Authors : Dr. Madhu S Ratre; Dr. Veena Kalburgi; Dr. Neha Patle; Dr. Mitisha Sawant; Dr. Shivangi Singh

Volume/Issue : Volume 11 - 2026, Issue 1 - January

Google Scholar : https://tinyurl.com/yuukzkw9

Scribd : https://tinyurl.com/5n83b68b

DOI : https://doi.org/10.38124/ijisrt/26jan1584

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Periodontal disease is a chronic inflammatory condition that has been increasingly associated with systemic inflammation, as indicated by elevated C-reactive protein (CRP) levels. Postmenopausal women are particularly susceptible due to estrogen deficiency–related alterations in bone metabolism, immune regulation, and inflammatory responses. Available evidence indicates that postmenopausal women exhibit a higher prevalence and greater severity of periodontal disease, often accompanied by increased CRP or high-sensitivity CRP levels, suggesting an enhanced systemic inflammatory burden. Estrogen deficiency contributes to alveolar bone loss and increased production of pro-inflammatory cytokines, while chronic periodontal infection acts as a persistent inflammatory stimulus, together promoting elevated CRP synthesis. Factors such as body mass index, diabetes mellitus, smoking, and hormone replacement therapy may modify this association. Overall, the literature supports a significant relationship between periodontal status and CRP levels in postmenopausal women, underscoring the importance of periodontal health in reducing systemic inflammation and related health risks.

Keywords : Postmenopausal Women; Periodontal Disease; Periodontitis; C-Reactive Protein; High-Sensitivity C-Reactive Protein; Systemic Inflammation; Estrogen Deficiency; Alveolar Bone Loss; Menopause; Oral-Systemic Health.

References :

1. Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017;3:17038.
2. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet. 2005;366(9499):1809–1820.
3. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest. 2003;111(12):1805–1812.
4. Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol. 2008;35(4):277–290.
5. D’Aiuto F, Parkar M, Tonetti MS. Periodontal therapy: a novel non-drug-induced reduction of systemic inflammatory markers. J Periodontol. 2006;77(6):988–997.
6. Passos JS, Vianna MI, Gomes-Filho IS, et al. Osteoporosis/osteopenia as an independent factor associated with periodontitis in postmenopausal women. Cien Saude Colet. 2013;18(6):1735–1742.
7. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin-6, and risk of developing type 2 diabetes mellitus. JAMA. 2001;286(3):327–334.
8. Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton. Trends Endocrinol Metab 2012;23(11):576–81.
9. Lerner UH. Bone remodeling in post-menopausal osteoporosis. J Dent Res. 2006;85(7):584–595.
10. Tezal M, Wactawski-Wende J, Grossi SG, et al. The relationship between bone mineral density and periodontitis in postmenopausal women. J Periodontol. 2000;71(9):1492–1498.
11. Pacifici R. Estrogen, cytokines and pathogenesis of postmenopausal osteoporosis. J Bone Miner Res 1996;11:1043-51. 33.
12. Pacifici R, Brown C, Pusheck E. Effect of surgical menopause and estrogen replacement on cytokine release from human blood mononuclear cells. Proc Natl Acad Sci USA 1991; 88:5134-8.
13. López Marcos JF, García Valle S, García Iglesias AA. Periodontal aspects in menopausal women undergoing hormone replacement therapy. Med Oral Patol Oral Cir Bucal 2005;10:132-41.
14. Scardina GA, Messina P. Oral microcirculation in post‐menopause: a possible correlation with periodontitis. Gerodontology. 2012 Jun;29(2):e1045-51.
15. Lee DJ, Wu L, Shimono M, Piao Z, Green DW, Lee JM, et al. Differential mechanism of periodontitis progression in postmenopause. Frontiers in physiology. 2018 Aug 14;9:1098.
16. Rajan T, Rajasekar A, Rajasekar A. Assessment of periodontal status among post menopausal women: A retrospective study. Int J Dent Oral Sci. 2020 Nov 25;7:1063-6.
17. Reinhardt RA, Payne JB, Maze CA, et al. Influence of estrogen and osteopenia/osteoporosis on clinical periodontitis in postmenopausal women. J Periodontol. 1999;70(8):823–828.
18. Sharma N, Sharma RK, Tewari S, Chauhan M, Bhatia A. Association of periodontal inflammation, systemic inflammation, and duration of menopausal years in postmenopausal women. Quintessence Int. 2018;49(2):123–131.
19. Riggs BL. The mechanisms of estrogen regulation of bone resorption. J Clin Invest. 2000;106(10):1203–1204.
20. Ridker PM. High-sensitivity C-reactive protein: potential adjunct for global risk assessment in primary prevention of cardiovascular disease. Circulation. 2001;103(13):1813–1818.
21. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease. Circulation. 2003;107(3):499–511.
22. Loos BG. Systemic markers of inflammation in periodontitis. Journal of periodontology. 2005 Nov;76:2106-15.
23. Salberz D, Dorn BR, Lang NP, Faddy MJ, Kinane DF. Elevated C-reactive protein levels in aggressive periodontitis. J Clin Periodontol. 2006;33(5):357–363.
24. El Khoudary SR, Thurston RC, Sutton-Tyrrell K, et al. Systemic inflammation during the menopausal transition: findings from the Study of Women’s Health Across the Nation (SWAN). Menopause. 2025;32(1):1–9.
25. Mariotti A. A Primer on Inflammation. Compendium 2004;25(suppl-1) 7-15.
26. Shapira L, Soskolne WA, Sela MN, Offenbacher S, Barak V. The secretion of PGE2, IL-1 beta, IL-6 and TNF alpha by adherent mononuclear cells from early onset periodontitis patients. J Periodontol.1994;65:139-46.
27. Loos BG, Craandijk J, Hoek FJ, Paulein ME. Wertheim-van Dillen PM, van der Velden U. Elevation of Systemic Markers Related to Cardiovascular Diseases in the Peripheral Blood of Periodontitis Patients. J Periodontal 2000;71:1528-34.
28. Potempa J, Banbula A, Travis J. Role of Bacterial Proteinases in matrix destruction and modulation of host responses. Periodontol 2000;24:153-92.
29. Amar S, Han X. The impact of periodontal infection on systemic diseases. Med Sci Monit 2003;9: RA291-9.
30. Zambson JJ, Reynolds JS, Chen P, Genco RJ. Slots J, Thomas ER. Microbiology of Periodontal Disease. In:Slots J Taubman JE, eds. Contemporary Oral Microbiology and Immunology, St. Louis, USA: Mosby. 1985;32-40.
31. Payne JB, Reinhardt RA, Nummikoski PV, Patil KD. Longitudinal alveolar bone loss in postmenopausal women with osteoporosis. Osteoporos Int. 1999;10(1):34–40.
32. López-Marcos JF, García-Valle S, García-Iglesias AA. Periodontal aspects in menopausal women undergoing hormone replacement therapy. Med Oral Patol Oral Cir Bucal. 2005;10:132–141.
33. Esteves-Lima RP, Reis CS, Santirocchi-Júnior F, Abreu LG, Costa FO. Association between periodontitis and serum C-reactive protein levels. J Periodontol. 2023;94(2):214–222.
34. Pacifici R. Cytokines, estrogen, and postmenopausal osteoporosis—the second decade. Endocrinology. 1998;139(6):2659–2661.
35. Visser M, Bouter LM, McQuillan GM, et al. Elevated C-reactive protein levels in overweight and obese adults. JAMA. 1999;282(22):2131–2135.
36. Shifren JL, Gass ML. The North American Menopause Society recommendations for hormone therapy. Menopause. 2014;21(10):1038–1062.