{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:49:48Z","timestamp":1781246988450,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["03\/13776\u20105"],"award-info":[{"award-number":["03\/13776\u20105"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["300559\/2009\u20107"],"award-info":[{"award-number":["300559\/2009\u20107"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Bone loss is a feature of both periodontitis and osteoporosis, and several studies have analyzed whether the periodontal destruction could have been influenced by systemic bone loss. The aim of this study is to assess the association between clinical attachment level (CAL) and bone mineral density (BMD) at the lumbar spine and hip, lifestyle, smoking, sociodemographic factors, and dental clinical variables in postmenopausal women.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> One hundred forty\u2010eight women were interviewed using a structured written questionnaire and clinically examined. The periodontal examination, which was performed by calibrated investigators, included CAL, probing depth, gingival recession, bleeding on probing (BOP), visible plaque, supragingival calculus, and mean tooth loss. The sample was stratified into two groups: moderate and severe CAL. The moderate group had all sites with CAL \u22645 mm. The severe group had \u22651 site with CAL &gt;5 mm. BMD, measured using dual\u2010energy x\u2010ray absorptiometry, was assessed at the lumbar spine, femoral neck, and total femur (grams per square centimeters).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Severe CAL was identified in 86 women (58.1%). The multiple linear regression analysis using CAL (dependent variable), adjusted by menopause, education, and family income, demonstrated an inverse relationship of severe CAL with the BMD of the femoral neck (<jats:italic>P<\/jats:italic> = 0.015), as well as a positive association of severe CAL with tooth loss (<jats:italic>P<\/jats:italic> = 0.000), BOP (<jats:italic>P<\/jats:italic> = 0.004), and heavy smokers (<jats:italic>P<\/jats:italic> = 0.001).<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Our study demonstrated that severe CAL was associated with low BMD of the femoral neck and deleterious clinical dental parameters and smoking. Our findings suggest that, in addition to appropriate oral care, individuals with severe CAL may also require additional attention to their systemic bone health.<\/jats:p>","DOI":"10.1902\/jop.2012.120090","type":"journal-article","created":{"date-parts":[[2012,5,2]],"date-time":"2012-05-02T01:06:24Z","timestamp":1335920784000},"page":"352-359","source":"Crossref","is-referenced-by-count":22,"title":["Severe Loss of Clinical Attachment Level: An Independent Association With Low Hip Bone Mineral Density in Postmenopausal Females"],"prefix":"10.1002","volume":"84","author":[{"given":"Val\u00e9ria","family":"Gondim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Aun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassia Tiemi","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliam","family":"Takayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria do Ros\u00e1rio","family":"Latorre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e1udio Mendes","family":"Pannuti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa Maria","family":"Rodrigues Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Alexandre","family":"Romito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0757.2002.290104.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2005.00799.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0305-182X.2003.01229.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-5712(96)00029-2"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2842.2003.00981.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1875-595X.2001.tb00860.x"},{"key":"e_1_2_6_8_1","first-page":"156","article-title":"Tooth loss, denture wearing and oral health\u2010related quality of life in elderly Chinese people","volume":"22","author":"Wong MC","year":"2005","journal-title":"Community Dent Health"},{"key":"e_1_2_6_9_1","first-page":"1","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. 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