| Osteoporosis (OP) has become one of the most important chronic diseases with a significant impact on health in ageing populations. Osteoporotic fractures are associated with substantial morbidity and high mortality risk in the elderly in the world. Periodontitis is an inflammation of the supporting tissues of the teeth, usually a progressively destructive change leading to loss of bone. Periodontitis are caused by microorganisms. It is now becoming widely recognized that periodontitis may be associated with certain systemic disorders—including endocrine disproportion, immunization defection, stress, genetic factors, malnutrition and osteoporosis—and periodontal infections may be modify the progression of these disorders or outcomes for such important medical outcomes. Systemic diseases can cut down the host capability of defense and repair. Also it may make more serious peridentalt inflammation and demage. Periodontitis and osteoporosis are major public health problems that affect large numbers of elders. They are characterized by the loss of bone mass. The relationship between periodontitis and osteoporosis in older subjects is undetermined. From the viewpoint of public health, prevention and early detection of both periodontal disease and osteoporosis have been recognized to be of great importance.ObjectiveTo provide clinical research making on the relationship between osteoporosis and periodontitis by means of Meta-analysis. The study was to investigate association between osteoporosis and periodontitis, through measuring and comparing the bone mineral density of lumbar and neck of femur, detecting periodontal disease clinical index and comparing the contents of osteocalcin, calcium, phosphonium and ALP in serum in normal healthy bone group, osteopenic group and osteoporosis group. Methods(1) Electronic databases about periodontics, orthopedics and endocrinology were searhed up from the association between osteoporosis and periodontitis by means of Meta-analysis. All studies and Meta-analysis related to osteoporosis and periodontitis. All data were limited to Chinese and English language articles which were selected. Data were analyzed using software for preparing and maintaining Cochrane reviews and statistical analysis software. Fix-effects model was used if there was no statistical difference among all data in one Meta-analysis, while random-effects model was chosen if there were. For assessment of publication bias, we used the funnel plot.(2) Study population: Osteoporosis group was consisted of 41 patients with osteoporosis. osteopenic group was consisted of 17 patients with osteopenic. 12 subjects with normal healthy bone were enrolled. Measurment of the bone mineral density of lumbar (L2~4) and neck of femur were measured by dual energy X-ray absorptiometry. Clinical parameters were periodontal index measured by Florida stylet and recorded by a single which included probing depth (PD), clinical attachment loss (CAL) and ginggival index (GI). All populations were detected the levels of osteocalcin, calcium, phosphonium and ALP in serum. Statistical tests were perfumed SPSS 13.0 statistics analysis software based on the data.Results(1) 293 studies were selected based on the criteria, 17 of which were from English journals, 11089 cases and 3650 periodontitis patients. The bone mineral density of older men in periodontitis patients was lower than that of the non periodontitis patients, and it has statistical means (Z=3.14, P=0.002). Statistically significant were identified for the bone mineral density of older men (WMD, -0.01; 95% CI: -0.01, -0.02~-0.01). Osteoporosis of older men in periodontitis patients was higher than that of non periodontitis patients, and it has statistical means (Z=2.20, P=0.007). Statistically significant were identified for osteoporosis of older men (OR, 1.44;95% CI: 1.04~2.00). Osteoporosis of older women in periodontitis patients was higher than that of the non periodontitis patients, and it has statistical means (Z=2.71, P=0.03). Statistically significant were identified for osteoporosis of older women (OR, 1.44; 95% CI: 1.07~1.50). The bone mineral density of older women in periodontitis patients was lower than that of non periodontitis patients, and it has statistical means (Z=35.94,P<0.00001). Statistically significant were identified for the bone mineral density of older women (WMD, -0.09;95% CI: -0.09~-0.10).(2) It has statistical means among in normal healthy bone group, osteopenic group and osteoporosis group about the PD (F=3.653, P=0.035). The PD of osteoporosis group was deeper than that of normal healthy bone group (t=1.154, P=0.011). The PD showed no obvious diference between osteopenic group and osteoporosis group, normal healthy bone group and osteopenic group. It has no statistical means among in normal healthy bone group, osteopenic group and osteoporosis group about the GI. It has statistical means among in normal healthy bone group, osteopenic group and osteoporosis group about the CAL (F=4.091, P=0.023). The CAL of osteoporosis group was deeper than that of normal healthy bone group (t=1.491, P=0.016). The CAL showed no obvious diference between osteopenic group and osteoporosis group, normal healthy bone group and osteopenic group.(3) No relationships were found between PD, CAL, GI and bone mineral density of lumbar,and that of neck of femur had no association with GI. But bone mineral density of neck of femur had negative relationship with PD and CAL.(4) It has statistical means among in normal healthy bone group, osteopenic group and osteoporosis group about the levels of osteocalcin in serum (F=3.545, P =0.047 ). The levels of osteocalcin in serum of osteoporosis group was lower than that of normal healthy bone group (t=1.2613,P=0.015). The levels of osteocalcin in serum showed no obvious diference between osteopenic group and osteoporosis group, normal healthy bone group and osteopenic group. The levels of calcium, phosphnium and ALP in serum showed no obvious diference among in normal healthy bone group, osteopenic group and osteoporosis group.Conclusions(1) The study showed that senile osteoporosis had relationship with periodontitis.(2) The PD and CAL of osteoporosis group was deeper than that of normal healthy bone group. Bone mineral density of neck of femur had negative relationship with PD and CAL. So it is presumed that the bone mineral density of neck of femur might have association with periodontitis.(3) The level of osteocalcin in serum of osteoporosis group was ignificantly lower than that of normal healthy bone group. So it is presumed that osteocalcin had certain relationship with bone mineral density. The results showed that the capability of bone transformation and formation in osteoporosis were all decreased.(4) No relationships were found between calcium, phosphonium and ALP in serum and bone mineral density.
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