bone. It overestimates the strain by a smaller amount when alveoli are modeled as trabecular bone. This study supports the assumption that primate mandibles behave like a closed-section under torsion under the limiting condition that the alveolar bone stiffness is more than half of the value of cortical bone; alveolar bone can then be modeled as cortical bone with a minimal loss of accuracy. In addition, this study suggests that the minimum cortical thickness should be considered for torsional strength. Finally, modeling accuracy can be significantly increased if both dental and periodontal structures can be realistically incorporated into mandibular biomechanical models. However, this may not be always feasible in studies of fossil mandibles. This is due mainly to the difficulties involved in estimating alveolar bone densities and in distinguishing boundaries between cortical bone, alveolar bone, periodontal ligaments, and dental roots in fossil specimens.     

Relationship between oral alveolar bone loss and aging among African-American and Caucasian individuals

BACKGROUND: The periodontal attachment apparatus consists of the periodontal ligament, alveolar bone, cementum and supra-crestal connective tissue. They are interdependent and provide protection and support to the dentition. It is theorized that the integrity of the periodontal apparatus can be maintained throughout life by exercising comprehensive oral hygiene practices and routine dental care. Additionally, it appears to be unaffected by aging. As a consequence, the investigators performed a study to determine the effects of chronological aging on alveolar bone loss. OBJECTIVE: The present study was conducted to determine the relationship between oral alveolar bone loss, oral hygiene, and aging among African-American and Caucasian populations. METHODS: The population consisted of 229 individuals. There were 131 men and 98 women. With respect to race there were 89 African-Americans and 140 Caucasians. Oral examinations, oral hygiene and missing teeth determinations and bitewing radiographs were performed on all the individuals. Radiographs were digitized and measurements were made from the cementum/enamel junction to the alveolar bone crest. Measurements were made for both the maxillary and mandibular jaws. RESULTS: The results of the study showed a significant multiple linear regression model relationship between oral bone loss and aging. Oral hygiene was a factor, but contributed only slightly to the overall model. Race, gender and the number of missing teeth were not significant variables in the overall model. CONCLUSION: The results of this study suggest age-related alveolar bone loss.     

Odontogenic focus as the etiology of cerebral ischemia]

Several authors have established a relationship between osteoporosis and periodontal disease. The ageing process is associated with a loss of both oral and total bone mass. It has been shown that a reduction of bone mineralization aggravates pathological periodontal changes, resulting in less support for the teeth. The present study investigates the nutritional influences that may condition the appearance of both pathological process. Insufficient dietary calcium and a reduction in the calcium: phosphorous ratio may favour the appearance of both these conditions by promoting bone reabsorption. Bone loss affects the following in descending order: jaw bones (especially alveolar bone), cranial bones, ribs, vertebrae and long bones. Alveolar bone which has the highest rate of renewal, is affected first and consequently is the most severely affected in the long term. The role of calcium in the etiology of osteoporosis is a controversial issue. Nevertheless, its implication has been proven in numerous investigations. The effect of adequate calcium intake on dental health has formed the basis of several recent studies. These investigations have demonstrated that increased calcium intake improves the suffering of inflammatory processes and tooth mobility in patients suffering from gingivitis with haemorrhaging. Based on the results of studies which link dietary calcium and phosphorous to the risk of osteoporosis and periodontal disease, and bearing in mind that in a large proportion of the Spanish population calcium intake is below that recommended, there is a need for a general improvement of the diet. It may be of special interest to increase the calcium intake of patients suffering periodontal disease. It may also help in the prevention of osteoporosis.     

Effect of temperature on electrical resonance in leopard frog saccular hair cells

There has been increasing interest in the interrelationship between systemic osteoporosis, oral bone loss, tooth loss, and risk factors for these conditions. Because the severity of alveolar bone loss increases with age, it has long been hypothesized that it may, in part, be related to systemic conditions that also predispose the patient to osteoporosis/osteopenia. The purpose of this paper is to review the risk factors for osteoporosis and periodontitis, as well as the evidence that loss of oral bone mineral may be related to systemic osteopenia. There is also evidence that therapies designed to influence systemic bone mineral density, such as hormone replacement and bisphosphonate therapy, may be associated with less tooth loss and a slower loss of alveolar bone, respectively.     

Variable expression of Mn SOD in three different human melanoma cell lines

The mechanism of age-related cortical bone loss was investigated in 229 Japanese women, 41-94 years of age, by metacarpal bone mass measurement. While no significant correlation was found between bone width and age, a significant increase in bone marrow width, and significant decreases in cortical bone density and total bone mass were observed in association with aging (P < 0.0001). There was a significant negative correlation between total bone mass and bone marrow width (r = -0.239; P < 0.0005), and significant positive correlations between both total bone mass and cortical bone density (r = 0.539; P < 0.0001) and cortical bone width (r = 0.839; P < 0.0001). The findings suggested that age-related cortical bone loss in middle-aged and elderly women resulted from two different factors; a decrease in cortical bone density caused by progression of intracortical porosity, and a decrease in cortical bone width as a result of bone loss on the endosteal surface. The latter had a greater influence on an age-related cortical bone loss than the former.     

The epidemiology of tuberculosis in New South Wales 1975-1995: the effects of immigration in a low prevalence population

Studies have shown that <20% of the US population has periodontal disease. Studies of radiographs have shown that alveolar bone loss increases with age. Bone loss assessed from intraoral radiographs describing 10,282 teeth from 416 subjects seeking dental care during a 3 month period at the University of Washington were studied. The mean age of the subjects was 47.2 years (SD+/-15.2). The youngest subjects (15-24) had on average 29.6 teeth (SD+/-2.2) and the oldest subjects (75-94) 19.3 teeth (SD+/-6.6). This difference was statistically significant (F=16.57, p<0.001). No association was found between alveolar bone loss (CEJ-ABC), and TMD symptoms. Smoking was significantly associated with both general bone loss (CEJ-ABC) (chi(2)=114.9, p<0.0001), and vertical bone defects (angular) (chi(2)=101.8, p<0.0001). In this study population (15-94 years), alveolar bone loss progressed as defined by the slope (beta=0.29) between age 15-44, but was almost flat from age 50 years (beta=0.04). The data suggested an overall rate of alveolar bone loss of 0.02 mm per year. Stepwise multiple regression analysis showed that smoking was the primary factor in bone loss (t= 7.7, p<0.0001), followed by age (t=7.0, p<0.001) and gender (t=3.0, p<0.01). TMD symptoms could not explain the presence and severity of horizontal or vertical defects. If the CEJ-ABC distance above the mean plus 2x the SD was used as the cutoff value to define abnormal bone levels, 10.9% of the younger (15-45 years), and 10.7% of the older subjects (50-94) had significant alveolar bone loss. 73.9% of the younger and 100% of the older subjects with such extent of alveolar bone loss were smokers.     

Histological, clinical, and digital subtraction radiographic evaluation of repair of periodontal defects resulting from mechanical perforation of the chamber floor using ePTFE membranes

The aim of this study was to test the hypothesis that a biocompatible membrane, when placed between the gingiva and cortical bone in teeth with periodontal defects that occurred following mechanical endodontic perforation, would facilitate greater regeneration than in control sites not treated with guided tissue regeneration. One beagle dog with a healthy periodontium was used in the study. The maxillary right first and second molars and the mandibular left first and second molars acted as the experimental group in which furcation perforations were treated by guided tissue regeneration. The maxillary left and mandibular right first and second molars served as the controls in which furcation perforation lesions were only treated by open flap debridement. Clinical, histological, and standardized radiographic evaluation showed significant differences between the test and control groups. In addition, digital subtraction radiography revealed a gain in alveolar bone height and increased density at all experimental sites, and a loss at all control sites. Histological evaluation showed extensive regeneration of both alveolar bone and connective tissue at experimental sites, but none at control sites. The results of this study suggest that the use of guided tissue regeneration in furcation lesions produced by endodontic perforations will result in significant new bone and connective tissue attachment.     

Distribution of periodontal disease in a Swedish adult population 1973, 1983 and 1993

The aim of this study was to compare changes in periodontal status in a Swedish population over a period of 20 years. Cross-sectional studies were carried out in J?nk?ping County in 1973, 1983, and 1993. Individuals were randomly selected from the following age groups: 20, 30, 40, 50, 60, and 70 years. A total of 600 individuals were examined in 1973, 597 in 1983, and 584 in 1993. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. Based on clinical data and full mouth intra-oral radiographs, all individuals were classified into 5 groups according to the severity of the periodontal disease experience. Individuals were classified as having a healthy periodontium (group 1), gingivitis without signs of alveolar bone loss (group 2), moderate alveolar bone loss not exceeding 1/3 of the normal alveolar bone height (group 3), severe alveolar bone loss ranging between 1/3 and 2/3 of the normal alveolar bone height (group 4), or alveolar bone loss exceeding 2/3 of the normal bone height and angular bony defects and/or furcation defects (group 5). During these 20 years, the number of individuals in groups 1 and 2 increased from 49% in 1973 to 60% in 1993. In addition, there was a decrease in the number of individuals in group 3, the group with moderate periodontal bone loss. Groups 4 and 5 comprised 13% of the population and showed no change in general between 1983 and 1993. The individuals comprising these groups in 1993, however, had more teeth than those who comprised these groups in 1983; on the average, the individuals in disease group 4 had 4 more teeth and those in disease group 5, 2 more teeth per subject. In 1973, these 2 groups were considerably smaller, probably because of wider indications for tooth extractions and fewer possibilities for periodontal care which meant that many of these individuals had become edentulous and were not placed in a group. Individuals in groups 3, 4, and 5 were subdivided according to the number of surfaces (%) with gingivitis and periodontal pockets (> or =4 mm). In 1993, 20%, 42%. and 67% of the individuals in groups 3, 4, and 5 respectively were classified as diseased and in need of periodontal therapy with >20% bleeding sites and >10% sites with periodontal pockets > or =4 mm. In conclusion, an increase in the number of individuals with no marginal bone loss and a decrease in the number of individuals with moderate alveolar bone loss can be seen. The prevalence of individuals in the severe periodontal disease groups (4, 5) was unchanged during the last 10 years; however, the number of teeth per subject increased.     

From basic science to future medical options for treatment of ulcerative colitis

There is little information concerning the incidence of alveolar bone loss in estrogen-deficient women. Ovariectomized sheep are valid models for study of the effects of estrogen deficiency on bone metabolism. The objective of this study was to compare alveolar bone loss in control (C) and ovariectomized sheep (OVX) at 3 and 12 months following surgery. OVX animals had decreased serum levels of 17-beta-estradiol and increased serum levels of osteocalcin, IL-6, and urinary levels of deoxypyridinoline which, taken together, suggest development of osteoporosis. The mean probing depths and percentage of sites with pocket depths 4 to 6 mm and > 6 mm were significantly greater in OVX than C at each time period and in OVX were significantly greater at 12 months that at 3 months. Gingival tissue interleukin-6 (IL-6) levels (but not the number of IL-6(+) cells) were elevated adjacent to deep periodontal pockets; however, there was no significant elevation of levels of the proinflammatory cytokines IL-1 beta and IL-8 within gingiva. Taken together, the data suggest a systemic contribution for progression of periodontal disease associated with estrogen deficiency. This may involve upregulation of systemic IL-6 synthesis and transfer to gingiva in serum, resulting in enhanced IL-6 accumulation within the gingival tissues or reduced bone density allowing for a greater amount of alveolar bone loss.     

Blood levels of insulin-like growth factors I and II in neonates of non-insulin-dependent diabetic rats

Immobilization bone loss, whether due to whole body immobilization or local causes, is associated with an initial rapid phase of trabecular bone loss, but the long-term effects of immobilization on cortical bone are not well described. We have studied metacarpal morphometry in 16 men who had undergone partial or complete traumatic digital amputations 4-71 years earlier. Noninvolved metacarpals from the affected and unaffected hands were used as controls. Cortical bone width was significantly reduced in the metacarpals proximal to the amputated digits (P = 0.001). In the 7 subjects who suffered amputation before the age of 19, the cortical bone deficit was primarily due to a reduction in the total width of the medullary shaft (P = 0.007), whereas medullary width was not changed. In these subjects the metacarpal was also significantly reduced in length, by a mean 2.9 mm (P = 0.35). In the 9 subjects who had their amputation after the age of 19, both a reduction in total width and an increase in medullary width (P = 0.017) accounted for the cortical bone deficit. The deficit in total width was related to the time since amputation (P = 0.008) and could be accounted for by loss of the normal age-related increase in total width (0.01 mm/year). We conclude that in this model of immobilization osteoporosis, the metacarpal proximal to the amputated digit demonstrates cortical osteopenia.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of dietary vitamin E supplementation and rotational stress on alveolar bone loss in rice rats

The effect of this supplementation on bone loss (distance from the cementum-enamel junction to the alveolar crest measured at the midline of the lingual aspect of each of the mandibular molar roots) was studied in rats that were either not stressed or stressed on a rotational device for 90 days. In the first study, neither vitamin E nor stress condition had statistically significant effects but there was substantial bone loss and bone-loss variability in all groups. Before the start of the second study, to reduce differences in bone loss that might otherwise exist before introduction of the treatments, rats received an antibiotic in their drinking water. In addition, rotational stress was introduced more abruptly than in the first study to reduce the likelihood of adaptation. Bone loss and bone-loss variability were substantially reduced in the second study. Analysis of these data indicated that vitamin E supplementation had a statistically significant protective effect, which was most pronounced at sites most susceptible to loss. Stressed subjects tended to lose more bone, but this effect was not significant. These findings suggest some role for vitamin E supplementation in the maintenance of periodontal health but also a sensitivity in this effect to initial periodontal status.     

Models to evaluate the role of stress in periodontal disease

We evaluated the association of stress,distress, and coping behaviors with periodontal disease in 1,426 subjects, aged 25 to 74, in Erie County, NY, Demographic characteristics, medical and dental history, and tobacco and alcohol consumption, as well as clinical assessments of supragingival plaque, subgingival flora, gingival bleeding, calculus, probing depth, clinical attachment level (CAL), and radiographic alveolar bone loss (ABL) were obtained for each subject. Subjects also completed a set of 5 psychosocial instruments that measured life events, daily strains, hassles and uplifts, distress, and coping behaviors. Internal consistencies of all subscales on the instruments were high, with Cronbach's alpha ranging from 0.88 to 0.99. Logistic regression indicated that financial strain was significantly associated with greater attachment and alveolar bone loss (OR 1.70; 95% CI, 1.09-2.65; and 1.68; 95% CI, 1.20-2.37, respectively) after adjusting for age, gender, and smoking. When those with financial strain were stratified with respect to coping behaviors, it was found that those who exhibited high emotion-focused coping (inadequate coping) had and even higher risk of having more severe attachment loss (OR 2.24; 95% CI, 1.15-4.38) and alveolar bone loss (OR 1.91; 95% CI, 1.15-3.17) than those with low levels of financial strain within the same coping group, after adjustment for age, gender, and cigarette smoking. After further adjusting for number of visits to the dentist, those with financial strain who were high emotion-focused copers still had higher levels of periodontal disease based on CAL (OR 2.12; 95% CI, 1.07-4.18). In contrast, subjects with high levels of financial strain who reported high levels of problem-based coping (good coping) had no more periodontal disease than those with low levels of financial strain. Salivary cortisol levels were higher in a test group exhibiting severe periodontitis, a high level of financial strain, and high emotion-focused coping, as compared to a control group consisting of those with little or no periodontal disease, low financial strain, and low levels of emotion-focused coping (11.04 +/-4.4 vs/ 8.6 +/- 4.1 nmol/L salivary cortisol, respectively). These findings suggest that psychosocial measures of stress associated with financial strain are significant risk indicators for periodontal disease in adults. Further prospective studies are needed to help establish the time course of stress, distress, and inadequate coping on the onset and progression of periodontal disease, as well as to evaluate the mechanisms by which stress exerts its effects on periodontal infections.     

Future time perspectives of the elderly; an empirical study rooted in theory

This study examined the efficacy of YM175 [disodium dihydrogen (cycloheptylamino) methylene-1, 1-bisphosphonate] in reducing alveolar bone loss caused by experimental periodontitis in beagle dogs. Thirty-six dogs were used and divided into 6 groups. Periodontitis was induced in 30 dogs (groups 2-6) by ligating the bilateral mandibular third and fourth premolar teeth with silk ligatures and by feeding a soft diet. Six dogs were sham-operated (group 1). Saline (placebo), flurbiprofen (0.02 mg/kg) and YM175 (0.01, 0.1 and 1.0 mg/kg) were administered to the dogs (groups 2-6) 5 d/wk for 25 wk. Radiographic and morphometric analyses were performed. In placebo-treated animals (group 2), the ligation caused a significant decrease in the alveolar bone height by 0.57 and 1.91 mm at 2 and 25 wk, respectively. YM175 (1.0 mg/kg) prevented the decrease in bone height by 47 and 31% at 2 and 25 wk. YM175 (0.1 mg/kg) and flurbiprofen tended to prevent bone loss after 15 wk. Although the ligation elicited no significant change in bone mineral density, it significantly decreased bone volume. YM175 (1.0 mg/kg) and flurbiprofen tended to increase the bone volume. The number of formative or resorptive Haversian canals and the bone turnover through the periosteal bone surface were increased by the ligation, indicating the increased turnover of the cortical bone. YM175 (1.0 mg/kg) reduced the increased bone turnover. The gingival index was maximally increased at 2 wk and was suppressed by YM175. These results suggest that YM175 prevents alveolar bone loss by reducing the increased alveolar bone turnover in dogs with periodontitis.     

Local delivery of an amino bisphosphonate prevents the resorptive phase of alveolar bone following mucoperiosteal flap surgery in rats

Mucoperiosteal flaps are used to access the bone and root surface in a wide range of periodontal procedures and in implant surgery. We have demonstrated that the mucoperiosteal surgical flap of the rat mandible produces a transient burst of alveolar bone resorption similar to the clinical observations in humans. This resorptive activity, when coupled with local irritation factors, may cause confined alveolar bone loss. Recently, we have demonstrated that an amino bisphosphonate, which is used in preventing systemic bone resorption in osteoporosis and other bone diseases, reduces alveolar bone resorption in the rat model when administered systemically. In this study we evaluated the effect of local delivery of the amino bisphosphonate on bone resorption associated with mucoperiosteal flaps. Following mucoperiosteal flap elevation in the premolar and molar region of the rat mandible, a surgical pellet soaked with amino bisphosphonate was locally applied on the exposed bone surface and covered by flap. The results show that local delivery of amino bisphosphonate reduces significantly alveolar bone resorption activated by mucoperiosteal flap surgery. This study suggests that local application of amino bisphosphonate can be used as an adjunct in therapy for reducing bone resorption following surgery.     

Association between marginal bone loss around osseointegrated mandibular implants and smoking habits: a 10-year follow-up study

While many factors are conceivable, occlusal loading and plaque-induced inflammation are frequently stated as the most important ones negatively affecting the prognosis of oral implants. Currently, little is known about the relative importance of such factors. The aim of this study was to analyze the influence of smoking and other possibly relevant factors on bone loss around mandibular implants. The participants were 45 edentulous patients, 21 smokers and 24 non-smokers, who were followed for 10-year period after treatment with a fixed implant-supported prosthesis in the mandible. The peri-implant bone level was measured on intraoral radiographs, information about smoking habits was based on a careful interview, and oral hygiene was evaluated from clinical registration of plaque accumulation. Besides standard statistical methods, multiple linear regression models were constructed for estimation of the relative influence of some factors on peri-implant bone loss. The long-term results of the implant treatment were good, and only three implants (1%) were lost. The mean marginal bone loss around the mandibular implants was very small, about 1 mm for the entire 10-year period. It was greater in smokers than in non-smokers and correlated to the amount of cigarette consumption. Smokers with poor oral hygiene showed greater marginal bone loss around the mandibular implants than those with good oral hygiene. Oral hygiene did not significantly affect bone loss in non-smokers. Multivariate analyses showed that smoking was the most important factor among those analyzed for association with peri-implant bone loss. The separate models for smokers and non-smokers revealed that oral hygiene had a greater impact on peri-implant bone loss among smokers than among non-smokers. This study showed that smoking was the most important factor affecting the rate of peri-implant bone loss, and that oral hygiene also had an influence, especially in smokers, while other factors, e.g., those associated with occlusal loading, were of minor importance. These results indicate that smoking habits should be included in analyses of implant survival and peri-implant bone loss.     

Oral and periodontal tissue. Maintenance, augmentation, rejuvenation, and regeneration

This article discusses the controversies, usefulness, and limitations of oral and periodontal tissue maintenance, augmentation, rejuvenation, and regeneration in the dog and cat. It details many of the specialized materials and techniques used in these procedures in attempts to re-establish healthy conditions within the periodontium. Bone loss following tooth extraction is discussed with consideration as to which teeth should have alveolar ridge maintenance procedures and the important reasons as to why. Radiographs show the degree of improvement demonstrated in treatment of various cases involving bone loss from periodontal disease, treatment of bone injuries with oral fractures and their prevention.     

The study of molar furcation involvements in adult periodontitis. II. Age, sex, location and prevalence

The purposes of the study were as follows: (1) to evaluate the molar furcation involvement and number of molar correlated with age and sex; and (2) to study the relationship between the means of alveolar bone loss and associated factors of molar furcation involvements (FIs). 1102 molars (703 males and 399 females) were measured in 219 individuals (136 males and 83 females) for the alveolar bone loss and associated factors of molar furcation involvements. Based on the results, we conclude the following: (1) the higher prevalence of FI was in the mandibular first molar (94.6%), whereas the lowest prevalence of FI was in maxillary second molar; (2) except for the mandibular first molar, the prevalence of molar FI markedly increased with an increased age group (16 & 26, r = 0.335, p < 0.01; 17 & 27, r = 0.345, p < 0.01; 37 & 47, r = 0.239, p < 0.01); (3) the prevalence of molar FI was significantly higher in males than in females (p < 0.05); (4) the mean number of molar FI was significant greater in males (mean = 3.45) than in females (mean = 2.69); (5) factors such as age (r = 0.222, p < 0.01), sex, (r = 0.145, p < 0.05), number of remaining teeth (r = -0.330, p < 0.01) and molar FI (r = 0.471, p < 0.01) are strongly associated with the mean alveolar bone loss of molars.     

osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification

Osteoprotegerin (OPG) is a secreted protein that inhibits osteoclast formation. In this study the physiological role of OPG is investigated by generating OPG-deficient mice. Adolescent and adult OPG-/- mice exhibit a decrease in total bone density characterized by severe trabecular and cortical bone porosity, marked thinning of the parietal bones of the skull, and a high incidence of fractures. These findings demonstrate that OPG is a critical regulator of postnatal bone mass. Unexpectedly, OPG-deficient mice also exhibit medial calcification of the aorta and renal arteries, suggesting that regulation of OPG, its signaling pathway, or its ligand(s) may play a role in the long observed association between osteoporosis and vascular calcification.     

Periodontal findings in elderly patients with non-insulin dependent diabetes mellitus

The periodontal status of 25 patients with non-insulin dependent diabetes mellitus (NIDDM) (age range 58 to 76) was investigated and compared with 40 non-diabetic control subjects (age range 59 to 77). Surfaces with visible plaque and bleeding after probing, calculus, recessions, and pathological pockets were examined. The total attachment loss was calculated as a sum of recessions and pockets in millimeters. Mesial and distal bone loss was measured from panoramic radiographs and mean alveolar bone loss was calculated. Periodontal disease was considered advanced when mean alveolar bone loss was over 50%, or 2 or more teeth had pockets > or = 6 mm. Microbiological analysis comprised the detection of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus by a polymerase chain reaction (PCR) method. Patients with NIDDM had significantly more often advanced periodontitis than control subjects, 40.0% and 12.5%, respectively. Diabetic patients did not harbor more pathogens than the control subjects. The HbA1C level deteriorated in patients with advanced periodontitis, but not in other patients with NIDDM, when compared to the situation 2 to 3 years earlier. Advanced periodontitis seems to be associated with the impairment of the metabolic control in patients with NIDDM, and a regular periodontal surveillance is therefore necessary.     

Attachment loss with postmenopausal age and smoking

To determine whether postmenopausal bone loss and factors associated with osteoporosis affect tooth retention, we examined vertebral and proximal femoral (postcranial) bone mineral density in relation to tooth loss and attachment loss in a cross-sectional study of 135 postmenopausal women (age range 41-70 yr). Women had at least 10 teeth and no evidence of moderate or severe periodontal disease. Full-mouth attachment loss measurements were made using a pressure-sensitive probe, and bone density was determined by dual-energy X-ray absorptiometry. Attachment loss was correlated with tooth loss (number of remaining teeth, radiologically determined), but not with vertebral or proximal femur bone density. Multivariate analysis showed current smoking (p = 0.01), years since menopause (p = 0.02) and the interaction of age and current smoking (p < 0.01), to be statistically significant predictors of attachment loss in our study population.