Skeletal bone loss, in concert with underlying local factors, may create an environment conducive to accelerated loss of oral bone. In the dentate, this may manifest as loss of tooth support. In the edentulous, osteoporosis may augment local anatomic, biologic and mechanical factors resulting in extensive ridge atrophy. Therefore, skeletal bone loss may increase the need for, and influence the outcome of periodontal, pre-prosthetic and implant surgical procedures. Research into this area, however, has been plagued with problems ranging from small sample sizes to the inability to control for confounding variables. We have a unique opportunity to use an existing cohort of men 65 years or older recruited for the Osteoporotic Fractures in Men study (MrOS) - a prospective, multi-center study on the determinants of osteoporosis and fractures in men. This cohort is well characterized for all known variables associated with bone biology and skeletal health and will allow us to carefully evaluate the relationship between skeletal and oral bone loss in a cost-effective manner. It will also give us the opportunity to evaluate the impact of medical, lifestyle, and dietary factors on the prevalence and progression of periodontitis. We are proposing adding a longitudinal study of oral health to MrOS (average follow-up of 2.5 years) in Portland, OR and Birmingham, AL (final n = 1,100). Using techniques similar to the Women's Health Initiative (WHI) Oral Ancillary Study we will evaluate alveolar bone height, mandibular bone density, tooth loss, attachment level, probing depth, residual ridge morphometry, and sex steroids. This study gives us a rare opportunity to evaluate the association between general skeletal health and oral disorders while controlling for all known confounding factors. By using techniques similar to the WHI, we will also have the ability to evaluate gender differences. In addition, the stored serum and DNA available from the MrOS should provide an opportunity to explore genetic and biochemical/endocrine factors that may be important regulators of oral bone biology. Since the MrOS cohort is already established through other funds, this request will provide a very cost-effective means for addressing these important oral health issues.
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