Prevalence of apical periodontitis in postmenopausal women with osteoporosis: A retrospective study

Purpose: The aim of this study was to compare the prevalence of apical periodontitis (AP) between postmenopausal women diagnosed with osteoporosis (OP) and systemically healthy postmenopausal women, representing a Mediterranean subpopulation.
Methods: The study included 71 postmenopausal women aged between 50 and 70 years. Based on dual-energy X-ray absorptiometry (DEXA) results, participants were classified into two groups: osteoporotic and healthy. Panoramic radiographs of each subject were evaluated for the presence of AP and scored using the periapical index (PAI). Additionally, the decayed, missing, and filled teeth (DMFT) index, the number of root canal-treated (RCT) teeth, and smoking status were recorded. Statistical analysis was performed using the independent samples t-test, Mann–Whitney U test, and Chi-square tests (p<0.05). Interobserver agreement was found to be high (κ=0.86).
Results: No statistically significant differences were observed between osteoporotic and systemically healthy postmenopausal women in terms of AP prevalence, PAI scores, DMFT index, or the number of RCT teeth (p>0.05).
Conclusion: The findings suggest that OP may not be an independent risk factor for the development of apical inflammation in postmenopausal women. From a clinical perspective, pharmacologically managed OP does not appear to negatively affect endodontic prognosis. Further comprehensive, multicenter studies are warranted to better understand the impact of systemic bone diseases on periapical inflammation.

Keywords: Apical periodontitis, DMF index, dual-energy X-ray absorptiometry, osteoporosis; panoramic radiography; postmenopausal woman.