Assessment of periodontal inflammatory burden and radiomorphometric indices in geriatric individuals in Turkey: a retrospective study

Abstract

Background: Oral health in older adults is frequently compromised due to a higher prevalence of periodontal disease, tooth loss, and systemic conditions such as osteoporosis. Altough the association between periodontitis and osteoporosis has been explored, further research is warranted to assess the periodontal inflammatory burden in the context of bone health. This study hypothesised that periodontal inflammatory burden, measured by Periodontal Inflamed Surface Area (PISA), may contribute to osteoporotic changes in the mandible. The objective was to evaluate the relationship between periodontal status and mandibular osteoporotic changes by assessing inflammatory burden via PISA and panoramic radiomorphometric indices in geriatric individuals. Methods: This retrospective study included 149 patients aged ≥ 65 years. Participants were grouped by periodontal health, and PISA values were calculated. Panoramic radiographs were analysed to assess mandibular bone quality using the Mental Index (MI), Panoramic Mandibular Index (PMI), and Mandibular Cortical Index (MCI). Statistical analyses evaluated the associations between periodontal status, PISA values, and radiomorphometric indices. Results: The mean participant age was 70 ± 4 years. There were no significant differences in MI, PMI, or MCI among periodontal health groups (p > 0.05). However, PISA values showed substantial correlations with MI (p = 0.024), PMI (p = 0.005), and MCI (p = 0.04), indicating a potential association between periodontal inflammation and mandibular bone structure. Conclusions: To the best of our knowledge, this is the first study to correlate PISA values with mandibular osteoporotic changes. While the periodontitis stage was not significantly associated with radiomorphometric indices, PISA was. These findings suggest that inflammatory burden, rather than disease severity alone, may influence mandibular bone characteristics. PISA may serve as a valuable indicator of inflammation-related bone changes. © 2025 Elsevier B.V., All rights reserved.