Vol 91, No 3 (2020)
Research paper
Published online: 2020-03-31

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Factors affecting puberty gingivitis in Polish girls with adolescent idiopathic scoliosis

Joanna Glowacka1, Justyna Opydo-Szymaczek2, Katarzyna Mehr3, Grazyna Jarzabek-Bielecka4, Jakub Glowacki5
Pubmed: 32266949
Ginekol Pol 2020;91(3):103-110.


Objectives: Age at menarche and hormonal disturbances have been linked to the occurrence and severity of adolescent
idiopathic scoliosis (AIS). Concomitantly, an increase in the production of sex hormones during puberty may result in steroid
hormones-related gingivitis. Thus, the study aimed to assess the prevalence and factors affecting puberty gingivitis,
including menarcheal status, in female patients with AIS and control subjects.
Material and methods: The study group was comprised of 59 girls aged 12–16 years with AIS and 50 healthy controls. Dental
examination included the assessment of oral hygiene, gingivitis, and dental caries intensity. Data were statistically analyzed
with a significance taken as p < 0.05.
Results: There wasn’t any statistically significant difference in the age at menarche and menarcheal status of both groups. During
regression analysis, three predictors significantly affected gingival status of girls: oral hygiene, orthopedic condition,
and laterality of the curve. Scoliosis and left convex of the curve significantly increased the index of gingival inflammation.
Conclusions: The results indicate that gingivitis is frequent among female adolescents with AIS, due to poor oral hygiene
and higher susceptibility to inflammation. It emphasizes a need for a development of preventive strategy for scoliotic patients,
since incipient periodontal problems in children may turn into irreversible advanced periodontal diseases in adults.

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  1. Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. Dtsch Arztebl Int. 2010; 107(49): 875–83; quiz 884.
  2. Fadzan M, Bettany-Saltikov J. Etiological Theories of Adolescent Idiopathic Scoliosis: Past and Present. Open Orthop J. 2017; 11: 1466–1489.
  3. Mao SH, Jiang J, Sun Xu, et al. Timing of menarche in Chinese girls with and without adolescent idiopathic scoliosis: current results and review of the literature. Eur Spine J. 2011; 20(2): 260–265.
  4. Durda-Masny M, Hanć T, Czapla Z, et al. BMI at menarche and timing of growth spurt and puberty in Polish girls - longitudinal study. Anthropol Anz. 2019; 76(1): 37–47.
  5. Grivas TB, Vasiliadis E, Mouzakis V, et al. Association between adolescent idiopathic scoliosis prevalence and age at menarche in different geographic latitudes. Scoliosis. 2006; 1: 9.
  6. Goldberg CJ, Dowling FE, Fogarty EE. Adolescent idiopathic scoliosis--early menarche, normal growth. Spine (Phila Pa 1976). 1993; 18(5): 529–535.
  7. Ylikoski M, Peltonen J, Poussa M. Biological factors and predictability of bracing in adolescent idiopathic scoliosis. J Pediatr Orthop. 1989; 9(6): 680–683.
  8. Kulis A, Goździalska A, Drąg J, et al. Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis. Int Orthop. 2015; 39(6): 1227–1236.
  9. Kaplowitz PB. Link between body fat and the timing of puberty. Pediatrics. 2008; 121 Suppl 3: S208–S217.
  10. Grivas TB, Burwell RG, Mihas C, et al. Relatively lower body mass index is associated with an excess of severe truncal asymmetry in healthy adolescents: Do white adipose tissue, leptin, hypothalamus and sympathetic nervous system influence truncal growth asymmetry? Scoliosis. 2009; 4: 13.
  11. Grivas TB, Arvaniti A, Maziotou C, et al. Comparison of body weight and height between normal and scoliotic children. Stud Health Technol Inform. 2002; 91: 47–53.
  12. Matusik E, Durmała J, Matusik P, et al. Evaluation of nutritional status of children and adolescents with idiopathic scoliosis: a pilot study. Ortop Traumatol Rehabil. 2012; 14(4): 351–362.
  13. Holmes SJ, Shalet SM. Role of growth hormone and sex steroids in achieving and maintaining normal bone mass. Horm Res. 1996; 45(1-2): 86–93.
  14. Saggese G, Bertelloni S, Baroncelli GI. Sex steroids and the acquisition of bone mass. Horm Res. 1997; 48 Suppl 5: 65–71.
  15. Hosoi T. Genetic aspects of osteoporosis. J Bone Miner Metab. 2010; 28(6): 601–607.
  16. Warren MP, Brooks-Gunn J, Hamilton LH, et al. Scoliosis and fractures in young ballet dancers. Relation to delayed menarche and secondary amenorrhea. N Engl J Med. 1986; 314(21): 1348–1353.
  17. Esposito T, Uccello R, Caliendo R, et al. Estrogen receptor polymorphism, estrogen content and idiopathic scoliosis in human: a possible genetic linkage. J Steroid Biochem Mol Biol. 2009; 116(1-2): 56–60.
  18. Raczkowski JW. The concentrations of testosterone and estradiol in girls with adolescent idiopathic scoliosis. Neuro Endocrinol Lett. 2007; 28(3): 302–304.
  19. Zhang HQ, Lu SJ, Tang MX, et al. Association of estrogen receptor beta gene polymorphisms with susceptibility to adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2009; 34(8): 760–764.
  20. Sooriyamoorthy M, Gower DB. Hormonal influences on gingival tissue: relationship to periodontal disease. J Clin Periodontol. 1989; 16(4): 201–208.
  21. Mariotti A, Mawhinney M. Endocrinology of sex steroid hormones and cell dynamics in the periodontium. Periodontol 2000. 2013; 61(1): 69–88.
  22. Saccucci M, Tettamanti L, Mummolo S, et al. Scoliosis and dental occlusion: a review of the literature. Scoliosis. 2011; 6: 15.
  23. Laskowska M, Tyrakowski M, Zadurska M, et al. Dental health status and needs associated with conservative and orthodontic treatment in children and adolescents with idiopathic scoliosis. Nowa Stom. 2017; 4: 171–180.
  24. D'Andrea LP, Betz RR, Lenke LG, et al. Do radiographic parameters correlate with clinical outcomes in adolescent idiopathic scoliosis? Spine (Phila Pa 1976). 2000; 25(14): 1795–1802.
  25. Bunnell WP. An objective criterion for scoliosis screening. J Bone Joint Surg Am. 1984; 66(9): 1381–1387.
  26. Petersen PE, Baez RJ. World Health Organization, Oral health surveys: basic methods, 5th edition. : 2013.
  27. Hiremath SS. Textbook of Preventive and Community Dentistry, 2nd Edition. Elsevier. ; 2011.
  28. World Health Organization, 2007. Growth reference 5-19. BMI-for-age for girls. https://www.who.int/growthref/bmifa_girls_5_19years_z.pdf?ua=1 (December 3, 2019).
  29. Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018; 45 Suppl 20: S1–S8.
  30. Nirola A, Batra P, Kaur J. Ascendancy of sex hormones on periodontium during reproductive life cycle of women. Journal of the International Clinical Dental Research Organization. 2018; 10(1): 3.
  31. Nakagawa S, Fujii H, Machida Y, et al. A longitudinal study from prepuberty to puberty of gingivitis. Correlation between the occurrence of Prevotella intermedia and sex hormones. J Clin Periodontol. 1994; 21(10): 658–665.
  32. Markou E, Eleana B, Lazaros T, et al. The influence of sex steroid hormones on gingiva of women. Open Dent J. 2009; 3: 114–119.
  33. von Bremen J, Lorenz N, Ruf S. Impact of body mass index on oral health during orthodontic treatment: an explorative pilot study. Eur J Orthod. 2016; 38(4): 386–392.
  34. Modéer T, Blomberg C, Wondimu B, et al. Association between obesity and periodontal risk indicators in adolescents. Int J Pediatr Obes. 2011; 6(2-2): e264–e270.
  35. Wood N, Johnson RB, Streckfus CF. Comparison of body composition and periodontal disease using nutritional assessment techniques: Third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol. 2003; 30(4): 321–327.
  36. Goldberg CJ, Moore DP, Fogarty EE, et al. Left thoracic curve patterns and their association with disease. Spine (Phila Pa 1976). 1999; 24(12): 1228–1233.
  37. Takahashi Y, Matsumoto M, Karasugi T, et al. Replication study of the association between adolescent idiopathic scoliosis and two estrogen receptor genes. J Orthop Res. 2011; 29(6): 834–837.
  38. Janusz P, Kotwicka M, Andrusiewicz M, et al. Estrogen receptors genes polymorphisms and age at menarche in idiopathic scoliosis. BMC Musculoskelet Disord. 2014; 15: 383.
  39. Vittek J, Hernandez MR, Wenk EJ, et al. Specific estrogen receptors in human gingiva. J Clin Endocrinol Metab. 1982; 54(3): 608–612.
  40. Zhang Li, Meng H, Zhao H, et al. Estrogen receptor-alpha gene polymorphisms in patients with periodontitis. J Periodontal Res. 2004; 39(5): 362–366.
  41. Wyganowska-Swiatkowska M. Potential Association of Estrogen Receptor 2 Variant with Chronic Periodontitis. Biomedical Journal of Scientific & Technical Research. 2019; 13(4).