Validity of Clinical Attachment Loss for Diagnosis of Osteoporosis in Postmenopausal Women

Abstract

Background: Osteoporosis is an important disease with significant fracture morbidity. Objective: To assess validity of clinical attachment loss (CAL)for diagnose osteoporosis in post-menopausal women Patients and Methods: This cross sectional study included 75 postmenopausal women. Osteoporosis was diagnosed by dual energy xray absorptiometry (DXA).CAL was calculated using the probing pocket depth and the level of the gingival margin Results: Of 75 women involved in the study, 25 were healthy postmenopausal women, 25 had osteopenia, and 25 had osteoporosis. There was no statistical significant differences between age and body mass index in all groups (p>0.05).The effect of osteoporosis on increasing CAL was stronger (ROC area=0.92) than that of osteopenia (ROC area=0.68). Clinical attachment loss showed high statistically significant moderately strong (r=0.55) positive linear correlation with bone tscore. CALwas a valid parameter to predict osteoporosis in postmenopausal woman(ROC area=0.88, p<0.001).CAL at the optimum cut off value ≥3.34has highest accuracy (86.7%) to diagnose osteoporosis in postmenopausal women with sensitivity was 84%, specificity 88 %, positive predictive value (PPV) at pretest probability 50% was 87.5 % and PPV at pretest probability 90% was 98.4 % and negative predictive value (NPV) atpretest probability 10% was 98 %. Conclusions: CAL was a simple, easy, and a valid clinical test to diagnose osteoporosis in postmenopausal women with high accuracy. This may indicate a hopeful measure for early diagnosis and treatment of osteoporosis