Title	Relationship Between Osteoporosis and Periodontal Disease Has Not Been Established
Clinical Question	Do patients with osteoporosis have a higher incidence of periodontal disease than the general population?
Clinical Bottom Line	The relationship between osteoporosis and periodontal disease cannot be established based on available data.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 20690866 Martinez-Maestre/2010 35 selected trials Systematic review of clinical trials Key results Few studies have been performed to demonstrate an association between systemic osteoporosis and fractures to dental loss. Most, from the few done, have found a positive correlation (five out of seven and three out of three). 21199381 Megson/2010 16 studies Narrative Review Key results Reduced bone mineral density is a shared risk factor, not a causal factor, for periodontitis. 16122665 Dervis/2005 97 studies Narrative Review Key results Studies support the contention that individuals with osteoporosis may be at increased risk for manifestations of oral osteoporosis, however, the risk is not definitely proven.
Evidence Search	"Osteoporosis"[Mesh] AND "Periodontal Diseases"[Mesh] AND (Meta-Analysis[ptyp] OR Review[ptyp])
Comments on The Evidence	The Martinex-Maestre 2010 Systematic review included controlled and randomized studies, with individual studies assessed for eligibility for inclusion in the review.The Megson 2010 Narrative review used exclusion/inclusion criteria for determining eligibility of studies to include in the review. The Dervis 2006 Database Med-Line search included studies reporting associations between osteoporosis and changes in dental and oral tissues.
Applicability	The relationship between osteoporosis and periodontal disease has not been clearly identified, although some studies have shown osteoporosis may be a risk factor for periodontal disease.
Specialty	(General Dentistry) (Periodontics)
Keywords	Osteoporosis, Periodontal Disease
ID#	2217
Date of submission	04/06/2012
E-mail	Gutierrezsa@livemail.uthscsa.edu
Author	Sherry Gutierrez
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Geza Terazhalmy, DDS
Faculty mentor e-mail	Terazhalmy@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Kelsey Reyes, Robert Edwards (San Antonio) on 11/28/2017 The PubMed database was searched for the above terms on 11/27/17. More recent research than that reported for this CAT was located; however, the findings are the same, and the level of this new evidence is significantly lower than the systematic review located earlier. Wang/2016 (PubMed ID: 27696284) is a narrative review and does not change the previously published answer but further supports the positive correlation between osteoporosis and periodontitis. However, a cross-sectional study done by Marjanovic in 2013 (PMID: 23340948) found that there was no association between osteoporosis and severe periodontal disease, citing a 39% prevalence of severe periodontal disease in the osteoporosis sample. Although several studies suggested a relationship between osteoporosis and periodontal disease, more evidence is needed. Future studies should be well-controlled.