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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Alveolar bone loss in osteoporosis: a loaded and cellular affair?</title>
<author><name sortKey="Jonasson, Grethe" sort="Jonasson, Grethe" uniqKey="Jonasson G" first="Grethe" last="Jonasson">Grethe Jonasson</name>
<affiliation><nlm:aff id="af1-ccide-8-095">Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-ccide-8-095">Research and Development Centre, Borås</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rythen, Marianne" sort="Rythen, Marianne" uniqKey="Rythen M" first="Marianne" last="Rythén">Marianne Rythén</name>
<affiliation><nlm:aff id="af2-ccide-8-095">Research and Development Centre, Borås</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af3-ccide-8-095">Specialist Clinic for Pediatric Dentistry, Public Dental Service, Mölndal, Sweden</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">27471408</idno>
<idno type="pmc">4948717</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948717</idno>
<idno type="RBID">PMC:4948717</idno>
<idno type="doi">10.2147/CCIDE.S92774</idno>
<date when="2016">2016</date>
<idno type="wicri:Area/Pmc/Corpus">000790</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000790</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Alveolar bone loss in osteoporosis: a loaded and cellular affair?</title>
<author><name sortKey="Jonasson, Grethe" sort="Jonasson, Grethe" uniqKey="Jonasson G" first="Grethe" last="Jonasson">Grethe Jonasson</name>
<affiliation><nlm:aff id="af1-ccide-8-095">Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af2-ccide-8-095">Research and Development Centre, Borås</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Rythen, Marianne" sort="Rythen, Marianne" uniqKey="Rythen M" first="Marianne" last="Rythén">Marianne Rythén</name>
<affiliation><nlm:aff id="af2-ccide-8-095">Research and Development Centre, Borås</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="af3-ccide-8-095">Specialist Clinic for Pediatric Dentistry, Public Dental Service, Mölndal, Sweden</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Clinical, Cosmetic and Investigational Dentistry</title>
<idno type="eISSN">1179-1357</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>Maxillary and mandibular bone mirror skeletal bone conditions. Bone remodeling happens at endosteal surfaces where the osteoclasts and osteoblasts are situated. More surfaces means more cells and remodeling. The bone turnover rate in the mandibular alveolar process is probably the fastest in the body; thus, the first signs of osteoporosis may be revealed here. Hormones, osteoporosis, and aging influence the alveolar process and the skeletal bones similarly, but differences in loading between loaded, half-loaded, and unloaded bones are important to consider. Bone mass is redistributed from one location to another where strength is needed. A sparse trabeculation in the mandibular premolar region (large intertrabecular spaces and thin trabeculae) is a reliable sign of osteopenia and a high skeletal fracture risk. Having dense trabeculation (small intertrabecular spaces and well-mineralized trabeculae) is generally advantageous to the individual because of the low fracture risk, but may imply some problems for the clinician.</p>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Von Wowern, N" uniqKey="Von Wowern N">N Von Wowern</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kribbs, Pj" uniqKey="Kribbs P">PJ Kribbs</name>
</author>
<author><name sortKey="Chesnut, Ch" uniqKey="Chesnut C">CH Chesnut</name>
</author>
<author><name sortKey="Ott, Sm" uniqKey="Ott S">SM Ott</name>
</author>
<author><name sortKey="Kilcoyne, Rf" uniqKey="Kilcoyne R">RF Kilcoyne</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Southard, Ka" uniqKey="Southard K">KA Southard</name>
</author>
<author><name sortKey="Southard, Te" uniqKey="Southard T">TE Southard</name>
</author>
<author><name sortKey="Schlechte, Ja" uniqKey="Schlechte J">JA Schlechte</name>
</author>
<author><name sortKey="Meis, Pa" uniqKey="Meis P">PA Meis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lindh, C" uniqKey="Lindh C">C Lindh</name>
</author>
<author><name sortKey="Horner, K" uniqKey="Horner K">K Horner</name>
</author>
<author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bollen, Am" uniqKey="Bollen A">AM Bollen</name>
</author>
<author><name sortKey="Taguchi, A" uniqKey="Taguchi A">A Taguchi</name>
</author>
<author><name sortKey="Hujoel, Pp" uniqKey="Hujoel P">PP Hujoel</name>
</author>
<author><name sortKey="Hollender, Lg" uniqKey="Hollender L">LG Hollender</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hassani Nejad, A" uniqKey="Hassani Nejad A">A Hassani-Nejad</name>
</author>
<author><name sortKey="Ahlqwist, M" uniqKey="Ahlqwist M">M Ahlqwist</name>
</author>
<author><name sortKey="Hakeberg, M" uniqKey="Hakeberg M">M Hakeberg</name>
</author>
<author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Billhult, A" uniqKey="Billhult A">A Billhult</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Sundh, V" uniqKey="Sundh V">V Sundh</name>
</author>
<author><name sortKey="Hakeberg, M" uniqKey="Hakeberg M">M Hakeberg</name>
</author>
<author><name sortKey="Hassani Nejad, A" uniqKey="Hassani Nejad A">A Hassani-Nejad</name>
</author>
<author><name sortKey="Lissner, L" uniqKey="Lissner L">L Lissner</name>
</author>
<author><name sortKey="Ahlqwist, M" uniqKey="Ahlqwist M">M Ahlqwist</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Sundh, V" uniqKey="Sundh V">V Sundh</name>
</author>
<author><name sortKey="Ahlqwist, M" uniqKey="Ahlqwist M">M Ahlqwist</name>
</author>
<author><name sortKey="Hakeberg, M" uniqKey="Hakeberg M">M Hakeberg</name>
</author>
<author><name sortKey="Bjorkelund, C" uniqKey="Bjorkelund C">C Björkelund</name>
</author>
<author><name sortKey="Lissner, L" uniqKey="Lissner L">L Lissner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Martin, B" uniqKey="Martin B">B Martin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lerner, Uh" uniqKey="Lerner U">UH Lerner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Reddy, Ms" uniqKey="Reddy M">MS Reddy</name>
</author>
<author><name sortKey="Morgan, Sl" uniqKey="Morgan S">SL Morgan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Seeman, E" uniqKey="Seeman E">E Seeman</name>
</author>
<author><name sortKey="Delmas, Pd" uniqKey="Delmas P">PD Delmas</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kanis, Ja" uniqKey="Kanis J">JA Kanis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Huja, Ss" uniqKey="Huja S">SS Huja</name>
</author>
<author><name sortKey="Fernandez, Sa" uniqKey="Fernandez S">SA Fernandez</name>
</author>
<author><name sortKey="Hill, Kj" uniqKey="Hill K">KJ Hill</name>
</author>
<author><name sortKey="Li, Y" uniqKey="Li Y">Y Li</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Marx, Re" uniqKey="Marx R">RE Marx</name>
</author>
<author><name sortKey="Cillo Jr, Je" uniqKey="Cillo Jr J">JE Cillo Jr</name>
</author>
<author><name sortKey="Ulloa, Jj" uniqKey="Ulloa J">JJ Ulloa</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lorentzon, M" uniqKey="Lorentzon M">M Lorentzon</name>
</author>
<author><name sortKey="Norjavaara, E" uniqKey="Norjavaara E">E Norjavaara</name>
</author>
<author><name sortKey="Kindblom, Jm" uniqKey="Kindblom J">JM Kindblom</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Ito, M" uniqKey="Ito M">M Ito</name>
</author>
<author><name sortKey="Yamada, M" uniqKey="Yamada M">M Yamada</name>
</author>
<author><name sortKey="Hayashi, K" uniqKey="Hayashi K">K Hayashi</name>
</author>
<author><name sortKey="Ohki, M" uniqKey="Ohki M">M Ohki</name>
</author>
<author><name sortKey="Uetani, M" uniqKey="Uetani M">M Uetani</name>
</author>
<author><name sortKey="Nakamura, T" uniqKey="Nakamura T">T Nakamura</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Karlsson, M" uniqKey="Karlsson M">M Karlsson</name>
</author>
<author><name sortKey="Bass, S" uniqKey="Bass S">S Bass</name>
</author>
<author><name sortKey="Seeman, E" uniqKey="Seeman E">E Seeman</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Riggs, Bl" uniqKey="Riggs B">BL Riggs</name>
</author>
<author><name sortKey="Khosla, S" uniqKey="Khosla S">S Khosla</name>
</author>
<author><name sortKey="Melton, Lj" uniqKey="Melton L">LJ Melton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ulm, Cw" uniqKey="Ulm C">CW Ulm</name>
</author>
<author><name sortKey="Solar, P" uniqKey="Solar P">P Solar</name>
</author>
<author><name sortKey="Ulm, Mr" uniqKey="Ulm M">MR Ulm</name>
</author>
<author><name sortKey="Matejka, M" uniqKey="Matejka M">M Matejka</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Jonasson, L" uniqKey="Jonasson L">L Jonasson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lanyon, Le" uniqKey="Lanyon L">LE Lanyon</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lang, Tf" uniqKey="Lang T">TF Lang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Mosekilde, L" uniqKey="Mosekilde L">L Mosekilde</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ruff, Cb" uniqKey="Ruff C">CB Ruff</name>
</author>
<author><name sortKey="Hayes, Wc" uniqKey="Hayes W">WC Hayes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Karlsson, Mk" uniqKey="Karlsson M">MK Karlsson</name>
</author>
<author><name sortKey="Hasserius, R" uniqKey="Hasserius R">R Hasserius</name>
</author>
<author><name sortKey="Obrant, Kj" uniqKey="Obrant K">KJ Obrant</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Magnusson, H" uniqKey="Magnusson H">H Magnusson</name>
</author>
<author><name sortKey="Obrant, K" uniqKey="Obrant K">K Obrant</name>
</author>
<author><name sortKey="Johnell, O" uniqKey="Johnell O">O Johnell</name>
</author>
<author><name sortKey="Karlsson, Km" uniqKey="Karlsson K">KM Karlsson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bresin, A" uniqKey="Bresin A">A Bresin</name>
</author>
<author><name sortKey="Johansson, Cb" uniqKey="Johansson C">CB Johansson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
<author><name sortKey="Bresin, A" uniqKey="Bresin A">A Bresin</name>
</author>
<author><name sortKey="Holm, J" uniqKey="Holm J">J Holm</name>
</author>
<author><name sortKey="Strid, Kg" uniqKey="Strid K">KG Strid</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Erhardson, S" uniqKey="Erhardson S">S Erhardson</name>
</author>
<author><name sortKey="Sheikholeslam, A" uniqKey="Sheikholeslam A">A Sheikholeslam</name>
</author>
<author><name sortKey="Forsberg, C M" uniqKey="Forsberg C">C-M Forsberg</name>
</author>
<author><name sortKey="Lockowandt, P" uniqKey="Lockowandt P">P Lockowandt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Elovic, Rp" uniqKey="Elovic R">RP Elovic</name>
</author>
<author><name sortKey="Hipp, Ja" uniqKey="Hipp J">JA Hipp</name>
</author>
<author><name sortKey="Hayes, Wc" uniqKey="Hayes W">WC Hayes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Von Wowern, N" uniqKey="Von Wowern N">N Von Wowern</name>
</author>
<author><name sortKey="Hjorting Hansen, E" uniqKey="Hjorting Hansen E">E Hjorting-Hansen</name>
</author>
<author><name sortKey="Stoltze, K" uniqKey="Stoltze K">K Stoltze</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Carlsson, Ge" uniqKey="Carlsson G">GE Carlsson</name>
</author>
<author><name sortKey="Persson, G" uniqKey="Persson G">G Persson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tallgren, A" uniqKey="Tallgren A">A Tallgren</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Von Wowern, N" uniqKey="Von Wowern N">N Von Wowern</name>
</author>
<author><name sortKey="Kollerup, G" uniqKey="Kollerup G">G Kollerup</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Klemetti, E" uniqKey="Klemetti E">E Klemetti</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Klemetti, E" uniqKey="Klemetti E">E Klemetti</name>
</author>
<author><name sortKey="Kroger, H" uniqKey="Kroger H">H Kröger</name>
</author>
<author><name sortKey="Lassila, V" uniqKey="Lassila V">V Lassila</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Bankvall, G" uniqKey="Bankvall G">G Bankvall</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Jonasson, L" uniqKey="Jonasson L">L Jonasson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
<author><name sortKey="Gunnarsson, R" uniqKey="Gunnarsson R">R Gunnarsson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Enlow, Dh" uniqKey="Enlow D">DH Enlow</name>
</author>
<author><name sortKey="Harris, Db" uniqKey="Harris D">DB Harris</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Pasco, Ja" uniqKey="Pasco J">JA Pasco</name>
</author>
<author><name sortKey="Seeman, E" uniqKey="Seeman E">E Seeman</name>
</author>
<author><name sortKey="Henry, Mj" uniqKey="Henry M">MJ Henry</name>
</author>
<author><name sortKey="Merriman, En" uniqKey="Merriman E">EN Merriman</name>
</author>
<author><name sortKey="Nicholson, Gc" uniqKey="Nicholson G">GC Nicholson</name>
</author>
<author><name sortKey="Kotowicz, Ma" uniqKey="Kotowicz M">MA Kotowicz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kanis, Ja" uniqKey="Kanis J">JA Kanis</name>
</author>
<author><name sortKey="Johnell, O" uniqKey="Johnell O">O Johnell</name>
</author>
<author><name sortKey="Oden, A" uniqKey="Oden A">A Oden</name>
</author>
<author><name sortKey="Johansson, H" uniqKey="Johansson H">H Johansson</name>
</author>
<author><name sortKey="Mccloskey, E" uniqKey="Mccloskey E">E McCloskey</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Johansson, C" uniqKey="Johansson C">C Johansson</name>
</author>
<author><name sortKey="Black, D" uniqKey="Black D">D Black</name>
</author>
<author><name sortKey="Johnell, O" uniqKey="Johnell O">O Johnell</name>
</author>
<author><name sortKey="Oden, A" uniqKey="Oden A">A Odén</name>
</author>
<author><name sortKey="Mellstrom, D" uniqKey="Mellstrom D">D Mellström</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Genant, Hk" uniqKey="Genant H">HK Genant</name>
</author>
<author><name sortKey="Jiang, Y" uniqKey="Jiang Y">Y Jiang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lindh, C" uniqKey="Lindh C">C Lindh</name>
</author>
<author><name sortKey="Obrant, K" uniqKey="Obrant K">K Obrant</name>
</author>
<author><name sortKey="Petersson, A" uniqKey="Petersson A">A Petersson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Southard, Ka" uniqKey="Southard K">KA Southard</name>
</author>
<author><name sortKey="Southard, Te" uniqKey="Southard T">TE Southard</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Klemetti, E" uniqKey="Klemetti E">E Klemetti</name>
</author>
<author><name sortKey="Kolmakov, S" uniqKey="Kolmakov S">S Kolmakov</name>
</author>
<author><name sortKey="Kroger, H" uniqKey="Kroger H">H Kröger</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Taguchi, A" uniqKey="Taguchi A">A Taguchi</name>
</author>
<author><name sortKey="Asano, A" uniqKey="Asano A">A Asano</name>
</author>
<author><name sortKey="Ohtsuka, M" uniqKey="Ohtsuka M">M Ohtsuka</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Taguchi, A" uniqKey="Taguchi A">A Taguchi</name>
</author>
<author><name sortKey="Tsuda, M" uniqKey="Tsuda M">M Tsuda</name>
</author>
<author><name sortKey="Ohtsuka, M" uniqKey="Ohtsuka M">M Ohtsuka</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="White, Sc" uniqKey="White S">SC White</name>
</author>
<author><name sortKey="Taguchi, A" uniqKey="Taguchi A">A Taguchi</name>
</author>
<author><name sortKey="Kao, D" uniqKey="Kao D">D Kao</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Okabe, S" uniqKey="Okabe S">S Okabe</name>
</author>
<author><name sortKey="Morimoto, Y" uniqKey="Morimoto Y">Y Morimoto</name>
</author>
<author><name sortKey="Ansai, T" uniqKey="Ansai T">T Ansai</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Devlin, H" uniqKey="Devlin H">H Devlin</name>
</author>
<author><name sortKey="Karayianni, K" uniqKey="Karayianni K">K Karayianni</name>
</author>
<author><name sortKey="Mitsea, A" uniqKey="Mitsea A">A Mitsea</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Horner, K" uniqKey="Horner K">K Horner</name>
</author>
<author><name sortKey="Devlin, H" uniqKey="Devlin H">H Devlin</name>
</author>
<author><name sortKey="Harvey, L" uniqKey="Harvey L">L Harvey</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Devlin, H" uniqKey="Devlin H">H Devlin</name>
</author>
<author><name sortKey="Allen, Pd" uniqKey="Allen P">PD Allen</name>
</author>
<author><name sortKey="Graham, J" uniqKey="Graham J">J Graham</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pham, D" uniqKey="Pham D">D Pham</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="White, Sc" uniqKey="White S">SC White</name>
</author>
<author><name sortKey="Rudolph, Dj" uniqKey="Rudolph D">DJ Rudolph</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="White, Sc" uniqKey="White S">SC White</name>
</author>
<author><name sortKey="Atchison, Ka" uniqKey="Atchison K">KA Atchison</name>
</author>
<author><name sortKey="Gornbein, Ja" uniqKey="Gornbein J">JA Gornbein</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Verheij, Jg" uniqKey="Verheij J">JG Verheij</name>
</author>
<author><name sortKey="Geraets, Wg" uniqKey="Geraets W">WG Geraets</name>
</author>
<author><name sortKey="Van Der Stelt, Pf" uniqKey="Van Der Stelt P">PF van der Stelt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chiba, K" uniqKey="Chiba K">K Chiba</name>
</author>
<author><name sortKey="Burghardt, Aj" uniqKey="Burghardt A">AJ Burghardt</name>
</author>
<author><name sortKey="Osaki, M" uniqKey="Osaki M">M Osaki</name>
</author>
<author><name sortKey="Majumdar, S" uniqKey="Majumdar S">S Majumdar</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Geraets, Wg" uniqKey="Geraets W">WG Geraets</name>
</author>
<author><name sortKey="Verheij, Jg" uniqKey="Verheij J">JG Verheij</name>
</author>
<author><name sortKey="Van Der Stelt, Pf" uniqKey="Van Der Stelt P">PF van der Stelt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lindh, C" uniqKey="Lindh C">C Lindh</name>
</author>
<author><name sortKey="Petersson, A" uniqKey="Petersson A">A Petersson</name>
</author>
<author><name sortKey="Rohlin, M" uniqKey="Rohlin M">M Rohlin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kawalilak, Ce" uniqKey="Kawalilak C">CE Kawalilak</name>
</author>
<author><name sortKey="Johnston, Jd" uniqKey="Johnston J">JD Johnston</name>
</author>
<author><name sortKey="Olszynski, Wp" uniqKey="Olszynski W">WP Olszynski</name>
</author>
<author><name sortKey="Kontulainen, Sa" uniqKey="Kontulainen S">SA Kontulainen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pham, D" uniqKey="Pham D">D Pham</name>
</author>
<author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
<author><name sortKey="Kiliaridis, S" uniqKey="Kiliaridis S">S Kiliaridis</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bartold, Pm" uniqKey="Bartold P">PM Bartold</name>
</author>
<author><name sortKey="Van Dyke, Te" uniqKey="Van Dyke T">TE Van Dyke</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Santos Tunes, R" uniqKey="Santos Tunes R">R Santos Tunes</name>
</author>
<author><name sortKey="Foss Freitas, Mc" uniqKey="Foss Freitas M">MC Foss-Freitas</name>
</author>
<author><name sortKey="Nogueira Filho, Gr" uniqKey="Nogueira Filho G">GR Nogueira-Filho</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Koromantzos, Pa" uniqKey="Koromantzos P">PA Koromantzos</name>
</author>
<author><name sortKey="Makrilakis, K" uniqKey="Makrilakis K">K Makrilakis</name>
</author>
<author><name sortKey="Dereka, X" uniqKey="Dereka X">X Dereka</name>
</author>
<author><name sortKey="Katsilambros, N" uniqKey="Katsilambros N">N Katsilambros</name>
</author>
<author><name sortKey="Vrotsos, Ia" uniqKey="Vrotsos I">IA Vrotsos</name>
</author>
<author><name sortKey="Madianos, Pn" uniqKey="Madianos P">PN Madianos</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chapple, Il" uniqKey="Chapple I">IL Chapple</name>
</author>
<author><name sortKey="Genco, R" uniqKey="Genco R">R Genco</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Buhlin, K" uniqKey="Buhlin K">K Buhlin</name>
</author>
<author><name sortKey="Gustafsson, A" uniqKey="Gustafsson A">A Gustafsson</name>
</author>
<author><name sortKey="Pockley, Ag" uniqKey="Pockley A">AG Pockley</name>
</author>
<author><name sortKey="Frosteg Rd, J" uniqKey="Frosteg Rd J">J Frostegård</name>
</author>
<author><name sortKey="Klinge, B" uniqKey="Klinge B">B Klinge</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Belstr M, D" uniqKey="Belstr M D">D Belstrøm</name>
</author>
<author><name sortKey="Damgaard, C" uniqKey="Damgaard C">C Damgaard</name>
</author>
<author><name sortKey="Nielsen, Ch" uniqKey="Nielsen C">CH Nielsen</name>
</author>
<author><name sortKey="Holmstrup, P" uniqKey="Holmstrup P">P Holmstrup</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tonetti, Ms" uniqKey="Tonetti M">MS Tonetti</name>
</author>
<author><name sortKey="Van Dyke, Te" uniqKey="Van Dyke T">TE Van Dyke</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kaur, S" uniqKey="Kaur S">S Kaur</name>
</author>
<author><name sortKey="White, S" uniqKey="White S">S White</name>
</author>
<author><name sortKey="Bartold, Pm" uniqKey="Bartold P">PM Bartold</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Sanz, M" uniqKey="Sanz M">M Sanz</name>
</author>
<author><name sortKey="Kornman, K" uniqKey="Kornman K">K Kornman</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Lerner, Uh" uniqKey="Lerner U">UH Lerner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Chesnut, Ch" uniqKey="Chesnut C">CH Chesnut</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jeffcoat, M" uniqKey="Jeffcoat M">M Jeffcoat</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Otomo Corgel, J" uniqKey="Otomo Corgel J">J Otomo-Corgel</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hildebolt, Cf" uniqKey="Hildebolt C">CF Hildebolt</name>
</author>
<author><name sortKey="Pilgram, Tk" uniqKey="Pilgram T">TK Pilgram</name>
</author>
<author><name sortKey="Yokoyama Crothers, N" uniqKey="Yokoyama Crothers N">N Yokoyama-Crothers</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Payne, Jb" uniqKey="Payne J">JB Payne</name>
</author>
<author><name sortKey="Reinhardt, Ra" uniqKey="Reinhardt R">RA Reinhardt</name>
</author>
<author><name sortKey="Nummikoski, Pv" uniqKey="Nummikoski P">PV Nummikoski</name>
</author>
<author><name sortKey="Patil, Kd" uniqKey="Patil K">KD Patil</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tezal, M" uniqKey="Tezal M">M Tezal</name>
</author>
<author><name sortKey="Wactawski Wende, J" uniqKey="Wactawski Wende J">J Wactawski-Wende</name>
</author>
<author><name sortKey="Grossi, Sg" uniqKey="Grossi S">SG Grossi</name>
</author>
<author><name sortKey="Ho, Aw" uniqKey="Ho A">AW Ho</name>
</author>
<author><name sortKey="Dunford, R" uniqKey="Dunford R">R Dunford</name>
</author>
<author><name sortKey="Genco, Rj" uniqKey="Genco R">RJ Genco</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Yoshihara, A" uniqKey="Yoshihara A">A Yoshihara</name>
</author>
<author><name sortKey="Seida, Y" uniqKey="Seida Y">Y Seida</name>
</author>
<author><name sortKey="Hanada, N" uniqKey="Hanada N">N Hanada</name>
</author>
<author><name sortKey="Miyazaki, H" uniqKey="Miyazaki H">H Miyazaki</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wactawski Wende, J" uniqKey="Wactawski Wende J">J Wactawski-Wende</name>
</author>
<author><name sortKey="Hausmann, E" uniqKey="Hausmann E">E Hausmann</name>
</author>
<author><name sortKey="Hovey, K" uniqKey="Hovey K">K Hovey</name>
</author>
<author><name sortKey="Trevisan, M" uniqKey="Trevisan M">M Trevisan</name>
</author>
<author><name sortKey="Grossi, S" uniqKey="Grossi S">S Grossi</name>
</author>
<author><name sortKey="Genco, Rj" uniqKey="Genco R">RJ Genco</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Elders, Pj" uniqKey="Elders P">PJ Elders</name>
</author>
<author><name sortKey="Habets, Ll" uniqKey="Habets L">LL Habets</name>
</author>
<author><name sortKey="Netelenbos, Jc" uniqKey="Netelenbos J">JC Netelenbos</name>
</author>
<author><name sortKey="Van Der Linden, Lw" uniqKey="Van Der Linden L">LW van der Linden</name>
</author>
<author><name sortKey="Van Der Stelt, Pf" uniqKey="Van Der Stelt P">PF van der Stelt</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Kinane, Df" uniqKey="Kinane D">DF Kinane</name>
</author>
<author><name sortKey="Marshall, Gj" uniqKey="Marshall G">GJ Marshall</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Civitelli, R1" uniqKey="Civitelli R">R1 Civitelli</name>
</author>
<author><name sortKey="Pilgram, Tk" uniqKey="Pilgram T">TK Pilgram</name>
</author>
<author><name sortKey="Dotson, M" uniqKey="Dotson M">M Dotson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Klemetti, E" uniqKey="Klemetti E">E Klemetti</name>
</author>
<author><name sortKey="Collin, Hl" uniqKey="Collin H">HL Collin</name>
</author>
<author><name sortKey="Forss, H" uniqKey="Forss H">H Forss</name>
</author>
<author><name sortKey="Markkanen, H" uniqKey="Markkanen H">H Markkanen</name>
</author>
<author><name sortKey="Lassila, V" uniqKey="Lassila V">V Lassila</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jonasson, G" uniqKey="Jonasson G">G Jonasson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rizzoli, R" uniqKey="Rizzoli R">R Rizzoli</name>
</author>
<author><name sortKey="Bonjour, J P" uniqKey="Bonjour J">J-P Bonjour</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Riggs, Bl" uniqKey="Riggs B">BL Riggs</name>
</author>
<author><name sortKey="Khosla, S" uniqKey="Khosla S">S Khosla</name>
</author>
<author><name sortKey="Atkinson, Ej" uniqKey="Atkinson E">EJ Atkinson</name>
</author>
<author><name sortKey="Dunstan, Cr" uniqKey="Dunstan C">CR Dunstan</name>
</author>
<author><name sortKey="Melton, Lj" uniqKey="Melton L">LJ Melton</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jacobs, R" uniqKey="Jacobs R">R Jacobs</name>
</author>
<author><name sortKey="Ghyselen, J" uniqKey="Ghyselen J">J Ghyselen</name>
</author>
<author><name sortKey="Koninckx, P" uniqKey="Koninckx P">P Koninckx</name>
</author>
<author><name sortKey="Van Steenberghe, D" uniqKey="Van Steenberghe D">D van Steenberghe</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Thumbigere Math, V" uniqKey="Thumbigere Math V">V Thumbigere-Math</name>
</author>
<author><name sortKey="Michalowicz, Bs" uniqKey="Michalowicz B">BS Michalowicz</name>
</author>
<author><name sortKey="Hodges, Js" uniqKey="Hodges J">JS Hodges</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Friberg, B" uniqKey="Friberg B">B Friberg</name>
</author>
<author><name sortKey="Jemt, T" uniqKey="Jemt T">T Jemt</name>
</author>
<author><name sortKey="Lekholm, U" uniqKey="Lekholm U">U Lekholm</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Friberg, B" uniqKey="Friberg B">B Friberg</name>
</author>
<author><name sortKey="Ekestubbe, A" uniqKey="Ekestubbe A">A Ekestubbe</name>
</author>
<author><name sortKey="Mellstrom, D" uniqKey="Mellstrom D">D Mellstrom</name>
</author>
<author><name sortKey="Sennerby, L" uniqKey="Sennerby L">L Sennerby</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Bridges, T" uniqKey="Bridges T">T Bridges</name>
</author>
<author><name sortKey="King, G" uniqKey="King G">G King</name>
</author>
<author><name sortKey="Mohammad, A" uniqKey="Mohammad A">A Mohammad</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Goldie, Rs" uniqKey="Goldie R">RS Goldie</name>
</author>
<author><name sortKey="King, Gj" uniqKey="King G">GJ King</name>
</author>
</analytic>
</biblStruct>
</listBibl>
</div1>
</back>
</TEI>
<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Cosmet Investig Dent</journal-id>
<journal-id journal-id-type="iso-abbrev">Clin Cosmet Investig Dent</journal-id>
<journal-id journal-id-type="publisher-id">Clinical, Cosmetic and Investigational Dentistry</journal-id>
<journal-title-group><journal-title>Clinical, Cosmetic and Investigational Dentistry</journal-title>
</journal-title-group>
<issn pub-type="epub">1179-1357</issn>
<publisher><publisher-name>Dove Medical Press</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27471408</article-id>
<article-id pub-id-type="pmc">4948717</article-id>
<article-id pub-id-type="doi">10.2147/CCIDE.S92774</article-id>
<article-id pub-id-type="publisher-id">ccide-8-095</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>Alveolar bone loss in osteoporosis: a loaded and cellular affair?</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Jonasson</surname>
<given-names>Grethe</given-names>
</name>
<xref ref-type="aff" rid="af1-ccide-8-095">1</xref>
<xref ref-type="aff" rid="af2-ccide-8-095">2</xref>
<xref ref-type="corresp" rid="c1-ccide-8-095"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rythén</surname>
<given-names>Marianne</given-names>
</name>
<xref ref-type="aff" rid="af2-ccide-8-095">2</xref>
<xref ref-type="aff" rid="af3-ccide-8-095">3</xref>
</contrib>
</contrib-group>
<aff id="af1-ccide-8-095"><label>1</label>
Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg</aff>
<aff id="af2-ccide-8-095"><label>2</label>
Research and Development Centre, Borås</aff>
<aff id="af3-ccide-8-095"><label>3</label>
Specialist Clinic for Pediatric Dentistry, Public Dental Service, Mölndal, Sweden</aff>
<author-notes><corresp id="c1-ccide-8-095">Correspondence: Grethe Jonasson, Research and Development Centre, Sven Eriksonplatsen 4, 50338 Borås, Sweden, Tel +46 70 928 5671, Email <email>grethe.jonasson@vgregion.se</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>13</day>
<month>7</month>
<year>2016</year>
</pub-date>
<volume>8</volume>
<fpage>95</fpage>
<lpage>103</lpage>
<permissions><copyright-statement>© 2016 Jonasson and Rythén. This work is published and licensed by Dove Medical Press Limited</copyright-statement>
<copyright-year>2016</copyright-year>
<license><license-p>The full terms of this license are available at <ext-link ext-link-type="uri" xlink:href="https://www.dovepress.com/terms.php">https://www.dovepress.com/terms.php</ext-link>
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.</license-p>
</license>
</permissions>
<abstract><p>Maxillary and mandibular bone mirror skeletal bone conditions. Bone remodeling happens at endosteal surfaces where the osteoclasts and osteoblasts are situated. More surfaces means more cells and remodeling. The bone turnover rate in the mandibular alveolar process is probably the fastest in the body; thus, the first signs of osteoporosis may be revealed here. Hormones, osteoporosis, and aging influence the alveolar process and the skeletal bones similarly, but differences in loading between loaded, half-loaded, and unloaded bones are important to consider. Bone mass is redistributed from one location to another where strength is needed. A sparse trabeculation in the mandibular premolar region (large intertrabecular spaces and thin trabeculae) is a reliable sign of osteopenia and a high skeletal fracture risk. Having dense trabeculation (small intertrabecular spaces and well-mineralized trabeculae) is generally advantageous to the individual because of the low fracture risk, but may imply some problems for the clinician.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>bone density</kwd>
<kwd>bone fracture</kwd>
<kwd>human</kwd>
<kwd>mandible</kwd>
<kwd>radiography</kwd>
<kwd>periodontitis</kwd>
</kwd-group>
</article-meta>
</front>
<body><sec sec-type="intro"><title>Introduction</title>
<p>A large proportion of the population visit their dentist annually, and dental radiographs are routinely taken then. Dentists are highly experienced in interpreting radiographs, but use them chiefly for the diagnosis of caries, marginal and apical periodontitis, and before implant treatment. However, there is much more information available in periapical radiographs. Therefore, many research teams have tried to develop methods for using the jawbones to predict osteoporosis <xref rid="b1-ccide-8-095" ref-type="bibr">1</xref>
–<xref rid="b4-ccide-8-095" ref-type="bibr">4</xref>
and fracture risk.<xref rid="b5-ccide-8-095" ref-type="bibr">5</xref>
–<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
</p>
<p>Possible links between osteoporosis and the degree of periodontitis have been debated for years. Both diseases are multifactorial and have many risk factors in common. The aims of the present article are to describe parallels between skeletal bone and alveolar bone and to illuminate some aspects of hormone function, loading and aging, which may explain alveolar bone loss caused by osteoporosis and/or periodontitis.</p>
</sec>
<sec><title>Bone</title>
<p>Bone is a dynamic tissue. During childhood and adolescence, the formation of bone dominates over the resorption of bone, this is the modeling phase. In mature adults, there is a balance between bone formation and resorption, whereas bone resorption dominates after menopause, and in older males. Skeletal loading produces microcracks in bone, which are replaced by remodeling.<xref rid="b10-ccide-8-095" ref-type="bibr">10</xref>
The remodeling process is regulated systematically by hormones and locally by growth factors and cytokines.<xref rid="b11-ccide-8-095" ref-type="bibr">11</xref>
,<xref rid="b12-ccide-8-095" ref-type="bibr">12</xref>
It takes place at the endosteal surfaces of cortical and trabecular bone.<xref rid="b13-ccide-8-095" ref-type="bibr">13</xref>
At first, osteoclasts identify a site for renewal and start resorption. After ~60 days, osteoblasts initiate bone formation. Although it takes 2 weeks to deposit ~60% of the mineral content of new bone, full mineralization takes several months. Remodeling occurs at ~1–2 million sites.<xref rid="b11-ccide-8-095" ref-type="bibr">11</xref>
The osteocytes are imbedded in the mineralized bone; their role is to sense bone strains and communicate with neighboring osteoblasts and osteoclasts.</p>
<p>All bones are constructed with an envelope of compact bone (cortical bone), which encloses the trabecular bone and marrow spaces. The ratio between compact and trabecular bone varies with ~10% compact and 90% trabecular bone in both the spine and maxilla, whereas the ratio in the mandible is close to that of the distal radius and other long bones: 80% compact and 20% trabecular bone.<xref rid="b1-ccide-8-095" ref-type="bibr">1</xref>
Because of its construction as a network of trabeculae, plates and rods, trabecular bone has a total surface ten times larger than compact bone. Consequentially, it has more endosteal surfaces, more cells, and more remodeling.<xref rid="b14-ccide-8-095" ref-type="bibr">14</xref>
</p>
<p>Bone turnover speed has been examined in adult dogs, where alveolar, trabecular bone remodeling in the mandible is double that in the maxilla (37%/year versus 19%/year) and six times faster than in the femur (6.4%/year).<xref rid="b15-ccide-8-095" ref-type="bibr">15</xref>
In addition, the rate of alveolar bone turnover at the alveolar crest is twice the rate of bone turnover at the level of the mandibular canal and three to five times the rate of the mandible at the inferior compact border.<xref rid="b16-ccide-8-095" ref-type="bibr">16</xref>
No exact remodeling rate has been established for human beings, but alveolar, trabecular bone remodels very quickly, especially in the mandible. The remodeling rate was estimated by the number of formation and resorption foci per area in autopsy materials.<xref rid="b1-ccide-8-095" ref-type="bibr">1</xref>
</p>
</sec>
<sec><title>Hormones</title>
<p>Delayed puberty decreases bone mineral density (BMD) and spinal growth. Males with late puberty have longer legs and lower bone density than those with early puberty.<xref rid="b17-ccide-8-095" ref-type="bibr">17</xref>
Males retain hormone protection throughout life and suffer half as many fractures as females.<xref rid="b18-ccide-8-095" ref-type="bibr">18</xref>
In females, early menarche and early menopause are considered to have a strong relationship with high and low BMD, respectively.<xref rid="b19-ccide-8-095" ref-type="bibr">19</xref>
Early menarche is associated with a significant decrease in fracture risk, whereas delayed menarche, as seen in amenorrheic athletes, increases fracture risk.<xref rid="b20-ccide-8-095" ref-type="bibr">20</xref>
Age-related (nonsex-hormone dependent) bone loss may begin in the third decade of life in both sexes at the spine and a decade later at the appendicular sites. With aging, compact bone strength is diminished by approximately 15%–20% and trabecular bone strength by ~50%.<xref rid="b10-ccide-8-095" ref-type="bibr">10</xref>
</p>
<p>The estrogen-related bone loss in females takes place predominantly in the trabecular bone with its larger endosteal surfaces, followed by a slower loss of both trabecular and cortical bone. Decreasing levels of estrogen are thought to be responsible for increased bone resorption and decreasing testosterone levels for decreased bone formation.<xref rid="b11-ccide-8-095" ref-type="bibr">11</xref>
,<xref rid="b21-ccide-8-095" ref-type="bibr">21</xref>
Testosterone is associated with bone apposition periosteally even in aged males, and, therefore, what is lost endosteally may be compensated periosteally in males, but not in females.<xref rid="b22-ccide-8-095" ref-type="bibr">22</xref>
In <xref ref-type="fig" rid="f1-ccide-8-095">Figure 1</xref>
, the large variations of bone loss and gain in 80 years olds are shown. <xref ref-type="fig" rid="f1-ccide-8-095">Figure 1A</xref>
illustrates dense trabecular bone and extremely thick basal compact bone in an old male. <xref ref-type="fig" rid="f1-ccide-8-095">Figure 1B</xref>
demonstrates the sparser trabeculation, larger intertrabecular spaces, and the thin, eroded basal bone in an old female. In <xref ref-type="fig" rid="f1-ccide-8-095">Figure 1C</xref>
, the extremely resorbed mandible in an edentulous female, also 80 years old, is presented. Age is strongly correlated with BMD in females but not in males, whereas bone size is more correlated with BMD in males than females.<xref rid="b23-ccide-8-095" ref-type="bibr">23</xref>
</p>
<p>Hormones influence the jaws and the rest of the skeleton to the same extent but with dissimilarities concerning loading, which, besides genetic factors and hormones, is the strongest factor influencing bone density.<xref rid="b11-ccide-8-095" ref-type="bibr">11</xref>
,<xref rid="b21-ccide-8-095" ref-type="bibr">21</xref>
</p>
</sec>
<sec><title>Loading</title>
<p>Weight-bearing physical activities increase skeletal bone mass,<xref rid="b24-ccide-8-095" ref-type="bibr">24</xref>
whereas space flight decreases bone mass.<xref rid="b25-ccide-8-095" ref-type="bibr">25</xref>
Increased loading leads to periosteal apposition (on the outer surface of compact bone), thereby increasing the cross-sectional area in the vertebrae<xref rid="b26-ccide-8-095" ref-type="bibr">26</xref>
and long bones.<xref rid="b27-ccide-8-095" ref-type="bibr">27</xref>
The legs and spine are “loaded” bones, the arms and the mandible half-loaded, and the skull relatively unloaded. As an example, weight-lifters have 3% higher BMD for the total body and 12% for the hip, whereas BMD for the upper part of the skull was 10% lower than in controls.<xref rid="b28-ccide-8-095" ref-type="bibr">28</xref>
Furthermore, after hip fracture, BMD decreases in legs and spine, remains the same in the arms, and increases in the skull.<xref rid="b29-ccide-8-095" ref-type="bibr">29</xref>
</p>
<p>Exercise by the elderly (>65 years) is associated with improved muscle strength, coordination, balance, and decreased fall frequency, and there is an association between continued physical activity throughout life and lower hip fracture risk.<xref rid="b20-ccide-8-095" ref-type="bibr">20</xref>
</p>
<p>Effects of loading are seen in the same way in the jaws, where the alveolar bone mass and the cross-sectional dimension of the alveolar bone in growing rats increase with increasing functional loading.<xref rid="b30-ccide-8-095" ref-type="bibr">30</xref>
,<xref rid="b31-ccide-8-095" ref-type="bibr">31</xref>
Bone mass can be redistributed to the most loaded sites to fortify the bone where it is most needed. When vertical trabeculae are resorbed, the horizontal trabeculae may be fortified (<xref ref-type="fig" rid="f2-ccide-8-095">Figure 2</xref>
). Bone around human molars is generally denser than the bone around premolars and canines, which can be explained by the findings that the highest biting force is recorded in the molar area.<xref rid="b32-ccide-8-095" ref-type="bibr">32</xref>
</p>
<p>After tooth extraction, reduced function leads to local bone loss,<xref rid="b33-ccide-8-095" ref-type="bibr">33</xref>
,<xref rid="b34-ccide-8-095" ref-type="bibr">34</xref>
and great interindividual variation in the remodeling pattern of the edentulous areas, with some individuals losing little bone, and others undergoing extensive resorption (<xref ref-type="fig" rid="f1-ccide-8-095">Figure 1C</xref>
).<xref rid="b35-ccide-8-095" ref-type="bibr">35</xref>
–<xref rid="b37-ccide-8-095" ref-type="bibr">37</xref>
However, no association, or only a weak one, has been found between skeletal bone mass and residual ridge resorption.<xref rid="b37-ccide-8-095" ref-type="bibr">37</xref>
–<xref rid="b39-ccide-8-095" ref-type="bibr">39</xref>
</p>
<p>Local factors, such as occluding tooth pairs and the size of the masseter muscles, influence the distal area of the mandible. In patients with heavy occlusion, bruxism, the jaw bone may be denser than the skeletal bones, and therefore symptoms of skeletal osteopenia may become masked in the jaws.<xref rid="b40-ccide-8-095" ref-type="bibr">40</xref>
However, if trabeculation is sparse in areas with occluding teeth (areas under bridge pontics excluded), it is an indication that something is “wrong”, bone formation may be impaired, and fracture risk increased.<xref rid="b41-ccide-8-095" ref-type="bibr">41</xref>
,<xref rid="b42-ccide-8-095" ref-type="bibr">42</xref>
Thus, mandibular bone often reflects the condition of the skeleton but differences in loading should be considered.</p>
</sec>
<sec><title>Bone size and alveolar process width</title>
<p>In females, the mandibular alveolar bone thickness is correlated with BMD.<xref rid="b43-ccide-8-095" ref-type="bibr">43</xref>
The alveolar bone is mostly thicker in the apical part in females with normal BMD compared to the crestal part, whereas it is significantly thinner in osteopenic and osteoporotic females.<xref rid="b43-ccide-8-095" ref-type="bibr">43</xref>
</p>
<p>A decreased bone size with time seems to be specific to the alveolar process, as it has not been recorded in any other bone. Not only has it been seen in edentulous regions<xref rid="b35-ccide-8-095" ref-type="bibr">35</xref>
,<xref rid="b36-ccide-8-095" ref-type="bibr">36</xref>
but also in dentate areas,<xref rid="b44-ccide-8-095" ref-type="bibr">44</xref>
where the largest decrease after 5 years was found in perimenopausal females. A decreased buccolingual dimension in the dentate alveolar process may be caused by periosteal resorption of this area, and the largest size changes correspond to areas where resorption was most evident in the modeling process during mandibular growth in young individuals.<xref rid="b45-ccide-8-095" ref-type="bibr">45</xref>
</p>
</sec>
<sec><title>Skeletal bone loss/osteoporosis</title>
<p>Osteoporosis occurs when bone mass decreases faster than it is replaced. It is a multifactorial disease characterized by low bone mass and deterioration of bone microarchitecture, leading to bone fragility and a subsequent increase in fracture risk.<xref rid="b46-ccide-8-095" ref-type="bibr">46</xref>
Osteoporosis may be the result of a deficiency of sex hormone, hyperparathyroidism, hyperthyroidism, chronic renal failure, posttransplantation, or medication with glucocorticosteroids.<xref rid="b46-ccide-8-095" ref-type="bibr">46</xref>
</p>
<p>Fracture risk increases exponentially with age, due not only to a decrease in BMD but also to the increased rate of falls among the elderly. Relatively, osteoporotic females have more fractures than nonosteoporotic, but up to 70% of all fractures, in absolute numbers, occur in osteopenic females.<xref rid="b47-ccide-8-095" ref-type="bibr">47</xref>
In a 15-year follow-up, the best predictors of future fracture were a previous fracture and glucocorticoid medication followed by alveolar bone texture, rheumatoid arthritis, gastrointestinal disease, and secondary osteoporosis.<xref rid="b7-ccide-8-095" ref-type="bibr">7</xref>
All variables, except alveolar bone texture, are identical with those identified by the large meta-analyses, on which the World Health Organization Fracture Risk Assessment Tool is based.<xref rid="b48-ccide-8-095" ref-type="bibr">48</xref>
Also included in the Fracture Risk Assessment Tool are age, sex, height, weight, smoking, alcohol, and parents with fractured hip.<xref rid="b48-ccide-8-095" ref-type="bibr">48</xref>
</p>
<p>Osteoporosis affects ~75 million people in the Western world, causing >2.3 million fractures a year in Europe and the US.<xref rid="b48-ccide-8-095" ref-type="bibr">48</xref>
Osteoporotic fractures lead to a high morbidity and mortality rate, and BMD predicts survival for subjects over 70 years of age.<xref rid="b49-ccide-8-095" ref-type="bibr">49</xref>
Bone strength depends on the degree of mineralization, bone size, and microstructural features, such as relative trabecular volume, trabecular spacing, and connectivity.<xref rid="b50-ccide-8-095" ref-type="bibr">50</xref>
</p>
</sec>
<sec><title>Measurements of compact bone in the mandible for assessment of osteoporosis</title>
<p>Measurements of bone mass and density in the mandible have been performed since the 1980s<xref rid="b1-ccide-8-095" ref-type="bibr">1</xref>
with different techniques, but most are not useful in the dental clinic, being too complicated, costly, or having an excessively high radiation dose. The dual X-ray absorptiometry method, which is the gold standard for diagnosis of osteoporosis, has low radiation, but for the jawbones, it is only applicable in edentulous individuals, and therefore other methods have been developed.</p>
<p>Maxillary bone consists mostly of trabecular bone, and compact bone is too thin for use as an osteoporosis indicator. Maxillary trabecular bone has been assessed but not as frequently as the mandible due to the difficulty of finding a standard site.<xref rid="b51-ccide-8-095" ref-type="bibr">51</xref>
,<xref rid="b52-ccide-8-095" ref-type="bibr">52</xref>
</p>
<p>The largest proportion of mandibular compact bone is situated in the inferior cortex, which is well imaged on panoramic radiographs. The mandibular cortical index (MCI) is the most frequently used method in osteoporosis studies.<xref rid="b53-ccide-8-095" ref-type="bibr">53</xref>
–<xref rid="b56-ccide-8-095" ref-type="bibr">56</xref>
Compact bone lying distal to the mental foramen is categorized by three groups (<xref ref-type="fig" rid="f3-ccide-8-095">Figure 3</xref>
): normal cortex (MCI-1) having a relatively even endosteal margin; moderately eroded cortex (MCI-2) with semilunar defects, and severely eroded cortex (MCI-3) with heavy endosteal porosities. A severely eroded compacta is associated with osteoporosis,<xref rid="b5-ccide-8-095" ref-type="bibr">5</xref>
,<xref rid="b55-ccide-8-095" ref-type="bibr">55</xref>
–<xref rid="b57-ccide-8-095" ref-type="bibr">57</xref>
but not consistently with fracture.<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
,<xref rid="b57-ccide-8-095" ref-type="bibr">57</xref>
Compact bone loss is seen ~20 years later than trabecular bone loss, which can be seen in females as young as 38 years old.<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
,<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
</p>
<p>The thickness of the basal compacta increases up to the age of 50 years and decreases significantly thereafter.<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
A cortex thickness <3 mm is associated with osteoporosis<xref rid="b57-ccide-8-095" ref-type="bibr">57</xref>
–<xref rid="b60-ccide-8-095" ref-type="bibr">60</xref>
but not fracture.<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
,<xref rid="b57-ccide-8-095" ref-type="bibr">57</xref>
The severely eroded inner cortex in MCI-3 creates difficulties when measuring cortex thickness. Therefore, a computer-based method has been developed.<xref rid="b60-ccide-8-095" ref-type="bibr">60</xref>
</p>
</sec>
<sec><title>Measurements of trabecular bone in the mandible for assessment of osteoporosis</title>
<p>Mandibular trabecular bone becomes denser in the jaws from puberty to middle age,<xref rid="b61-ccide-8-095" ref-type="bibr">61</xref>
thereafter, alveolar trabecular bone becomes sparser in most females,<xref rid="b1-ccide-8-095" ref-type="bibr">1</xref>
,<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
,<xref rid="b62-ccide-8-095" ref-type="bibr">62</xref>
whereas males more often maintain their trabecular pattern (<xref ref-type="fig" rid="f1-ccide-8-095">Figure 1A and B</xref>
).</p>
<p>Trabecular bone structure can be assessed on radiographs by the thickness of the trabeculae, the spacing between the trabeculae, trabecular connectivity,<xref rid="b62-ccide-8-095" ref-type="bibr">62</xref>
–<xref rid="b64-ccide-8-095" ref-type="bibr">64</xref>
and by measuring trabecular volume by computed tomography and magnetic resonance. However, the cost and complexity of these methods limit their utility for routine use.<xref rid="b63-ccide-8-095" ref-type="bibr">63</xref>
–<xref rid="b66-ccide-8-095" ref-type="bibr">66</xref>
Therefore, a simple three-step visual index has been introduced. It was initially meant for bone evaluation before implant treatment,<xref rid="b67-ccide-8-095" ref-type="bibr">67</xref>
but the index has been proven a valuable indicator for osteoporosis risk<xref rid="b4-ccide-8-095" ref-type="bibr">4</xref>
,<xref rid="b23-ccide-8-095" ref-type="bibr">23</xref>
,<xref rid="b41-ccide-8-095" ref-type="bibr">41</xref>
,<xref rid="b42-ccide-8-095" ref-type="bibr">42</xref>
,<xref rid="b51-ccide-8-095" ref-type="bibr">51</xref>
and for fracture risk assessment.<xref rid="b6-ccide-8-095" ref-type="bibr">6</xref>
–<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
</p>
<p>The index classifies the mandibular premolar bone, which is the standard site, as having either sparse, mixed dense plus sparse, or dense trabecular bone (<xref ref-type="fig" rid="f4-ccide-8-095">Figure 4</xref>
).<xref rid="b41-ccide-8-095" ref-type="bibr">41</xref>
,<xref rid="b67-ccide-8-095" ref-type="bibr">67</xref>
Sparse trabeculation has large intertrabecular spaces in most of the alveolar processes, especially in the crestal, dentate, and premolar area. Dense trabeculation has small intertrabecular spaces and well-mineralized trabeculae in the entire radiographed area. Mixed dense plus sparse trabeculation is mostly dense crestally and sparse apically. In case of uncertainty, the mixed category is chosen. Most important is identifying individuals with sparse trabeculation because of their high fracture risk. Dense trabeculation is protective. Most individuals have mixed dense and sparse trabeculation in the mandible; BMD varies greatly in this trabeculation group and fracture risk is moderate. The older the participants, the better the fracture prediction.<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
,<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
</p>
<p>The Kaplan–Meier curve in <xref ref-type="fig" rid="f5-ccide-8-095">Figure 5</xref>
shows the graded association between trabecular density and fracture risk.<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
All participants start free of fracture. The upper curve describing dense trabeculation remains relatively stable, which means ~90% of those with dense trabeculation stay free of fracture during the period 1980–2006, whereas the lowest curve describing sparse trabeculation dives distinctly; only 25% remained fracture free. The curve in between for mixed dense plus sparse also dives, illustrating ~62% free of fracture at the end of the 26-year follow-up. The hazard ratio of future fracture for sparse trabeculation compared to mixed trabeculation was 2.9 (95% CI: 2.2–3.8, <italic>P</italic>
<0.0001) and for dense versus mixed trabeculation 0.21 (95% CI: 0.1–0.4, <italic>P</italic>
<0.0001).<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
</p>
<p>When the visual trabecular pattern was tested in males, it was not a significant factor for the prediction of osteoporosis,<xref rid="b23-ccide-8-095" ref-type="bibr">23</xref>
but significant for fracture prediction.<xref rid="b6-ccide-8-095" ref-type="bibr">6</xref>
</p>
<p>Trabeculation does not change visually after 5 years,<xref rid="b42-ccide-8-095" ref-type="bibr">42</xref>
but radiographs of females performed after 12 and 24 years show a gradual transformation with increased intertrabecular spaces and less mineralized trabeculae.<xref rid="b8-ccide-8-095" ref-type="bibr">8</xref>
,<xref rid="b9-ccide-8-095" ref-type="bibr">9</xref>
Similar bone changes to those that could be seen after 12 years in the mandible could be measured in the radius after 1 year using three-dimensional, high-resolution, peripheral quantitative computed tomography.<xref rid="b6-ccide-8-095" ref-type="bibr">6</xref>
In females (mean age 77 years), total density and trabecular number decreased, while trabecular thickness, separation, and heterogeneity increased.<xref rid="b68-ccide-8-095" ref-type="bibr">68</xref>
</p>
<p>Both the trabecular visual index and the automated methods work best on intraoral radiographs, which are most widely used in dental practices. With training, the visual trabecular index can be used on panoramic radiographs but the noise level is larger.<xref rid="b69-ccide-8-095" ref-type="bibr">69</xref>
</p>
</sec>
<sec><title>Periodontitis</title>
<p>Periodontitis is induced by specific bacteria from biofilms on tooth surfaces, which triggers an immunoinflammatory response in the adjacent bone tissue. Bacteria are required to initiate the disease process where host proteolytic enzymes mediate direct destruction of the periodontal tissue.<xref rid="b70-ccide-8-095" ref-type="bibr">70</xref>
The progression of periodontitis is influenced by factors such as genetics, general health, smoking, and diet. Furthermore, education and socioeconomic factors are determinants.<xref rid="b70-ccide-8-095" ref-type="bibr">70</xref>
Severe periodontitis is linked to some systemic diseases, for example, diabetes mellitus,<xref rid="b71-ccide-8-095" ref-type="bibr">71</xref>
–<xref rid="b73-ccide-8-095" ref-type="bibr">73</xref>
cardiovascular disease,<xref rid="b74-ccide-8-095" ref-type="bibr">74</xref>
–<xref rid="b76-ccide-8-095" ref-type="bibr">76</xref>
rheumatoid arthritis,<xref rid="b77-ccide-8-095" ref-type="bibr">77</xref>
and adverse pregnancy outcomes.<xref rid="b78-ccide-8-095" ref-type="bibr">78</xref>
</p>
<p>Periodontitis and osteoporosis both progress with advancing age, smoking, estrogen deficiency, and family history.<xref rid="b79-ccide-8-095" ref-type="bibr">79</xref>
Current knowledge regarding the effects of osteoporosis or osteopenia on periodontal disease and alveolar bone loss is inconclusive.<xref rid="b12-ccide-8-095" ref-type="bibr">12</xref>
,<xref rid="b80-ccide-8-095" ref-type="bibr">80</xref>
–<xref rid="b91-ccide-8-095" ref-type="bibr">91</xref>
Some previous studies have indicated a relationship between periodontal disease and osteoporosis,<xref rid="b83-ccide-8-095" ref-type="bibr">83</xref>
–<xref rid="b87-ccide-8-095" ref-type="bibr">87</xref>
while others have not shown any significant relationship.<xref rid="b88-ccide-8-095" ref-type="bibr">88</xref>
,<xref rid="b89-ccide-8-095" ref-type="bibr">89</xref>
The lack of consistency in the results may be due to differences in the alveolar bone structure and thickness, which were not considered. This could be supported by the fact that individuals with high mineral levels in the skeleton seem to retain their teeth with deep periodontal pockets more easily than those with osteoporosis.<xref rid="b91-ccide-8-095" ref-type="bibr">91</xref>
Furthermore, individuals with broad, dense jaws have more bone substances to lose than those with thin jaws, and therefore the size of an individual may play an important role for the vertical changes of the alveolar process.<xref rid="b91-ccide-8-095" ref-type="bibr">91</xref>
</p>
<p>The multifactorial etiology and confounding factors have limited the understanding of the relationship between osteoporosis and periodontitis. The coarseness of trabeculation may be one such confounding factor. In a new report, the group with sparse trabeculation had more skeletal bone loss, lower BMD, and larger marginal bone level decrease after 5 years than those with not-sparse trabeculation, but surprisingly the little group with dense trabeculation experienced both the greatest 5-year skeletal bone loss and marginal bone level decrease.<xref rid="b92-ccide-8-095" ref-type="bibr">92</xref>
The reason may be that dense trabeculation implies the greatest trabecular endosteal bone surface, and consequently the largest number of bone cells and remodeling sites. Negative events may lead to the most negative responses in dense trabecular bone but research is warranted to clarify whether dense trabeculation leads to the best results after appropriate treatment?</p>
<p>Estrogen deficiency influences BMD,<xref rid="b21-ccide-8-095" ref-type="bibr">21</xref>
,<xref rid="b93-ccide-8-095" ref-type="bibr">93</xref>
,<xref rid="b94-ccide-8-095" ref-type="bibr">94</xref>
and the remodeling of the alveolar process negatively, whereas treatment with hormone replacement therapy ameliorates the periodontal condition and local bone mass.<xref rid="b85-ccide-8-095" ref-type="bibr">85</xref>
,<xref rid="b95-ccide-8-095" ref-type="bibr">95</xref>
</p>
<p>Patients with cancer and bisphosphonate-related osteonecrosis of the jaw have significantly fewer teeth, and lower average bone height compared to controls after adjusting for the number of bisphosphonate infusions.<xref rid="b96-ccide-8-095" ref-type="bibr">96</xref>
The antiresorptive effect of bisphosphonates is therapeutic when used in treatment of osteoporosis for a limited period, but the problem is the extremely long elimination time due to large accumulations of bisphosphonate in bone, diminishing bone turnover and preventing bone renewal.<xref rid="b16-ccide-8-095" ref-type="bibr">16</xref>
</p>
</sec>
<sec><title>Clinical relevance</title>
<p>To maintain quality of life for the elderly, targeting individuals with high fracture risk is an important challenge to the dentist. An assessment of the trabecular bone can easily be included in an annual examination.</p>
<p>The trabeculation pattern is of direct interest to the dental profession, since a dense trabeculation indicates a need to exercise prudence when drilling for implants because of increased heating and consequently increased risk of local necrosis.<xref rid="b97-ccide-8-095" ref-type="bibr">97</xref>
A periapical radiograph revealing sparse trabeculation may indicate a need for cortical fixation and long duration of the healing process before the implant can be loaded.<xref rid="b98-ccide-8-095" ref-type="bibr">98</xref>
</p>
<p>In adult orthodontics, a different tissue reaction could be expected when teeth are moved with sparse or dense trabeculation. This could be supported by the findings that rats with lower initial bone density have a faster orthodontic tooth movement than rats with significantly higher initial bone density.<xref rid="b99-ccide-8-095" ref-type="bibr">99</xref>
Orthodontic tooth movement is faster in lactating rats on a calcium-deficient diet than in rats on a normal diet.<xref rid="b100-ccide-8-095" ref-type="bibr">100</xref>
Dense trabeculation implies that extraction and surgical extirpation of wisdom teeth are more complicated and probably more difficult to obtain full anesthesia.</p>
<p>Because dentists are in an ideal position to assess oral bone loss on radiographs, they may be the first to discover early signs of osteoporosis. Identifying individuals with high fracture risk before the first fracture occurs is important in order to avoid suffering and minimize high costs to society. If these patients can be easily identified by a dentist, they can improve their bone quality through training and nutrition, and appropriate medication for older people can be prescribed.</p>
</sec>
</body>
<back><fn-group><fn><p><bold>Disclosure</bold>
</p>
<p>The authors report no conflicts of interest in this work.</p>
</fn>
</fn-group>
<ref-list><title>References</title>
<ref id="b1-ccide-8-095"><label>1</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Von Wowern</surname>
<given-names>N</given-names>
</name>
</person-group>
<article-title>Bone mass of mandibles. In vitro and in vivo analyses</article-title>
<source>Dan Med Bull</source>
<year>1986</year>
<volume>33</volume>
<fpage>23</fpage>
<lpage>44</lpage>
<pub-id pub-id-type="pmid">3948537</pub-id>
</element-citation>
</ref>
<ref id="b2-ccide-8-095"><label>2</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kribbs</surname>
<given-names>PJ</given-names>
</name>
<name><surname>Chesnut</surname>
<given-names>CH</given-names>
</name>
<name><surname>Ott</surname>
<given-names>SM</given-names>
</name>
<name><surname>Kilcoyne</surname>
<given-names>RF</given-names>
</name>
</person-group>
<article-title>Relationships between mandibular and skeletal bone in an osteoporotic population</article-title>
<source>J Prosthet Dent</source>
<year>1989</year>
<volume>62</volume>
<fpage>703</fpage>
<lpage>707</lpage>
<pub-id pub-id-type="pmid">2585328</pub-id>
</element-citation>
</ref>
<ref id="b3-ccide-8-095"><label>3</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Southard</surname>
<given-names>KA</given-names>
</name>
<name><surname>Southard</surname>
<given-names>TE</given-names>
</name>
<name><surname>Schlechte</surname>
<given-names>JA</given-names>
</name>
<name><surname>Meis</surname>
<given-names>PA</given-names>
</name>
</person-group>
<article-title>The relationship between the density of the alveolar process and that of post-cranial bone</article-title>
<source>J Dent Res</source>
<year>2000</year>
<volume>79</volume>
<fpage>964</fpage>
<lpage>969</lpage>
<pub-id pub-id-type="pmid">10831099</pub-id>
</element-citation>
</ref>
<ref id="b4-ccide-8-095"><label>4</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lindh</surname>
<given-names>C</given-names>
</name>
<name><surname>Horner</surname>
<given-names>K</given-names>
</name>
<name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<etal></etal>
</person-group>
<article-title>The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>2008</year>
<volume>106</volume>
<fpage>285</fpage>
<lpage>293</lpage>
<pub-id pub-id-type="pmid">18299223</pub-id>
</element-citation>
</ref>
<ref id="b5-ccide-8-095"><label>5</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bollen</surname>
<given-names>AM</given-names>
</name>
<name><surname>Taguchi</surname>
<given-names>A</given-names>
</name>
<name><surname>Hujoel</surname>
<given-names>PP</given-names>
</name>
<name><surname>Hollender</surname>
<given-names>LG</given-names>
</name>
</person-group>
<article-title>Case-control study on self-reported osteoporotic fractures and mandibular cortical bone</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>2000</year>
<volume>90</volume>
<fpage>518</fpage>
<lpage>524</lpage>
<pub-id pub-id-type="pmid">11027391</pub-id>
</element-citation>
</ref>
<ref id="b6-ccide-8-095"><label>6</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hassani-Nejad</surname>
<given-names>A</given-names>
</name>
<name><surname>Ahlqwist</surname>
<given-names>M</given-names>
</name>
<name><surname>Hakeberg</surname>
<given-names>M</given-names>
</name>
<name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
</person-group>
<article-title>Mandibular trabecular bone as fracture indicator in 80-year-old men and women</article-title>
<source>Eur J Oral Sci</source>
<year>2013</year>
<volume>121</volume>
<fpage>525</fpage>
<lpage>531</lpage>
<pub-id pub-id-type="pmid">24102691</pub-id>
</element-citation>
</ref>
<ref id="b7-ccide-8-095"><label>7</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Billhult</surname>
<given-names>A</given-names>
</name>
</person-group>
<article-title>Mandibular bone structure, bone mineral density, and clinical variables as fracture predictors: a 15-year follow-up of female patients in a dental clinic</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol</source>
<year>2013</year>
<volume>116</volume>
<fpage>362</fpage>
<lpage>368</lpage>
<pub-id pub-id-type="pmid">23953422</pub-id>
</element-citation>
</ref>
<ref id="b8-ccide-8-095"><label>8</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Sundh</surname>
<given-names>V</given-names>
</name>
<name><surname>Hakeberg</surname>
<given-names>M</given-names>
</name>
<name><surname>Hassani-Nejad</surname>
<given-names>A</given-names>
</name>
<name><surname>Lissner</surname>
<given-names>L</given-names>
</name>
<name><surname>Ahlqwist</surname>
<given-names>M</given-names>
</name>
</person-group>
<article-title>Mandibular bone changes in 24 years and skeletal fracture prediction</article-title>
<source>Clin Oral Investig</source>
<year>2013</year>
<volume>17</volume>
<fpage>565</fpage>
<lpage>572</lpage>
</element-citation>
</ref>
<ref id="b9-ccide-8-095"><label>9</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Sundh</surname>
<given-names>V</given-names>
</name>
<name><surname>Ahlqwist</surname>
<given-names>M</given-names>
</name>
<name><surname>Hakeberg</surname>
<given-names>M</given-names>
</name>
<name><surname>Björkelund</surname>
<given-names>C</given-names>
</name>
<name><surname>Lissner</surname>
<given-names>L</given-names>
</name>
</person-group>
<article-title>A prospective study of mandibular trabecular bone to predict fracture incidence in women: a low-cost screening tool in the dental clinic</article-title>
<source>Bone</source>
<year>2011</year>
<volume>49</volume>
<fpage>873</fpage>
<lpage>879</lpage>
<pub-id pub-id-type="pmid">21777710</pub-id>
</element-citation>
</ref>
<ref id="b10-ccide-8-095"><label>10</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Martin</surname>
<given-names>B</given-names>
</name>
</person-group>
<article-title>Aging and strength of bone as a structural material</article-title>
<source>Calcif Tissue Int</source>
<year>1993</year>
<volume>53</volume>
<fpage>S34</fpage>
<lpage>S40</lpage>
<pub-id pub-id-type="pmid">8275378</pub-id>
</element-citation>
</ref>
<ref id="b11-ccide-8-095"><label>11</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lerner</surname>
<given-names>UH</given-names>
</name>
</person-group>
<article-title>Bone remodeling in post-menopausal osteoporosis</article-title>
<source>J Dent Res</source>
<year>2006</year>
<volume>85</volume>
<fpage>584</fpage>
<lpage>595</lpage>
<pub-id pub-id-type="pmid">16798857</pub-id>
</element-citation>
</ref>
<ref id="b12-ccide-8-095"><label>12</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Reddy</surname>
<given-names>MS</given-names>
</name>
<name><surname>Morgan</surname>
<given-names>SL</given-names>
</name>
</person-group>
<article-title>Decreased bone mineral density and periodontal management</article-title>
<source>Periodontol 2000</source>
<year>2013</year>
<volume>61</volume>
<fpage>195</fpage>
<lpage>218</lpage>
<pub-id pub-id-type="pmid">23240950</pub-id>
</element-citation>
</ref>
<ref id="b13-ccide-8-095"><label>13</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Seeman</surname>
<given-names>E</given-names>
</name>
<name><surname>Delmas</surname>
<given-names>PD</given-names>
</name>
</person-group>
<article-title>Bone quality – the material and structural basis of bone strength and fragility</article-title>
<source>N Engl J Med</source>
<year>2006</year>
<volume>354</volume>
<fpage>2250</fpage>
<lpage>2261</lpage>
<pub-id pub-id-type="pmid">16723616</pub-id>
</element-citation>
</ref>
<ref id="b14-ccide-8-095"><label>14</label>
<element-citation publication-type="book"><person-group person-group-type="author"><name><surname>Kanis</surname>
<given-names>JA</given-names>
</name>
</person-group>
<source>Osteoporosis</source>
<publisher-loc>Oxford</publisher-loc>
<publisher-name>Blackwell Science Ltd</publisher-name>
<year>1994</year>
</element-citation>
</ref>
<ref id="b15-ccide-8-095"><label>15</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Huja</surname>
<given-names>SS</given-names>
</name>
<name><surname>Fernandez</surname>
<given-names>SA</given-names>
</name>
<name><surname>Hill</surname>
<given-names>KJ</given-names>
</name>
<name><surname>Li</surname>
<given-names>Y</given-names>
</name>
</person-group>
<article-title>Remodeling dynamics in the alveolar process in skeletally mature dogs</article-title>
<source>Anat Rec Discov Mol Cell Evol Biol</source>
<year>2006</year>
<volume>288</volume>
<fpage>1243</fpage>
<lpage>1249</lpage>
</element-citation>
</ref>
<ref id="b16-ccide-8-095"><label>16</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Marx</surname>
<given-names>RE</given-names>
</name>
<name><surname>Cillo Jr</surname>
<given-names>JE</given-names>
</name>
<name><surname>Ulloa</surname>
<given-names>JJ</given-names>
</name>
</person-group>
<article-title>Oral bisphosphonate-induced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment</article-title>
<source>J Oral Maxillofac Surg</source>
<year>2007</year>
<volume>65</volume>
<fpage>2397</fpage>
<lpage>2410</lpage>
<pub-id pub-id-type="pmid">18022461</pub-id>
</element-citation>
</ref>
<ref id="b17-ccide-8-095"><label>17</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lorentzon</surname>
<given-names>M</given-names>
</name>
<name><surname>Norjavaara</surname>
<given-names>E</given-names>
</name>
<name><surname>Kindblom</surname>
<given-names>JM</given-names>
</name>
</person-group>
<article-title>Pubertal timing predicts leg length and childhood body mass index predicts sitting height in young adult men</article-title>
<source>J Pediatr</source>
<year>2011</year>
<volume>158</volume>
<fpage>452</fpage>
<lpage>457</lpage>
<pub-id pub-id-type="pmid">20961561</pub-id>
</element-citation>
</ref>
<ref id="b18-ccide-8-095"><label>18</label>
<element-citation publication-type="book"><person-group person-group-type="author"><collab>SBU</collab>
</person-group>
<source>Osteoporosis - prevention, diagnosis and treatment. Stockholm: Swedish Council on Health Technology Assessment in Health Care (SBU)</source>
<series>SBU report 165/1</series>
<year>2003</year>
</element-citation>
</ref>
<ref id="b19-ccide-8-095"><label>19</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ito</surname>
<given-names>M</given-names>
</name>
<name><surname>Yamada</surname>
<given-names>M</given-names>
</name>
<name><surname>Hayashi</surname>
<given-names>K</given-names>
</name>
<name><surname>Ohki</surname>
<given-names>M</given-names>
</name>
<name><surname>Uetani</surname>
<given-names>M</given-names>
</name>
<name><surname>Nakamura</surname>
<given-names>T</given-names>
</name>
</person-group>
<article-title>Relation of early menarche to high bone mineral density</article-title>
<source>Calcif Tissue Int</source>
<year>1995</year>
<volume>57</volume>
<fpage>11</fpage>
<lpage>14</lpage>
<pub-id pub-id-type="pmid">7671158</pub-id>
</element-citation>
</ref>
<ref id="b20-ccide-8-095"><label>20</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Karlsson</surname>
<given-names>M</given-names>
</name>
<name><surname>Bass</surname>
<given-names>S</given-names>
</name>
<name><surname>Seeman</surname>
<given-names>E</given-names>
</name>
</person-group>
<article-title>The evidence that exercise during growth or adulthood reduces the risk of fragility fractures is weak</article-title>
<source>Best Pract Res Clin Rheumatol</source>
<year>2001</year>
<volume>15</volume>
<fpage>429</fpage>
<lpage>450</lpage>
<pub-id pub-id-type="pmid">11485339</pub-id>
</element-citation>
</ref>
<ref id="b21-ccide-8-095"><label>21</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Riggs</surname>
<given-names>BL</given-names>
</name>
<name><surname>Khosla</surname>
<given-names>S</given-names>
</name>
<name><surname>Melton</surname>
<given-names>LJ</given-names>
<suffix>III</suffix>
</name>
</person-group>
<article-title>Sex steroids and the construction and conservation of the adult skeleton</article-title>
<source>Endocrin Rev</source>
<year>2002</year>
<volume>23</volume>
<fpage>279</fpage>
<lpage>302</lpage>
</element-citation>
</ref>
<ref id="b22-ccide-8-095"><label>22</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ulm</surname>
<given-names>CW</given-names>
</name>
<name><surname>Solar</surname>
<given-names>P</given-names>
</name>
<name><surname>Ulm</surname>
<given-names>MR</given-names>
</name>
<name><surname>Matejka</surname>
<given-names>M</given-names>
</name>
</person-group>
<article-title>Sex-related changes in the bone mineral content of atrophic mandibles</article-title>
<source>Calcif Tissue Int</source>
<year>1994</year>
<volume>54</volume>
<fpage>203</fpage>
<lpage>207</lpage>
<pub-id pub-id-type="pmid">8055367</pub-id>
</element-citation>
</ref>
<ref id="b23-ccide-8-095"><label>23</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Jonasson</surname>
<given-names>L</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Skeletal bone mineral density in relation to thickness, bone mass, and structure of the mandibular alveolar process in dentate men and women</article-title>
<source>Eur J Oral Sci</source>
<year>2007</year>
<volume>115</volume>
<fpage>117</fpage>
<lpage>123</lpage>
<pub-id pub-id-type="pmid">17451501</pub-id>
</element-citation>
</ref>
<ref id="b24-ccide-8-095"><label>24</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lanyon</surname>
<given-names>LE</given-names>
</name>
</person-group>
<article-title>Functional strain in bone tissue as an objective, and controlling stimulus for adaptive bone remodelling</article-title>
<source>J Biomech</source>
<year>1987</year>
<volume>20</volume>
<fpage>1083</fpage>
<lpage>1093</lpage>
<pub-id pub-id-type="pmid">3323200</pub-id>
</element-citation>
</ref>
<ref id="b25-ccide-8-095"><label>25</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lang</surname>
<given-names>TF</given-names>
</name>
</person-group>
<article-title>What do we know about fracture risk in long-duration spaceflight?</article-title>
<source>J Musculoskelet Neuronal Interact</source>
<year>2006</year>
<volume>6</volume>
<fpage>319</fpage>
<lpage>321</lpage>
<pub-id pub-id-type="pmid">17185806</pub-id>
</element-citation>
</ref>
<ref id="b26-ccide-8-095"><label>26</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Mosekilde</surname>
<given-names>L</given-names>
</name>
</person-group>
<article-title>Age-related changes in bone mass, structure, and strength – effects of loading</article-title>
<source>Z Rheumatol</source>
<year>2000</year>
<volume>59</volume>
<issue>Suppl 1</issue>
<fpage>1</fpage>
<lpage>9</lpage>
<pub-id pub-id-type="pmid">10769428</pub-id>
</element-citation>
</ref>
<ref id="b27-ccide-8-095"><label>27</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ruff</surname>
<given-names>CB</given-names>
</name>
<name><surname>Hayes</surname>
<given-names>WC</given-names>
</name>
</person-group>
<article-title>Sex differences in age-related remodeling of the femur and tibia</article-title>
<source>J Orthop Res</source>
<year>1988</year>
<volume>6</volume>
<fpage>886</fpage>
<lpage>896</lpage>
<pub-id pub-id-type="pmid">3171769</pub-id>
</element-citation>
</ref>
<ref id="b28-ccide-8-095"><label>28</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Karlsson</surname>
<given-names>MK</given-names>
</name>
<name><surname>Hasserius</surname>
<given-names>R</given-names>
</name>
<name><surname>Obrant</surname>
<given-names>KJ</given-names>
</name>
</person-group>
<article-title>Bone mineral density in athletes during and after career: a comparison between loaded and unloaded skeletal regions</article-title>
<source>Calcif Tissue Int</source>
<year>1996</year>
<volume>59</volume>
<fpage>245</fpage>
<lpage>248</lpage>
<pub-id pub-id-type="pmid">8781046</pub-id>
</element-citation>
</ref>
<ref id="b29-ccide-8-095"><label>29</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Magnusson</surname>
<given-names>H</given-names>
</name>
<name><surname>Obrant</surname>
<given-names>K</given-names>
</name>
<name><surname>Johnell</surname>
<given-names>O</given-names>
</name>
<name><surname>Karlsson</surname>
<given-names>KM</given-names>
</name>
</person-group>
<article-title>Bone mass changes in weight- loaded and unloaded skeletal regions following a fracture of the hip</article-title>
<source>Osteoporos Int</source>
<year>2001</year>
<volume>69</volume>
<fpage>78</fpage>
<lpage>83</lpage>
</element-citation>
</ref>
<ref id="b30-ccide-8-095"><label>30</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bresin</surname>
<given-names>A</given-names>
</name>
<name><surname>Johansson</surname>
<given-names>CB</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Effects of occlusal strain on the development of the dentoalveolar process in the growing rat</article-title>
<source>Eur J Exp Musculoskel Res</source>
<year>1994</year>
<volume>3</volume>
<fpage>112</fpage>
<lpage>122</lpage>
</element-citation>
</ref>
<ref id="b31-ccide-8-095"><label>31</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
<name><surname>Bresin</surname>
<given-names>A</given-names>
</name>
<name><surname>Holm</surname>
<given-names>J</given-names>
</name>
<name><surname>Strid</surname>
<given-names>KG</given-names>
</name>
</person-group>
<article-title>Effects of masticatory muscle function on bone mass in the mandible of the growing rat</article-title>
<source>Acta Anat</source>
<year>1996</year>
<volume>155</volume>
<fpage>200</fpage>
<lpage>205</lpage>
<pub-id pub-id-type="pmid">8870788</pub-id>
</element-citation>
</ref>
<ref id="b32-ccide-8-095"><label>32</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Erhardson</surname>
<given-names>S</given-names>
</name>
<name><surname>Sheikholeslam</surname>
<given-names>A</given-names>
</name>
<name><surname>Forsberg</surname>
<given-names>C-M</given-names>
</name>
<name><surname>Lockowandt</surname>
<given-names>P</given-names>
</name>
</person-group>
<article-title>Vertical forces developed by the jaw elevator muscles during unilateral maximal clenching and their distribution on teeth and condyles</article-title>
<source>Swed Dent J</source>
<year>1993</year>
<volume>17</volume>
<fpage>23</fpage>
<lpage>34</lpage>
<pub-id pub-id-type="pmid">8362360</pub-id>
</element-citation>
</ref>
<ref id="b33-ccide-8-095"><label>33</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Elovic</surname>
<given-names>RP</given-names>
</name>
<name><surname>Hipp</surname>
<given-names>JA</given-names>
</name>
<name><surname>Hayes</surname>
<given-names>WC</given-names>
</name>
</person-group>
<article-title>Maxillary molar extraction causes increased bone loss in the mandible of ovariectomized rats</article-title>
<source>J Bone Miner Res</source>
<year>1995</year>
<volume>10</volume>
<fpage>1087</fpage>
<lpage>1093</lpage>
<pub-id pub-id-type="pmid">7484284</pub-id>
</element-citation>
</ref>
<ref id="b34-ccide-8-095"><label>34</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Von Wowern</surname>
<given-names>N</given-names>
</name>
<name><surname>Hjorting-Hansen</surname>
<given-names>E</given-names>
</name>
<name><surname>Stoltze</surname>
<given-names>K</given-names>
</name>
</person-group>
<article-title>Changes in bone mass in rat mandibles after tooth extraction</article-title>
<source>Int J Oral Surg</source>
<year>1979</year>
<volume>8</volume>
<fpage>229</fpage>
<lpage>233</lpage>
<pub-id pub-id-type="pmid">118129</pub-id>
</element-citation>
</ref>
<ref id="b35-ccide-8-095"><label>35</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Carlsson</surname>
<given-names>GE</given-names>
</name>
<name><surname>Persson</surname>
<given-names>G</given-names>
</name>
</person-group>
<article-title>Morphologic changes of the mandible after extraction and wearing of dentures; a longitudinal, clinical, and X-ray cephalometric study covering 5 years</article-title>
<source>Odontol Revy</source>
<year>1967</year>
<volume>18</volume>
<fpage>27</fpage>
<lpage>54</lpage>
<pub-id pub-id-type="pmid">5227389</pub-id>
</element-citation>
</ref>
<ref id="b36-ccide-8-095"><label>36</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tallgren</surname>
<given-names>A</given-names>
</name>
</person-group>
<article-title>The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years</article-title>
<source>J Prosthet Dent</source>
<year>1972</year>
<volume>27</volume>
<fpage>120</fpage>
<lpage>132</lpage>
<pub-id pub-id-type="pmid">4500507</pub-id>
</element-citation>
</ref>
<ref id="b37-ccide-8-095"><label>37</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Von Wowern</surname>
<given-names>N</given-names>
</name>
<name><surname>Kollerup</surname>
<given-names>G</given-names>
</name>
</person-group>
<article-title>Symptomatic osteoporosis: a risk factor for residual ridge reduction of the jaws</article-title>
<source>J. Prosthet Dent</source>
<year>1992</year>
<volume>67</volume>
<fpage>656</fpage>
<lpage>660</lpage>
<pub-id pub-id-type="pmid">1527750</pub-id>
</element-citation>
</ref>
<ref id="b38-ccide-8-095"><label>38</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Klemetti</surname>
<given-names>E</given-names>
</name>
</person-group>
<article-title>Review of residual ridge resorption and bone density</article-title>
<source>J Prosthet Dent</source>
<year>1996</year>
<volume>75</volume>
<fpage>512</fpage>
<lpage>514</lpage>
<pub-id pub-id-type="pmid">8709016</pub-id>
</element-citation>
</ref>
<ref id="b39-ccide-8-095"><label>39</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Klemetti</surname>
<given-names>E</given-names>
</name>
<name><surname>Kröger</surname>
<given-names>H</given-names>
</name>
<name><surname>Lassila</surname>
<given-names>V</given-names>
</name>
</person-group>
<article-title>Relationships between body mass index and the remaining alveolar ridge</article-title>
<source>J Oral Rehab</source>
<year>1997</year>
<volume>24</volume>
<fpage>808</fpage>
<lpage>812</lpage>
</element-citation>
</ref>
<ref id="b40-ccide-8-095"><label>40</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>The association between the masseter muscle, the mandibular alveolar bone mass and thickness in dentate women</article-title>
<source>Arch Oral Biol</source>
<year>2004</year>
<volume>49</volume>
<fpage>1001</fpage>
<lpage>1006</lpage>
<pub-id pub-id-type="pmid">15485642</pub-id>
</element-citation>
</ref>
<ref id="b41-ccide-8-095"><label>41</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Bankvall</surname>
<given-names>G</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Estimation of skeletal bone mineral density by means of the trabecular pattern of the alveolar bone, its interdental thickness, and the bone mass of the mandible</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>2001</year>
<volume>92</volume>
<fpage>346</fpage>
<lpage>352</lpage>
<pub-id pub-id-type="pmid">11552157</pub-id>
</element-citation>
</ref>
<ref id="b42-ccide-8-095"><label>42</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Jonasson</surname>
<given-names>L</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Changes in the radiographic characteristics of the mandibular alveolar process in dentate women with varying bone mineral density: a 5-year prospective study</article-title>
<source>Bone</source>
<year>2006</year>
<volume>38</volume>
<fpage>714</fpage>
<lpage>721</lpage>
<pub-id pub-id-type="pmid">16326156</pub-id>
</element-citation>
</ref>
<ref id="b43-ccide-8-095"><label>43</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
<name><surname>Gunnarsson</surname>
<given-names>R</given-names>
</name>
</person-group>
<article-title>Cervical thickness of the mandibular alveolar process and skeletal bone mineral density</article-title>
<source>Acta Odontol Scand</source>
<year>1999</year>
<volume>57</volume>
<fpage>155</fpage>
<lpage>161</lpage>
<pub-id pub-id-type="pmid">10480282</pub-id>
</element-citation>
</ref>
<ref id="b44-ccide-8-095"><label>44</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Changes in the bucco-lingual thickness of the mandibular alveolar process and skeletal bone mineral density in dentate women: a 5-yr prospective study</article-title>
<source>Eur J Oral Sci</source>
<year>2005</year>
<volume>113</volume>
<issue>2</issue>
<fpage>114</fpage>
<lpage>120</lpage>
<pub-id pub-id-type="pmid">15819816</pub-id>
</element-citation>
</ref>
<ref id="b45-ccide-8-095"><label>45</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Enlow</surname>
<given-names>DH</given-names>
</name>
<name><surname>Harris</surname>
<given-names>DB</given-names>
</name>
</person-group>
<article-title>A study of the postnatal growth of the human mandible</article-title>
<source>Am J Orthodont</source>
<year>1964</year>
<volume>50</volume>
<fpage>25</fpage>
<lpage>50</lpage>
</element-citation>
</ref>
<ref id="b46-ccide-8-095"><label>46</label>
<element-citation publication-type="book"><person-group person-group-type="author"><collab>WHO Scientific Group</collab>
</person-group>
<source>Prevention and management of osteoporosis</source>
<series>WHO Technical Report Series 921</series>
<publisher-loc>Geneva</publisher-loc>
<publisher-name>WHO Press</publisher-name>
<year>2003</year>
</element-citation>
</ref>
<ref id="b47-ccide-8-095"><label>47</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pasco</surname>
<given-names>JA</given-names>
</name>
<name><surname>Seeman</surname>
<given-names>E</given-names>
</name>
<name><surname>Henry</surname>
<given-names>MJ</given-names>
</name>
<name><surname>Merriman</surname>
<given-names>EN</given-names>
</name>
<name><surname>Nicholson</surname>
<given-names>GC</given-names>
</name>
<name><surname>Kotowicz</surname>
<given-names>MA</given-names>
</name>
</person-group>
<article-title>The population burden of fractures originates in women with osteopenia, not osteoporosis</article-title>
<source>Osteoporos Int</source>
<year>2006</year>
<volume>17</volume>
<fpage>1404</fpage>
<lpage>1409</lpage>
<pub-id pub-id-type="pmid">16699736</pub-id>
</element-citation>
</ref>
<ref id="b48-ccide-8-095"><label>48</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kanis</surname>
<given-names>JA</given-names>
</name>
<name><surname>Johnell</surname>
<given-names>O</given-names>
</name>
<name><surname>Oden</surname>
<given-names>A</given-names>
</name>
<name><surname>Johansson</surname>
<given-names>H</given-names>
</name>
<name><surname>McCloskey</surname>
<given-names>E</given-names>
</name>
</person-group>
<article-title>FRAX™ and the assessment of fracture probability in men and women from the UK</article-title>
<source>Osteoporos Int</source>
<year>2008</year>
<volume>19</volume>
<fpage>385</fpage>
<lpage>397</lpage>
<pub-id pub-id-type="pmid">18292978</pub-id>
</element-citation>
</ref>
<ref id="b49-ccide-8-095"><label>49</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Johansson</surname>
<given-names>C</given-names>
</name>
<name><surname>Black</surname>
<given-names>D</given-names>
</name>
<name><surname>Johnell</surname>
<given-names>O</given-names>
</name>
<name><surname>Odén</surname>
<given-names>A</given-names>
</name>
<name><surname>Mellström</surname>
<given-names>D</given-names>
</name>
</person-group>
<article-title>Bone mineral density is a predictor of survival</article-title>
<source>Calcif Tissue Int</source>
<year>1998</year>
<volume>63</volume>
<fpage>190</fpage>
<lpage>196</lpage>
<pub-id pub-id-type="pmid">9701621</pub-id>
</element-citation>
</ref>
<ref id="b50-ccide-8-095"><label>50</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Genant</surname>
<given-names>HK</given-names>
</name>
<name><surname>Jiang</surname>
<given-names>Y</given-names>
</name>
</person-group>
<article-title>Advanced imaging assessment of bone quality</article-title>
<source>Ann N Y Acad Sci</source>
<year>2006</year>
<volume>1068</volume>
<fpage>410</fpage>
<lpage>428</lpage>
<pub-id pub-id-type="pmid">16831940</pub-id>
</element-citation>
</ref>
<ref id="b51-ccide-8-095"><label>51</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lindh</surname>
<given-names>C</given-names>
</name>
<name><surname>Obrant</surname>
<given-names>K</given-names>
</name>
<name><surname>Petersson</surname>
<given-names>A</given-names>
</name>
</person-group>
<article-title>Maxillary bone mineral density and its relationship to the bone mineral density of the lumbar spine and hip</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>2004</year>
<volume>98</volume>
<fpage>102</fpage>
<lpage>109</lpage>
<pub-id pub-id-type="pmid">15243479</pub-id>
</element-citation>
</ref>
<ref id="b52-ccide-8-095"><label>52</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Southard</surname>
<given-names>KA</given-names>
</name>
<name><surname>Southard</surname>
<given-names>TE</given-names>
</name>
</person-group>
<article-title>Detection of simulated osteoporosis in human anterior maxillary alveolar bone with digital subtraction</article-title>
<source>Oral Surg Oral Med Oral Pathol</source>
<year>1994</year>
<volume>78</volume>
<fpage>655</fpage>
<lpage>661</lpage>
<pub-id pub-id-type="pmid">7838476</pub-id>
</element-citation>
</ref>
<ref id="b53-ccide-8-095"><label>53</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Klemetti</surname>
<given-names>E</given-names>
</name>
<name><surname>Kolmakov</surname>
<given-names>S</given-names>
</name>
<name><surname>Kröger</surname>
<given-names>H</given-names>
</name>
</person-group>
<article-title>Pantomography in assessment of the osteoporosis risk group</article-title>
<source>Scand J Dent Res</source>
<year>1994</year>
<volume>102</volume>
<fpage>68</fpage>
<lpage>72</lpage>
<pub-id pub-id-type="pmid">8153584</pub-id>
</element-citation>
</ref>
<ref id="b54-ccide-8-095"><label>54</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Taguchi</surname>
<given-names>A</given-names>
</name>
<name><surname>Asano</surname>
<given-names>A</given-names>
</name>
<name><surname>Ohtsuka</surname>
<given-names>M</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Observer performance in diagnosing osteoporosis by dental panoramic radiographs: results from the osteoporosis screening project in dentistry (OSPD)</article-title>
<source>Bone</source>
<year>2008</year>
<volume>43</volume>
<fpage>209</fpage>
<lpage>213</lpage>
<pub-id pub-id-type="pmid">18482878</pub-id>
</element-citation>
</ref>
<ref id="b55-ccide-8-095"><label>55</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Taguchi</surname>
<given-names>A</given-names>
</name>
<name><surname>Tsuda</surname>
<given-names>M</given-names>
</name>
<name><surname>Ohtsuka</surname>
<given-names>M</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Use of dental panoramic radiographs in identifying younger postmenopausal women with osteoporosis</article-title>
<source>Osteoporos Int</source>
<year>2006</year>
<volume>17</volume>
<fpage>387</fpage>
<lpage>394</lpage>
<pub-id pub-id-type="pmid">16331360</pub-id>
</element-citation>
</ref>
<ref id="b56-ccide-8-095"><label>56</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>White</surname>
<given-names>SC</given-names>
</name>
<name><surname>Taguchi</surname>
<given-names>A</given-names>
</name>
<name><surname>Kao</surname>
<given-names>D</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Clinical and panoramic predictors of femur bone mineral density</article-title>
<source>Osteoporos Int</source>
<year>2005</year>
<volume>16</volume>
<fpage>339</fpage>
<lpage>346</lpage>
<pub-id pub-id-type="pmid">15726238</pub-id>
</element-citation>
</ref>
<ref id="b57-ccide-8-095"><label>57</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Okabe</surname>
<given-names>S</given-names>
</name>
<name><surname>Morimoto</surname>
<given-names>Y</given-names>
</name>
<name><surname>Ansai</surname>
<given-names>T</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Assessment of the relationship between the mandibular cortex on panoramic radiographs and the risk of bone fracture and vascular disease in 80-year-olds</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>2008</year>
<volume>106</volume>
<fpage>433</fpage>
<lpage>442</lpage>
<pub-id pub-id-type="pmid">18299222</pub-id>
</element-citation>
</ref>
<ref id="b58-ccide-8-095"><label>58</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Devlin</surname>
<given-names>H</given-names>
</name>
<name><surname>Karayianni</surname>
<given-names>K</given-names>
</name>
<name><surname>Mitsea</surname>
<given-names>A</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>2007</year>
<volume>104</volume>
<fpage>821</fpage>
<lpage>828</lpage>
<pub-id pub-id-type="pmid">17428694</pub-id>
</element-citation>
</ref>
<ref id="b59-ccide-8-095"><label>59</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Horner</surname>
<given-names>K</given-names>
</name>
<name><surname>Devlin</surname>
<given-names>H</given-names>
</name>
<name><surname>Harvey</surname>
<given-names>L</given-names>
</name>
</person-group>
<article-title>Detecting patients with low skeletal bone mass</article-title>
<source>J Dent</source>
<year>2002</year>
<volume>30</volume>
<fpage>171</fpage>
<lpage>175</lpage>
<pub-id pub-id-type="pmid">12450724</pub-id>
</element-citation>
</ref>
<ref id="b60-ccide-8-095"><label>60</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Devlin</surname>
<given-names>H</given-names>
</name>
<name><surname>Allen</surname>
<given-names>PD</given-names>
</name>
<name><surname>Graham</surname>
<given-names>J</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis</article-title>
<source>Bone</source>
<year>2007</year>
<volume>40</volume>
<fpage>835</fpage>
<lpage>842</lpage>
<pub-id pub-id-type="pmid">17188590</pub-id>
</element-citation>
</ref>
<ref id="b61-ccide-8-095"><label>61</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pham</surname>
<given-names>D</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Evaluation of changes in trabecular alveolar bone during growth using conventional panoramic radiographs</article-title>
<source>Acta Odontol Scand</source>
<year>2012</year>
<volume>70</volume>
<fpage>127</fpage>
<lpage>132</lpage>
<pub-id pub-id-type="pmid">21793639</pub-id>
</element-citation>
</ref>
<ref id="b62-ccide-8-095"><label>62</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>White</surname>
<given-names>SC</given-names>
</name>
<name><surname>Rudolph</surname>
<given-names>DJ</given-names>
</name>
</person-group>
<article-title>Alterations of the trabecular pattern of the jaws in patients with osteoporosis</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</source>
<year>1999</year>
<volume>88</volume>
<fpage>628</fpage>
<lpage>635</lpage>
<pub-id pub-id-type="pmid">10556761</pub-id>
</element-citation>
</ref>
<ref id="b63-ccide-8-095"><label>63</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>White</surname>
<given-names>SC</given-names>
</name>
<name><surname>Atchison</surname>
<given-names>KA</given-names>
</name>
<name><surname>Gornbein</surname>
<given-names>JA</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Change in mandibular trabecular pattern and hip fracture rate in elderly women</article-title>
<source>Dentomaxillofac Radiol</source>
<year>2005</year>
<volume>34</volume>
<fpage>168</fpage>
<lpage>174</lpage>
<pub-id pub-id-type="pmid">15897288</pub-id>
</element-citation>
</ref>
<ref id="b64-ccide-8-095"><label>64</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Verheij</surname>
<given-names>JG</given-names>
</name>
<name><surname>Geraets</surname>
<given-names>WG</given-names>
</name>
<name><surname>van der Stelt</surname>
<given-names>PF</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Prediction of osteoporosis with dental radiographs and age</article-title>
<source>Dentomaxillofac Radiol</source>
<year>2009</year>
<volume>38</volume>
<fpage>431</fpage>
<lpage>437</lpage>
<pub-id pub-id-type="pmid">19767512</pub-id>
</element-citation>
</ref>
<ref id="b65-ccide-8-095"><label>65</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chiba</surname>
<given-names>K</given-names>
</name>
<name><surname>Burghardt</surname>
<given-names>AJ</given-names>
</name>
<name><surname>Osaki</surname>
<given-names>M</given-names>
</name>
<name><surname>Majumdar</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Heterogeneity of bone microstructure in the femoral head in patients with osteoporosis: an ex vivo HR-pQCT study</article-title>
<source>Bone</source>
<year>2013</year>
<volume>56</volume>
<fpage>139</fpage>
<lpage>146</lpage>
<pub-id pub-id-type="pmid">23748104</pub-id>
</element-citation>
</ref>
<ref id="b66-ccide-8-095"><label>66</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Geraets</surname>
<given-names>WG</given-names>
</name>
<name><surname>Verheij</surname>
<given-names>JG</given-names>
</name>
<name><surname>van der Stelt</surname>
<given-names>PF</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Prediction of bone mineral density with dental radiographs</article-title>
<source>Bone</source>
<year>2007</year>
<volume>40</volume>
<fpage>1217</fpage>
<lpage>1221</lpage>
<pub-id pub-id-type="pmid">17317351</pub-id>
</element-citation>
</ref>
<ref id="b67-ccide-8-095"><label>67</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lindh</surname>
<given-names>C</given-names>
</name>
<name><surname>Petersson</surname>
<given-names>A</given-names>
</name>
<name><surname>Rohlin</surname>
<given-names>M</given-names>
</name>
</person-group>
<article-title>Assessment of the trabecular pattern before endosseous implant treatment: diagnostic outcome of periapical radiography in the mandible</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endod</source>
<year>1996</year>
<volume>82</volume>
<fpage>335</fpage>
<lpage>343</lpage>
</element-citation>
</ref>
<ref id="b68-ccide-8-095"><label>68</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kawalilak</surname>
<given-names>CE</given-names>
</name>
<name><surname>Johnston</surname>
<given-names>JD</given-names>
</name>
<name><surname>Olszynski</surname>
<given-names>WP</given-names>
</name>
<name><surname>Kontulainen</surname>
<given-names>SA</given-names>
</name>
</person-group>
<article-title>Characterizing microarchitectural changes at the distal radius and tibia in postmenopausal women using HR-pQCT</article-title>
<source>Osteoporos Int</source>
<year>2014</year>
<volume>25</volume>
<fpage>2057</fpage>
<lpage>2066</lpage>
<pub-id pub-id-type="pmid">24781379</pub-id>
</element-citation>
</ref>
<ref id="b69-ccide-8-095"><label>69</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Pham</surname>
<given-names>D</given-names>
</name>
<name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
<name><surname>Kiliaridis</surname>
<given-names>S</given-names>
</name>
</person-group>
<article-title>Assessment of trabecular pattern on periapical and panoramic radiographs: a pilot study</article-title>
<source>Acta Odontol Scand</source>
<year>2010</year>
<volume>68</volume>
<fpage>91</fpage>
<lpage>97</lpage>
<pub-id pub-id-type="pmid">20085501</pub-id>
</element-citation>
</ref>
<ref id="b70-ccide-8-095"><label>70</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bartold</surname>
<given-names>PM</given-names>
</name>
<name><surname>Van Dyke</surname>
<given-names>TE</given-names>
</name>
</person-group>
<article-title>Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts</article-title>
<source>Periodontol 2000</source>
<year>2013</year>
<volume>62</volume>
<fpage>203</fpage>
<lpage>217</lpage>
<pub-id pub-id-type="pmid">23574467</pub-id>
</element-citation>
</ref>
<ref id="b71-ccide-8-095"><label>71</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Santos Tunes</surname>
<given-names>R</given-names>
</name>
<name><surname>Foss-Freitas</surname>
<given-names>MC</given-names>
</name>
<name><surname>Nogueira-Filho</surname>
<given-names>GR</given-names>
</name>
</person-group>
<article-title>Impact of periodontitis on the diabetes-related inflammatory status</article-title>
<source>J Can Dent Assoc</source>
<year>2010</year>
<volume>76</volume>
<fpage>a35</fpage>
<pub-id pub-id-type="pmid">20831852</pub-id>
</element-citation>
</ref>
<ref id="b72-ccide-8-095"><label>72</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Koromantzos</surname>
<given-names>PA</given-names>
</name>
<name><surname>Makrilakis</surname>
<given-names>K</given-names>
</name>
<name><surname>Dereka</surname>
<given-names>X</given-names>
</name>
<name><surname>Katsilambros</surname>
<given-names>N</given-names>
</name>
<name><surname>Vrotsos</surname>
<given-names>IA</given-names>
</name>
<name><surname>Madianos</surname>
<given-names>PN</given-names>
</name>
</person-group>
<article-title>A randomized, controlled trial on the effect of nonsurgical periodontal therapy in patients with type 2 diabetes</article-title>
<source>J Clin Periodontol</source>
<year>2011</year>
<volume>38</volume>
<fpage>142</fpage>
<lpage>147</lpage>
<pub-id pub-id-type="pmid">21114680</pub-id>
</element-citation>
</ref>
<ref id="b73-ccide-8-095"><label>73</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chapple</surname>
<given-names>IL</given-names>
</name>
<name><surname>Genco</surname>
<given-names>R</given-names>
</name>
<collab>working group 2 of the joint EFP/AAP workshop</collab>
</person-group>
<article-title>Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases</article-title>
<source>J Periodontol</source>
<year>2013</year>
<volume>84</volume>
<fpage>S106</fpage>
<lpage>S112</lpage>
<pub-id pub-id-type="pmid">23631572</pub-id>
</element-citation>
</ref>
<ref id="b74-ccide-8-095"><label>74</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Buhlin</surname>
<given-names>K</given-names>
</name>
<name><surname>Gustafsson</surname>
<given-names>A</given-names>
</name>
<name><surname>Pockley</surname>
<given-names>AG</given-names>
</name>
<name><surname>Frostegård</surname>
<given-names>J</given-names>
</name>
<name><surname>Klinge</surname>
<given-names>B</given-names>
</name>
</person-group>
<article-title>Risk factors for cardiovascular disease in patients with periodontitis</article-title>
<source>Eur Heart J</source>
<year>2003</year>
<volume>24</volume>
<fpage>2099</fpage>
<lpage>2107</lpage>
<pub-id pub-id-type="pmid">14643270</pub-id>
</element-citation>
</ref>
<ref id="b75-ccide-8-095"><label>75</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Belstrøm</surname>
<given-names>D</given-names>
</name>
<name><surname>Damgaard</surname>
<given-names>C</given-names>
</name>
<name><surname>Nielsen</surname>
<given-names>CH</given-names>
</name>
<name><surname>Holmstrup</surname>
<given-names>P</given-names>
</name>
</person-group>
<article-title>Does a causal relation between cardiovascular disease and periodontitis exist?</article-title>
<source>Microbes Infect</source>
<year>2012</year>
<volume>14</volume>
<fpage>411</fpage>
<lpage>418</lpage>
<pub-id pub-id-type="pmid">22200601</pub-id>
</element-citation>
</ref>
<ref id="b76-ccide-8-095"><label>76</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tonetti</surname>
<given-names>MS</given-names>
</name>
<name><surname>Van Dyke</surname>
<given-names>TE</given-names>
</name>
</person-group>
<article-title>Periodontitis and atherosclerotic cardiovascular disease: consensus report of the joint EFP/AAP workshop on periodontitis and systemic diseases</article-title>
<source>J Periodontol</source>
<year>2013</year>
<volume>84</volume>
<fpage>24</fpage>
<lpage>29</lpage>
<pub-id pub-id-type="pmid">22420871</pub-id>
</element-citation>
</ref>
<ref id="b77-ccide-8-095"><label>77</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kaur</surname>
<given-names>S</given-names>
</name>
<name><surname>White</surname>
<given-names>S</given-names>
</name>
<name><surname>Bartold</surname>
<given-names>PM</given-names>
</name>
</person-group>
<article-title>Periodontal disease and rheumatoid arthritis: a systematic review</article-title>
<source>J Dent Res</source>
<year>2013</year>
<volume>92</volume>
<fpage>399</fpage>
<lpage>408</lpage>
<pub-id pub-id-type="pmid">23525531</pub-id>
</element-citation>
</ref>
<ref id="b78-ccide-8-095"><label>78</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sanz</surname>
<given-names>M</given-names>
</name>
<name><surname>Kornman</surname>
<given-names>K</given-names>
</name>
</person-group>
<article-title>Working group 3 of the joint EFP/AAP workshop. periodontitis and adverse pregnancy outcomes: consensus report of the joint EFP/AAP workshop on periodontitis and systemic diseases</article-title>
<source>J Periodontol</source>
<year>2013</year>
<volume>84</volume>
<fpage>S164</fpage>
<lpage>S169</lpage>
<pub-id pub-id-type="pmid">23631576</pub-id>
</element-citation>
</ref>
<ref id="b79-ccide-8-095"><label>79</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lerner</surname>
<given-names>UH</given-names>
</name>
</person-group>
<article-title>Inflammation-induced bone remodeling in periodontal disease and the influence of post-menopausal osteoporosis</article-title>
<source>J Dent Res</source>
<year>2006</year>
<volume>85</volume>
<fpage>596</fpage>
<lpage>607</lpage>
<pub-id pub-id-type="pmid">16798858</pub-id>
</element-citation>
</ref>
<ref id="b80-ccide-8-095"><label>80</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chesnut</surname>
<given-names>CH</given-names>
<suffix>3rd</suffix>
</name>
</person-group>
<article-title>The relationship between skeletal and oral bone mineral density: an overview</article-title>
<source>Ann Periodontol</source>
<year>2001</year>
<volume>6</volume>
<fpage>193</fpage>
<lpage>196</lpage>
<pub-id pub-id-type="pmid">11887464</pub-id>
</element-citation>
</ref>
<ref id="b81-ccide-8-095"><label>81</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jeffcoat</surname>
<given-names>M</given-names>
</name>
</person-group>
<article-title>The Association between osteoporosis and oral bone loss</article-title>
<source>J Periodontol</source>
<year>2005</year>
<volume>76</volume>
<fpage>2125</fpage>
<lpage>2132</lpage>
<pub-id pub-id-type="pmid">16277585</pub-id>
</element-citation>
</ref>
<ref id="b82-ccide-8-095"><label>82</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Otomo-Corgel</surname>
<given-names>J</given-names>
</name>
</person-group>
<article-title>Osteoporosis and osteopenia: implications for periodontal and implant therapy</article-title>
<source>Periodontol. 2000</source>
<year>2012</year>
<volume>59</volume>
<fpage>111</fpage>
<lpage>139</lpage>
<pub-id pub-id-type="pmid">22507063</pub-id>
</element-citation>
</ref>
<ref id="b83-ccide-8-095"><label>83</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hildebolt</surname>
<given-names>CF</given-names>
</name>
<name><surname>Pilgram</surname>
<given-names>TK</given-names>
</name>
<name><surname>Yokoyama-Crothers</surname>
<given-names>N</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Alveolar bone height and postcranial bone mineral density: negative effects of cigarette smoking and parity</article-title>
<source>J Periodontol</source>
<year>2000</year>
<volume>71</volume>
<fpage>683</fpage>
<lpage>689</lpage>
<pub-id pub-id-type="pmid">10872947</pub-id>
</element-citation>
</ref>
<ref id="b84-ccide-8-095"><label>84</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Payne</surname>
<given-names>JB</given-names>
</name>
<name><surname>Reinhardt</surname>
<given-names>RA</given-names>
</name>
<name><surname>Nummikoski</surname>
<given-names>PV</given-names>
</name>
<name><surname>Patil</surname>
<given-names>KD</given-names>
</name>
</person-group>
<article-title>Longitudinal alveolar bone loss in postmenopausal osteoporotic⁄osteopenic women</article-title>
<source>Osteoporos Int</source>
<year>1999</year>
<volume>10</volume>
<fpage>34</fpage>
<lpage>40</lpage>
<pub-id pub-id-type="pmid">10501777</pub-id>
</element-citation>
</ref>
<ref id="b85-ccide-8-095"><label>85</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tezal</surname>
<given-names>M</given-names>
</name>
<name><surname>Wactawski-Wende</surname>
<given-names>J</given-names>
</name>
<name><surname>Grossi</surname>
<given-names>SG</given-names>
</name>
<name><surname>Ho</surname>
<given-names>AW</given-names>
</name>
<name><surname>Dunford</surname>
<given-names>R</given-names>
</name>
<name><surname>Genco</surname>
<given-names>RJ</given-names>
</name>
</person-group>
<article-title>The relationship between bone mineral density and periodontitis in postmenopausal women</article-title>
<source>J Periodontol</source>
<year>2000</year>
<volume>71</volume>
<fpage>1492</fpage>
<lpage>1498</lpage>
<pub-id pub-id-type="pmid">11022780</pub-id>
</element-citation>
</ref>
<ref id="b86-ccide-8-095"><label>86</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yoshihara</surname>
<given-names>A</given-names>
</name>
<name><surname>Seida</surname>
<given-names>Y</given-names>
</name>
<name><surname>Hanada</surname>
<given-names>N</given-names>
</name>
<name><surname>Miyazaki</surname>
<given-names>H</given-names>
</name>
</person-group>
<article-title>A longitudinal study of the relationship between periodontal disease and bone mineral density in community-dwelling older adults</article-title>
<source>J Clin Periodontol</source>
<year>2004</year>
<volume>31</volume>
<fpage>680</fpage>
<lpage>684</lpage>
<pub-id pub-id-type="pmid">15257747</pub-id>
</element-citation>
</ref>
<ref id="b87-ccide-8-095"><label>87</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wactawski-Wende</surname>
<given-names>J</given-names>
</name>
<name><surname>Hausmann</surname>
<given-names>E</given-names>
</name>
<name><surname>Hovey</surname>
<given-names>K</given-names>
</name>
<name><surname>Trevisan</surname>
<given-names>M</given-names>
</name>
<name><surname>Grossi</surname>
<given-names>S</given-names>
</name>
<name><surname>Genco</surname>
<given-names>RJ</given-names>
</name>
</person-group>
<article-title>The association between osteoporosis and alveolar crestal height in postmenopausal women</article-title>
<source>J Periodontol</source>
<year>2005</year>
<volume>77</volume>
<fpage>2116</fpage>
<lpage>2124</lpage>
<pub-id pub-id-type="pmid">16277584</pub-id>
</element-citation>
</ref>
<ref id="b88-ccide-8-095"><label>88</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Elders</surname>
<given-names>PJ</given-names>
</name>
<name><surname>Habets</surname>
<given-names>LL</given-names>
</name>
<name><surname>Netelenbos</surname>
<given-names>JC</given-names>
</name>
<name><surname>van der Linden</surname>
<given-names>LW</given-names>
</name>
<name><surname>van der Stelt</surname>
<given-names>PF</given-names>
</name>
</person-group>
<article-title>The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age</article-title>
<source>J Clin Periodontol</source>
<year>1992</year>
<volume>19</volume>
<fpage>492</fpage>
<lpage>496</lpage>
<pub-id pub-id-type="pmid">1430285</pub-id>
</element-citation>
</ref>
<ref id="b89-ccide-8-095"><label>89</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kinane</surname>
<given-names>DF</given-names>
</name>
<name><surname>Marshall</surname>
<given-names>GJ</given-names>
</name>
</person-group>
<article-title>Periodontal manifestations of systemic disease</article-title>
<source>Aust Dent J</source>
<year>2001</year>
<volume>46</volume>
<fpage>2</fpage>
<lpage>12</lpage>
<pub-id pub-id-type="pmid">11355236</pub-id>
</element-citation>
</ref>
<ref id="b90-ccide-8-095"><label>90</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Civitelli</surname>
<given-names>R1</given-names>
</name>
<name><surname>Pilgram</surname>
<given-names>TK</given-names>
</name>
<name><surname>Dotson</surname>
<given-names>M</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Alveolar and postcranial bone density in postmenopausal women receiving hormone/estrogen replacement therapy: a randomized, double-blind, placebo-controlled trial</article-title>
<source>Arch Intern Med</source>
<year>2002</year>
<volume>24</volume>
<issue>162</issue>
<fpage>1409</fpage>
<lpage>1415</lpage>
<pub-id pub-id-type="pmid">12076241</pub-id>
</element-citation>
</ref>
<ref id="b91-ccide-8-095"><label>91</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Klemetti</surname>
<given-names>E</given-names>
</name>
<name><surname>Collin</surname>
<given-names>HL</given-names>
</name>
<name><surname>Forss</surname>
<given-names>H</given-names>
</name>
<name><surname>Markkanen</surname>
<given-names>H</given-names>
</name>
<name><surname>Lassila</surname>
<given-names>V</given-names>
</name>
</person-group>
<article-title>Mineral status of skeleton and advanced periodontal disease</article-title>
<source>J Clin Periodontol</source>
<year>1994</year>
<volume>21</volume>
<fpage>184</fpage>
<lpage>188</lpage>
<pub-id pub-id-type="pmid">8157771</pub-id>
</element-citation>
</ref>
<ref id="b92-ccide-8-095"><label>92</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jonasson</surname>
<given-names>G</given-names>
</name>
</person-group>
<article-title>Five-year alveolar bone level changes in women of varying skeletal bone mineral density and bone trabeculation</article-title>
<source>Oral Surg Oral Med Oral Pathol Oral Radiol</source>
<year>2015</year>
<volume>120</volume>
<fpage>86</fpage>
<lpage>93</lpage>
<pub-id pub-id-type="pmid">26093684</pub-id>
</element-citation>
</ref>
<ref id="b93-ccide-8-095"><label>93</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Rizzoli</surname>
<given-names>R</given-names>
</name>
<name><surname>Bonjour</surname>
<given-names>J-P</given-names>
</name>
</person-group>
<article-title>Hormones and bones</article-title>
<source>Lancet</source>
<year>1997</year>
<volume>349</volume>
<fpage>120</fpage>
<lpage>123</lpage>
</element-citation>
</ref>
<ref id="b94-ccide-8-095"><label>94</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Riggs</surname>
<given-names>BL</given-names>
</name>
<name><surname>Khosla</surname>
<given-names>S</given-names>
</name>
<name><surname>Atkinson</surname>
<given-names>EJ</given-names>
</name>
<name><surname>Dunstan</surname>
<given-names>CR</given-names>
</name>
<name><surname>Melton</surname>
<given-names>LJ</given-names>
<suffix>III</suffix>
</name>
</person-group>
<article-title>Evidence that type I osteoporosis results from enhanced responsiveness of bone to estrogen deficiency</article-title>
<source>Osteoporos Int</source>
<year>2003</year>
<volume>14</volume>
<fpage>728</fpage>
<lpage>733</lpage>
<pub-id pub-id-type="pmid">12879223</pub-id>
</element-citation>
</ref>
<ref id="b95-ccide-8-095"><label>95</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jacobs</surname>
<given-names>R</given-names>
</name>
<name><surname>Ghyselen</surname>
<given-names>J</given-names>
</name>
<name><surname>Koninckx</surname>
<given-names>P</given-names>
</name>
<name><surname>van Steenberghe</surname>
<given-names>D</given-names>
</name>
</person-group>
<article-title>Long-term bone mass evaluation of mandible and lumbar spine in a group of women receiving hormone replacement therapy</article-title>
<source>Eur J Oral Sci</source>
<year>1996</year>
<volume>104</volume>
<fpage>10</fpage>
<lpage>16</lpage>
<pub-id pub-id-type="pmid">8653490</pub-id>
</element-citation>
</ref>
<ref id="b96-ccide-8-095"><label>96</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Thumbigere-Math</surname>
<given-names>V</given-names>
</name>
<name><surname>Michalowicz</surname>
<given-names>BS</given-names>
</name>
<name><surname>Hodges</surname>
<given-names>JS</given-names>
</name>
<etal></etal>
</person-group>
<article-title>Periodontal disease as a risk factor for bisphosphonate-related osteonecrosis of the jaw</article-title>
<source>J Periodontol</source>
<year>2014</year>
<volume>85</volume>
<fpage>226</fpage>
<lpage>233</lpage>
<pub-id pub-id-type="pmid">23786404</pub-id>
</element-citation>
</ref>
<ref id="b97-ccide-8-095"><label>97</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Friberg</surname>
<given-names>B</given-names>
</name>
<name><surname>Jemt</surname>
<given-names>T</given-names>
</name>
<name><surname>Lekholm</surname>
<given-names>U</given-names>
</name>
</person-group>
<article-title>Early failures in 4,641 consecutively placed Brånemark dental implants: a study from stage 1 surgery to the connection of completed prostheses</article-title>
<source>Int J Oral Maxillofac Implants</source>
<year>1991</year>
<volume>6</volume>
<fpage>142</fpage>
<lpage>146</lpage>
<pub-id pub-id-type="pmid">1809668</pub-id>
</element-citation>
</ref>
<ref id="b98-ccide-8-095"><label>98</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Friberg</surname>
<given-names>B</given-names>
</name>
<name><surname>Ekestubbe</surname>
<given-names>A</given-names>
</name>
<name><surname>Mellstrom</surname>
<given-names>D</given-names>
</name>
<name><surname>Sennerby</surname>
<given-names>L</given-names>
</name>
</person-group>
<article-title>Branemark implants and osteoporosis: a clinical exploratory study</article-title>
<source>Clin Implant Dent Relat Re</source>
<year>2001</year>
<volume>3</volume>
<fpage>50</fpage>
<lpage>56</lpage>
</element-citation>
</ref>
<ref id="b99-ccide-8-095"><label>99</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bridges</surname>
<given-names>T</given-names>
</name>
<name><surname>King</surname>
<given-names>G</given-names>
</name>
<name><surname>Mohammad</surname>
<given-names>A</given-names>
</name>
</person-group>
<article-title>The effect of age on tooth movement and mineral density in the alveolar tissue of the rat</article-title>
<source>Am J Orthod Dentofacial Orthop</source>
<year>1988</year>
<volume>93</volume>
<fpage>245</fpage>
<lpage>250</lpage>
<pub-id pub-id-type="pmid">3422781</pub-id>
</element-citation>
</ref>
<ref id="b100-ccide-8-095"><label>100</label>
<element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Goldie</surname>
<given-names>RS</given-names>
</name>
<name><surname>King</surname>
<given-names>GJ</given-names>
</name>
</person-group>
<article-title>Root resorption and tooth movement in orthodontically treated, calcium-deficient, and lactating rats</article-title>
<source>Am J Orthod</source>
<year>1984</year>
<volume>85</volume>
<fpage>424</fpage>
<lpage>430</lpage>
<pub-id pub-id-type="pmid">6586081</pub-id>
</element-citation>
</ref>
</ref-list>
</back>
<floats-group><fig id="f1-ccide-8-095" position="float"><label>Figure 1</label>
<caption><p>The three panoramic radiographs show the large variation in bone mass, trabeculation, and basal cortex in persons 79- or 80-years-old.</p>
<p><bold>Notes:</bold>
(<bold>A</bold>
) Shows a male with dense trabecular bone and thick basal compacta, (<bold>B</bold>
) a female with sparse trabecular bone and thin eroded compacta, and (<bold>C</bold>
) an old edentulous female with extremely resorbed alveolar process.</p>
</caption>
<graphic xlink:href="ccide-8-095Fig1"></graphic>
</fig>
<fig id="f2-ccide-8-095" position="float"><label>Figure 2</label>
<caption><p>The radiograph is of a 48-year-old osteoporotic female. The trabecular network is disrupted in two locations around the second premolar.</p>
<p><bold>Notes:</bold>
The vertical trabeculae have disappeared, whereas the horizontal ones have been reinforced.</p>
</caption>
<graphic xlink:href="ccide-8-095Fig2"></graphic>
</fig>
<fig id="f3-ccide-8-095" position="float"><label>Figure 3</label>
<caption><p>Visual index for assessment of cortical shape.</p>
<p><bold>Notes:</bold>
Reference images presenting dense trabeculation and a normal mandibular cortex with even and sharp endosteal margin (<bold>A</bold>
), mixed trabeculation, and a moderately eroded cortex with endosteal margin showing semilunar defects (<bold>B</bold>
), sparse trabeculation, and severely eroded cortex, with the cortical layer being clearly porous (<bold>C</bold>
).</p>
</caption>
<graphic xlink:href="ccide-8-095Fig3"></graphic>
</fig>
<fig id="f4-ccide-8-095" position="float"><label>Figure 4</label>
<caption><p>Visual index for assessment of trabecular bone.</p>
<p><bold>Notes:</bold>
Reference images presenting the trabecular pattern as sparse trabeculation in females with: large intertrabecular spaces (<bold>A</bold>
); mixed dense plus sparse trabeculation with small intertrabecular spaces cervically and larger spaces more apically (<bold>B</bold>
); and dense trabeculation with small intertrabecular spaces (<bold>C</bold>
).</p>
</caption>
<graphic xlink:href="ccide-8-095Fig4"></graphic>
</fig>
<fig id="f5-ccide-8-095" position="float"><label>Figure 5</label>
<caption><p>Kaplan–Meier survival curve showing cumulative “fracture” survival and risk time for fracture in three different trabeculation groups.</p>
<p><bold>Notes:</bold>
1) Survival of women with dense trabeculation, 2) mixed trabeculation, and 3) sparse trabeculation. Risk time represents the time interval between baseline assessment and fracture event. All participants included (n=518), started “fracture-free” at baseline (1980) and experienced 136 first, incident fractures during the period 1980–2006.</p>
</caption>
<graphic xlink:href="ccide-8-095Fig5"></graphic>
</fig>
</floats-group>
</pmc>
</record>
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