Some postmenopausal women rapidly lose postcranial bone, and estrogen replacement therapy (ERT) can reduce this loss. Since 1993, the applicant has studied healthy postmenopausal women in a prospective, double-blind, placebo-controlled investigation to determine if the rate of postcranial bone loss is related to the rate of alveolar bone loss and to determine the effect of ERT on bone-loss rates at these sites. Initial results indicate that alveolar bone loss is correlated with postcranial bone loss and that alveolar bone loss increases with years since menopause, cigarette smoking and parity. To further understand the effect of hormonal replacement therapy as a preventive measure for alveolar and postcranial bone loss in postmenopausal women, the applicant proposes to test the hypothesis that HRT that arrests or reduces the rate of postcranial bone deterioration after menopause will similarly affect alveolar bone loss, and thus prevent or delay loss of teeth. An open-label ERT study is proposed for two years on the cohort of postmenopausal women currently enrolled in the ongoing trial. The long term protective effect of ERT on postcranial and alveolar bone will be evaluated as a function of bone loss rates. The filmless photostimulable phosphor plate (PSP) technology will be used and validated for quantitative measurement of alveolar bone mass. Preliminary studies indicate that PSP technology offers significant advantages over current film-based methods including sensitivity and quantitation. If the protective effect of HRT is related to the rate of alveolar bone loss, then a simple, routine dental visit may identify subjects that would most benefit from postmenopausal HRT. This study will assay effective interventions that can delay or prevent tooth loss in elderly women, an important dental public health problem.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Research Project (R01)
Project #
5R01DE009861-06
Application #
2770258
Study Section
Oral Biology and Medicine Subcommittee 1 (OBM)
Project Start
1993-08-01
Project End
2001-08-31
Budget Start
1998-09-01
Budget End
2001-08-31
Support Year
6
Fiscal Year
1998
Total Cost
Indirect Cost
Name
Washington University
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
062761671
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Hildebolt, Charles F; Pilgram, Thomas K; Dotson, Mary et al. (2004) Estrogen and/or calcium plus vitamin D increase mandibular bone mass. J Periodontol 75:811-6
Hildebolt, Charles F; Pilgram, Thomas K; Yokoyama-Crothers, Naoko et al. (2002) The pattern of alveolar crest height change in healthy postmenopausal women after 3 years of hormone/estrogen replacement therapy. J Periodontol 73:1279-84
Civitelli, Roberto; Pilgram, Thomas K; Dotson, Mary et al. (2002) Alveolar and postcranial bone density in postmenopausal women receiving hormone/estrogen replacement therapy: a randomized, double-blind, placebo-controlled trial. Arch Intern Med 162:1409-15
Pilgram, Thomas K; Hildebolt, Charles F; Dotson, Mary et al. (2002) Relationships between clinical attachment level and spine and hip bone mineral density: data from healthy postmenopausal women. J Periodontol 73:298-301
Pilgram, T K; Hildebolt, C F; Yokoyama-Crothers, N et al. (2000) Relationships between radiographic alveolar bone height and probing attachment level: data from healthy post-menopausal women. J Clin Periodontol 27:341-6
Hildebolt, C F; Pilgram, T K; Yokoyama-Crothers, N et al. (2000) Alveolar bone height and postcranial bone mineral density: negative effects of cigarette smoking and parity. J Periodontol 71:683-9
Pilgram, T K; Hildebolt, C F; Yokoyama-Crothers, N et al. (1999) Relationships between longitudinal changes in radiographic alveolar bone height and probing depth measurements: data from postmenopausal women. J Periodontol 70:829-33
Hildebolt, C F; Pilgram, T K; Yokoyama-Crothers, N et al. (1998) Reliability of linear alveolar bone loss measurements of mandibular posterior teeth from digitized bitewing radiographs. J Clin Periodontol 25:850-6
Conover, G L; Hildebolt, C F; Anthony, D (1995) A comparison of six intra-oral X-ray films. Dentomaxillofac Radiol 24:169-72
Conover, G L; Hildebolt, C F; Anthony, D (1995) Objective and subjective evaluations of Kodak Ektaspeed Plus dental x-ray film. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 79:246-50

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