Abstract
Periodontal disease has been correlated with skeletal bone mineral density (BMD). Estrogen deficiency due to menopause or other reasons and low dietary calcium (Ca) intake have been reported as common risk factors for systemic bone loss and periodontal disease. The purpose of this randomized controlled trial was to investigate the effects of dietary supplementation with Ca and soy isoflavone, a natural analog of estrogen, on skeletal bone and periodontal health in postmenopausal women during periodontal maintenance. Forty-eight patients were randomly assigned to one of the following groups : l) the test group : Ca (500nig/day) and isoflavone (10mg/day) ; 2) the double-dose group : Ca (1,000 mg/day) and isoflavone (20mg/day) ; or 3) the placebo group : 4 placebo tablets per day. Measurements of plaque index (Pi), clinical attachment level (CAL), alveolar bone density (ABD), alveolar crestal height (ACH) and cross-linked carboxyterminal telopeptide of type I collagen (ICTP) in the gingival crevicular fluid (GCF) were performed at baseline, and 6 and/or 12 months following dietary supplementation. In addition, skeletal BMD was measured at baseline and 12 months. Though the CAL in all 3 groups showed significant improvement during this trial (p< 0.01), there were no significant differences among the groups. The mean ABD gain from baseline to 12 months in the test group was significantly higher than that in the placebo group (p<0.05). That in the double-dose group showed the tendency to be higher than that in the placebo group. In addition, the ACH gain in the test group showed the tendency to be higher than that in the placebo group. Patients in the placebo group showed a significant decrease of skeletal BMD, compared to that at baseline, at 12 months (p< 0.01). In addition, the mean ICTP level of the GCF of the placebo group was significantly increased from baseline to 6 months (p< 0.01). The results from this study suggest that dietary supplementation with Ca and Soy isoflavone may suppress the loss of skeletal BMD, ABD and ACH, and maintain levels of periodontal health in postmenopausal women in periodontal maintenance.
