Estrogen treatment and periodontal disease progression: an experimental study in ovariectomized rats
TL;DR: Investigation of different periods of estrogen replacement therapy onset on the progression of experimental periodontitis in ovariectomized rats indicated that estrogen-deficient state may not have a direct effect on the alveolar bone adjacent to the maxillary second molar roots.
Abstract: The aim of this study was to investigate different periods of estrogen replacement therapy onset on the progression of experimental periodontitis in ovariectomized rats. MATERIAL AND METHODS: Sixty five female Wistar rats were ovariectomized and divided into two groups, experimental and control that received 17s estradiol or vehicle, respectively. Each group was subdivided into five subgroups that started the treatment immediately, one, two, three and four weeks after the ovariectomy. A month after ovariectomy, a cotton ligature was placed around the maxillary second molars. Thirty five days after ligature placement, the animals were killed. It was analyzed the macroscopic, radiographic, microscopic and histometric aspects of the periodontal area. RESULTS: The results indicated that estrogen-deficient state may not have a direct effect on the alveolar bone adjacent to the maxillary second molar roots. CONCLUSIONS: Under the conditions of this experiment, estrogen replacement therapy did not delay the progression of induced periodontitis. KEYWORDS: Estradiol; osteoporosis, ovariectomy; periodontal diseases.
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TL;DR: In this paper, the authors analyzed chronic alcohol consumption influence on induced periodontitis in rats presenting estrogen deficiency, and concluded that the association between estrogen deficiency and 20% ethanol was just relevant for sites without periodontal disease induction, since it induces stronger severity in the inflammatory process in the presence of the inflammatory cells scattered in the conjunctive tissue and of the disorientation of periodont ligament fibers.
Abstract: The immune system plays an important role in the pathogenesis of periodontal diseases. The host may modulate periodontal inflammatory reactions and it determines variances in the individual susceptibility and in the periodontal disease progression speed. Osteoporosis and alcoholism are described as risk indicators of periodontal disease among the systemic acquired factors. Objective: The current study aims to analyze chronic alcohol consumption influence on induced periodontitis in rats presenting estrogen deficiency. Material and Methods: Sixty rats approximately 90 days old were used in the experiment; they were divided into two groups: correlated surgery (OVZ) or surgical ovariectomy simulation (SHAM). Each group was divided into three subgroups: (C) control diet, (A) ethanol containing 20% liquid diet and (I) par-fed control diet. Thirty days after castration the diet and the experimental periodontitis induction were kept for 56 days. Interproximal regions between the first and the second lower left molar and the respective contralateral site without periodontal disease induction were assessed for inflammatory features. Results: Hormone deficiency resulted in important inflammatory changes concerning the meaning of SHAM-C and OVZ-C. The ethanol diet has resulted in inflammatory changes to both groups SHAM-A and OVZ-A in the absence of periodontitis, with also greater severity when combined with ovariectomy. Conclusion: It was concluded that the association between estrogen deficiency and 20% ethanol was just relevant for sites without periodontitis disease induction, since it induces stronger severity in the inflammatory process in the presence of the inflammatory cells scattered in the conjunctive tissue and of the disorientation of periodontal ligament fibers. Keywords Alcoholism; Osteoporosis; Ovariectomy; Periodontal disease.
2 citations
01 Jan 2016
TL;DR: It was concluded that the association between estrogen deficiency and 20% ethanol was just relevant for sites without periodontitis disease induction, since it induces stronger severity in the inflammatory process in the presence of the inflammatory cells scattered in the conjunctive tissue and of the disorientation of periodontal ligament fibers.
Abstract: The immune system plays an important role in the pathogenesis of periodontal diseases.The host may modulate periodontal inflammatory reactions and it determines variances in the individual susceptibility and in the periodontal disease progression speed. Osteoporosis and alcoholism are described as risk indicators of periodontal disease among the systemic acquired factors. Objective: The current study aims to analyze chronic alcohol consumption influence on induced periodontitis in rats presenting estrogen deficiency. Material and Methods: Sixty rats approximately 90 days old were used in the experiment; they were divided into two groups: correlated surgery (OVZ) or surgical ovariectomy simulation (SHAM). Each group was divided into three subgroups: (C) control diet, (A) ethanol containing 20% liquid diet and (I) par-fed control diet. Thirty days after castration the diet and the experimental periodontitis induction were kept for 56 days. Interproximal regions between the first and the second lower left molar and the respective contralateral site without periodontal disease induction were assessed for inflammatory features. Results: Hormone deficiency resulted in important inflammatory changes concerning the meaning of SHAM-C and OVZ-C. The ethanol diet has resulted in inflammatory changes to both groupsSHAM-A and OVZ-A in the absence of periodontitis, with also greater severity when combined with ovariectomy. Conclusion: It was concluded that the association between estrogen deficiency and 20% ethanol was just relevant for sites without periodontitis disease induction, since it induces stronger severity in the inflammatory process in the presence of the
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TL;DR: The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years.
Abstract: Objective: This position statement aimed to update the evidence-based position statement published by The North American Menopause Society (NAMS) in 2010 regarding recommendations for hormone therapy (HT) for postmenopausal women. This updated position statement further distinguishes the emerging differences in the therapeutic benefit-risk ratio between estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) at various ages and time intervals since menopause onset. Methods: An Advisory Panel of expert clinicians and researchers in the field of women’s health was enlisted to review the 2010 NAMS position statement, evaluate new evidence, and reach consensus on recommendations. The Panel’s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. Results: Current evidence supports the use of HT for perimenopausal and postmenopausal women when the balance of potential benefits and risks is favorable for the individual woman. This position statement reviews the effects of ET and EPT on many aspects of women’s health and recognizes the greater safety profile associated with ET. Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms and to prevent osteoporosis in women at high risk of fracture. The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years.
630 citations
"Estrogen treatment and periodontal ..." refers background in this paper
...Recent data support the initiation of hormone therapy around the time of menopause to prevent osteoporosis [31]....
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...It is also important to highlight that currently no hormone therapy has government approval for the treatment of osteoporosis, however many systemic HT products have government approval for the prevention of postmenopausal osteoporosis [31]....
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580 citations
"Estrogen treatment and periodontal ..." refers background in this paper
...A hypothesis of an increased risk for periodontal disease due to systemic disorders has long been proposed [1]....
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TL;DR: Further elucidation of the mechanisms by which sex steroids affect bone has the potential to improve the clinical management not only of osteoporosis, both in men and women, but also of a number of other diseases related to sex hormone status.
Abstract: Sex steroids are essential for skeletal development and the maintenance of bone health throughout adult life, and estrogen deficiency at menopause is a major pathogenetic factor in the development of osteoporosis in postmenopausal women. The mechanisms by which the skeletal effects of sex steroids are mediated remain incompletely understood, but in recent years there have been considerable advances in our knowledge of how estrogens and, to a lesser extent androgens, influence bone modeling and remodeling in health and disease. New insights into estrogen receptor structure and function, recent discoveries about the development and activity of osteoclasts, and lessons learned from human and animal genetic mutations have all contributed to increased understanding of the skeletal effects of estrogen, both in males and females. Studies of untreated and treated osteoporosis in postmenopausal women have also contributed to this knowledge and have provided unequivocal evidence for the potential of high-dose estrogen therapy to have anabolic skeletal effects. The development of selective estrogen receptor modulators has provided a new approach to the prevention of osteoporosis and other major diseases of menopause and has implications for the therapeutic use of other steroid hormones, including androgens. Further elucidation of the mechanisms by which sex steroids affect bone thus has the potential to improve the clinical management not only of osteoporosis, both in men and women, but also of a number of other diseases related to sex hormone status.
489 citations
"Estrogen treatment and periodontal ..." refers background in this paper
...It has been long established that estrogen deficiency increases bone turnover and induces an imbalance between resorption and formation, and thereby accelerates skeletal losses and can lead to osteoporosis [19]....
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TL;DR: Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered, and a recommended list of areas for future HT research.
Abstract: Objective: To update for both clinicians and the lay public the evidence-based position statement published by The North American Menopause Society (NAMS) in July 2008 regarding its recommendations for menopausal hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at various times through menopause and beyond Methods: An Advisory Panel of clinicians and researchers expert in the field of women_s health was enlisted to review the July 2008 NAMS position statement, evaluate new evidence through an evidence-based analysis, and reach consensus on recommendations The Panel_s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement Also participating in the review process were other interested organizations who then endorsed the document Results: Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered This paper lists all these areas along with explanatory comments Areas that vary from the 2008 position statement are noted A suggested reading list of key references published since the last statement is also provided Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both The benefit-risk ratio for menopausal HT is favorable for women who initiate HT close to menopause but decreases in older women and with time since menopause in previously untreated women
388 citations
"Estrogen treatment and periodontal ..." refers background in this paper
...Many systemic ET-containing products have regulatory agency approval for prevention of postmenopausal osteoporosis through long-term treatment, although the use of hormone should be consistent with treatment goals, benefits and risks [9]....
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...There is evidence that estrogen therapy (ET) reduces postmenopausal osteoporotic fractures, including hip fractures [9]....
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...The sooner the treatment starts after menopause it seems to have a strong impact on long-term health outcomes [9]....
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TL;DR: The data suggest that osteoporosis/osteopenia and estrogen deficiency are risk factors for alveolar bone density loss in postmenopausal women with a history of periodontitis.
Abstract: The purpose of this 2-year longitudinal clinical study was to investigate alveolar (oral) bone height and density changes in osteoporotic/osteopenic women compared with women with normal lumbar spine bone mineral density (BMD) Thirty-eight postmenopausal women completed this study; 21 women had normal BMD of the lumbar spine, while 17 women had osteoporosis or osteopenia of the lumbar spine at baseline All subjects had a history of periodontitis and participated in 3- to 4-month periodontal maintenance programs No subjects were current smokers All patients were within 5 years of menopause at the start of the study Four vertical bitewing radiographs of posterior sextants were taken at baseline and 2-year visits Radiographs were examined using computer-assisted densitometric image analysis (CADIA) for changes in bone density at the crestal and subcrestal regions of interproximal bone Changes in alveolar bone height were also measured Radiographic data were analyzed by the t-test for two independent samples Osteoporotic/osteopenic women exhibited a higher frequency of alveolar bone height loss (p<005) and crestal (p<0025) and subcrestal (p<003) density loss relative to women with normal BMD Estrogen deficiency was associated with increased frequency of alveolar bone crestal density loss in the osteoporotic/osteopenic women and in the overall study population (p<005) These data suggest that osteoporosis/osteopenia and estrogen deficiency are risk factors for alveolar bone density loss in postmenopausal women with a history of periodontitis
251 citations
"Estrogen treatment and periodontal ..." refers background in this paper
...Papers addressing the relationships among osteoporosis, estrogen deficiency and periodontitis have been published [2,3,6,20-23]....
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