The relationship between skeletal and oral bone mineral density: an overview.

Is oral osteopenia (bone loss of the jaws) a component of systemic osteopenia/osteoporosis (systemic bone loss, with or without fracture) or only an accompanying manifestation of periodontal disease? Put other ways: 1) is systemic osteopenia a risk factor for periodontitis; 2) is systemic osteopenia a risk factor for oral osteopenia independent of periodontal disease; or 3) is periodontal disease the primary (exclusive) risk factor for oral osteopenia? Despite 2 decades of scientific inquiry into these questions, the answers remain elusive.