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Mandibular and Palatal Tori, Bone Mineral Density, and Salivary Cortisol in Community-Dwelling Elderly Men and Women

^a Division of Oral Medicine and Diagnostic Sciences, Marquette University School of Dentistry, Milwaukee, Wisconsin
^b Departments of Medicine, Medical College of Wisconsin, Milwaukee
^c Departments of Biophysics and Radiology, Medical College of Wisconsin, Milwaukee
^d Zablocki Veterans Affairs Medical Center, Milwaukee, Wisconsin
^e Department of Psychology, University of Wisconsin-Milwaukee
^f Endocrine Research Laboratory, St. Luke's Medical Center, Milwaukee, Wisconsin

Jadwiga Hjertstedt, Division of Oral Medicine and Diagnostic Sciences, Marquette University School of Dentistry, P.O. Box 1881, Milwaukee, WI 53201-1881 E-mail: Jadwiga.Hjertstedt{at}marquette.edu.

Decision Editor: John E. Morley, MB, BCh

Background. This investigation evaluated the relationship between the presence of tori and bone mineral density (BMD) and salivary cortisol levels.

Methods. A total of 230 healthy, community-dwelling elderly men (n = 129) and women (n = 101) aged 60 and older participated in this study. Forty-three women were on hormone replacement therapy (HRT). This was a component of a 5-year longitudinal study measuring subjects' body composition, hormone levels, physical activity, and diet every 6 months. Subjects were examined for the presence of tori by visual inspection and digital palpation. BMD at six sites was measured by dual-energy X-ray absorptiometry. Salivary cortisol levels were measured by radioimmunoassay.

Results. Twenty-three percent of all subjects had mandibular tori, 13% had palatal tori, and 12% had both mandibular and palatal tori. Mandibular tori were more common in men, and palatal tori were more common in women. The presence of mandibular tori was significantly correlated with BMD of the lumbar spine, femoral neck, trochanter, and Ward's triangle for all subjects, and with the femoral neck and trochanter of women not on HRT. Men with palatal tori had lower levels of salivary cortisol in the evening.

Conclusions. This study documented the high prevalence of mandibular and palatal tori in a group of 230 elderly, community-dwelling subjects. Women not on HRT and all subjects taken as a group with mandibular tori had higher BMD. The presence of tori at young adulthood may be a marker of higher BMD in the future and of a lower risk for developing osteoporosis.