Outcome Measurements in Studies on the Association Between Osteoporosis and Periodontal Disease

Background: The present study aims to compare different diagnostic criteria for periodontal disease that were used to study the association between periodontal disease and osteoporosis. Methods: A database from a case-control study was used. The present study included sociodemographic, lifestyle, and health-condition data; panoramic radiographs; and clinical measurements on periodontal conditions from 139 postmenopausal women. Each participant was classified with regard to the diagnosis of periodontal disease using five different criteria for the outcome measurement (OM) found in the literature in studies on the association between osteoporosis and periodontal disease (OM1 through OM5). The frequency of periodontal disease and diagnostic values were calculated taking OM5 as the gold standard and the main association measurement for all criteria using odds ratios. Results: The frequency of periodontal disease varied from 24.5% to 98.6% depending on the OM used. OM4 and OM3 presented the highest specificity (98.9% and 94.5%, respectively), whereas OM2 and OM1 presented the highest sensitivity (100% and 77.1%, respectively). The association measurements with adjustments for age and smoking varied significantly according to the OM over a range from 1.87 to 3.75, and there were also variations in the statistical significance of the associations found. Conclusions: The results of this study emphasize that the frequency of periodontal disease may be influenced by different OMs and indicated variations outside of the association between osteoporosis and periodontal disease. Therefore, there is a need for prior selection of a precise measurement of periodontal disease in investigations on this topic. J Periodontol 2010;81:1773-1780.