Association Between Vitamin D Deficiency and Alveolar Bone Loss in Postmenopausal Women: A Cone-Beam CT-Based Clinical Investigation

Abstract

The reduction in bone mass of postmenopausal women is faster because of the lack of estrogen (and possibly because of a lack of vitamin D). Alveolar bone resorption has major implications on oral health as well as tooth retention in population. To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and alveolar bone loss in postmenopausal women using cone-beam computed tomography (CBCT) analysis. This cross-sectional research considered 284 postmenopausal women (aged 45-75 years) in dental clinics in Baghdad, Iraq, in January 2024- January 2025. Quantification of serum 25 (OH) D levels was done through chemiluminescent immunoassay. To determine alveolar bone height (ABH), bone density, and cortical thickness CBCT scans were done. The participants were stratified into three categories as vitamin D deficient (<20 ng/ mL), insufficient (20-29.9 ng/ mL), and sufficient (>= 30 ng/ mL). ANOVA, Pearson correlation, and multiple linear regressions were used to analyse the results statistically. The age of the participants (58.73 8.37 years) was normally distributed, with 147 (51.80%), 89 (31.30%), and 48 (16.90%) participants having a vitamin D deficiency, insufficiency, and sufficiency. Vitamin D deficient women exhibited statistically significant increases in alveolar bone loss (4.2:1.8 mm, p<0.001), decrease in bone density (421.3:89.2 HU vs 587.4:94.6 HU, p<0.001), and cortical thickness (0.8: 3 mm vs 1.4:4 mm, p<0.001) as compared to vitamin D sufficient women. A near inverse relationship was between the strength of 25(OH)D level and the loss of alveolar bone (r -0.742, p<0.001). The results of multiple regression analysis showed vitamin D deficiency to be the independent predictor of alveolar bone loss (B = -0.521, p<0.001), in which the predictor explained the variance of 55.1 percent. Deficiency of vitamin D is strongly related to added alveolar bone loss by postmenopausal women. BCT has the ability to give accurate measures of bone parameters. Vitamin D supplementation treatment options need to be proposed to generate oral bone health in this demographic.