Sex hormone replacement therapy in periodontology-A systematic review

Oral Dis. 2020 Mar;26(2):270-284. doi: 10.1111/odi.13059. Epub 2019 Mar 7.

Abstract

Objective: To analyse whether sex hormone replacement therapy (HRT) improves periodontal parameters and dental implants osseointegration in humans.

Materials and methods: Electronic databases and hand searches were performed from June to August 2018 in SciELO, LILACS and PubMed/MEDLINE. Human observational and interventional studies that evaluated the following parameters were included: clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BOP), radiographic bone loss (RBL) or osseointegration.

Results: Initial search retrieved 1,282 non-duplicated articles. Fifteen studies were selected after inclusion criteria were applied. All studies were performed in postmenopausal women. Mean differences for PPD reduction ranged from 0.02 to 0.2 mm in HRT-positive patients; mean CAL gain -0.18 to 0.54 mm; mean RBL reduction -0.87 to 0.15 mm; and mean BOP reduction 9%-30.3%. Failure rate of dental implants increased -5.5% to 11.21% when HRT was used.

Conclusions: Very low but consistent evidence suggests a reduction in BOP and no impact on RBL in postmenopausal women receiving HRT. There are inconsistent reports that suggest that HRT in postmenopausal women: (a) improves or does not impact PPD reduction and CAL gain; and (b) does not impact or increase implant loss. In summary, there is no evidence to support HRT prescription for either men or women for periodontal/implant placement purposes.

Keywords: dental implants; hormone replacement therapy; menopause; oestrogens; periodontitis; testosterone.

Publication types

  • Systematic Review

MeSH terms

  • Alveolar Bone Loss / epidemiology
  • Dental Implants*
  • Female
  • Gonadal Steroid Hormones / physiology
  • Gonadal Steroid Hormones / therapeutic use*
  • Hormone Replacement Therapy* / adverse effects
  • Humans
  • Male
  • Osseointegration*
  • Periodontal Attachment Loss / epidemiology
  • Periodontal Index
  • Postmenopause

Substances

  • Dental Implants
  • Gonadal Steroid Hormones