Sex-Specific Associations with Periodontal Inflammation and Bone Loss: A Cross-Sectional Analysis

Background: To assess sex-related differences in periodontal inflammation and bone loss and identify sex-specific associations with systemic and local risk factors. Methods: This cross-sectional study analyzed records from a university setting. Outcomes were bleeding on probing (BOP) and bone loss index (BLI). Predictors included smoking, diabetes mellitus, age, plaque control record (PCR), the proportion of sites with pocket depth (PD) ≥ 5 mm, and number of teeth. Sex-stratified generalized linear models were applied. Results: A total of 232 participants were included (114 men, 118 women; mean age 55.6 ± 11.6 years). Men showed higher PD ≥ 5 mm (p = 0.030), with no sex difference in mean BOP or BLI. PD ≥ 5 mm predicted higher BOP in both sexes (men p < 0.001; women p = 0.002). Smoking was associated with higher BOP in men and with increased BLI in women (p = 0.010). PCR was positively associated with BOP in women and inversely with BLI in men (p = 0.042). Conclusions: In this study, sex-specific associations between behavioral/clinical factors and periodontal outcomes were observed. PD ≥ 5 mm was related to BOP in both sexes, while smoking and plaque control showed sex-divergent patterns. These exploratory findings warrant confirmation in prospective studies.