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Bostan SA, Özarslantürk S, Günaçar DN, Gonca M, Göller Bulut D, Ok Bostan H. Direct-Acting Oral Anticoagulant/Vitamin K Antagonists: Do They Affect the Trabecular and Cortical Structure of the Mandible? J Clin Densitom 2024; 27:101495. [PMID: 38688206 DOI: 10.1016/j.jocd.2024.101495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND This study aimed to evaluate the mandibular bone structure of patients using oral anticoagulants (OACs) vitamin K antagonist drugs (warfarin) and other OACs including direct oral anticoagulants [(DOACs) apixaban, rivaroxaban, dabigatran, edoxaban]. Analyses were based upon the fractal dimension (FD), the panoramic mandibular index (PMI) and the Klemetti index (KI), which is also known as the mandibular cortical index (MCI). METHODOLOGY Ninety participants were divided into three groups: group 1: 30 systemically healthy individuals who had not used any anticoagulants before, group 2: 30 individuals using warfarin, and group 3: 30 individuals using DOACs. FD was used to analyze trabecular bone architecture in the condyle, angle, and two sites in the alveolar bone. PMI was used to evaluate the quantity of cortical bone and KI was used to evaluate the cortical bone quality. RESULTS There was no difference between the groups regarding FD analysis and KI; however, a difference was found between groups 1, 2, and 3 in the PMI (P≤ 0.001). The PMI in group 1 was higher than in groups 2 and 3. CONCLUSION Mandibular radiomorphometric indices can be used on panoramic radiographs to evaluate the quantity of mandibular cortical bone in patients using oral anticoagulants.
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Affiliation(s)
- Semih Alperen Bostan
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Periodontology, Rize, Turkey
| | - Savaş Özarslantürk
- University of Health Sciences, Gulhane Faculty of Dental Medicine, Department of Dentomaxillofacial Radiology, Ankara, Turkey
| | - Dilara Nil Günaçar
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Rize, Turkey
| | - Merve Gonca
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Orthodontics, Rize, Turkey
| | - Duygu Göller Bulut
- Bolu Abant İzzet Baysal University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu, Turkey
| | - Hilal Ok Bostan
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Prosthodontics, Rize, Turkey.
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Serindere G, Aktuna Belgin C, Gunduz K. EVALUATION OF MANDIBULAR TRABECULAR AND CORTICAL STRUCTURE BY FRACTAL ANALYSIS IN HYPERLIPIDEMIA AND HYPERTENSION PATIENTS. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101953. [PMID: 38908478 DOI: 10.1016/j.jormas.2024.101953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/12/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION This study aimed to evaluate the mandibular trabecular and cortical changes in patients with hyperlipidemia (HL) and/or hypertension (HT) using fractal dimension (FD) analysis, mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI). MATERIALS AND METHODS Panoramic radiographs of 100 patients were evaluated. FD measurement of three region of interest (ROI) including the angulus, corpus and interdental bone area were made. MCW, PMI and MCI were also measured and noted. RESULTS Angulus, corpus and interdental FD values were significantly lower in three disease groups than the control group. Angulus, corpus, and interdental FD values were significantly lower in the HL+HT group than in the HL group and HT group. MCW value was significantly lower in the HL group, HT group, and HL+HT group than the control group. The cortical index C1 was more common in the control group while C2 was more common in the HT, HL and HL+HT group. CONCLUSION The fact that FD was significantly lower in the HL+HT group compared to the HL and HT groups indicates the positive effect of their association on bone loss and quality. FD measurements on images obtained using a direct digital panoramic system can be used for treatment planning and follow-up of patients with HL and/or HT.
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Affiliation(s)
| | - Ceren Aktuna Belgin
- Hatay Mustafa Kemal University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Hatay, TÜRKİYE.
| | - Kaan Gunduz
- Ondokuz Mayıs University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Samsun, TÜRKİYE.
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Acar G, Aktaş A. Assessment of jaw bone mineral density, resorption rates, and oral health in patients with severe hemophilia: a case-control study. Acta Odontol Scand 2024; 83:132-139. [PMID: 38597918 PMCID: PMC11302628 DOI: 10.2340/aos.v83.40337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/14/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Knowledge about oral hygiene, gingival bleeding, mineral density, and resorption of jaw bones in patients with hemophilia is limited. We evaluated the periodontal and bone status in such patients. Material and methods: Forty-eight patients with severe type A/B hemophilia and 49 age- and sex-matched controls were included. Assessments included simplified oral hygiene index (OHI-S), calculus index, debris index, gingival index (GI), gingival bleeding time index (GBTI), and decayed, missing, and filled teeth index (DMFTI). Bone resorption was evaluated using panoramic mandibular index (PMI), mental index (MI), and alveolar crest ratio (ACR). Mineral density in the condyle, angulus, and premolar areas was assessed using fractal analysis, with fractal dimensions denoted as condyle fractal dimension (CFD) for the condyle, angulus fractal dimension (AFD) for angulus, and premolar fractal dimension (PFD) for premolar region. RESULTS The mean scores were DMFTI = 11.77, OHI-S = 2.44, PMI = 0.268, MI = 5.822, GI = 3.02, GBTI = 2.64, ACR = 2.06, CFD = 1.31, AFD = 1.31, and PFD = 1.17 in the hemophilia group and DMFTI = 11.449, PMI = 0.494, MI = 7.43, GI = 0.67, GBTI = 0.98, OHI-S = 1.45, ACR = 2.87, CFD = 1.35, AFD = 1.35, and PDF = 1.23 in the control group. Differences were significant for all parameters (p < 0.005) except for the DMFTI index. Conclusions: Because of poor oral hygiene, high bone resorption, and low bone mineral density in these patients, clinicians should consider potential bone changes when planning to treat these patients.
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Affiliation(s)
- Gülin Acar
- Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey.
| | - Alper Aktaş
- Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey
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Heuchert J, Kozieł S, Spinek AE. Radiomorphometric indices of the mandible as indicators of decreased bone mineral density and osteoporosis - meta-analysis and systematic review. Osteoporos Int 2024; 35:401-412. [PMID: 37870561 PMCID: PMC10867062 DOI: 10.1007/s00198-023-06949-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
This review aims to evaluate the accuracy of various mandibular radiomorphometric indices in comparison with DEXA BMD measurements in the diagnosis of osteopenia and osteoporosis based on a meta-analysis of the sensitivity and specificity of the indices. PRISMA statement was followed. The materials for analysis were collected in August 2023 by searching three databases: PubMed Central, Web of Science, and Scopus. The selection of studies consisted of three selection stages, and 64 articles were finally obtained. Quality assessment was performed with the QUADAS-2 tool, and the general methodological quality of retrieved studies was low. Statistical analysis was performed based on 2 × 2 tables and estimated sensitivity and specificity were obtained using SROC curves. The most used indices were MCI, MCW and PMI. The best results in detecting reduced BMD obtained for MCW ≤ 3 mm, estimated sensitivity and specificity were 0.712 (95% CI, 0.477-0.870) and 0.804 (95% CI, 0.589-0.921), respectively. The most prone to the risk of bias is the MCI due to the examiner's subjectivism. Radiomorphometric indices of the mandible can be useful as a screening tool to identify patients with low BMD, but should not be used as a diagnostic method. Further research needs to focus on analysing the ability of the indices to detect osteoporosis and also in combination the indices with clinical parameters.
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Affiliation(s)
- Joanna Heuchert
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland.
| | - Sławomir Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Anna E Spinek
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
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Usha AM, Thelekkat Y, John J, Nair R, Nazar J, Kumar DS. Evaluation of the Linear Relationship of the Inferior Alveolar Nerve Canal to the Lateral Cortex and the Alveolar Crest in the Posterior Mandible: A Computed Tomographic Study. J Maxillofac Oral Surg 2024; 23:68-74. [PMID: 38312975 PMCID: PMC10830932 DOI: 10.1007/s12663-023-02010-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/23/2023] [Indexed: 02/06/2024] Open
Abstract
Background and Objective A cross-sectional study was conducted to evaluate a clinically relevant position of the inferior alveolar nerve and canal with respect to the lateral cortex, alveolar crest, and first and second molar root apices in adult dentate patients. Methods The study was conducted in the patients who reported various oral and maxillofacial surgical procedures at the Department of Oral and Maxillofacial Surgery for whom preoperative computed tomography (CT) scan was taken for the required surgical procedures. CTs were selected based on the selection criteria, and a total of 50 CTs were evaluated. Predictor variables were gender and side. Outcome variables were the average linear buccal measurements from the lateral cortex to the outer cortical margin of the inferior alveolar canal from below the mandibular foramen till the mental foramen, linear vertical measurements from the alveolar crest to the superior crest of the inferior alveolar canal in the third, second and first molar regions, and linear vertical distance from the superior aspect of inferior alveolar canal till the apices of second and third molars. Descriptive statistics were analysed with t test and paired t test. P value < 0.05 was taken as significant. Results The study sample was composed of 27 male and 23 female patients with a mean age of 29 ± 4.6 years. The mean value of linear measurements of IAN to the right lateral cortex at the mandibular foramen was 4.96 ± 1.13, and for the left side, it was 4.79 ± 1.33. The mean values of linear measurements from the superior aspect of IAN canal to the alveolar crest at third, second and first molar regions obtained in this study were 18.5 ± 3.79, 19 + 3.83 and 19.5 + 3.48 for the right side and 17.8 + 3.86, 18.8 + 3.54 and 19.143.31 for the left side, respectively. The average linear measurements of IAN to the root apex of first molar were 10.8 3.89 for the right side and 10.868 + 3.85 for the left side; for second molars, they were 10.5 + 3.62 for the right side and 10.52 + 3.62 for the left side. Gender and side influenced the outcome with varying statistical significance. Conclusion The study has identified the average linear measurements of the buccal cortical bone along the path of IAN in the mandible, average height of alveolar bone above the IAN and average distance between the IAN with the first and second molar root apices. This will be useful guide while planning and performing various mandibular surgical procedures close to the IAN nerve and procedures that can disturb the IAN. The implications of these findings will influence the course of surgery.
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Affiliation(s)
- Arjun Madhu Usha
- Azeezia College of Dental Sciences and Research, Kollam, Kerala India
| | | | - Jacob John
- Azeezia College of Dental Sciences and Research, Kollam, Kerala India
| | - Roopesh Nair
- Azeezia College of Dental Sciences and Research, Kollam, Kerala India
| | - Jincy Nazar
- Azeezia College of Dental Sciences and Research, Kollam, Kerala India
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Rupel K, Dal Broi C, Ottaviani G, Bellassai L, Bogdan Preda TM, Di Lenarda R, Biasotto M. Changes in mandibular radiomorphometric indices in osteoporosis patients treated with denosumab: a retrospective case-control study. BMC Oral Health 2024; 24:89. [PMID: 38229055 DOI: 10.1186/s12903-024-03870-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Radiomorphometric indices measured on Dental Panoramic Radiography (DPR) can reflect Bone Mineral Density (BMD). The aim of our study is to evaluate changes in DPR radiographic markers in patients undergoing antiresorptive therapy with denosumab and correlate them to BMD and serum bone turnover markers (BTM). METHODS We evaluated two radiomorphometric indices: Mandibular Cortical Width (MCW) and Panoramic Mandibular Index (PMI), in patients undergoing antiresorptive therapy with denosumab at T0 (before starting the therapy) and at T1 (after 12 months), comparing results with a control group of healthy patients who performed two DPRs at a one-year time distance. Correlation analysis was performed in the denosumab group, as well as ROC curves were obtained for both indices. RESULTS The study included 18 patients and 21 controls according to specific inclusion and exclusion criteria, matched by gender and age. Both MCW and PMI were significantly lower at T0 in the denosumab group, consistently with lower BMD. MCW showed significant correlation with femoral and lumbar DEXA and was significantly lower in patients with osteoporosis compared to osteopenia. Only PMI index increased significantly in the denosumab group from T0 to T1. After one year (T1), there weren't any differences between patients and controls for both indices. No significant correlations were found with BTMs. Sensitivity and specificity for MCW and PMI were also calculated. CONCLUSIONS Our results show how CMW shows sufficient sensitivity and specificity to be used as a radiographic marker to screen and intercept patients with osteoporosis. PMI seems to be able to reflect changes in response to antiresorptive therapy with denosumab. Further studies are needed to confirm our hypothesis.
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Affiliation(s)
- Katia Rupel
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy.
| | - Chiara Dal Broi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | - Giulia Ottaviani
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | - Laura Bellassai
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | | | - Roberto Di Lenarda
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | - Matteo Biasotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
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Dedeoğlu N, Eşer G, Çelik Özen D, Altun O. Five-year change of panoramic radiomorphometric indices and fractal dimension values in type 2 diabetes patients. Oral Radiol 2024; 40:49-57. [PMID: 37610653 DOI: 10.1007/s11282-023-00707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Diabetes mellitus is a chronic disease characterized by dysregulation of glucose metabolism, with characteristic long-term complications accompanied by changes in bone quality. The purpose of this study is to compare the results with a control group by performing radiomorphometric analyses on panoramic radiographs obtained 5 years apart to examine changes in the mandibular bone cortex and microstructures of type 2 diabetes mellitus (T2DM) patients. METHODS Two panoramic radiographs that were taken 5 years (mean 5.26 ± 0.134) apart from 52 patients with T2DM (n:26) and a control group (n:26) were used. A total of 104 images were evaluated. Analyses were done from the condyle (FD1), angulus (FD2), distal second premolar apex (FD3), and anterior to the mental foramen (FD4) for fractal dimension (FD) in the mandible. Symphysis index (SI), anterior index (AI), molar index (MI), posterior index (PI), and panoramic mandibular index (PMI) measurements were taken for cortical analysis. Three-way ANOVA, three-way robust ANOVA, two-way ANOVA, and two-way robust ANOVA tests were used for statistical analysis (p < 0.05). RESULTS After a 5-year period, there was a significant decrease in all FD measures of the mandible in both T2DM and control groups (p < 0.05). This resulted in a statistical difference in the main effect of time. After a 5-year period, no significant difference in mandibular cortical measures was identified between the T2DM and control groups (p > 0.05). CONCLUSION According to panoramic radiography, the mandibular trabecular structure deteriorated after 5 years, whereas cortical values remained the same. It concluded that T2DM had no effect on these results.
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Affiliation(s)
- Numan Dedeoğlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
| | - Gözde Eşer
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Duygu Çelik Özen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Oğuzhan Altun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
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Gulec M, Erturk M, Tassoker M, Basdemirci M. Evaluation of cortical and trabecular bone structure of the mandible in patients with ankylosing spondylitis. Sci Rep 2023; 13:19762. [PMID: 37957329 PMCID: PMC10643636 DOI: 10.1038/s41598-023-47233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
This study aimed to examine the difference between the fractal dimension (FD) values of the mandibular trabecular bone and the panoramic mandibular index (PMI), mandibular cortical index (MCI) and mandibular cortical thickness (MCW) of patients with ankylosing spondylitis (AS) and healthy control group. A total of 184 individuals (92 cases, 92 controls), were examined in our study. PMI, MCI, and MCW values were calculated on panoramic images of all individuals. For FD values, the region of interest (ROI) was selected with the size of 100 × 100 pixels from the right-left gonial and interdental regions and 50 × 50 pixels from the condylar region. Degenerative changes in the temporomandibular joint (TMJ) region were recorded. PMI, MCI, and MCW values showed statistically significant differences between the groups (p = 0.000, p < 0.001). The radiological signs of mandibular cortical resorption were more severe in the case group than in the control group. PMI and MCW values were found to be lower in the case group than in the control group. It was determined that the number of C3 and C2 values, among the MCI values, was higher in the case group. Only the FD values of the ROI selected from the condyle region were found to be statistically significant and were lower in the case group (p = 0.026, p < 0.05). Degenerative changes in the TMJ region were significantly more frequent in the case groups (p = 0.000, p < 0.001). The fact that the mandibular cortex shows more resorptive features in individuals with AS may require further evaluation in terms of osteoporosis. Because of the low FD values of the condylar regions of these patients and the more frequent degenerative changes, the TMJ region should be followed carefully. Detailed examination of the mandibular cortex and condylar region is beneficial in patients with AS for screening and following osteoporotic changes in these individuals, which is essential for the patient's life quality.
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Affiliation(s)
- Melike Gulec
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Mediha Erturk
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Melek Tassoker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey.
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Ersan N, Özel B. Evaluation of mandibular cortical and trabecular radiomorphometry in familial Mediterranean fever patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:640-648. [PMID: 37422403 DOI: 10.1016/j.oooo.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The objective of this retrospective study was to evaluate the mandibular cortical and trabecular morphology and microarchitecture of patients with familial Mediterranean fever (FMF) and compare them to those of healthy individuals by examining radiomorphometric indices on panoramic radiographs. STUDY DESIGN We examined a group of 56 FMF patients aged 5 to 71 years and an age- and sex-matched control group of individuals with no systemic diseases. We classified the FMF and control groups according to age and sex and the FMF group according to colchicine use. We evaluated the quantitative radiomorphometic indices of gonial index, antegonial index, molar cortical thickness, mental index, panoramic mandibular index, and lacunarity, and the qualitative mandibular cortical index on all panoramic radiographs and performed between and within group analysis. RESULTS Mean gonial index, antegonial index, and molar cortical thickness values of the FMF group were significantly smaller than those of the control group. Significantly fewer patients in the FMF group were classified as mandibular cortical index type 1 compared to the control group. There were no significant differences in quantitative index values according to colchicine use in the FMF group or regarding the categorical parameters of age, sex, and mandibular cortical index classification. CONCLUSIONS Radiomorphometric values of the mandibular basal cortex posterior to the mental foramen differ significantly in FMF patients compared to healthy counterparts. Dentists should note mandibular morphologic changes indicative of low bone density when examining panoramic images of patients with this disease.
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Affiliation(s)
- Nilüfer Ersan
- Department of Dentomaxillofacial Radiology, Yeditepe University Faculty of Dentistry, Istanbul, Turkey.
| | - Beliz Özel
- Department of Endodontics, Academic Centre for Dentistry Amsterdam, Amsterdam, Netherlands
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Mupparapu M, Akintoye SO. Application of Panoramic Radiography in the Detection of Osteopenia and Osteoporosis-Current State of the Art. Curr Osteoporos Rep 2023; 21:354-359. [PMID: 37382808 DOI: 10.1007/s11914-023-00807-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE OF REVIEW Osteoporosis ranks high among morbidities in the elderly as it is a natural process to lose bone, making them susceptible to fractures from minor falls. The cost of managing these patients is staggering. The fractures can be prevented with better care of the elderly, and by treating the major predisposing factor, osteoporosis. Clinicians and scientists, in general, constantly look for early diagnostic and prognostic indicators for osteopenia and osteoporosis to proactively prevent fractures. Dental panoramic radiography (DPR) is a rotational pantomography used for identifying dental pathology in patients. Early signs of osteopenia and osteoporosis can be identified in DPR. The usefulness of notable jaw changes in DPR to predict osteopenia and osteoporosis is still evolving as more studies continue to delve into this concept. The purpose of this review is to present advances made in the practical application of DPR for predicting early onset of osteopenia and osteoporosis. RECENT FINDINGS Dental panoramic radiography, a form of tomography commonly used by dental practitioners, has been the standard of care for decades for detecting dento-alveolar pathology. Several technological advancements have taken place with respect to the use of DPR. These include conversion from plain film to digital radiography, advancements in the manufacture of flat panel detectors, and accurate imaging of the layers of mandible and maxilla that has become possible with appropriate patient positioning within the focal trough of the machine. Improvements in the software infrastructure make it easier to view, enhance, and save the radiographic images. The radiographic appearance of the trabecular bone within the mandible and indices measured from the dental panoramic radiographs focusing on the inferior cortex of the mandible are considered useful tools for identifying asymptomatic individuals with osteoporosis or at risk for developing osteoporosis. These indices apparently correlate with risks of fragility fractures of osteoporosis in other parts of the body. Dental panoramic radiography (DPR) is a commonly used radiographic procedure in dentistry for evaluation of teeth and associated maxillofacial structures. The evaluation of the inferior border of the mandible for reduction or loss of cortical thickness and evaluation of the trabecular bone within the mandible are helpful markers for early signs of osteopenia to identify patients at risk for osteoporosis. This review focused on research advancements on practical application of DPR in early identification of osteopenia and osteoporosis.
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Affiliation(s)
- Mel Mupparapu
- School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA, USA.
| | - Sunday O Akintoye
- School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA, USA
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Çitir M, Karslioglu H, Uzun C. Evaluation of mandibular trabecular and cortical bone by fractal analysis and radiomorphometric indices in bruxist and non-bruxist patients. BMC Oral Health 2023; 23:522. [PMID: 37491268 PMCID: PMC10369695 DOI: 10.1186/s12903-023-03245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effect of bruxism on the cortical and trabecular bone of the mandible using the radiomorphometric indexes and fractal analysis (FA) additionally to examine the efficiency of FA as diagnostic test for bruxism. METHODS Evaluation was performed on panoramic radiographs of 94 bruxists and 94 non-bruxist individuals with the ImageJ program. Cortical bone was assessed with mandibular cortical index, mental index, and panoramic mental index. Trabecular bone in the condyle, gonial, and corpus region was evaluated by FA. An independent sample t and Mann-Whitney-U tests and Pearson and Spearman rank correlations were conducted for statistical analysis. RESULTS A total of 188 participants, 112 female, and 76 male, were included in the study. The sample age ranged from 18 to 43, with a mean of 27.55 (± 7.022) years. FA values of the angulus were significantly higher than those of the condyle and corpus, and the mean of the sample for the angulus, condyle, and corpus, respectively, were; 1.36 (± 10), 1.10 (± 0.9), 1.13 (± 0.8). There was a positive correlation between FA of the mandibular corpus and age (r = .163, p = .025). Females' values were smaller than males' in the FAs of three regions, and significant differences were found in FA of the condyle and angulus of the mandible, MCI, and PMI according to gender. There was no statistically significant difference between bruxist and non-bruxist patients in term of FAs of three regions, MCI, MI, and PMI values (p > .05). CONCLUSIONS FA of the condyle and angulus of the mandible, MCI, and PMI are significantly affected by gender. However bruxism doesn't cause a significant change in the fractal dimensions of the bone in the mandible and doesn't change substantially MCI, MI, and PMI.
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Affiliation(s)
- Mesude Çitir
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey.
| | - Hazal Karslioglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Baskent, Ankara, Turkey
| | - Canan Uzun
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Health Sciences, İstanbul, Turkey
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Ozturk T, Soylu S, Coban G, Turker G. Mandibular Radiomorphometric Characteristics of Individuals with Bilateral or Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2023:10556656231178504. [PMID: 37229644 DOI: 10.1177/10556656231178504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE This study aimed to investigate and compare the mandibular radiomorphometric characteristics of patients with unilateral or bilateral cleft lip and palate (CLP) with those of individuals without CLP and to determine whether there was a difference. DESIGN Retrospective cohort study. SETTING Orthodontic Department in Faculty of Dentistry. PATIENTS AND INTERVENTIONS Mandibular cortical bone thickness was measured on high-quality panoramic radiographs taken from 46 patients with unilateral or bilateral CLP aged 13-15 years and 21 control patients. MAIN OUTCOME MEASURES Three radiomorphometric indices [antegonial index (AI), mental index (MI), and panoramic mandibular index (PMI)] were measured bilaterally. AutoCAD software was used for MI, PMI, and AI measurements. RESULTS Left MI values were significantly lower in individuals with unilateral cleft lip and palate (UCLP; 0.029 ± 0.04) than in individuals with bilateral cleft lip and palate (BCLP; 0.033 ± 0.07). In addition, right MI values of individuals with right UCLP (0.26 ± 0.06) were significantly lower than those of individuals with left UCLP (0.34 ± 0.06) or BCLP (0.32 ± 0.08). No difference was observed between individuals with BCLP and left UCLP. These values did not differ between groups. CONCLUSIONS Antegonial index and PMI values did not differ between individuals with different types of CLP or when compared with control patients. In patients with UCLP, cortical bone thickness was found to be reduced on the cleft side compared to the intact side. Patients with UCLP with a right-sided cleft had a more substantial decrease in cortical bone thickness.
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Affiliation(s)
- Taner Ozturk
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Sertan Soylu
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Gokhan Coban
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Gokhan Turker
- Department of Orthodontics, Faculty of Dentistry, Mersin University, Mersin, Türkiye
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13
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Evaluation of bone changes on dental panoramic radiography using mandibular indexes and fractal dimension analysis in children with familial Mediterranean fever. Oral Radiol 2023; 39:312-320. [PMID: 35854189 DOI: 10.1007/s11282-022-00639-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022]
Abstract
AIM It was aimed to evaluate the bone microarchitecture of children with FMF in the city of Tokat, where the disease is highly prevalent, in Turkey, one of the countries where familial Mediterranean Fever (FMF) disease is the most common, using mandibular indexes and fractal dimension analysis on panoramic radiography. METHODS In this retrospective study, the results were evaluated and compared using the mandibular cortical index (MCI), the mental index (MI), the panoramic mandibular index (PMI), and the fractal dimension analysis of six different regions (condyle, angulus, and interdental) on dental panoramic radiographs in 124 children with FMF and 124 healthy children. The data were analyzed using the IBM SPSS V23. RESULTS The distribution of MCI in children with FMF was similar to the control group (p > 0.05). The mean MI (3.59) values in FMF patients were statistically higher than the control group (p = 0.016). No statistically significant difference was found in PMI between the patients with FMF and the control group (p > 0.05). No statistically significant difference was found between the mean fractal dimension (FD) values according to the groups (p > 0.05). CONCLUSION Trabecular bone microarchitecture of children with FMF is similar to healthy children. There is no correlation between the duration of colchicine use and bone microarchitecture.
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Evaluation of the effect of antiepileptic drugs on mandibular bone quality by fractal analysis. Oral Radiol 2023:10.1007/s11282-023-00671-0. [PMID: 36786955 DOI: 10.1007/s11282-023-00671-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES Antiepileptic drugs (AEDs) are used to control seizures in epilepsy and their long-term use is common. AED use has been associated with decreased bone mineral density. The aim of this study is to determine the effect of AEDs on mandibular bone quality using fractal analysis and panoramic morphometric indices. METHODS In this study, dental and medical records of 132 patients (66 AED users and 66 control group) were used. Fractal analysis (FA), the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) measurements were performed on panoramic radiographs. RESULTS In all metrics, the mean values of the study group were significantly lower than the control group (p < 0.000). There is a statistically significant difference between the study and control groups in terms of KI distribution (p < 0.000). The mean fractal dimension (FD) values in each measured region of the female patients in the study group were found to be significantly lower than the female patients in the control group (p < 0.05). The mean FD values measured in ROI-2 and ROI-3 of male patients in the study group were found to be significantly lower than male patients in the control group (p < 0.05). CONCLUSION The side effects of AEDs on bone metabolism were shown in this study. Dentists examining patients with epilepsy should be careful about osteoporotic changes in the jaws.
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Kiswanjaya B, Bachtiar-Iskandar HH, Yoshihara A. Correlations of the Osteoporosis Self-Assessment Tool for Asians (OSTA) and Three Panoramic Indices Using Quantitative Ultrasound (QUS) Bone Densitometry. Dent J (Basel) 2023; 11:dj11020034. [PMID: 36826179 PMCID: PMC9955170 DOI: 10.3390/dj11020034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/31/2023] Open
Abstract
This study aimed to evaluate the correlation between the Osteoporosis Self-Assessment Tool for Asians (OSTA) and three panoramic indices in relation to z-score and t-score values using quantitative ultrasound (QUS) bone densitometry. The sensitivity, specificity, and area under the curve (AUC) of the OSTA index were also measured using the QUS tool to evaluate the method's performance in identifying people at risk of osteoporosis. The study employed a cross-sectional design with 387 participants (190 men, 197 women). Patients' mandibular cortical indexes (MCI), mandibular cortical widths (MCW), and panoramic mandibular indexes (PMI) were measured from panoramic images. The sensitivity, specificity, and AUC were calculated using an OSTA index cutoff of ≤-1 and a t-score of ≤-1.0 for the QUS bone densitometry. The coefficient correlation of the OSTA index with the z-score (r = -0.563, p < 0.001) and t-score (r = -0.740, p < 0.001) shows a higher value than the MCI, MCW, and PMI, per the QUS. The sensitivity, specificity, and AUC values with a cutoff t-score of ≤-1.0 per the QUS in men was 90%, 50%, and 0.812, and in women, 96.8%, 30%, and 0.862. The OSTA index is a simple method that can be used in general dental practice.
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Affiliation(s)
- Bramma Kiswanjaya
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Indonesia, Jl. Salemba Raya No. 4, Jakarta 10430, Indonesia
- Correspondence: ; Tel.: +6281-192-10180; Fax: +621-319-30355
| | - Hanna H. Bachtiar-Iskandar
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Universitas Indonesia, Jl. Salemba Raya No. 4, Jakarta 10430, Indonesia
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health Science and Promotion, Graduate School of Medical and Dental Sciences, Niigata University, Niigata-City 951-8514, Japan
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Zihni Korkmaz M, Yemenoğlu H, Günaçar DN, Ustaoğlu G, Ateş Yildirim E. The effects of vitamin D deficiency on mandibular bone structure: a retrospective radiological study. Oral Radiol 2023; 39:67-74. [PMID: 35277812 PMCID: PMC8916492 DOI: 10.1007/s11282-022-00602-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/21/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of the study was to evaluate the effects of vitamin D deficiency on the mandibular bone structure by fractal analysis and panoramic morphometric indices. METHODS Ninety participants were divided into three groups as 30 individuals with severe vitamin D deficiency, 30 individuals with vitamin D deficiency, and 30 individuals with vitamin D sufficiency. Fractal dimension analysis (FD), panoramic mandibular index (PMI), mandibular cortical index (MCI), and mandibular cortical thickness measurement (CTM) were evaluated on panoramic radiographs. RESULTS FD values of the patients with vitamin D deficiency were found to be statistically lower than the patients with vitamin D sufficiency (p < 0.05). FD value of supracortical area above the angulus mandible (FD2) in patients with severe vitamin D deficiency was significantly lower than FD values (p = 0.002). There was no statistically significant difference between the groups in the CTM (p > 0.05). PMI was significantly lower in patients with severe vitamin D deficiency (p < 0.001). There was a significant difference in MCI values between the groups (p < 0.05). CONCLUSION Vitamin D deficiency causes a decrease in bone mineral density in the mandible, and an increase in alveolar porosity. FD analysis and radiomorphometric indices in panoramic radiographs can be used to assess osteoporotic changes in patients with vitamin D deficiency.
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Affiliation(s)
- Meltem Zihni Korkmaz
- Faculty of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, TR-53100, Rize, Turkey.
| | - Hatice Yemenoğlu
- Faculty of Dentistry, Department of Periodontology, Recep Tayyip Erdogan University, TR-53100, Rize, Turkey
| | - Dilara Nil Günaçar
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Recep Tayyip Erdogan University, Rize, Turkey
| | - Gülbahar Ustaoğlu
- Faculty of Dentistry, Department of Periodontology, Abant İzzet Baysal University, Bolu, Turkey
| | - Esra Ateş Yildirim
- Faculty of Dentistry, Department of Periodontology, Abant İzzet Baysal University, Bolu, Turkey
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Aranha Watanabe PC, Machado LF, Rodrigues GA, Lourenço AG, Bitencourt MA, Zerbato RM. Oblique line contrast: A new radiomorphometric index for assessing bone quality in dental panoramic radiographs. Heliyon 2022; 8:e12266. [PMID: 36582704 PMCID: PMC9792747 DOI: 10.1016/j.heliyon.2022.e12266] [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: 05/29/2022] [Revised: 10/14/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
The present study was carried out to assess the possible changes in mandibular bone density according to age and gender through dental panoramic radiographs (PAN). More specifically, the region of the mandibular oblique line. Materials & methods A group of 374 dental patients previously treated in the Ribeirão Preto Dental School (FORP/USP) was included in the study. The complete dental profiling of all the subjects (including PAN images) was previously available in the archive of the same institution. Those subjects were separated into four groups considering age and gender: Group 1-100 young adult men (21.48 ± 3.34 y. o.), Group 2-100 young adult women (20.66 ± 1.52 y. o.), Group 3-87 postmenopausal women (74.07 ± 9.82 y. o.), and Group 4-87 men over 70 years old (75.92 ± 8.71 y. o.). A new index called "W-index" (WI) was proposed for analyzing the possible difference in mandibular bone density. This new index is the ratio between the average pixel value of the image area of the mandibular ramus (AVMR) and the average pixel value of the image area of the mandibular oblique line (AVOL) (WI = AVMR/AVOL). WI was measured for each subject on each PAN and statistical analysis was performed to search how well WI can characterize each study group. Results The largest difference in WI is observed when we compare older subjects (WI 0.73 ± 0.11) with younger subjects (0.89 ± 0.05). WI also varies significantly with gender but in a smaller amount. Mean WI for old women (0.68 ± 0.11) was found lower than for old men (0.77 ± 0.09), and mean WI for young women (0.89 ± 0.05) was also inferior to young men (0.91 ± 0.05). The differences in WI observed in the subject group were tested for a significance level of α = 0,01. We speculate that WI refers to an aspect of bone mineral density. First, the sharp contrast of the mandibular oblique line may signify the loss of mandibular bone mass. And second, it showed to vary significantly with gender and age, but with higher intensity with age. Clinical significance WI might be used in the future for low bone mineral density risk assessment.
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Affiliation(s)
- Plauto Christopher Aranha Watanabe
- Department of Stomatology, Public Oral Healthy and Forensic Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil,Corresponding author.
| | - Leonardo Ferreira Machado
- Department of Physics, Faculty of Philosophy Sciences and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Giovani Antonio Rodrigues
- Department of Stomatology, Public Oral Healthy and Forensic Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - Alan Grupioni Lourenço
- Department of Basic and Oral Biology, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
| | - Matheus Arazin Bitencourt
- Department of Stomatology, Public Oral Healthy and Forensic Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil
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Nakamoto T, Taguchi A, Kakimoto N. Osteoporosis screening support system from panoramic radiographs using deep learning by convolutional neural network. Dentomaxillofac Radiol 2022; 51:20220135. [PMID: 35816516 PMCID: PMC10043624 DOI: 10.1259/dmfr.20220135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study was performed to develop computer-aided screening systems that could predict osteoporosis. The systems were constructed using panoramic radiographs of women aged ≥ 50 years through three types of deep convolutional neural networks (CNNs): Alexnet, VGG-16, and GoogLeNet; the performances of the constructed systems were evaluated. METHODS One oral radiologist classified 1500 panoramic radiographs into three types. In C1, the endosteal margin of the cortex was smooth and sharp, whereas porosities were observed in C2 and C3. The risks of osteoporosis were higher in C2 and C3 than in C1; C3 had the highest risk. This information was included with the images as training data; three CNNs were transfer trained. Using each trained CNN, the diagnostic accuracy was assessed using panoramic radiographs and bone mineral density inspection findings in the lumbar spine and femoral neck of 100 additional patients. RESULTS All CNNs exhibited relatively good agreement with the oral radiologist's judgement (86.0%-90.7%). The predictive results of the three systems for osteoporosis of the lumbar spine showed sensitivities of 78.3%-82.6%, specificities of 71.4%-79.2%, and accuracies of 74.0%-79.0%. The predictive results for osteoporosis of the femoral neck showed sensitivities of 80.0%-86.7%, specificities of 67.1%-74.1%, and accuracies of 70.0%-75.0%. CONCLUSIONS The constructed systems were generally more accurate than the previously developed conventional system. The new systems may facilitate osteoporosis prediction and prevent subsequent fractures by encouraging patients with suspected osteoporosis to undergo further inspections (e.g., dual-energy X-ray absorptiometry) and treatment.
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Affiliation(s)
- Takashi Nakamoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Nagano, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
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Selvakumar R, Chandran A, Patil A, Harini TC, Dandekeri S, Verma D, Babu JS, Swarnalatha C, Nayyar AS. Osteoporosis risk group: Screening for osteoporosis in dental clinics using panoramic radiographs. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:271. [PMID: 36325220 PMCID: PMC9621361 DOI: 10.4103/jehp.jehp_1727_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 02/07/2022] [Indexed: 06/16/2023]
Abstract
Osteoporosis is a specific condition which is characterized by low bone mineral density (BMD) and deterioration of bone structure resulting in an increased susceptibility to fractures. It contributes to a great deal of morbidity and mortality, and is a large burden to the healthcare system, especially in the case of the elderly population. In the last four decades, a plethora of studies have reported characteristic oral radiographic findings in the early stages of osteoporosis, suggesting the possible use of oral radiographic signs for the early detection of the condition. Digital orthopantomographs (OPGs) are usually taken for the screening of dental patients during routine dental evaluations. These radiographs and the characteristic changes seen on them may have a significant role in the screening for initial osteoporotic changes. A number of precise radiomorphometric indices of the mandible have also been developed to allow quantification of the mandibular bone mass for identification of the initial signs of osteoporosis. The present review focuses on the possible role of panoramic radiographs in the initial screening for osteoporosis in dental clinics in high-risk groups.
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Affiliation(s)
- Rajkumar Selvakumar
- Department of Oral and Maxillofacial Surgery, Rajah Muthiah Dental College and Hospital, Annamalai University, Annamalai Nagar, Tamil Nadu, India
| | - Ajay Chandran
- Department of Oral and Maxillofacial Surgery, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Abhijit Patil
- Department of Prosthodontics and Crown and Bridge, The KLE Academy of Higher Education and Research, KLE V.K. Institute of Dental Sciences and Hospital, Belgaum, Karnataka, India
| | - TC Harini
- Department of Oral Pathology and Microbiology, SJM Dental College and Hospital, Chitradurga, Karnataka, India
| | - Shilpa Dandekeri
- Department of Prosthodontics and Crown and Bridge, Nitte (Deemed to be university), AB, Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Diksha Verma
- Department of Prosthodontics and Crown and Bridge, Jaipur Dental College, Jaipur, Rajasthan, India
| | - J Suresh Babu
- Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia
| | - C Swarnalatha
- Division of Periodontology, Department of Preventive Dental Sciences, College of Dentistry, University of Ha’il, Ha’il, Kingdom of Saudi Arabia
| | - Abhishek S. Nayyar
- Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
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20
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Colakoglu G, Kaya Buyukbayram I, Elcin MA, Garip Berker Y, Ercalik Yalcinkaya S. Association between second mesiobuccal canal and apical periodontitis in retrospective cone‐beam computed tomographic images. AUST ENDOD J 2022; 49:20-26. [PMID: 35908285 DOI: 10.1111/aej.12672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022]
Abstract
This retrospective cone-beam computed tomography study aimed to investigate the possible associations of apical periodontitis (AP) with missed/unmissed second mesiobuccal (MB2) canals. MB2 canals and AP were investigated in 257 endodontically treated and 673 untreated maxillary molars, and the former were analyzed regarding missed/unmissed MB2 canals. The chi-squared test and odds ratio (OR) were used for statistics. The prevalence of MB2 canals in maxillary first molars was higher than that in second molars (p = 0.001). MB2 canals were 1.751 times more common in males than in females (OR: 1.751; 95% CI: 1.334-2.297), with a significant difference in the 18-39 age groups (p = 0.005). The risk for AP was 5.5 times greater in endodontically treated maxillary molars with missed MB2 canals than in those with unmissed MB2 canals (p = 0.012) (OR: 5.5, 95% CI: 1.549-19.527). The findings of this study reveal that the likelihood of the MB2 canal is higher in the maxillary first molars of young adult males.
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Affiliation(s)
- Gizem Colakoglu
- Department of Dentomaxillofacial Radiology, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | - Isil Kaya Buyukbayram
- Department of Endodontics, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | - Mehmet Ali Elcin
- Department of Dentomaxillofacial Radiology, Faculty of DentistryIstanbul Aydin UniversityKucukcekmece, IstanbulTurkey
| | | | - Sebnem Ercalik Yalcinkaya
- Department of Dentomaxillofacial Radiology, Faculty of DentistryMarmara UniversityMaltepe, IstanbulTurkey
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Czajkowska S, Rupa-Matysek J, Wojtasińska E, Nijakowski K, Gil L, Surdacka A, Kulczyk T. Potential Biochemical Markers and Radiomorphometric Indices as Predictors of Reduced Bone Mass in Patients with Congenital Hemophilia. J Clin Med 2022; 11:jcm11123391. [PMID: 35743462 PMCID: PMC9224603 DOI: 10.3390/jcm11123391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/27/2022] [Accepted: 06/10/2022] [Indexed: 12/26/2022] Open
Abstract
Background: The study aimed to evaluate radiomorphometric indices derived from panoramic X-rays and selected blood markers of bone turnover and neutrophil extracellular traps, with a view to identifying hemophilic patients at risk of developing osteoporosis. Methods: The study consisted of 50 adult men with hemophilia A and B (mild, moderate, and severe). The control group consisted of 25 healthy adult men. In both groups, blood samples were collected to determine concentrations of citrullinated histone H3 (CH3) and osteocalcin (BGLAP) with ELISA tests, and panoramic X-rays were obtained. Images were imported into AudaXCeph software to calculate two radiomorphometric indices: mental index (MI) and panoramic mandibular index (PMI). Concentrations of BGLAP and CH3 were compared with MI and PMI values in patients with and without hemophilia. Results: There were statistically significant differences in BGLAP, CH3, and PMI between the study and the control group (p < 0.05). Multivariate logistic regression analysis showed a predictive value for PMI, BGLAP, and CH3.The ROC curve with cutoff point (Youden index) at 0.40—PMI was calculated. No correlation was observed for the PMI index in any particular subgroup of patients. No correlation between MI and BGLAP/CH3 was observed. Conclusions: Simultaneous use of PMI value and BGLAP and CH3 levels may allow the identification of patients with hemophilia who requirea detailed diagnosis of osteoporosis with DXA.
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Affiliation(s)
- Sylwia Czajkowska
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (S.C.); (K.N.); (A.S.)
| | - Joanna Rupa-Matysek
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 67-701 Poznan, Poland; (J.R.-M.); (E.W.); (L.G.)
| | - Ewelina Wojtasińska
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 67-701 Poznan, Poland; (J.R.-M.); (E.W.); (L.G.)
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (S.C.); (K.N.); (A.S.)
| | - Lidia Gil
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 67-701 Poznan, Poland; (J.R.-M.); (E.W.); (L.G.)
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (S.C.); (K.N.); (A.S.)
| | - Tomasz Kulczyk
- Department of Diagnostics, Poznan University of Medical Sciences, 67-701 Poznan, Poland
- Correspondence:
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22
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Bangeennavar BF, Ullah MK, Gokak KV, Ahmed H, Meshram AD, Pavani B, Hassan I, Hassan SS. Panoramic Indices: An Aid to Early Detection of Patients with Low Bone Mineral Density. Asian J Neurosurg 2022; 17:255-261. [PMID: 36120607 PMCID: PMC9473863 DOI: 10.1055/s-0042-1751009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective An early identification of patients who are at an obvious increased risk of osteoporosis and subsequent high risk of pathological bone fractures is important to prevent morbidity and its subsequent impact on the quality of life of the affected patients. Dental professionals have a chance of identifying such cases in their very initial stages through routinely prescribed dental radiographs. The aim of this study was to assess the influence of gender and age on different parameters of alveolar bone loss using orthopantomograph (OPG) as an aid to identify patients with low bone mineral density (BMD).
Materials and Methods This study included eighty subjects in whom after taking OPGs, mandibular cortical index (MCI), mandibular cortical width (MCW), and panoramic mandibular index were assessed, while the results obtained were subjected to statistical analysis. One-way analysis of variance followed by Tukey's test was used to compare the means, while p-value less than 0.05 was considered statistically significant.
Results The findings of this study revealed a significant association between MCI and age for females, with C2 and C3 categories being more common with advancing age. Also, a significant difference could be seen in relation to gender (p-value = 0.0315) for MCW with a concomitant decrease in the values of MCW in females over 60 years of age.
Conclusion Panoramic radiographic measurements could provide valuable information and help in screening patients with low BMD.
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Affiliation(s)
- Bheemappa F. Bangeennavar
- Department of Oral and Maxillofacial Surgery, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Md. Kalim Ullah
- Department of Dentistry, Tezpur Medical College and Hospital, Tezpur, Assam, India
| | - Kajal V. Gokak
- Department of Oral Medicine and Radiology, The KLE Academy of Higher Education and Research, KLE V.K. Institute of Dental Sciences and Hospital, Belgaum, Karnataka, India
| | - Hina Ahmed
- Department of Conservative Dental Sciences, Ibn Sina National College for Medical Studies, Jeddah, Kingdom of Saudi Arabia
| | - Ashish D. Meshram
- Department of Prosthodontics and Crown and Bridge, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College and Hospital (MGV KBH Dental College and Hospital), Nashik, Maharashtra, India
| | - Bellamkonda Pavani
- Department of Public Health Dentistry, Sathyabama Dental College and Hospital, Chennai, Tamil Nadu, India
| | - Irfan Hassan
- Department of Maxillofacial Surgery and Rehabilitation, Oral and Maxillofacial Surgery Section, Dentistry Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Syed Sirajul Hassan
- Department of Maxillofacial Surgery and Rehabilitation, Oral and Maxillofacial Surgery Section, Dentistry Administration, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
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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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Kiswanjaya B, Priaminiarti M, Bachtiar-Iskandar HH. Three panoramic indices for identification of healthy older people at a high risk of osteoporosis. Saudi Dent J 2022; 34:503-508. [PMID: 36092521 PMCID: PMC9453511 DOI: 10.1016/j.sdentj.2022.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/26/2022] Open
Abstract
Three panoramic indices could be used to detect the risk of osteoporosis. Severely eroded mandibular cortex as a potent marker of osteoporosis. Low bone density may occur in older people under 65 years.
Background This study aimed to identify whether healthy older adults are at a high risk of osteoporosis based on the association between the T-score values of bone mineral density (BMD) and three panoramic indices. Materials and methods All participants (50–64 years old) underwent calcaneal quantitative ultrasound (QUS) bone densitometry. In total, 371 panoramic images were included in the analysis. The mandibular cortical width (MCW), mandibular cortical index (MCI), and panoramic mandibular index (PMI) were the three parameters assessed. The data were examined using one-way analysis of variance or Kruskal–Wallis H and post hoc tests. Spearman’s rho was used to measure correlation coefficients. Results T-score distributions in the normal, osteopenia, and osteoporosis categories were 80 (21.6%), 236 (63.6%), and 55 (14.8%), respectively. T-scores were significantly related to age, MCW, PMI, and MCI (p < 0.001). Participants with osteopenia and a risk of progression to osteoporosis had an average MCW value of < 3.38 mm, a PMI of < 0.31, and an MCI class 2 and 3 distribution in 211 (56.9%) participants. The highest to lowest correlation coefficients with a significant relationship to the T-score were for age (r = -0.844), MCI (r = 0.456), MCW (r = 0.359), sex (r = 0.354), and PMI value (r = 0.292). Conclusions This study found that healthy older people with Class 3 MCI, an MCW < 3 mm, and a PMI ratio < 0.3 had a significant association with lower BMD T-scores on QUS and were at higher risk of osteoporosis.
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Karadag I, Yilmaz HG. Evaluation of change in trabecular bone structure surrounding dental implants by fractal dimension analysis and comparison with radiomorphometric indicators: a retrospective study. PeerJ 2022; 10:e13145. [PMID: 35341061 PMCID: PMC8953503 DOI: 10.7717/peerj.13145] [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: 10/21/2021] [Accepted: 03/01/2022] [Indexed: 01/12/2023] Open
Abstract
Background The trabecular bone surrounding dental implant show some structural changes during healing period. The purpose of this study is to observe the change in trabecular bone with fractal dimensional analysis from baseline to 3rd month of implant placement. It was also aimed to determine the correlation of fractal dimension (FD) change with morphometric indices, mandibular cortical index (MCI) and mandibular cortical width (MCW). Methods Digital panoramic radiographs taken from 14 patients were evaluated in this study. A total of 30 implants which were placed on mandibular premolar or molar region were included. MCI and MCW assessments were made on baseline radiograph and FD were analyzed on baseline and 3rd month radiograph. FD change by time was recorded separately for every ROI. A paired sample t-test was used to evaluate the change between FD-baseline and FD-3rdmonth values. One-way ANOVA was used to determine the relationship between FD change and MCI. FD change and MCW measurements correlation was calculated by Pearson correlation analysis. Results FD value increased in 75 of 90 implant-adjacent regions evaluated in the 3rd month and it was observed that the FD values were statistically significantly increased in the mesial, distal and apical regions at the 3rd month measurements. There was no statistically significant relationship between mean FD change and MCI, and there was no correlation between mean FD change and MCW value. Discussion There are many studies evaluating the resorptive changes in bone. However, there are few studies investigating whether there is a correlation between pre- and post-operative trabecular pattern with MCI and MCW. The results of this study indicate that the implants have an improving effect on bone trabeculation in the region where they are placed.
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Affiliation(s)
- Ilkim Karadag
- Faculty of Dentistry Department of Periodontology, Ankara University, Ankara, Turkey
| | - Hasan Guney Yilmaz
- Faculty of Dentistry Department of Periodontology, Near East University (Cyprus), Mersin, Turkey
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Schliephake H. The role of systemic diseases and local conditions as risk factors. Periodontol 2000 2022; 88:36-51. [PMID: 35103330 DOI: 10.1111/prd.12409] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Henning Schliephake
- Department of Oral Maxillofacial Surgery, University Medicine George-Augusta-University, Göttingen, Germany
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Günaçar DN, Yemenoğlu H, Ustaoğlu G, Arıöz Ö. Effects of hyperlipidemia on trabecular and cortical structures of the mandible. Dentomaxillofac Radiol 2022; 51:20210214. [PMID: 34283651 PMCID: PMC8802705 DOI: 10.1259/dmfr.20210214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To evaluate the mandibular bone structure of patients with hyperlipidemia by fractal dimension (FD) analysis and panoramic radiomorphometric indices including mandibular cortical thickness measurement, panoramic mandibular index (PMI), mandibular cortical index (MCI) and to compare with the healthy group. METHODS In total, 60 panoramic radiographs were included, including panoramic radiographs of 30 individuals with hyperlipidemia and 30 individuals with systemically healthy. FD analysis in the mandibular condyle, angle of the mandible, the distal side of the second premolar and anterior to mental foramen, PMI, MCI, and mandibular cortical thickness measurements were evaluated on radiographs. Independent samples t-test was used for differences between healthy and hyperlipidemia groups with regard to age and PMI. Repeated measurement of variance with one within and one between factors in the comparison of four regions and two groups in terms of FD and cortical thickness measurements. Following this analysis, significant differences were detected by post-hoc Sidak test. Fisher-Freeman-Halton analysis was applied to determine the relationship between categorical variables. RESULTS FD values of the hyperlipidemic patients were found to be lower than the healthy group. Between the hyperlipidemic and healthy groups, there was a difference in the angle of the mandible FD values (p = 0.020). There were no differences in the cortical thickness measurements and PMI between the groups (p > 0.05). There was a difference in MCI values between the groups (p < 0.05). CONCLUSION The trabecular structure of the angle of the mandible and the cortical bone structure of the mandible were found to be negatively affected by hyperlipidemia.
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Affiliation(s)
- Dilara Nil Günaçar
- Oral and Maxillofacial Radiology Department, Recep Tayyip Erdoğan University, Faculty of Dentistry, Rize, Turkey
| | - Hatice Yemenoğlu
- Periodontology Department, Recep Tayyip Erdoğan University, Faculty of Dentistry, Rize, Turkey
| | - Gülbahar Ustaoğlu
- Periodontology Department, Abant İzzet Baysal University, Faculty of Dentistry, Bolu, Turkey
| | - Özkan Arıöz
- Periodontology Department, Abant İzzet Baysal University, Faculty of Dentistry, Bolu, Turkey
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Genc E, Buyuk SK. Evaluation of mandibular indices and cephalometric parameters in adolescents with impacted maxillary canines. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_38_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
Maxillary impacted canines have an important place in orthodontics for the reason of being a common anomaly and its treatment is time consuming and difficult. The aim of this study was to investigate the mandibular indexes and cephalometric parameters in adolescents with impacted maxillary canines.
Materials and Methods:
The radiographs of 4026 patients aged 12–19 years old were scanned and a total of 155 patients were included in the study. Subjects were divided into three groups according to the permanent maxillary canines: Bilateral impacted canine (BIC) (52 subjects; mean age 15.02 ± 1.74 years), unilaterally impacted canine (UIC) (51 subjects; mean age 14.89 ± 1.39 years), and the control (52 subjects; mean age 14.84 ± 1.65 years) groups. Skeletal, soft tissue and dental measurements were performed on cephalometric radiographs. Mandibular index analyzes including the panoramic mandibular index (PMI), mental index (MI), antegonial index (AI), and gonial index (GI) measurements and also angular measurements of impacted maxillary canines were performed on panoramic radiographs. Data were analyzed statistically and P < 0.05 was considered significant.
Results:
Maxillary skeletal and dental measurements showed retrusive positioned maxillary dental arch in the sagittal direction in the impacted canine groups (P < 0.05). PMI and MI values were greater in the BIC and UIC groups than in control group (P < 0.05). There was no statistically significant difference in AI value among groups (P < 0.05). GI value of BIC group was found statistically lower than other groups (P < 0.05).
Conclusion:
Individuals with impacted maxillary canines have more retrusive maxillary dental arch and soft-tissue components. Furthermore, mandibular cortex was thicker in subjects with impacted maxillary canine than individuals with not and clinicians should keep in mind this when examine the panoramic radiographs in terms of early diagnosis of impacted maxillary canine teeth.
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Affiliation(s)
- Esra Genc
- Department of Orthodontics, Ordu University, Ordu, Turkey,
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Eninanc I, Yeler DY, Cinar Z. Evaluation of the effect of bruxism on mandibular cortical bone using radiomorphometric indices on panoramic radiographs. Niger J Clin Pract 2021; 24:1742-1748. [PMID: 34782517 DOI: 10.4103/njcp.njcp_71_21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background This prospective study was designed to evaluate the effects of bruxism on mandibular cortical bone using radiomorphometric indices on digital panoramic radiographs. Materials and Methods The mandibular cortical index (MCI), mental index (MI), and panoramic mandibular index (PMI) were measured on digital panoramic radiographs and evaluated for 128 bruxers (66 female, 60 male) and 128 control subjects. The data were analyzed statistically using intraclass correlation coefficients (ICC), Kappa statistics, Chi-square test, Kolmogorov-Smirnov test, independent t-test, and Pearson's correlation analysis. Results There was no difference between the groups in terms of MCI type (P > 0.05). While mean MI values were significantly higher in bruxers than the control group (P = 0.007), the difference between groups in mean PMI values was nonsignificant (P > 0.05). In both groups, the C1 type was more prevalent in females than in males (P = 0.001). Females showed significantly lower mean MI values than males in both groups (P ≤ 0.040). However, the difference between genders in mean PMI values was not significant (P > 0.05). Conclusions MI measurements may be useful when radiomorphometric indices are to be used for the diagnosis or follow-up of bruxism in the mandible. Among radiomorphometric indices, MI and MCI values are affected by gender differences.
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Affiliation(s)
- I Eninanc
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
| | - D Yalcin Yeler
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
| | - Z Cinar
- Department of Biostatistics, Medical Faculty, Sivas Cumhuriyet University, Sivas, Turkey
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Aytekin Z, Yilmaz SG. Evaluation of osseous changes in dental panoramic radiography using radiomorphometric indices in patients with hyperthyroidism. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:492-499. [PMID: 34844888 DOI: 10.1016/j.oooo.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the present study was to compare radiomorphometric measurements on panoramic images of patients with hyperthyroidism (HT) to those of a control population. STUDY DESIGN In this retrospective study, the mental index (MI), inferior panoramic mandibular index (PMI), antegonial index (AI), gonial index (GI), and mandibular cortical index (MCI) were evaluated on dental panoramic radiographs (DPRs) of 40 patients with HT and 40 healthy age- and sex-matched individuals and compared between the groups. Quantitative data (MI, PMI, AI, and GI) were analyzed with the Student t and Mann-Whitney U tests. Categorical data (MCI) were analyzed with the chi-square test. RESULTS Statistically significant differences between the patient and control groups were found for inferior PMI (P = .001) and AI (P = .017) values, with smaller mean values among the patients. However, the measurements of MI (P = .59) and GI (P = .164) and the MCI distribution (P = .13) were similar in both groups. CONCLUSIONS Evaluating the radiomorphometric indices of inferior PMI and AI on the DPRs of patients with HT who are at high risk of secondary osteoporosis could be helpful in the early diagnosis of osteoporotic changes and in formulating surgical treatment plans.
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Affiliation(s)
- Zeliha Aytekin
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Sevcihan Günen Yilmaz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
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Coşgunarslan A, Canger EM, Soydan Çabuk D. Proton pump inhibitors and mandibular bone quality: A preliminary study. Dentomaxillofac Radiol 2021; 50:20200505. [PMID: 33544631 DOI: 10.1259/dmfr.20200505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Proton pump inhibitors (PPI) provide a long-lasting anti-acidic effect by inhibiting the proton pump, and they are one of the most commonly prescribed drugs worldwide. PPIs adversely affect the bone structure via deficiency of vitamins and minerals. The aim of this study was to investigate the possible PPI-induced bone changes in the mandible on panoramic radiographs with the methods of fractal analysis and panoramic morphometric indices. METHODS Panoramic radiographs of 402 patients were used (201 PPI users, 201 control group). Fractal analysis was performed on 4 regions of interests (ROI): 1- upper part of the ramus, 2- angulus, 3- anterior of the mental foramen, 4- distal of the middle ramus. Also, the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) were performed on radiographs. RESULTS There were significant differences in terms of ROI3, MCW, and KI between the control and study groups (p < 0.05) while there was no significant difference for ROI1, ROI2, ROI4, and PMI (p > 0.05). Males were severely affected than females. CONCLUSIONS Osteoporotic changes were detected in the trabecular and cortical bone in the mental foramen region in PPI users with fractal analysis and morphometric indices, while there were no differences for mandibular ramus and angulus regions according to fractal analysis.
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Affiliation(s)
| | - Emin Murat Canger
- Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Kayseri, Turkey
| | - Damla Soydan Çabuk
- Department of Oral and Maxillofacial Radiology, Çukurova University Faculty of Dentistry, Adana, Turkey
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Munhoz L, Morita L, Nagai AY, Moreira J, Arita ES. Mandibular cortical index in the screening of postmenopausal at low mineral density risk: a systematic review. Dentomaxillofac Radiol 2021; 50:20200514. [PMID: 33591840 DOI: 10.1259/dmfr.20200514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This systematic literature review addressed the use of mandibular cortical index (MCI), assessed by panoramic radiography, for the identification of postmenopausal women at risk of osteoporosis. METHODS Databases were searched for original research studies published from September 2010 to September 2020 using the following keywords: "postmenopausal osteoporosis" and synonyms combined with "panoramic radiography" and synonyms. Only English language manuscripts and studies pertaining to the MCI were selected. RESULTS A total of 24 studies were included. The publications were highly heterogeneous in terms of the subject of interest, i.e. the MCI, with some studies comparing the usefulness of the MCI using panoramic radiography and using cone beam computed tomography, and others comparing different radiomorphometric indexes developed for panoramic radiography. CONCLUSIONS Based on the literature included in this systematic review, we conclude that the MCI is useful as an auxiliary tool for identifying postmenopausal females at risk of low bone mineral density (BMD), as it correlates with skeletal BMD measured by dual X-ray absorptiometry. Nevertheless, other radiomorphometric indexes obtained from panoramic radiographs, such as panoramic mandibular index, mental index, and mandibular cortical width, are also valuable as auxiliary tools in the identification of postmenopausal females at risk, as they also correlate with BMD. Thus, it is not possible to affirm which index is the most reliable for the identification of postmenopausal females considering the literature screened. PROSPERO registration systematic review CRD42020208152.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
| | - Lucas Morita
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
| | - Aline Yukari Nagai
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
| | - Julia Moreira
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
| | - Emiko Saito Arita
- Department of Stomatology, School of Dentistry, São Paulo University, São Paulo, Brazil
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Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis. Oral Radiol 2021; 37:189-208. [PMID: 33620644 DOI: 10.1007/s11282-021-00518-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Osteoporotic fractures are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. We undertook a worldwide literature survey and present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. In addition, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. These incidental findings on panoramic radiographs, when used for identifying asymptomatic postmenopausal female patients at risk of having osteoporosis in general dental practice, may be helpful in reducing the incidence of first fractures, with a consequent reduction in the secondary fractures, medical costs, and mortality associated with osteoporotic fragility fractures, without incurring any additional cost.
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Do Morphological Changes in the Anterior Mandibular Region Interfere with Standard Implant Placement? A Cone Beam Computed Tomographic Cross-Sectional Study. ScientificWorldJournal 2021; 2020:8861301. [PMID: 33414691 PMCID: PMC7769664 DOI: 10.1155/2020/8861301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/06/2020] [Accepted: 12/10/2020] [Indexed: 11/18/2022] Open
Abstract
Objective To determine the morphological features in the anterior mandibular region, the presence of lingual foramen and canal dimensions in Saudi subjects that would interfere with standard implant placement. Methods CBCT scans of patients seeking implant treatment were examined. Based on the dentition status, patients were categorized into edentulous (group I) and dentulous (group I). On the panoramic view, the distance between the two mental foramina was divided into vertical segments of 10 mm width. In each segment, vertical bone height and buccolingual thickness at three levels (alveolar crest, 5 mm, and 10 mm apical to the crest) were assessed. The lingual foramen prevalence and canal features were assessed as well. Comparisons between the two groups regarding the assessed parameters were performed using the t-test. The percentage of edentulous mandibles with thickness <6 mm corresponding to the standard implant diameter was also calculated. Results Following the inclusion and exclusion criteria, group I consisted of 45 subjects and group II comprised 26 subjects. Bone height and thickness at the crestal level were significantly less in edentulous (I) than dentate mandibles (II) (P < 0.0001). The lingual foramen was detected in 90% of patients. In both groups, males had significantly greater mandibular height than females (P=0.02 and 0.005). At the crestal level, the thickness was <6 mm in 50% of the anterior mandibular segments. Conclusion Half of the edentulous patients may receive normal size implants in the anterior interforaminal segments, while the other half will be limited to narrow implants (3.5 mm and less). The lingual foramen location, canal size, and position may represent another limitation for implant placement in that segment.
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Is Decreased Local Bone Quality an Independent Risk Factor for Complications Following Fracture Fixation of Facial Bones. J Craniofac Surg 2021; 32:1385-1390. [PMID: 33427779 DOI: 10.1097/scs.0000000000007436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Although osteoporosis is associated with increased risks of complications of fracture fixation in the orthopedic literature, the association between local bone quality (LBQ) and complications of facial fracture fixation is unknown. The authors aim to identify that if decreased LBQ is an independent risk factor for complications following facial fracture fixation? METHODS The authors conducted a prospective cohort study on patients over age of 50 years who underwent open reduction and rigid internal fixation for facial fractures. The primary predictor was LBQ (low or normal), decided by a combination of 3 panoramic indices. Other predictors included age, gender, body mass index (BMI), comorbidities, trauma-related characteristics, etc. The outcome variable was the presence of hardware-related, fracture-healing, wound, or neurosensory complications during 2-year follow-up. Univariate and multivariate regressions were performed to identify any significant association between predictor and outcome variables. RESULTS The sample was composed of 69 patients (27 females) with an average age of 58.6 ± 8.6 years and BMI of 25 ± 3.8. Low-LBQ patients were significantly older, more females, had lower BMI, mainly injured from falls, had more complications compared to their normal-LBQ counterparts. However, multivariable logistic regressions demonstrated that only age (adjusted OR: 1.12, P = 0.031, 95% CI: 1.01, 1.23) and diabetes (adjusted OR: 12.63, P = 0.029, 95% CI: 1.3, 122.53) were significantly associated with overall complications after confounding adjustment. CONCLUSIONS The results of the present study indicate that reduced LBQ is not an independent risk factor for complications following facial fracture fixation. The increased risk of complications in low-LBQ patients is more likely to be attributed to other age-related comorbidities such as diabetes. Therefore, the authors recommend detailed workup and good control of comorbidities in elderly trauma patient.
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Isman O. Evaluation of jaw bone density and morphology in bruxers using panoramic radiography. J Dent Sci 2020; 16:676-681. [PMID: 33854718 PMCID: PMC8025186 DOI: 10.1016/j.jds.2020.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/14/2020] [Indexed: 11/20/2022] Open
Abstract
Background/purpose Bruxism affects the stomatognathic system and causes tissue damage by the excessive jaw movements. The purpose of this study was to evaluate the effects of sleep bruxism on jaw bone density, mineralisation and morphology by comparing bruxers and non-bruxers. Materials and methods 60 bruxers and 60 non-bruxers (control) patients were included in the analysis. Cortical width at the gonion (GI), at the mental foramen (MI), at the antegonion (AI), the panoramic mandibular index (PMI), the mandibular cortical index (MCI) and antegonial notch depth (AND) were measured bilaterally on 120 panoramic radiographs. The measurements were evaluated for repeatability, correlation with age, gender and correlation between the variables. Results A significant association was observed between cortical shape (MCI) and bruxism status (p = 0.012). The MI was significantly different between the bruxers and non-bruxers (p = 0.006). There was a significant but weak correlation between the MI value and age in bruxers and the control (p = 0.003, p = 0.04). The AI was not associated with bruxism status and did not vary by age or gender (p > 0.05). The AND was higher in bruxers than non-bruxers (p = 0.001). Male bruxers had a significantly higher AND value than female bruxers (p = 0.001). The GI was higher in male bruxers (p = 0.001). Conclusion Defects in the endosteal margin of the cortex and cortical thickening in the mental region were detected in bruxer patients. Furthermore, AND was increased in bruxers. Tiny bone peaks accompanied the cortical thickening seen in the gonial region. Male bruxer patients had higher GI and AND values than female bruxers.
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Affiliation(s)
- Ozlem Isman
- Gaziantep University Vocational High School of Health Service, Kilis Road, Main Campus Street, No.3, Gaziantep, 27310, Turkey. Fax: +90 0342 3604423.
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Profico A, Bondioli L, Raia P, O'Higgins P, Marchi D. morphomap: An R package for long bone landmarking, cortical thickness, and cross‐sectional geometry mapping. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 174:129-139. [DOI: 10.1002/ajpa.24140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/15/2020] [Accepted: 08/11/2020] [Indexed: 01/15/2023]
Affiliation(s)
- Antonio Profico
- PalaeoHub, Department of Archaeology University of York York UK
| | - Luca Bondioli
- Service of Bioarchaeology Service Museo delle Civiltà Rome Italy
| | - Pasquale Raia
- Dipartimento di Scienze della Terra, dell'Ambiente e delle Risorse Università di Napoli Federico II Naples Italy
| | - Paul O'Higgins
- PalaeoHub, Department of Archaeology University of York York UK
- Hull York Medical School University of York York UK
- Centre for Forensic Anthropology University of Western Australia Perth Australia
| | - Damiano Marchi
- Department of Biology University of Pisa Pisa Italy
- Evolutionary Studies Institute and Centre for Excellence in PalaeoSciences University of the Witwatersrand Johannesburg‐Braamfontein South Africa
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Mizukuchi T, Naitoh M, Hishikawa T, Nishida S, Mitani A, Ariji E, Koyama S. Automatic measurement of mandibular cortical bone width on cone-beam computed tomography images. Oral Radiol 2020; 37:412-420. [PMID: 32812125 DOI: 10.1007/s11282-020-00469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The computed tomography cortical index (CTCI), computed tomography mandibular index (CTMI), and computed tomography index (inferior) [CTI(I)] are indexes obtained from cone-beam computed tomography images for the assessment of the mandibular cortex quality for implant planning or osteoporosis. However, cross-sectional image reconstruction for the measurements is labor-intensive. This study aimed to develop and evaluate a method to automatically reconstruct cross-sectional images and measure the cortex width in all areas inferior to the mental foramen (MF). METHODS Seventy-one women (mean age: 52.4 years; range: 20-78 years) were enrolled. They were divided into four age and CTCI groups, including females younger (FY) and females older (FO) than 50 years (C1: normal, C2: mild/moderate erosion, and C3: severe porosity). Automatic and manual measurements of CTMI and CTI(I) were compared, and the inter- and intraobserver agreements were assessed using the intraclass correlation coefficient (ICC). The relationships between CTMI or CTI(I) and CTCI were also assessed. RESULTS The mean processing times for reconstruction and measurements were 31.9 s and 1.22 s, respectively. ICCs for the comparison of automatic and manual measurements were 0.932 and 0.993 in the C1 and C2/C3 groups, respectively. Significant differences in CTMI and CTI(I) were observed between the FY or the FO-C1 and FO-C3 groups (p < 0.05). CONCLUSION The automatic and manual measurements showed a strong agreement. The new method could drastically reduce routine clinical workload. Additionally, our method enables the measurement of the cortex width in all the mandibular bones inferior to the MF.
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Affiliation(s)
- Takashi Mizukuchi
- Department of Radiological and Medical Laboratory Sciences, Graduate School of Medicine, Ngoya University, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, 461-8673, Japan.
| | - Munetaka Naitoh
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Toshimitsu Hishikawa
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Satoshi Nishida
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Shuji Koyama
- Department of Radiological and Medical Laboratory Sciences, Graduate School of Medicine, Ngoya University, 1-1-20 Daiko-minami, Higashi-ku, Nagoya, 461-8673, Japan
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Barra SG, Gomes IP, Amaral TMP, Brasileiro CB, Abreu LG, Mesquita RA. New mandibular indices in cone beam computed tomography to identify low bone mineral density in postmenopausal women. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:347-355. [PMID: 32843313 DOI: 10.1016/j.oooo.2020.07.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/17/2020] [Accepted: 07/24/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate new radiomorphometric indices in cone beam computed tomography (CBCT) for assessing bone mineral density (BMD) status in postmenopausal women. STUDY DESIGN Mandibular inferior cortical bone thickness was evaluated in 48 postmenopausal women in cross-sectional images at 4 sites: (1) symphysis (S): cross-sectional image equidistant from the centers of the right and left mental foramina (MF); (2) anterior (A): 10 mm anterior to the MF; (3) molar (M): 10 mm posterior to the MF; and (4) posterior (P): 25 mm posterior to the MF. Participants underwent dual-energy x-ray absorptiometry and were divided into normal, osteopenia, and osteoporosis groups. In the study, t tests with Bonferroni correction were conducted. Statistical significance was set at P < .017. Receiver operator characteristic (ROC) analyses were performed. RESULTS Mean S index was significantly lower in osteoporosis than in osteopenia (P = .005). Mean M index was significantly lower in osteopenia (P < .001) and osteoporosis (P = .001) than in normal individuals. Mean P index was significantly lower in osteoporosis than in normal patients (P = .008). ROC values ranged between 0.643 and 0.740. Cortical thicknesses separating normal from abnormal varied from 1.73 mm to 3.37 mm. CONCLUSIONS M and P indices in CBCT may be useful for identifying low BMD in postmenopausal women.
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Affiliation(s)
- Sâmila Gonçalves Barra
- PhD student in Dentistry, Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte/Minas Gerais, Brazil.
| | - Isadora Pereira Gomes
- MSc student in Dentistry, Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais
| | - Tânia Mara Pimenta Amaral
- Adjunct Professor, Department of Oral Radiology, School of Dentistry, Universidade Federal de Minas Gerais
| | - Cláudia Borges Brasileiro
- Adjunct Professor, Department of Oral Radiology, School of Dentistry, Universidade Federal de Minas Gerais
| | - Lucas Guimarães Abreu
- Adjunct Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais
| | - Ricardo Alves Mesquita
- Professor, Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Pampulha, 31270-010 Belo Horizonte/Minas Gerais, Brazil
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Faraj BM. The frequency of the second mesiobuccal canal in maxillary first molars among a sample of the Kurdistan Region-Iraq population - A retrospective cone-beam computed tomography evaluation. J Dent Sci 2020; 16:91-95. [PMID: 33384783 PMCID: PMC7770281 DOI: 10.1016/j.jds.2020.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/21/2020] [Indexed: 11/22/2022] Open
Abstract
Background/purpose One of the most complexes in root and canal anatomy is the maxillary first permanent molar. This study aimed to analyze the frequency of mesiobuccal (MB2) canal and its apical portals of exit, in patients belonging to different gender-age groups and determine the possible relation with sex and age. Materials and methods A CBCT scan images were accessed from a documented database of 343 patients (178 male, 165 female), who had an oral and maxillofacial examination. The age of the patients ranging from 12 to 63 years. The frequency of the MB2 canal and its portals of exit apically were observed. Age and gender correlation were calculated using the χ2 test. P < 0.05 was considered significant. Results A total of 634 maxillary first molars (335 male, 299 female) were included. The MB2 canal was found in 53.78% of the cases. A significantly higher incidence of the MB2 canal was detected in males than in females. No correlation in the presence and/or absence of the MB2 canal in terms of age. When MB2 canal present, a single apical foramen was observed in 66.28% of the cases, two apical foramina were present in 33.72% of the cases. Conclusion MB2 canals may be present in approximately half of the cases, from which one third of the cases have their own apical portal of exit.
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Kato CNAO, Barra SG, Pereira MJC, Gomes LTF, Amaral TMP, Abreu LG, Brasileiro CB, Mesquita RA. Mandibular radiomorphometric parameters of women with cemento-osseous dysplasia. Dentomaxillofac Radiol 2020; 49:20190359. [PMID: 31846355 PMCID: PMC7213529 DOI: 10.1259/dmfr.20190359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To compare the radiomorphometric parameters of mandibular trabecular and cortical bone of females with and without cemento-osseous dysplasia (COD). METHODS A retrospective cross-sectional paired study was conducted. Digital panoramic radiographs were obtained from females diagnosed in a public service of Oral Medicine. The participants were divided into two groups of 50 subjects each: females with a diagnosis of COD (COD group) and females without a diagnosis of COD (non-COD group), randomly chosen from the image database and paired for age. The radiomorphometric parameters analyzed were: mandibular cortical width (MCW), fractal dimension (FD) and mandibular cortical index (MCI). The paired t-test and Wilcoxon test were used to compare MCW and FD values and the McNemar-Bowker test compared the MCI. RESULTS The mean age of both groups was 46.84 ± 11.38 years. The median MCW index was 3.12 mm (2.15-4.55) for the COD group and 3.52 mm (1.90-4.70) for the non-COD group (p = 0.034). The mean FD value of the COD group (1.2039 ± 0.0926) was lower than that of the non-COD group (1.2472 ± 0.0894) in the anatomical region of the interest of mandibular cortical bone (p = 0.031), while no difference was detected in alveolar trabecular bone. The C3 degree of MCI was more frequent in the COD group (p = 0.009). CONCLUSION Females with COD had lower values of radiomorphometric parameters in mandibular cortical bone than females of the same age without COD. These results suggest that, in addition to the dental care recommended in the literature, COD females also require more attention and screening for low bone mineral density.
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Affiliation(s)
- Camila NAO Kato
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Sâmila G Barra
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Mateus JC Pereira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Lucas TF Gomes
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Tânia MP Amaral
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Lucas G Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Cláudia B Brasileiro
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Ricardo A Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
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The Innovative and Sustainable Use of Dental Panoramic Radiographs for the Detection of Osteoporosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072449. [PMID: 32260243 PMCID: PMC7178244 DOI: 10.3390/ijerph17072449] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/01/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022]
Abstract
This bibliometric study evaluated the scientific impact of papers dealing with osteoporosis detected by dental panoramic radiographs by performing citation analysis and cited reference analysis. Retrospective data was extracted from the Web of Science Core Collection database and imported into VOSviewer, CRExplorer, and CitNetExplorer for analyzing semantic contents, cited references, and temporal citation network. The 280 relevant papers identified were cited 4874 times, having an h-index of 38 and 17.4 citations per paper. The top five major contributing countries were Japan (n = 54, 19.3%), USA (n = 43, 15.4%), Brazil (n = 38, 13.6%), Turkey (n = 38, 13.6%), and the UK (n = 32, 11.4%). Citation per paper correlated with publication count among the authors and institutions. Mandibular cortical width was the most frequently used and most cited measurement index. References published during the 1970s and 1980s have built the foundation for the development of research that investigates the potential associations between osteoporosis and radiographic measurements on panoramic radiographs. Osteoporosis detection by dental panoramic radiographs is a perennially investigated research topic with global contributions. Panoramic radiographs are considered early detection and screening tools for osteoporosis by worldwide research.
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Sghaireen MG, Alam MK, Patil SR, Rahman SA, Alhabib S, Lynch CD, Al-Omiri M. Morphometric analysis of panoramic mandibular index, mental index, and antegonial index. J Int Med Res 2020; 48:300060520912138. [PMID: 32228352 PMCID: PMC7132799 DOI: 10.1177/0300060520912138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mohammed G Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, KSA.,Department of Prosthodontics, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Santosh R Patil
- Department of Oral Medicine and Radiology, College of Dentistry, Jouf University, Sakaka, KSA
| | - Saifulizan Ab Rahman
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Selham Alhabib
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, KSA
| | - Christopher D Lynch
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Mahmoud Al-Omiri
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, KSA
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Goyushov S, Dursun E, Tözüm TF. Mandibular cortical indices and their relation to gender and age in the cone-beam computed tomography. Dentomaxillofac Radiol 2020; 49:20190210. [PMID: 31714158 PMCID: PMC7068079 DOI: 10.1259/dmfr.20190210] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study is to evaluate normal ranges of cortical bone Hounsfield units indices through cone beam CT images, and to investigate their relationships with age and sex. METHODS 700 adult human cone beam CT images were evaluated retrospectively, and divided into 4 age groups. Six different cortical bone Hounsfield unit measurements were applied bilaterally, where gender and age were recorded. Collected data were subjected to statistical analysis and ANOVA tests were used for various comparisons. RESULTS The cortical bone measurements between female and male patients were significantly different (p<0.05). Cortical bone thickness indices showed greater values in male patients compare to female patients (p<0.05). Quantitative mandibular indices were significantly lower in first age group (18-30 years) than other three older age groups (p<0.01). CONCLUSION The results of this study seems to propose a persistent alteration in the mandibular cortical bone with age and that this influced by sex. Further studies with larger patient groups are needed to clarify and understand these mandibular indices.
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Affiliation(s)
- Samir Goyushov
- Department of Periodontology, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey
| | - Erhan Dursun
- Department of Periodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Tolga Fikret Tözüm
- Department of Periodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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Aliaga I, Vera V, Vera M, García E, Pedrera M, Pajares G. Automatic computation of mandibular indices in dental panoramic radiographs for early osteoporosis detection. Artif Intell Med 2020; 103:101816. [PMID: 32143810 DOI: 10.1016/j.artmed.2020.101816] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 01/31/2020] [Accepted: 02/04/2020] [Indexed: 11/29/2022]
Abstract
AIM A new automatic method for detecting specific points and lines (straight and curves) in dental panoramic radiographies (orthopantomographies) is proposed, where the human knowledge is mapped to the automatic system. The goal is to compute relevant mandibular indices (Mandibular Cortical Width, Panoramic Mandibular Index, Mandibular Ratio, Mandibular Cortical Index) in order to detect the thinning and deterioration of the mandibular bone. Data can be stored for posterior massive analysis. METHODS Panoramic radiographies are intrinsically complex, including: artificial structures, unclear limits in bony structures, jawbones with irregular curvatures and intensity levels, irregular shapes and borders of the mental foramen, irregular teeth alignments or missing dental pieces. An intelligent sequence of linked imaging segmentation processes is proposed to cope with the above situations towards the design of the automatic segmentation, making the following contributions: (i) Fuzzy K-means classification for identifying artificial structures; (ii) adjust a tangent line to the lower border of the lower jawbone (lower cortex), based on texture analysis, grey scale dilation, binarization and labelling; (iii) identification of the mental foramen region and its centre, based on multi-thresholding, binarization, morphological operations and labelling; (iv) tracing a perpendicular line to the tangent passing through the centre of the mental foramen region and two parallel lines to the tangent, passing through borders on the mental foramen intersected by the perpendicular; (v) following the perpendicular line, a sweep is made moving up the tangent for detecting accumulation of binary points after applying adaptive filtering; (vi) detection of the lower mandible alveolar crest line based on the identification of inter-teeth gaps by saliency and interest points feature description. RESULTS The performance of the proposed approach was quantitatively compared against the criteria of expert dentists, verifying also its validity with statistical studies based on the analysis of deterioration of bone structures with different levels of osteoporosis. All indices are computed inside two regions of interest, which tolerate flexibility in sizes and locations, making this process robust enough. CONCLUSIONS The proposed approach provides an automatic procedure able to process with efficiency and reliability panoramic X-Ray images for early osteoporosis detection.
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Affiliation(s)
- Ignacio Aliaga
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - Vicente Vera
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - María Vera
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - Enrique García
- Dept. of Conservative Dentistry and Prostheses. Faculty of Dentistry. Complutense University, Madrid, Spain.
| | - María Pedrera
- Hospital Clínico San Carlos, Complutense University, Madrid, Spain.
| | - Gonzalo Pajares
- Instituto del Conocimiento (Knowledge Institute). Complutense University, Madrid, Spain.
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Yasa Y, Buyuk SK, Genc E. Comparison of mandibular cortical bone among obese, overweight, and normal weight adolescents using panoramic mandibular index and mental index. Clin Oral Investig 2019; 24:2919-2924. [PMID: 31802243 DOI: 10.1007/s00784-019-03158-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 11/13/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study is to evaluate the mental index (MI) and panoramic mandibular index (PMI) of a group of adolescent patients in different body mass index (BMI) percentile. MATERIAL AND METHODS Subjects were divided into three different groups in accordance to their BMI percentile status: normal weight (35 subjects; mean age, 14.81 ± 2.12 years), overweight (32 subjects; mean age, 14.77 ± 2.56 years), and obese (33 subjects; mean age, 14.06 ± 2.59 years) groups. Mental index (MI) and panoramic mandibular index (PMI) were assessed on panoramic radiographs. RESULTS There were statistically significant differences in PMI and MI that were observed among groups (p < 0.0001 and p < 0.001, respectivel). MI and PMI are higher in overweight and obese individuals than in normal-weight. CONCLUSIONS Mandibular cortex was found thicker in patients who are obese and overweight compared to normal weight patients. We can suggest that young obese individuals' bone structure can be take in consideration in orthodontic or dental surgical treatment planning. CLINICAL RELEVANCE Dense cortical bone may cause some difficulties in orthodontic and surgical treatment. Clinicians should understand obesity and overweight-related jaw bone changes and consider these factors to treat their patients.
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Affiliation(s)
- Yasin Yasa
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, Turkey.
| | | | - Esra Genc
- Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
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Increased Plasma Osteocalcin, Oral Disease, and Altered Mandibular Bone Density in Postmenopausal Women. Int J Dent 2019; 2019:3715127. [PMID: 31781221 PMCID: PMC6855022 DOI: 10.1155/2019/3715127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/06/2019] [Accepted: 09/11/2019] [Indexed: 01/20/2023] Open
Abstract
An association between oral diseases and postmenopausal status has been recognized. However, the relationship between all oral disease, mandibular bone density, health status, and osteocalcin (OCN) bone markers in postmenopausal dental patients has not been reported. This study was therefore to verify the differences in plasma OCN levels, dental, periodontal, and oral mucosal disease, and mandibular bone density alterations from panoramic radiograph and systemic parameters in postmenopausal women, compared to premenopausal women. Oral, radiographic, and blood examination were performed in 92 females. Dental, periodontal, and oral mucosal statuses were recorded. Health profile parameters were collected from medical charts. Plasma OCN was evaluated by enzyme-linked immunosorbent assay. Forty-two (45.7%) participants were postmenopausal with a higher median age (55 (51, 62) years) than the premenopausal group (43 (38, 45) years). Overweight or obesity, hypercholesterolemia, and impaired fasting blood sugar were more prevalent in postmenopause. The average postmenopausal OCN level (425.62 ng/mL) was significantly higher than the premenopausal group (234.77 ng/mL, p < 0.001). The average number of missing teeth, mean attachment loss, alveolar bone loss, periapical lesion count, and clinical oral dryness score were also significantly higher in postmenopause (p=0.008, < 0.001, 0.031, 0.006, and 0.005, respectively). However, mandibular bone density determined by mandibular cortical index was lower in postmenopause (p < 0.001). The panoramic mandibular index, mandibular cortical width, fractal dimension, and other oral mucosal disease did not differ between the groups. Postmenopause was associated with elevated plasma OCN (β = 0.504, p < 0.001) when related covariates were adjusted. Elevated plasma OCN, oral mucosal dryness, high number of periapical radiolucencies and missing teeth, and lower mandibular bone density from panoramic radiograph were prevalent in postmenopausal women. Dentists should suspect an increased risk of low bone mineral density in postmenopausal patients who display these clinical and radiographic findings, and they should be referred for further examination. Plasma OCN may interconnect a relationship between postmenopausal status and the low mandibular bone density.
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Khaitan T, Shukla AK, Gupta P, Naik SR. Is panoramic mandibular index a reliable marker in the evaluation of bone mineral density and sexual dimorphism?? J Forensic Dent Sci 2019; 11:133-136. [PMID: 32801584 PMCID: PMC7398367 DOI: 10.4103/jfo.jfds_92_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/07/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction: Osteoporosis is a silent, progressive, and chronic disease affecting bones of the adults, especially postmenopausal women. Its effect on mandibular bone quality has also been described by some authors in men inferring that gender and age are factors that may influence bone mineral density (BMD) and prognosis. The panoramic radiograph is used widely for the early detection of osteoporosis. The present study was undertaken to evaluate whether the panoramic mandibular index (PMI) is useful for BMD and sexual dimorphism. Materials and Methods: A total of 60 patients (30 males and 30 females) in the age group of 25–40 years were selected for the study. Orthopantomograph was taken and PMI determined with the help of Sidexis next-generation software. All the measurements were performed by four observers and data subjected to the statistical analysis. Results: The mean superior PMI was 0.22–0.27, and the inferior PMI was 0.28–0.34. The mean superior and inferior linear measurements from the mental foramen were higher in males than females and statistically significant. The mean mandibular cortical width was 3.8–4.7 mm but did not show much gender difference. Conclusion: PMI is a reliable indicator for determining BMD but is not much influenced by gender variation.
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Affiliation(s)
- Tanya Khaitan
- Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Anjani Kumar Shukla
- Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Prashant Gupta
- Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Shantala R Naik
- Department of Oral Medicine and Radiology, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Akay G, Akarslan Z, Karadag O, Gungor K. Does tooth loss in the mandibular posterior region have an effect on the mental index and panoramic mandibular index? Eur Oral Res 2019; 53:56-61. [PMID: 31309194 PMCID: PMC6614691 DOI: 10.26650/eor.20192146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/10/2018] [Accepted: 01/04/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Mental index (MI) and panoramic mandibular index (PMI) are important radiomorphometric indices used for assessing the quality of the mandibular bone. The aim of this study was to investigate the possible effect of mandibular posterior tooth/teeth loss in young adults on the MI and PMI (superior panoramic mandibular index: PMI-s, and inferior panoramic mandibular index: PMI-i). MATERIALS AND METHODS Digital panoramic radiographs belonging to 253 patients aged between 18-35 years old were examined. According to the inclusion criteria of the study, a patient and control group was formed. The patient group (n=46) included individuals having at least one extracted tooth in the posterior region of the mandible, and the control group (n=45) included full dentate patients. The MI and PMI (PMI-i and PMI-s) were calculated bilaterally for all of the individuals. RESULTS No significant difference was found between the MI, PMI-i and PMI-s indices of the patient group and the control group among both genders. CONCLUSION The mandibular premolar and/or molar teeth loss in young adults did not lead to any change in the MI, PMI-i and PMI-s indices among both genders.
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Affiliation(s)
- Gulsun Akay
- Gazi University, Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, AnkaraTurkey
| | - Zuhre Akarslan
- Gazi University, Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, AnkaraTurkey
| | - Ozge Karadag
- Hacettepe University, Graduate school of Science and Engineering Department of Statistics, AnkaraTurkey
| | - Kahraman Gungor
- Gazi University, Faculty of Dentistry, Department of Oral and Dentomaxillofacial Radiology, AnkaraTurkey
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Neves FS, Barros AS, Cerqueira GA, Cruz GA, Reis AA, Alves LB, Crusoé-Rebello I. Assessment of fractal dimension and panoramic radiomorphometric indices in women with celiac disease. Oral Radiol 2019; 36:141-147. [DOI: 10.1007/s11282-019-00388-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/20/2019] [Indexed: 12/11/2022]
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