Clinical and panoramic predictors of femur bone mineral density

Abstract

Dentists are a potentially valuable resource for initial patient screening for signs of osteoporosis, as individuals with osteoporosis have altered architecture of the inferior border of the mandible as seen on panoramic radiographs. Our aim was to evaluate the efficacy of combining clinical and dental panoramic radiographic risk factors for identifying individuals with low femoral bone mass. Bone mineral density was measured at the femoral neck and classified as normal, osteopenic or osteoporotic using WHO criteria in 227 Japanese postmenopausal women (33-84 years). Panoramic radiographs were made of all subjects. Mandibular cortical shape and width was determined and trabecular features were measured in each ramus. Mean subject age, height, and weight were significantly different in the three bone-density groups (P<0.0001). A classification and regression trees (CART) analysis using just clinical risk factors identified 136 (87%) of the 157 individuals with femoral osteopenia or osteoporosis. Mean mandible cortical width (P<0.0001), cortical index (P<0.0001) and trabecular features (P=0.02) were also significantly different in the three bone density groups. A CART analysis considering only radiographic features found 130 (83%) of the 157 individuals with femoral osteopenia or osteoporosis, although none of the subjects with osteoporosis was correctly identified. A CART analysis using both clinical and radiographic features found that the most useful risk factors were thickness of inferior border of the mandible and age. This algorithm identified 130 (83%) of the 157 individuals with femoral osteopenia or osteoporosis. The results of this study suggest that 1) clinical information is as useful as panoramic radiographic information for identifying subjects having low bone mass, and 2) dentists have sufficient clinical and radiographic information to play a useful role in screening for individuals with osteoporosis.

Association of type 2 diabetes mellitus with the reduction of mandibular residual ridge among edentulous patients using panoramic radiographs

“…As changes in the mandibular cortex can be detected on the OPG of patients with osteoporosis, it can be considered an important diagnostic tool [52] provided that diagnostic values are not lost due to projection errors resulting from disposition of the head [53]. OPGs can be used in determining the bone density, as a relationship between mandibular bone mineral density and the skeletal areas in evaluating osteoporosis has been shown [54].…”

Radiographic Signals Detection of Systemic Disease: Orthopantomographic Radiography

“…Yet in 2005 (White et al, 2005a) was suggested that the dentists possess clinical and radiographic information sufficient to detect patients with osteoporosis. White et al, 2005b concluded that changes in panoramic radiographic trabecular structure complemented by clinical information are predictive for hip fracture of aged women.…”

Bone Microarchitecture by Dentistry Digital X-Ray (B&micro;A-DDX) Software: A Pilot Study of the Analysis of Bone Density using Digital Dental X-Rays

“…Panoramic radiography is frequently used for dental office patients, especially in cases of dental implant treatment. Several studies have reported a correlation between radiomorphometric indices on dental radiographs and bone mineral density at the lumbar spine, femoral neck and mandible (Geraets et al, 2007;Devlin and Horner, 2002;Drozdzowska et al, 2001;White et al, 2005;Taguchi et al, 2006). It is therefore important to evaluate the use of panoramic radiography for the screening of individuals with low bone mineral density in order to aid in the referral of patients for bone densitometry.…”