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Seki K, Nagasaki M, Yoshino T, Yano M, Kawamoto A, Shimizu O. Radiographical Diagnostic Evaluation of Mandibular Cortical Index Classification and Mandibular Cortical Width in Female Patients Prescribed Antiosteoporosis Medication: A Retrospective Cohort Study. Diagnostics (Basel) 2024; 14:1009. [PMID: 38786307 PMCID: PMC11119882 DOI: 10.3390/diagnostics14101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Osteoporosis is often detected late and becomes severe because of a lack of subjective symptoms. Digital panoramic radiography (DPR) has been reported to be useful for osteoporosis screening based on the morphological classification of the mandibular inferior cortex. The purpose of this study was to evaluate the sensitivity and specificity of the mandibular cortical index (MCI) in the diagnosis of osteoporosis in a group of patients who were and were not using antiosteoporosis medication (AOM). Three hundred and fifty female patients aged 40 years or older who had DPR imaging performed during a 6-year period from December 2015 to February 2022 met the selection criteria. Two examiners recorded mandibular cortical width and MCI from the images. These results were statistically examined together with the patients' demographic data. Forty-nine patients were using AOM (13 nonbisphosphonate/denosumab and 36 bisphosphonate/denosumab). MCI type 3 was the most common in the AOM group. In the MCI classification, DPR imaging among the AOM group was more sensitive (0.95) than that of the control group. This method of estimating osteoporosis based on MCI classification using DPR images has high sensitivity, especially in patients using AOM, suggesting that this method is useful as a screening test.
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Affiliation(s)
- Keisuke Seki
- Department of Comprehensive Dentistry and Clinical Education, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
- Division of Dental Education, Dental Research Center, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
| | - Maki Nagasaki
- Department of Oral and Maxillofacial Surgery I, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan; (M.N.); (O.S.)
| | - Tona Yoshino
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan;
| | - Mayuko Yano
- Nihon University School of Dentistry Dental Hospital, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan;
| | - Aki Kawamoto
- Dental Hygienist Section, Nihon University School of Dentistry Dental Hospital, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan;
| | - Osamu Shimizu
- Department of Oral and Maxillofacial Surgery I, Nihon University School of Dentistry, 1-8-13, Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan; (M.N.); (O.S.)
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Teterina A, Niratisairak S, Morseth B, Bolstad N. General and local predictors of mandibular cortical bone morphology in adult females and males: the seventh survey of the Tromsø Study. Clin Oral Investig 2023; 27:6577-6587. [PMID: 37735212 PMCID: PMC10630240 DOI: 10.1007/s00784-023-05263-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES To analyze factors predicting mandibular cortical width (MCW) and mandibular cortical index (MCI) in adult females and males. MATERIAL AND METHODS Data on 427 females and 335 males aged 40-84 from The Tromsø study: Tromsø7 were used. T-score, age, menopausal status (for females), remaining teeth, and periodontal status were analyzed in linear and logistic regression analyses as predictors of MCW and MCI, respectively. RESULTS T-score, age, and the number of remaining teeth significantly predicted MCW in females but not males. Standardized β coefficients were 0.286, -0.231, and 0.131, respectively. The linear regression model explained 24% of MCW variation in females. MCI in females was significantly predicted by T-score, age, and remaining teeth with the Wald values of 9.65, 6.17, and 5.83, respectively. The logistic regression model explained 16.3-23% of the variation in MCI in females. In males, T-score was the only significant predictor of the eroded cortex, and the logistic model explained only 4.3-5.8% of the variation in MCI. CONCLUSIONS The T-score demonstrated a stronger relationship with MCW and MCI than other factors in females, which supports the usefulness of those indices for osteoporosis screening. Conversely, the T-score exhibited no association with MCW and remained the only significant predictor of MCI in males, yet to a lesser extent than in females. CLINICAL RELEVANCE Understanding factors affecting mandibular cortical morphology is essential for further investigations of MCW and MCI usefulness for osteoporosis screening in females and males.
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Affiliation(s)
- Anna Teterina
- Department of Clinical Dentistry, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway.
| | - Sanyalak Niratisairak
- Department of Orthopaedics, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Biomechanics Laboratory, Rikshospitalet, Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway
| | - Napat Bolstad
- Department of Clinical Dentistry, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway
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Lee DH, Seo JI, Song SI, Lee JK. Radiographic changes of mandibular cortical bone in bisphosphonate drug holiday. J Korean Assoc Oral Maxillofac Surg 2022; 48:219-224. [PMID: 36043252 PMCID: PMC9433857 DOI: 10.5125/jkaoms.2022.48.4.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives There have been few studies to date on the residual effect of bisphosphonate. This study investigated the radiographic changes of mandibular cortical thickness upon bisphosphonate drug holiday. Materials and Methods This retrospective study includes 36 patients diagnosed with MRONJ (medication-related osteonecrosis of the jaw) at Ajou University Dental Hospital in 2010-2021. All patients stopped taking bisphosphonate under consultation with the prescribing physicians. Panoramic radiographs were taken at the start of discontinuation (T0), 12 months after (T1), and 18 months after (T2) discontinuation of bisphosphonate, respectively. Mental index and panoramic mandibular index were calculated using Ledgerton’s method. Paired t-tests were used to analyze differences over time. Results The difference in indices (mental index and panoramic mandibular index) between T0 and T1 was not statistically significant (paired t-test, P>0.05). However, the difference in these indices between T1 and T2 was statistically significant (paired t-test, P<0.05). Conclusion The cortical thickness of the mandible decreased in the late stage (after 18 months) as observed by panoramic radiograph.
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Affiliation(s)
- Dae-Hoon Lee
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine, Suwon, Korea
| | - Ja-In Seo
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine, Suwon, Korea
| | - Seung-Il Song
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine, Suwon, Korea
| | - Jeong-Keun Lee
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Ajou University School of Medicine, Suwon, Korea
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Santolia DD, Dahiya DS, Sharma DS, Khan DMA, Mohammed DN, Priya DH, Gupta DSR, Bhargava DS, Gupta DSR. Fractal Dimension and Radiomorphometric analysis of Orthopantomographs in patients with tobacco and areca nut associated oral mucosal lesions: a pilot in- vivo study in a North Indian cohort. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:627-638. [DOI: 10.1016/j.oooo.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 11/24/2022]
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Hong SW, Kang JH. Decreased mandibular cortical bone quality after botulinum toxin injections in masticatory muscles in female adults. Sci Rep 2020; 10:3623. [PMID: 32107437 PMCID: PMC7046747 DOI: 10.1038/s41598-020-60554-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 02/10/2020] [Indexed: 02/06/2023] Open
Abstract
This study aimed to clarify how masticatory muscle atrophy induced by botulinum toxin (BTX) injection affects cortical bone quality of the mandible using 3D modeling technology. A total of 39 young (26.9 ± 6.0 years) and 38 post-menopausal (55.3 ± 6.3 years) females were included. Computed tomography (CT) images were obtained before and after 12 months of treatment. Predictor variables were application of a stabilization splint, and/or two times of BTX injection in the bilateral temporalis and masseter muscles within a six-month interval. Outcome variables were changes in average Hounsfield units (HU) and cortical thickness of region of interest (ROI). 3D mandibular models were reconstructed using CT images, and models were used to calculate average HU and cortical thickness of ROIs, including inferior half of the lateral surface of ascending ramus, coronoid process, and temporomandibular joint condyle. Cortical bone quality at muscle insertion site was influenced by decreased muscle thickness but seemed not to be affected by decreased functional loading. Reduced functional loading seemed to influence cortical bone quality of the condyles. These effects were more remarkable in post-menopausal females. Hence, decreased masticatory muscle thickness may lead to alterations of the mandibular cortical structures, especially in post-menopausal females.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul, 03181, Korea
| | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Korea.
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Rashad A, Al-Dam A, Haydar Y. Is there a change in the mandibular cortical shape index in panoramic radiographs over time? A longitudinal retrospective study. Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.302898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Balto KA, Gomaa MM, Feteih RM, AlAmoudi NM, Elsamanoudy AZ, Hassanien MA, Ardawi MSM. Dental Panoramic Radiographic Indices as a Predictor of Osteoporosis in Postmenopausal Saudi Women. J Bone Metab 2018; 25:165-173. [PMID: 30237996 PMCID: PMC6135653 DOI: 10.11005/jbm.2018.25.3.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 01/27/2023] Open
Abstract
Background Many oral presentations of osteoporosis-a bone metabolic disease-were recorded. Thus, we aimed to assess panoramic radiomorphometric indices with bone mineral density (BMD) values among Saudi postmenopausal women and its importance in the prediction of osteoporosis. Methods A total of 431 Saudi women were enrolled in this study. Panoramic radiographs were obtained at the time of BMD measurement. Subjects were fatherly classified into; normal BMD, osteopenia, and osteoporosis groups. Serum follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), 25-hydroxy-vitamin D (25[OH]D) and intact-parathyroid hormone were measured. Moreover, serum creatinine, calcium, and phosphate, together with serum osteocalcin (s-OC), procollagen type I N-terminal propeptide (s-PINP) and cross-linked C-terminal telopeptide of type 1 collagen (s-CTX) were measured. Receiver-operator curve (ROC) curve analysis for use of mandibular cortical width (MCW), panoramic mandibular index (PMI), and maxillary-mandibular ratio (M/M ratio) to differentiate women with osteoporosis or osteopenia from normal subjects was calculated. Cut off values of 4.6 at T score <−1 and 4.1 at T score ≤−2.5 were used. Results Body mass index is significantly low in the osteoporotic group. There is no significant difference in serum levels of LH, E2, calcium, phosphate, and 25(OH)D between the studied groups. Moreover, s-OC, C-terminal propeptide of procollagen type I, s-PINP, s-CTX, and urinary-CTX are significantly higher in osteoporosis than normal and osteopenia groups. ROC curve analysis revealed that MCW and PMI showed significant data while M/M ratio is non-significant. Conclusions It could be concluded that MCW as an important panoramic radiographic parameter can be used for prediction and diagnosis of osteoporosis in postmenopausal Saudi women with low BMD.
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Affiliation(s)
- Khaled Abdullah Balto
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Madiha Mahmoud Gomaa
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rabab Mohammed Feteih
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthodontics and Maxillofacial Orthopedics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Najlaa Mohammed AlAmoudi
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayman Zaky Elsamanoudy
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Ahmed Hassanien
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed-Salleh M Ardawi
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
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Kurşun-Çakmak EŞ, Bayrak S. Comparison of fractal dimension analysis and panoramic-based radiomorphometric indices in the assessment of mandibular bone changes in patients with type 1 and type 2 diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:184-191. [PMID: 29805101 DOI: 10.1016/j.oooo.2018.04.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/16/2018] [Accepted: 04/21/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This study compared the fractal dimension (FD) and radiomorphometric indices in the assessment of mandibular bone of patients with type 1 (T1 DM) and type 2 diabetes mellitus (T2 DM). STUDY DESIGN Panoramic radiographs of 104 patients were evaluated to calculate FD, mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI) in the mandible. RESULTS No statistically significant differences were found in FD when T1 DM and T2 DM groups were compared with controls (P ≥ .168). Patients with T1 DM had significantly lower MCW (P < .001) and PMI (P = .030) compared with controls. Patients with T2 DM had no significant differences in MCW (P = .228) or PMI (P = .137) compared with controls. No significant differences were observed between patients with T1 DM and those with T2 DM for FD, MCW, and PMI (P > .05). In the T1 DM and T2 DM groups, there was a significant correlation between MCW and FD (P ≤ .011). No correlation was observed between FD and PMI in either the T1 DM group or the T2 DM group (P ≥ .142). No significant differences in MCI were observed between the DM groups and controls (P = .740) or between the T1 DM and T2 DM groups (P = 1.000). CONCLUSIONS The cortical and trabecular bone architectures of patients with T1 DM and T2 DM were not different. Patients with T1 DM had lower cortical measurements compared with controls.
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Affiliation(s)
| | - Seval Bayrak
- Abant İzzet Baysal University, Dentistry Faculty, Department of Dentomaxillofacial Radiology, Bolu, Turkey.
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Li G, Qian H, Guo S, Wang D, Sun C, Du Y, Cheng J, Jiang H. Assessment of aging characteristics of female condylar trabecular structure by cone-beam computed tomography. Oral Radiol 2018; 35:16-22. [DOI: 10.1007/s11282-018-0322-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/18/2017] [Indexed: 10/17/2022]
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Detecting the earliest radiological signs of bisphosphonate-related osteonecrosis. Br Dent J 2017; 224:26-31. [PMID: 29192692 DOI: 10.1038/sj.bdj.2017.1001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 01/14/2023]
Abstract
Introduction Oral bisphosphonates are the most commonly prescribed anti-resorptive drugs used in the treatment of osteoporosis, but osteonecrosis of the jaw is a serious complication. The early diagnosis of this destructive side effect is crucial in preventing excessive bone loss, pain and infection.Objective To aid dental practitioners in the early identification of bisphosphonate-related osteonecrosis of the jaw.Method A scoping review was carried out.Data sources We searched MEDLINE via OVID, EMBASE via OVID, Dentistry and Oral Sciences Source (DOSS), Proquest Dissertation and Theses Search, to identify references that described clinical and radiological findings in medication-related osteonecrosis of the jaw (MRONJ).Data selection Nineteen references mentioned the earliest radiological changes in MRONJ with a description of the observations and were included in the analysis.Data synthesis The radiographic signs included osteosclerosis/lysis, widening of the periodontal ligament and thickening of the lamina dura and cortex. To assess the quality of original data on which recommendations had been made, these 19 studies were subjected to a quality appraisal.Conclusion Using bone exposure as a criterion for diagnosis of MRONJ, leads to delayed diagnosis and a poor response to treatment. In those patients at risk of bone exposure with MRONJ, insufficient information is present in the literature to allow the general dental practitioner to reliably identify the radiographic features indicating imminent bone exposure. A well-designed prospective study is needed.
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Kwon AY, Huh KH, Yi WJ, Lee SS, Choi SC, Heo MS. Is the panoramic mandibular index useful for bone quality evaluation? Imaging Sci Dent 2017; 47:87-92. [PMID: 28680844 PMCID: PMC5489673 DOI: 10.5624/isd.2017.47.2.87] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/20/2017] [Accepted: 04/25/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose The aim of this study was to determine whether the panoramic mandibular index (PMI) is useful for assessing bone mineral density. We also analyzed the potential correlations between PMI parameters and patient age. Materials and Methods Four observers measured the PMI of both sides of the mental foramen using a picture archiving and communication system and images in the Digital Imaging and Communications in Medicine format. They studied 300 panoramic radiographic images of patients belonging to the following age groups: 40–49 years, 50–59 years, 60–69 years, 70–79 years, and 80–89 years. The observers were allowed to zoom in or out and to adjust the contrast of the images. Further, they were instructed to record the reasons for any measurements that could not be made. Then, we conducted a reliability analysis of the measured PMI and assessed the correlations between different patient age groups and the 3 parameters used for determining the PMI from the available data. Results Among the 600 data items collected, 23 items were considered unmeasurable by at least 1 observer for the following 4 reasons: postoperative state, lesion, unidentified mental foramen, and alveolar bone loss. The intraobserver reproducibility of the measurable data was 0.611-0.752. The mandibular cortical width (MCW) decreased significantly as patient age increased. Conclusion PMI had limited usability when the margin of the mental foramen was not clear. In contrast, MCW, a parameter used for determining the PMI, had fewer drawbacks than the PMI with respect to bone mineral density measurements and exhibited a significant correlation with patient age.
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Affiliation(s)
- Ah-Young Kwon
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Kavitha MS, Park SY, Heo MS, Chien SI. Distributional Variations in the Quantitative Cortical and Trabecular Bone Radiographic Measurements of Mandible, between Male and Female Populations of Korea, and its Utilization. PLoS One 2016; 11:e0167992. [PMID: 28002443 PMCID: PMC5176279 DOI: 10.1371/journal.pone.0167992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 11/24/2016] [Indexed: 11/18/2022] Open
Abstract
It is important to investigate the irregularities in aging-associated changes in bone, between men and women for bone strength and osteoporosis. The purpose of this study was to characterize the changes and associations of mandibular cortical and trabecular bone measures of men and women based on age and to the evaluation of cortical shape categories, in a large Korean population. Panoramic radiographs of 1047 subjects (603 women and 444 men) aged between 15 to 90 years were used. Mandibular cortical width (MCW), mandibular cortical index (MCI), and fractal dimensions (FD) of the molar, premolar, and anterior regions of the mandibular trabecular bone were measured. Study subjects were grouped into six 10-years age groups. A local linear regression smoothing with bootstrap resampling for robust fitting of data was used to estimate the relationship between radiographic mandibular variables and age groups as well as genders. The mean age of women (49.56 ± 19.5 years) was significantly higher than that of men (45.57 ± 19.6 years). The MCW of men and women (3.17mm and 2.91mm, respectively, p < 0.0001) was strongly associated with age and MCI. Indeed, trabecular measures also correlated with age in men (r > −0.140, p = 0.003), though not as strongly as in women (r > −0.210, p < 0.0001). In men aged over 55 years, only MCW was significantly associated (r = −0.412, p < 0.0001). Furthermore, by comparison of mandibular variables from different age groups and MCI categories, the results suggest that MCW was detected to be strongly associated in both men and women for the detection of bone strength and osteoporosis. The FD measures revealed relatively higher association with age among women than men, but not as strong as MCW.
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Affiliation(s)
- Muthu Subash Kavitha
- Department of Computer Vision and Image Processing, School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
| | - Soon-Yong Park
- Department of Computer and Robot Vision, School of Computer Science and Engineering, Kyungpook National University, Daegu, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National niversity, Seoul, South Korea
- * E-mail: (MSH); (SIC)
| | - Sung-Il Chien
- Department of Computer Vision and Image Processing, School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
- * E-mail: (MSH); (SIC)
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Barngkgei I, Halboub E, Almashraqi AA, Khattab R, Al Haffar I. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices. Imaging Sci Dent 2016; 46:185-202. [PMID: 27672615 PMCID: PMC5035724 DOI: 10.5624/isd.2016.46.3.185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 10/13/2015] [Accepted: 12/11/2015] [Indexed: 01/10/2023] Open
Abstract
Purpose The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. Materials and Methods A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. Results The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). Conclusion IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.
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Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria.; Department of Oral Medicine, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abeer Abdulkareem Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Razan Khattab
- Department of Periodontology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
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Kayipmaz S, Akçay S, Sezgin ÖS. Osteoporotic mandibular changes caused by type 2 diabetes mellitus: a comparative study by cone beam computed tomography imaging. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0252-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Apolinário AC, Sindeaux R, de Souza Figueiredo PT, Guimarães ATB, Acevedo AC, Castro LC, de Paula AP, de Paula LM, de Melo NS, Leite AF. Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment. Dentomaxillofac Radiol 2016; 45:20150400. [PMID: 26954289 DOI: 10.1259/dmfr.20150400] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To verify radiomorphometric indices and fractal dimension (FD) in dental panoramic radiographs (DPRs) of children with different types of osteogenesis imperfecta (OI) and also to verify the effect of pamidronate (PAM) treatment in such panoramic analyses. METHODS In this retrospective study, 197 DPRs of 62 children with OI Types I, III and IV who were in treatment with a comparable dosage of intravenous PAM were selected. The mandibular cortical width (MCW), mandibular cortical index, visual estimation of the cortical width and FD of three standardized trabecular and cortical mandibular regions of interest were obtained from the radiographs. Factorial analysis of variance and Fisher test were used to compare FD and MCW measurements in children with different types of OI for different PAM cycles. RESULTS Children with all types of OI have thinner and more porous mandibular cortices at the beginning of treatment. There were significant differences between MCW and FD of the cortical bone, regarding different types of OI and number of PAM cycles (p = 0.037 and p = 0.044, respectively). FD measurements of the trabecular bone were not statistically different among OI types nor were PAM cycles (p > 0.05). CONCLUSIONS Children with OI presented cortical bone alterations after PAM treatment. Both MCW and the FD of the cortical bone were higher in children with OI after PAM treatment. It is argued that cortical bone should be considered for analyzing patients with OI, as well as to monitor the progress of PAM treatment.
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Affiliation(s)
- Ana C Apolinário
- 1 Department of Dentistry, University of Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brazil
| | - Rafael Sindeaux
- 1 Department of Dentistry, University of Brasília, Campus Universitário Darcy Ribeiro, Asa Norte, Brazil
| | - Paulo T de Souza Figueiredo
- 2 Department of Rheumatology, Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitário Darcy Ribeiro, Brazil
| | - Ana T B Guimarães
- 3 Biological Sciences Department, State University of West Paraná, Rua Universitária, Cascavel, Paraná, Brazil
| | - Ana C Acevedo
- 4 Oral Care Center for Inherited Diseases, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitário Darcy Ribeiro, Brazil
| | - Luiz C Castro
- 5 Division of Endocrinology, University of Brasília's Hospital, Brasília, Brazil
| | - Ana P de Paula
- 6 Hospital de Base of Federal District, Brasília, Brazil
| | - Lilian M de Paula
- 4 Oral Care Center for Inherited Diseases, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitário Darcy Ribeiro, Brazil
| | - Nilce S de Melo
- 7 Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitário Darcy Ribeiro Asa Norte, Brazil
| | - André F Leite
- 2 Department of Rheumatology, Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitário Darcy Ribeiro, Brazil
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16
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Yoo JH, Moon SH, Ha YC, Lee DY, Gong HS, Park SY, Yang KH. Osteoporotic Fracture: 2015 Position Statement of the Korean Society for Bone and Mineral Research. J Bone Metab 2015; 22:175-81. [PMID: 26713308 PMCID: PMC4691591 DOI: 10.11005/jbm.2015.22.4.175] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 11/24/2015] [Accepted: 11/24/2015] [Indexed: 11/11/2022] Open
Abstract
Osteoporotic fractures are one of the most common causes of disability and a major contributor to medical care costs worldwide. Prior osteoporotic fracture at any site is one of the strongest risk factors for a new fracture, which occurs very soon after the first fracture. Bone mineral density (BMD) scan, a conventional diagnostic tool for osteoporosis, has clear limitations in diagnosing osteoporotic fractures and identifying the risk of subsequent fractures. Therefore, early and accurate diagnosis of osteoporotic fractures using the clinical definition which is applicable practically and independent of BMD, is essential for preventing subsequent fractures and reducing the socioeconomic burden of these fractures. Fractures caused by low-level trauma equivalent to a fall from a standing height or less at major (hip, spine, distal radius, and proximal humerus) or minor (pelvis, sacrum, ribs, distal femur and humerus, and ankle) sites in adults over age 50, should be first regarded as osteoporotic. In addition, if osteoporotic fractures are strongly suspected on history and physical examination even though there are no positive findings on conventional X-rays, more advanced imaging techniques such as computed tomography, bone scan, and magnetic resonance imaging are necessary as soon as possible.
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Affiliation(s)
- Je-Hyun Yoo
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Seong-Hwan Moon
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Dong Yeon Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Sik Gong
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Si Young Park
- Department of Orthopaedic Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kyu Hyun Yang
- Department of Orthopedic Surgery, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea
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17
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Abstract
Osteoporosis is a major health problem affecting one in three women over the age of 50 and may not be detected until fractures occur. Since osteoporotic fractures are a health burden worldwide, identifying subjects with a high risk of osteoporosis and preventing osteoporosis-related mortality and morbidity are a very important health strategy. Women show an estrogen-related bone loss starting at menopause, predominantly occurring in trabecular bone. Diagnosis of osteoporosis is usually based on the bone mineral density measurement, but this is not a practical and economical technique for early detection. Therefore, investigators are interested in the possibility of detecting osteoporosis from the panoramic radiographs. Mandibular cortical bone undergoes resorptive activity in osteoporotic patients, leading to a decreased thickness and more porous inferior border. Therefore, studies have demonstrated the usefulness of cortical width and shape, determined from panoramic radiographs, in identifying elderly individuals with undetected osteoporosis, especially postmenopausal women. In conclusion, postmenopausal women with C3 category, Mental Index (MI) <3 mm, and panoramic mandibular index (PMI) <0.3 may be considered for further osteoporosis investigation.
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Affiliation(s)
- Ayse Gulsahi
- Department of Dentomaxillofacial Radiology, Baskent University, Ankara, Turkey
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18
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Graham J. Detecting low bone mineral density from dental radiographs: a mini-review. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2015; 12:178-82. [PMID: 26604946 PMCID: PMC4625777 DOI: 10.11138/ccmbm/2015.12.2.178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over a number of years researchers have reported associations between osteoporosis or low bone mineral density and signs that can be detected on dental radiographs, particularly in the width of the inferior mandibular cortex and the texture of the trabecular bone. As patients visit the dentist more regularly than they visit their doctor, there is the possibility that such signs could be used as a means of identifying individuals at risk of developing osteoporosis or suffering from consequent fracture. This paper reviews the historical background behind this research and the current status, including recent developments in automation of measurement using computer image analysis.
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Affiliation(s)
- James Graham
- Centre for Imaging Science, Institute of Population Health, Faculty of Medicine and Human Sciences, The University of Manchester, United Kingdom
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Barngkgei I, Al Haffar I, Khattab R. Osteoporosis prediction from the mandible using cone-beam computed tomography. Imaging Sci Dent 2014; 44:263-71. [PMID: 25473633 PMCID: PMC4245467 DOI: 10.5624/isd.2014.44.4.263] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 06/20/2014] [Accepted: 06/30/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. MATERIALS AND METHODS Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cm×15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. RESULTS RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. CONCLUSION Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.
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Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Razan Khattab
- Department of Periodontology, Faculty of Dentistry, Damascus University, Damascus, Syria
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20
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Matsuura T, Mizumachi E, Katafuchi M, Tokutomi K, Kido H, Matsuura M, Sato H. Sex-related Differences in Cortical and Trabecular Bone Quantities at the Mandibular Molar. J HARD TISSUE BIOL 2014. [DOI: 10.2485/jhtb.23.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Sindeaux R, Figueiredo PTDS, de Melo NS, Guimarães ATB, Lazarte L, Pereira FB, de Paula AP, Leite AF. Fractal dimension and mandibular cortical width in normal and osteoporotic men and women. Maturitas 2013; 77:142-8. [PMID: 24289895 DOI: 10.1016/j.maturitas.2013.10.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 09/20/2013] [Accepted: 10/16/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To verify whether fractal dimensions (FD) on the mandibular trabecular and cortical bone and mandibular cortical width (MCW) differ between patients with normal bone mineral density (BMD) and osteoporosis. STUDY DESIGN In this retrospective study, 133 dental panoramic radiographs from men aged >60 years and postmenopausal women with a bone densitometry report of the lumbar spine and hip classified as either normal or osteoporotic were selected. Fractal dimensions of five standardized trabecular and cortical mandibular regions of interest and mandibular cortical width were measured on the panoramic radiographs by an experienced oral radiologist, blinded to the densitometric diagnosis. The following statistical analyses were performed: ANOVA and a forward logistic stepwise regression to verify associations between dental panoramic measurements and the densitometric diagnosis. P values less than .05 indicated statistical significance. MAIN OUTCOME MEASURES Fractal dimension and mandibular cortical width. RESULTS Differences were found in the FD values on mandibular cortical bone and MCW between patients with normal BMD and with osteoporosis, but not in the FD values of trabecular bone. The odds of having lower mean values of MCW and FD on cortical bone were 2.16, 3125 and 1005 times in osteoporotic patients, respectively, compared with patients with normal BMD. CONCLUSION The values of FD analysis on mandibular cortical bone and MCW were lower in women with osteoporosis. A well-adjusted logistic regression model showed that cortical bone measurements might be considered as auxiliary tools to referring patients for DXA exam.
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Affiliation(s)
| | | | - Nilce Santos de Melo
- Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Brazil
| | | | | | | | | | - André Ferreira Leite
- Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Brazil.
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Devlin H, Whelton C. Can mandibular bone resorption predict hip fracture in elderly women? A systematic review of diagnostic test accuracy. Gerodontology 2013; 32:163-8. [PMID: 24128044 DOI: 10.1111/ger.12077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this systematic review was to determine the diagnostic accuracy of the mandibular cortical width measurements and porosity in detecting hip osteoporosis. BACKGROUND All of the included studies used measurements on panoramic radiographs. MATERIALS AND METHODS Studies were included if they compared the radiographic measurements (or index tests) with central dual energy X-ray absorptiometry (DXA) of the hip as the reference standard. A measure of diagnostic accuracy such as sensitivity and specificity or area under the receiver operating characteristic curve was also required for inclusion. RESULTS Seven studies were identified. Meta-analysis was not possible because of the heterogeneity of the studies. The studies all demonstrated moderate diagnostic accuracy. CONCLUSION If a patient with a thin or porous mandibular cortex is identified by a chance radiographic finding, additional clinical risk factors need to be considered and the patient referred for further investigation with DXA where necessary.
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Affiliation(s)
- Hugh Devlin
- School of Dentistry, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
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23
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Kavitha MS, Asano A, Taguchi A, Heo MS. The combination of a histogram-based clustering algorithm and support vector machine for the diagnosis of osteoporosis. Imaging Sci Dent 2013; 43:153-61. [PMID: 24083208 PMCID: PMC3784674 DOI: 10.5624/isd.2013.43.3.153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 04/28/2013] [Accepted: 05/07/2013] [Indexed: 12/04/2022] Open
Abstract
Purpose To prevent low bone mineral density (BMD), that is, osteoporosis, in postmenopausal women, it is essential to diagnose osteoporosis more precisely. This study presented an automatic approach utilizing a histogram-based automatic clustering (HAC) algorithm with a support vector machine (SVM) to analyse dental panoramic radiographs (DPRs) and thus improve diagnostic accuracy by identifying postmenopausal women with low BMD or osteoporosis. Materials and Methods We integrated our newly-proposed histogram-based automatic clustering (HAC) algorithm with our previously-designed computer-aided diagnosis system. The extracted moment-based features (mean, variance, skewness, and kurtosis) of the mandibular cortical width for the radial basis function (RBF) SVM classifier were employed. We also compared the diagnostic efficacy of the SVM model with the back propagation (BP) neural network model. In this study, DPRs and BMD measurements of 100 postmenopausal women patients (aged >50 years), with no previous record of osteoporosis, were randomly selected for inclusion. Results The accuracy, sensitivity, and specificity of the BMD measurements using our HAC-SVM model to identify women with low BMD were 93.0% (88.0%-98.0%), 95.8% (91.9%-99.7%) and 86.6% (79.9%-93.3%), respectively, at the lumbar spine; and 89.0% (82.9%-95.1%), 96.0% (92.2%-99.8%) and 84.0% (76.8%-91.2%), respectively, at the femoral neck. Conclusion Our experimental results predict that the proposed HAC-SVM model combination applied on DPRs could be useful to assist dentists in early diagnosis and help to reduce the morbidity and mortality associated with low BMD and osteoporosis.
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Affiliation(s)
- Muthu Subash Kavitha
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea. ; Graduate School of Engineering, Hiroshima University, Hiroshima, Japan
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24
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Martínez-Maestre MÁ, Corcuera Flores JR, Machuca G, González-Cejudo C, Torrejón R, Castelo-Branco C. Panoramic radiomorphometry and vertebral fractures in Spanish postmenopausal women. Maturitas 2013; 76:364-9. [PMID: 24090925 DOI: 10.1016/j.maturitas.2013.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 07/10/2013] [Accepted: 08/29/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the relationship between panoramic radiomorphometric indexes, and the presence of osteoporotic fractures in a Spanish postmenopausal women. METHODS A sample of 120 women (60 with fragility spine fractures and 60 healthy), aged 55-70 years, with fragility spine fractures, were included in this cross-sectional study that was conducted from 2008 to 2011. All the women were referred to undergo a radiological spine examination, spinal densitometry and a panoramic radiograph for assessing osteoporosis using 3 radiomorphometric indexes: Panoramic Mandibular Index (PMI), Mental Index (MI) and Mandibular Cortical Index (MCI). According to mandibular cortical shape, in MCI, three groups were defined: C3 (osteoporosis), C2 (osteopenia), C1 (health). RESULTS Significant differences were found between all the MCI groups due to their composition between fractures and non-fractures. C1 group (healthy) has less fractures women than C2 (Bonferroni p<0.001), C1 has less fractures than C3 (Bonferroni p<0.001) and finally, C2 has less fractures than C3 (Bonferroni p<0.006). PMI and MI values were significantly lower in cases than in controls (U Mann-Whitney p<0.001). CONCLUSIONS Panoramic radiomorphometrics mandibular indexes such as MCI, PMI, and MI, may be useful for identifying the population at higher risk for fracture. The relationship between panoramic index and osteoporosis remains unclear and further studies using fragility fracture as a real marker of osteoporosis are warranted to clarify the exact role and effect of one condition on the other and the corresponding clinical implications.
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Glowacki J, Christoph K. Gender differences in the growing, abnormal, and aging jaw. Dent Clin North Am 2013; 57:263-80. [PMID: 23570805 DOI: 10.1016/j.cden.2013.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Despite wide variations in the size and shape of the human face, head, and body, there is remarkable consistency for quantifiable gender-specific facial traits. The relationships between the growing jaws and tooth eruption are complex, but they show gender-specific trajectories in children and adolescents. Disturbances in genetic, endocrine, and nutritional regulatory controls result in gender-specific and nonspecific disorders. Gender-specific differences are also apparent in the aging jaw, with the acceleration of jawbone atrophy upon loss of teeth, especially in women.
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Affiliation(s)
- Julie Glowacki
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
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26
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Roberts MG, Graham J, Devlin H. Image texture in dental panoramic radiographs as a potential biomarker of osteoporosis. IEEE Trans Biomed Eng 2013; 60:2384-92. [PMID: 23568478 DOI: 10.1109/tbme.2013.2256908] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Previous studies have shown an association between osteoporosis and automatic measurements of mandibular cortical width on dental panoramic radiographs (DPRs). In this study, we show that additional image texture features increase this association and propose the combined features as a potential biomarker for osteoporosis. We used an existing dataset of 663 DPRs of female patients with bone mineral density (BMD) measurements. The mandibular cortex was located using a previously described computer algorithm. Texture features, based on co-occurrence matrices and fractal dimension, were measured in the bone within the cortex and also in the superior basal bone above the cortex. These, augmented by cortical width measurements, were used by a random forest classifier to identify osteoporosis at femoral neck, total hip, and lumbar spine. Classification performance was assessed by ROC analysis. Area-under-curve (AUC) values for identifying osteoporosis at femoral neck were 0.830, 0.824, and 0.872 using, respectively, cortical width alone, cortical texture (co-occurrence matrix features) alone, and combined width and texture. At 80% sensitivity, these classifiers produced specificity values of 74.4%, 73.6%, and 80.0%, respectively. Fractal dimension was a less effective texture feature. Prediction of osteoporosis at the lumbar spine was poorer, but a combined width and superior basal bone texture classifier gave a significant improvement in AUC at over the use of width alone.
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Affiliation(s)
- Martin G Roberts
- Centre for Imaging Science, Institute of Population Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, M13 9PT, U K.
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27
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Tooth loss and osteoporosis: to assess the association between osteoporosis status and tooth number. Br Dent J 2013; 214:E10. [DOI: 10.1038/sj.bdj.2013.165] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2012] [Indexed: 02/07/2023]
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28
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Automated measurement of mandibular cortical width on dental panoramic radiographs. Int J Comput Assist Radiol Surg 2012. [DOI: 10.1007/s11548-012-0800-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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29
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Ogawa T, Osato S. Growth changes of the mandibular body with eruption of mandibular third molars: analysis of anatomical morphometry and quantitative bone mineral content by using radiography. Ann Anat 2012; 195:143-50. [PMID: 23031389 DOI: 10.1016/j.aanat.2012.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 07/11/2012] [Accepted: 07/31/2012] [Indexed: 11/29/2022]
Abstract
This study aimed to analyze growth changes in mandibular body morphology and quantitative bone mineral content (QBMC) with eruption of mandibular third molars (M3s) and the relationship between those variables and posterior mandibular body length. Linear and angular measurements were conducted using standard lateral radiographs of 37 dried mandibles in Hellman's dental developmental stages IVA (14 specimens) to VA (23 specimens). Cortical and trabecular basal bone mineral contents (CBMC and TBMC) in the mandible were expressed in millimeter titanium equivalent values using a titanium step wedge. The largest significant change in the mandibular body morphology was an increase in the horizontal dimension (M2DP'-Go': 7.59mm), followed by vertical dimension - total height of the mandibular body (THOMB: 4.96mm) and mandibular cortical width (MCW: 1.22mm). The gonial angle (GA) decreased significantly by 6.72° between stages IVA and VA. The mandibular cortical index (MCI) was classified only as C1 or C2 in each stage. Among 4 types of line profile, types 1 and 2 were most commonly observed in both stages. Mean values for CBMC and TBMC increased significantly between stages IVA and VA. Posterior mandibular body length (MeF'-Go') correlated positively with M2DP'-Go', THOM, MCW, and CBMC (r=0.816, 0.698, 0.595, and 0.507), respectively and negatively with GA (r=-0.582). These results demonstrated that the morphological changes in the posterior mandibular body and the QBMC increased significantly with M3 eruption, while the GA became significantly smaller. The posterior mandibular body length had a linear correlation with these variables.
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Affiliation(s)
- Takahiro Ogawa
- Department of Histology, The Nippon Dental University, School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan
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Abstract
This article describes how dentists can recognize osteoporosis before fractures develop, and discusses whether osteoporosis affects tooth loss or inhibits implant osseointegration. Some success in diagnosing osteoporosis has been obtained using clinical questionnaires that attempt to identify those who have strong risk factors for the disease, and analysis of the sparse trabeculation and thinning of the mandibular cortex often seen in dental panoramic radiographs. The role of osteoporosis in periodontal disease is unclear as there are many conflicting reports, but the evidence suggests that tooth loss may be more prevalent in patients with osteoporosis.
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Affiliation(s)
- Hugh Devlin
- School of Dentistry, University of Manchester, UK.
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