The Association between Estrogen Status and Alveolar Bone Density Changes in Postmenopausal Women with a History of Periodontitis

While numerous studies have demonstrated a relationship between 17-β-estradiol (E₂) deficiencies and skeletal bone loss in postmenopausal females, the influence of E₂ deficiency on alveolar bone resorption is poorly understood. The purpose of this study was to examine the association between the estrogen status of postmenopausal women and alveolar bone density changes in a 1-year longitudinal study. Twenty-four postmenopausal women, within 7 years of menopause, were divided into 2 groups, E₂-sufficient (n = 10) and E₂-deficient (n = 14). Venous blood samples were taken at baseline, 6 months, and 1 year for radioimmunoassay determination of serum E₂ levels. At baseline and 1 year, 4 vertical bite-wing radiographs were taken for computer-assisted densitometric image analysis (CADIA). Areas of interest (AOIs) for CADIA were crestal and subcrestal regions of posterior interproximal alveolar bone. Serum E₂ levels were significantly higher at all 3 time points in the E₂-sufficient subjects (P < 0.002, repeated measures ANOVA). Overall, mean CADIA values (0.30 ± 0.07 for the E₂-sufficient women and -0.44 ± 0.07 for the E₂-deficient women) were statistically different between groups (P < 0.001, repeated measures ANOVA), indicating that the E₂-sufficient women displayed a mean net gain in alveolar bone density and the E₂-deficient women displayed a mean net loss in alveolar bone density. Furthermore, the E₂-sufficient women exhibited a higher frequency of sites demonstrating a gain in alveolar bone density, while the E₂-deficient women exhibited a higher frequency of sites demonstrating loss in alveolar bone density. These data suggest that estrogen status may influence alveolar bone density changes as demonstrated with CADIA.