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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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Musulluoğlu F, Alan H, Yılmaz S. Investigation of the effect of oral and internal bisphosphonate use on bone density in the jaws in patients with osteoporosis in panoramic radiography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:284-293. [PMID: 37316421 DOI: 10.1016/j.oooo.2023.02.009] [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: 11/15/2022] [Revised: 02/02/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES This study aims to quantitatively evaluate the effects of bisphosphonate use duration and route of administration on mandibular cortical and trabecular bone in postmenopausal women. STUDY DESIGN Ninety postmenopausal women over the age of 50 were included in this study. Trabecular bone density was specified numerically by fractal dimension (FD) in the region of interest selected on the panoramic radiograph. The width of the mandibular cortical (MCW) bone under the mental foramen of the mandible was measured. Mann-Whitney U test was used for parameters that did not show a normal distribution. Spearman rho correlation test was used to determine the relationship between continuous measurement parameters. RESULTS It was observed that FD and MCW of dentate and edentate individuals using bisphosphonate were statistically significantly lower than those of healthy individuals (P < .05). There was no significant correlation was found between the duration of use of bisphosphonates and the fractal values obtained from the relevant regions of the mandible (P > .05). CONCLUSION Fractal dimension was found to be lower in oral bisphosphonate use than in intravenous bisphosphonate use. The width of the mandibular cortical bone values was found to be lower in individuals using bisphosphonate than in healthy individuals. Fractal dimension and MCW may benefit clinicians as quantitative parameters in panoramic radiography in the diagnosis of osteoporosis.
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Affiliation(s)
- Ferhat Musulluoğlu
- Department of Oral and Maxillofacial Surgery, Inonu University Faculty of Dentistry, Malatya, Turkey.
| | - Hilal Alan
- Department of Oral and Maxillofacial Surgery, Inonu University Faculty of Dentistry, Malatya, Turkey
| | - Serkan Yılmaz
- Department of Dentomaxillofacial Radiology, Ministry of Health, Mersin Oral and Dental Health Hospital, Mersin, Turkey
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Unal Erzurumlu Z, Sadik E, Gokkurt BN, Ozbey F, Erzurumlu K, Kasko Arici Y. Morphological evaluation of gonial and antegonial regions in bruxers on panoramic radiographic images. BMC Oral Health 2023; 23:457. [PMID: 37420199 PMCID: PMC10327333 DOI: 10.1186/s12903-023-03162-0] [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: 04/26/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND This is the first study to report both cortical and trabecular bone evaluation of mandibles in bruxers, within the knowledge of the authors. The purpose of this study was to evaluate the effects of bruxism on both the cortical and the trabecular bone in antegonial and gonial regions of the mandible, which is the attachment of the masticatory muscles, by using panoramic radiographic images. METHODS In this study, the data of 65 bruxer (31 female, 34 male) and 71 non-bruxer (37 female, 34 male) young adult patients (20-30 years) were evaluated. Antegonial Notch Depth (AND), Antegonial-Index (AI), Gonial-Index, Fractal Dimension (FD) and Bone Peaks (BP) were evaluated on panoramic radiographic images. The effects of the bruxism, gender and side factors were investigated according to these findings. The statistical significance level was set atP ≤ 0.05. RESULTS The mean AND of bruxers (2.03 ± 0.91) was significantly higher than non-bruxers (1.57 ± 0.71; P < 0.001). The mean AND of males was significantly higher than females on both sides (P < 0.05). The mean AI of bruxers (2.95 ± 0.50) was significantly higher than non-bruxers (2.77 ± 0.43; P = 0.019). The mean FD on each side was significantly lower in bruxers than in non-bruxers (P < 0.05). The mean FD of males (1.39 ± 0.06) was significantly higher than females (1.37 ± 0.06; P = 0.049). BP were observed in 72.5% of bruxers and 27.5% of non-bruxers. The probability of existing BP, in bruxers was approximately 3.4 times higher than in non-bruxers (P = 0.003), in males was approximately 5.5 times higher than in females (P < 0.001). CONCLUSION According to the findings of this study, the morphological differences seen in cortical and trabecular bone in the antegonial and gonial regions of the mandible in bruxers can be emphasized as deeper AND, higher AI, increased of existing BPs, and lower FD, respectively. The appearance of these morphological changes on radiographs may be useful for indication and follow-up of bruxism. Gender is an effective factor on AND, existing BP and FD.
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Affiliation(s)
- Zerrin Unal Erzurumlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Elif Sadik
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Busra Nur Gokkurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Furkan Ozbey
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey.
| | - Kerem Erzurumlu
- Computer Science and Engineer, Department of Computer Programming, Vocational School of Technical Sciences, Ordu University, Ordu, Turkey
| | - Yeliz Kasko Arici
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ordu University, Ordu, Turkey
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Palaskar JN, Ambildhok KA. Reference values of Orthopantomographic indices for early detection of low bone mineral density in Indian population. J Oral Biol Craniofac Res 2023; 13:150-154. [PMID: 36618008 PMCID: PMC9811193 DOI: 10.1016/j.jobcr.2022.12.009] [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: 02/16/2022] [Revised: 08/22/2022] [Accepted: 12/23/2022] [Indexed: 12/26/2022] Open
Abstract
Purpose Orthopantomographic (OPG) indices are considered tools for early screening for low Bone Mineral Density and Osteoporosis. This tool is being used in the western population, and they have developed their reference values for all the OPG indices. The current study aimed to check the validity of the reference values for OPG indices in the Indian population. Material and methods A cross-sectional study was conducted on 325 participants, and they were recruited in two sets. Dataset one of 130 aged 20-30 years and dataset two of 195 participants aged 40-60 years. OPG was performed, and indices such as Mental Index (MI), Panoramic Mandibular Index (PMI), Gonial Index (GI) and Antegonial Index (AI) were measured. Values obtained in our study were compared with the established OPG indices for the Indian and Western populations. Results The mean age of participants in dataset one to develop references was 23.5 ± 2.5 years. Females had a significantly lower MI, PMI, and AI than males (p < 0.05). MI was significantly higher in validation dataset one males than females (p < 0.05). A good agreement was found in MI and PMI of the two references (p < 0.05). Conclusions The reference values derived from this study for MI, PMI, GI and AI are 3.50,0.27,1.10, 2.50, respectively. Compared with previous studies in Indian and western populations, these references were significantly lower.
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Affiliation(s)
- Jayant N. Palaskar
- Department of Prosthodontics, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
- Faculty of Dentistry, Maharashtra University of Health Sciences, Nashik, India
| | - Kadambari A. Ambildhok
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
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Triantafyllopoulos G, Mitsea A, Rontogianni A, Korres D. Osteoporosis Screening Using Dental Panoramic Radiographs and Age at Menarche. Diagnostics (Basel) 2023; 13:diagnostics13050881. [PMID: 36900024 PMCID: PMC10000716 DOI: 10.3390/diagnostics13050881] [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: 02/08/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Since early detection of osteoporosis is essential, the development of an efficient and cost-effective screening model would be incredibly beneficial. The aim of this study was to evaluate the diagnostic accuracy of MCW and MCI indices from dental panoramic radiographs in combination with a new variable, age at menarche, for the detection of osteoporosis. The study enrolled 150 Caucasian women (aged 45 to 86) who met the eligibility criteria, had DXA scans of the left hip and lumbar spine (L2 to L4), and were classified as osteoporotic, osteopenic, or normal based on T-score. Two observers evaluated MCW and MCI indexes on panoramic radiographs. There was a statistically significant correlation between the T-score and MCI and MCW. In addition, age at menarche had a statistically significant correlation with T-score (p = 0.006). In conclusion, in the current study, MCW proved to be more effective in detecting osteoporosis when combined with age at menarche. Individuals with MCW less than 3.0 mm and age at menarche later than 14 years old should be referred for DXA since they present high risk of osteoporosis.
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Affiliation(s)
| | - Anastasia Mitsea
- Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-6937025812
| | - Aliki Rontogianni
- Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Demitrios Korres
- Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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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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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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Michels M, Morais-Faria K, Rivera C, Brandão TB, Santos-Silva AR, Oliveira ML. Structural complexity of the craniofacial trabecular bone in multiple myeloma assessed by fractal analysis. Imaging Sci Dent 2022; 52:33-41. [PMID: 35387107 PMCID: PMC8967490 DOI: 10.5624/isd.20210160] [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] [Received: 06/24/2021] [Revised: 08/30/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the structural complexity of craniofacial trabecular bone in multiple myeloma by fractal analysis of panoramic and lateral skull radiography, and to compare the fractal dimension values of healthy patients (HPs), pre-treatment patients (PTPs), and patients during bisphosphonate treatment (DTPs). Materials and Methods Pairs of digital panoramic and lateral skull radiographs of 84 PTPs and 72 DTPs were selected. After application of exclusion criteria, 43 panoramic and 84 lateral skull radiographs of PTPs, 56 panoramic and 72 lateral skull radiographs of DTPs, and 99 panoramic radiographs of age- and sex-matched HPs were selected. The fractal dimension values from panoramic radiographs were compared among HPs, PTPs, and DTPs and between anatomical locations within patient groups using analysis of variance with the Tukey test. Fractal dimension values from lateral skull radiographs were compared between PTPs and DTPs using the Student t-test. Pearson correlation coefficients were used to assess the relationship between the mandible from panoramic radiographs and the skull from lateral skull radiographs. Intra-examiner agreement was assessed using intraclass correlation coefficients (α=0.05). Results The fractal dimension values were not significantly different among HPs, PTPs, and DTPs on panoramic radiographs or between PTPs and DTPs on lateral skull radiographs (P>0.05). The mandibular body presented the highest fractal dimension values (P≤0.05). The fractal dimension values of the mandible and skull in PTPs and DTPs were not correlated. Conclusion Fractal analysis was not sensitive for distinguishing craniofacial trabecular bone complexity in multiple myeloma patients using panoramic and lateral skull radiography.
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Affiliation(s)
- Mariane Michels
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Karina Morais-Faria
- Dental Oncology Service, São Paulo State Cancer Institute, São Paulo University Medical School, São Paulo, SP, Brazil
| | - César Rivera
- Oral Medicine and Pathology Research Group, Department of Basic Biomedical Sciences, Faculty of Health Sciences, University of Talca, Talca, Maule, Chile
| | - Thaís Bianca Brandão
- Dental Oncology Service, São Paulo State Cancer Institute, São Paulo University Medical School, São Paulo, SP, Brazil
| | - Alan Roger Santos-Silva
- Division of Oral Medicine, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Matheus L Oliveira
- Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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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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Vargas JA, Bonato RCS, Orenha ES, Sales-Peres SHDC. ASSESSMENT OF ALVEOLAR BONE PATTERN IN OBESE AND NON-OBESE WOMEN, BEFORE AND AFTER BARIATRIC SURGERY: A PROSPECTIVE COHORT STUDY. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2020; 33:e1501. [PMID: 32667531 PMCID: PMC7357551 DOI: 10.1590/0102-672020190001e1501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 09/24/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Right and left periapical radiographs in A eutrophic example of normal bone level; in B of morbidly obese before bariatric surgery, presenting bone loss; and in morbidly obese C after six months of the operation presenting great bone loss. Bariatric surgery may have a negative impact on oral bone structure. AIM To verify the alveolar bone pattern through radiomorphometric indices of panoramic radiography and linear measurements performed in periapical radiographs in eutrophic and morbidly obese patients before and after bariatric surgery. METHODS The sample consisted of 31 women aged 20-35 years old, divided into two groups: obese group (GO-obese grade III) and control group (GC-eutrophic). Twenty eutrophic and 11 obese morbidities were evaluated in the pre and postoperative bariatric surgery (six months). Radiomorphometric and plaque indices were evaluated at T0 (baseline) and T1 (six months) times, in both groups. In the radiographic analysis the trabecular pattern through the Lindh visual ladder and the bone loss were evaluated by calculating the distance from the cement-enamel junction to the bone crest in periapical radiographs. Panoramic radiographs were used to measure the mandibular cortical index (ICM), mentonian index (IM) and panoramic mandibular index (MPI), in addition to the Turesky plate index. RESULTS There was a significant loss of bone in T1 in patients submitted to bariatric surgery, when compared to eutrophic patients (p<0.05). The trabecular pattern became sparser after surgery with a visual difference. The plate index showed a slight improvement after surgery and the eutrophic maintained similar values over time. CONCLUSION The standard alveolar bone presents greater bone loss in obese patients and worsens this standard after bariatric surgery when compared to eutrophic patients. The same happens with the trabecular pattern that becomes sparser after bariatric surgery.
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Affiliation(s)
- Jefry Alberto Vargas
- Pediatric Dentistry, Orthodontics and Public Health Department, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Rafaela Carolina Soares Bonato
- Pediatric Dentistry, Orthodontics and Public Health Department, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Eliel Soares Orenha
- Pediatric Dentistry, Orthodontics and Public Health Department, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Geraets WG, Jonasson G, Hakeberg M. Changing trabecular patterns in panoramic radiographs of Swedish women during 25 years of follow-up. Dentomaxillofac Radiol 2020; 49:20190494. [PMID: 32207990 DOI: 10.1259/dmfr.20190494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The radiographic trabecular pattern on dental radiographs may be used to predict fractures. The aim of this study was to analyze longitudinal changes in the mandibles of 145 females between 1980 and 2005. METHODS Panoramic radiographs were obtained in 1980 and 2005. On 290 radiographs, regions of interest (ROIs) were selected in the ramus, angle and body. In all ROIs, the orientation was measured in 36 directions with the line frequency deviation method. The effects of ageing were analyzed for the fracture and the non-fracture groups separately. RESULTS During the follow-up, 61 females suffered fractures of the hip, wrist, spine, leg or arm. The fracture and non-fracture groups displayed dissimilar age changes in each investigated ROI. All significant changes pertained to increasing values of line frequency deviation. With increasing age, the trabecular network in the mandible lost details and the trabeculae became more aligned in their main direction. In the "ramus", the alignment was to the 110-120˚ axis, parallel to the posterior and anterior ramus border. In the "angle", the alignment was to the 135-150˚ axis, parallel to the oblique line, and in the "body" ROI to the 150-175˚ direction, approximately parallel to the occlusal plane and inferior cortex. CONCLUSION Most changes were consistent with the notion that the bone aged less severely in the non-fracture group. In the fracture group, the findings indicate that bone loss leads to redistribution of the remaining bone tissue in such a way that the trabeculae are accentuated perpendicular to the principal loading.
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Affiliation(s)
- Wil Gm Geraets
- Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
| | - Grethe Jonasson
- Research & Development Unit in Southern Ӓlvsborg County, Sven Eriksonplatsen 4, SE-50338 Borås, Sweden.,Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30 Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30 Gothenburg, Sweden
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Zuchuat J, Manzano A, Decco O. Image-based analysis of trabecular bone in osteoporotic rabbits: correlation of morphological features and bone mineral density profile. Biomed Phys Eng Express 2019; 6:015005. [PMID: 33438593 DOI: 10.1088/2057-1976/ab575f] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To analyse a set of morphological features from digital radiographs (RX) and bone mineral density (BMD) values estimated from quantitative computerized tomography scans (QCT scans) of the knee joint of an osteoporotic rabbits, and to determine the relationship and correlation of these variables to be considered as an alternative diagnosis method. METHODS The knee joint of rabbits (N = 9 ovariectomized and injected with of methylprednisolone sodium succinate (OVX + MPSS) and 3 sham operated healthy controls) were subjected to radiographic examination before the beginning of the study and after 6 weeks; after sacrifice, they were immediately scanned with a 64-channel CT. A set of morphological features was extracted from RX images and then subjected to Principal Component Analysis (PCA); BMD-values were calculated at different depths from the articular surface of the femur and the tibia. The selected morphological variables and the BMD values were correlated in order to determine useful information in medical diagnostics. RESULTS Ten morphological variables explained 80.39% of the total variability, but only some of them demonstrated significant differences between baseline and OVX + SSMP states and between OVX + SSMP and control. Spearman analysis showed higher positive and negative correlation of these parameters among them (r = 0.67, 0.81, 0.83 and 1); and a moderate correlation with the BMD values (r = 0.50, 0.52, 0.52 and 0.55) during the progression of osteoporosis (OP). CONCLUSION The Spearman's rank test supported the overall significant correlation between both, the morphological features and BMD values, making them as a reliable alternative option to the diagnosis of osteoporosis.
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Affiliation(s)
- Jésica Zuchuat
- Bioimplants Laboratory, Faculty of Engineering-National University of Entre Rios, Oro Verde-Entre Rios, Argentina
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14
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Gumussoy I, Duman SB. Alternative cone-beam CT method for the analysis of mandibular condylar bone in patients with degenerative joint disease. Oral Radiol 2019; 36:177-182. [PMID: 31256307 DOI: 10.1007/s11282-019-00395-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the use of 3D microstructural bone analysis in patients with degenerative joint disorder (DJD) to enhance the diagnostic capacity of cone beam computed tomography (CBCT) in the evaluation of bone tissue. METHODS 147 TMJ CBCT images of 88 participants were assessed with regard to DJD in the mandibular condyle. We divided each condyle into 3 groups (0, 1, 2) according to diagnosis of DJD: 0 indicates normal condyles (control individuals), 1 indicates mild erosive osteoarthritic change (EOC) and 2 indicates severe EOC. 3D fractal dimension (FD) was calculated on CBCT images of mandibular condyle and were compared with the radiographic diagnosis of patients. RESULTS ANOVA test showed that there was statistically significant difference in FD values among each groups. The average FD value of group 0 was 1.971, group 1 was 1.918 and group 2 was 1.863. Lower FD values and more severe degenerative changes were seen in patient group 2. To evaluate the reliability of fractal analysis (FA) method, receiver operating characteristic (ROC) curve analysis was performed. Area under the curve (AUC) was 0.717 (p < 0.001). CONCLUSION This study provides a preliminary conclusion that fractal analysis may be a helpful tool to enhance the diagnostic capacity of CBCT in the evaluation of DJD.
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Affiliation(s)
- I Gumussoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Sakarya University, Sakarya, Turkey
| | - S B Duman
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, İnonu University, Malatya, Turkey.
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15
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Queiroz SM, Andrade ALDLD, Oliveira PTD, Leite Maia PR, Oliveira ÂGRDC, Almeida Freitas RD, Galvão HC. Correlation of Radiomorphometric Indices of the Mandible and Biochemical Parameters in Patients with Secondary Hyperparathyroidism Due to Chronic Kidney Disease. Eur J Dent 2019; 13:303-309. [PMID: 31794998 PMCID: PMC6890480 DOI: 10.1055/s-0039-1688738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The aim was to correlate radiomorphometric indices and biochemical analyses as an auxiliary method in bone evaluation in male and female patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and controls. MATERIALS AND METHODS Nine radiomorphometric indices and four biochemical parameters were obtained: mental index (MI), height at the mental foramen, total mandibular height (THM), panoramic mandibular index (PMI), original height of the mandible, alveolar bone resorption, distance from the mental foramen to the alveolar bone crest (MF-ABC), mandibular cortical index (MCI), trabecular bone pattern, parathyroid hormone (PTH), calcium (Ca), phosphorus (P), and Ca × P product (Ca × P). STATISTICAL ANALYSIS The Mann-Whitney U-test, chi-squared test, and Spearman's correlation were applied at a significance level of 95%. RESULTS There was a moderate negative and significant correlation between MI, PMI, and PTH in female patients with CKD-MBD as well as between THM, MF-ABC, and Ca × P. The MCI and trabecular bone pattern indicated altered bone quality in male patients. CONCLUSIONS The radiomorphometric evaluation was an auxiliary, noninvasive method to detect possible alterations in the cortex and mandibular bone trabeculation in male and female patients with CKD-MBD.
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Affiliation(s)
- Stenio Medeiros Queiroz
- Department of Dentistry, Health Sciences Postgraduate Program, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana Luiza Dias Leite De Andrade
- Department of Dentistry, Oral Pathology Postgraduate Program, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | - Patrícia Teixeira De Oliveira
- Department of Dentistry, Postgraduate Program in Dental Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Paulo Raphael Leite Maia
- Department of Dentistry, Postgraduate Program in Dental Sciences, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Roseana De Almeida Freitas
- Department of Dentistry, Oral Pathology Postgraduate Program, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
| | - Hébel Cavalcanti Galvão
- Department of Dentistry, Health Sciences Postgraduate Program, Federal University of Rio Grande Do Norte, Natal, Rio Grande do Norte, Brazil
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S R, R M. An Automatic Bone Disorder Classification Using Hybrid Texture Feature Extraction with Bone Mineral Density. Asian Pac J Cancer Prev 2018; 19:3517-3523. [PMID: 30583678 PMCID: PMC6428536 DOI: 10.31557/apjcp.2018.19.12.3517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A novel approach has been proposed to classify bone disorders for classifying the radiographic bone image as normal, Osteopenia and Osteoporosis. The proposed system consists of three major stages to predict the accurate bone disorder classification. In the first stage, image preprocessing is performed where bilateral filtering is applied to remove noise and to enhance the image quality. Then, the image is fed to Otsu based segmentation approach for segmenting the abnormal area of the bone image. In the second stage, Discrete Wavelet Transform (DWT) is used to the segmented image. Once the image gets segmented then, the Gray-Level Co-occurrence Matrix (GLCM) method is applied to extract the features in terms of statistical texture-based. Further the image which is applied to Principle Component Analysis (PCA) to reduce size of the feature vector. Besides, Bone Mineral Density (BMD) feature namely calcium volume is estimated from abnormal region in the segmented bone image and it is concatenated with the extracted texture features to obtain the final feature vectors. In the final stage, the Multi-class Support Vector Machine (MSVM) takes feature vectors as a inputto classify bone disorders. The simulation result demonstrates that the proposed system achieved the accuracy of 95.1% and sensitivity of 96.15%.
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Affiliation(s)
- Ramkumar S
- Department of EIE, Annamalai University, India.
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Effect of bisphosphonate treatment on the jawbone: an exploratory study using periapical and panoramic radiographic evaluation. Oral Radiol 2018; 35:159-170. [DOI: 10.1007/s11282-018-0358-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/13/2018] [Indexed: 11/30/2022]
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18
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Albayati RM, Saliem SS, Al Nakib LH. Osteoporosis effect on posterior mandible in preimplanted area for postmenopausal females using cone-beam computed tomography. J Indian Soc Periodontol 2018; 22:390-394. [PMID: 30210186 PMCID: PMC6128132 DOI: 10.4103/jisp.jisp_145_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Hormonal changes in women affect bone mineral density, especially during and postmenopausal years, which leads to susceptibility to osteoporosis which interfere with implantation. Aims: This study aims to use cone-beam computed tomography (CBCT) viewer program to predict patients with osteoporosis which may decrease the success rate of implantation and to evaluate osteoporosis effect on the posterior mandible. Settings and Design: This cross-sectional study consists of 60 Iraqi females who were divided into three groups: Group 1 consisted of 20 nonosteoporotic females aged 20–30 years as a control group, Group 2 consisted of 20 nonosteoporotic females aged 50 years and above, and Group 3 consisted of 20 osteoporotic females aged 50 years and above. Materials and Methods: The posterior mandibular first molar area was examined for alveolar bone height and radiographic density (RD) using CBCT. Statistical Analysis Used: Statistical analysis was computer assisted using the Statistical Package for the Social Sciences (SPSS version 21). Interclass correlation coefficient was used for calibration. Normally distributed variables were assessed using one-way ANOVA, and Dunnett test with control and not normally distributed were assessed by Kruskal–Wallis test, and multiple Mann–Whitney U-test with Bonferroni adjustment. Results: RD showed a significant difference between Group 2 and Group 3 (P = 0.000, MD = 158.554). On the other hand, alveolar bone height showed a significant difference between Group 1 and Group 2 (P = 0.039). Conclusions: RD in the posterior mandible first molar area is significantly affected in osteoporotic patients and it can be used as a predictor for the presence of osteoporosis using CBCT.
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Affiliation(s)
- Raya Madhat Albayati
- Department of Oral Radiology, Tikrit Specialized Dental Center, Ministry of Health, Tikrit, Salaheldin, Iraq
| | - Saif Sehaam Saliem
- Department of Periodontology, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Barngkgei I, Khattab R. Detecting the effect of bisphosphonates during osteoporosis treatment on jawbones using multidetector computed tomography: The
OSTEOSYR
project. ACTA ACUST UNITED AC 2018; 9:e12332. [DOI: 10.1111/jicd.12332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Imad Barngkgei
- Department of Oral MedicineFaculty of DentistrySyrian Private University Damascus Syria
- Department of Oral MedicineFaculty of DentistryDamascus University Damascus Syria
| | - Razan Khattab
- Department of PeriodontologyFaculty of DentistryDamascus University Damascus Syria
- Department of PeriodontologyFaculty of DentistryAlsham Private University Damascus Syria
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Li G, Qian H, Guo S, Wang D, Sun C, Du Y, Cheng J, Jiang H. Assessment of aging characteristics of female condylar trabecular structure by cone-beam computed tomography. Oral Radiol 2018; 35:16-22. [DOI: 10.1007/s11282-018-0322-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 12/18/2017] [Indexed: 10/17/2022]
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Mashalkar VN, Suragimath G, Zope SA, Varma SA. A Cross-Sectional Study to Assess and Correlate Osteoporosis and Periodontitis among Postmenopausal Women: A Dual Energy X-Ray Absorptiometry Study. J Midlife Health 2018; 9:2-7. [PMID: 29628721 PMCID: PMC5879842 DOI: 10.4103/jmh.jmh_39_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Periodontitis and osteoporosis are two diseases found worldwide and increase in intensity with increasing age of the patients. The severity of osteoporosis and periodontitis are found to be more in women during menopause. The aim of this study was to assess and correlate osteoporosis and periodontal disease among post-menopausal women. Materials and Methods: The study consisted of 94 postmenopausal women in the age range of 45–65 years. All the women underwent dual-energy X-ray absorptiometry (DXA) scan to measure bone mineral density (BMD) and were graded as normal, osteopenic, and osteoporotic based on the T score obtained. Data regarding patient's educational level, socioeconomic status (SES), and body mass index (BMI) was recorded. A detailed periodontal examination was carried out using clinical parameters such as oral hygiene index (OHI), plaque Index (PI), probing pocket depth , and clinical attachment loss to check the level of periodontitis. The level of osteoporosis was correlated with the level of periodontitis. Results: The DXA scan revealed that four women were normal, 44 were osteopenic and 46 were osteoporotic. There was no association found between BMD and OHI, PI, educational status, SES, and BMI. Slight periodontitis was observed in eight women, moderate periodontitis in 62, and severe periodontitis in 24 women. Result suggests that there was a statistical correlation between periodontitis and osteoporosis (P = 0.045). Conclusion: There is a definite correlation found between the severity of periodontitis and osteoporosis among postmenopausal women. A close cooperation between general practitioners and dentists in early diagnosis and treatment of both the diseases will reduce the risk and morbidity among postmenopausal women.
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Affiliation(s)
- Vaishali Narayan Mashalkar
- Department of Periodontology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Girish Suragimath
- Department of Periodontology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Sameer Anil Zope
- Department of Periodontology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
| | - Siddhartha A Varma
- Department of Periodontology, School of Dental Sciences, Krishna Institute of Medical Sciences Deemed University, Karad, Maharashtra, India
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Chandak LG, Lohe VK, Bhowate RR, Gandhi KP, Vyas NV. Correlation of Mandibular Radiomorphometric Indices with Serum Calcium and Serum Estradiol in Pre- and Post-menopausal Women. Contemp Clin Dent 2017; 8:53-58. [PMID: 28566852 PMCID: PMC5426167 DOI: 10.4103/0976-237x.205044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Osteoporosis is a disease that is seen commonly with increasing age. The purpose of this study was to compare the bone quality of pre- and post-menopausal women using the quantitative indices determined by measurements on panoramic radiographs (mental index, inferior and superior panoramic mandibular indices, antegonion index [AGI], and gonion index) and to determine the effects of serum calcium and serum estradiol levels on alveolar bone loss. Materials and Methods: Sixty female patients in the age group of 25–55 years were included in the study. The patients were divided into three equal groups, i.e., control Group A (twenty - premenopausal women), study Group B (twenty - postmenopausal women with healthy periodontium), study Group C (twenty - postmenopausal women with periodontitis). Quantitative indices were measured on digital panoramic radiographs of the patients and serum calcium and estradiol levels were determined. Results: Correlation of serum calcium with radiomorphometric indices of all the groups showed statistically nonsignificant differences. On correlating mean estradiol levels with radiographic indices of patients of Group A and Group B showed statistically nonsignificant differences. On correlating mean estradiol levels with radiographic indices of patients of Group C patients showed statistically significant difference with positive correlation with cortical width (P = 0.04) and AGI (P = 0.02) while statistically nonsignificant correlation with other indices. The statistical tests used for the analysis of the result were one-way ANOVA, multiple comparison Tukey test, Chi-square test, Student's t-test. Conclusion: There is a little evidence of correlation of these indices with serum estradiol and calcium levels, and therefore, detailed further research about this correlation is required.
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Affiliation(s)
- Lina Govind Chandak
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi, Wardha, Maharashtra, India
| | - Vidya Krushnarao Lohe
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi, Wardha, Maharashtra, India
| | - Rahul R Bhowate
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi, Wardha, Maharashtra, India
| | - Krushna P Gandhi
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi, Wardha, Maharashtra, India
| | - Neha V Vyas
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences (Deemed University) Sawangi, Wardha, Maharashtra, India
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Gumussoy I, Miloglu O, Cankaya E, Bayrakdar IS. Fractal properties of the trabecular pattern of the mandible in chronic renal failure. Dentomaxillofac Radiol 2017; 45:20150389. [PMID: 27091088 DOI: 10.1259/dmfr.20150389] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate fractal analysis as a tool to quantitatively determine the mandibular trabecular bone changes in patients with chronic renal failure (CRF). METHODS In the present study, fractal analysis was performed using ImageJ (National Institutes of Health, Bethesda, MD) program with box-counting method over panoramic radiographs of 25 patients (14 females and 11 males) with CRF and 26 healthy individuals (14 females and 12 males) as a control group. The fractal dimension (FD) values of the patients and healthy individuals were compared. In addition, average biochemical parameters [parathyroid hormone (PTH), calcium (Ca), phosphorus (P), product of Ca and P levels (CaxP), alkaline phosphatase (ALP), vitamin D] of the patients with CRF, as measured during the 3 months before the panoramic radiographs, were compared with FD values. RESULTS According to the results, FD values of the patients with CRF were found to be statistically lower than the control group (p < 0.05). The average PTH levels of the patients with CRF were 416.16 ± 310.3 pg ml(-1); average Ca levels were 8.94 ± 1.2 mg dl(-1); average P levels were 5.76 ± 1.7 mg dl(-1); average CaxP values were 51.12 ± 15.03; average ALP levels were 83.44 ± 36.8 U l(-1); and the average vitamin D values were 19.43 ± 9.7 ng ml(-1). In addition, there was no significant correlation between FD values and the biochemical parameters of the patients, and there was no correlation between age, gender and FD. CONCLUSIONS The FD values of the patients with CRF were lower than those of the controls. This finding suggests that FD analysis might be a promising simple and cost-effective tool for evaluating trabecular bone structure.
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Affiliation(s)
- Ismail Gumussoy
- 1 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ozkan Miloglu
- 2 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Erdem Cankaya
- 3 Department of Nephrology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Ibrahim S Bayrakdar
- 4 Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Osmangazi University, Eskişehir, Turkey
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Effect of Osteoporosis on Bone Density of Orthognathic Osteotomy Sites in Maxillofacial Region. J Craniofac Surg 2016; 27:e678-e683. [DOI: 10.1097/scs.0000000000003064] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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25
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Singh SV, Aggarwal H, Gupta V, Kumar P, Tripathi A. Measurements in Mandibular Pantomographic X-rays and Relation to Skeletal Mineral Densitometric Values. J Clin Densitom 2016; 19:255-61. [PMID: 25934028 DOI: 10.1016/j.jocd.2015.03.004] [Citation(s) in RCA: 8] [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: 01/01/2015] [Revised: 03/10/2015] [Accepted: 03/24/2015] [Indexed: 12/01/2022]
Abstract
The gold standard diagnostic modality for osteoporosis is dual-energy X-ray absorptiometry (DXA). But it is expensive and often unavailable. Studies have demonstrated that decreased bone mineral density (BMD) may affect mandibular bone morphometrically on radiographs. Such studies are rare in the Indian population. This study was conducted to evaluate correlation between radiomorphometric markers on digital orthopantomograms (OPGs) and BMD measurements done by DXA in an Indian population. A total of 344 subjects aged 45 years or above, who visited a dental outpatient department over a period of 6 years were included in the study after obtaining ethical committee approval and informed consent. Digital OPG and DXA BMD measurements were obtained. Subjects' T-scores were obtained, on the basis of which they were divided into osteoporotic, osteopenic, and normal. OPGs were evaluated to obtain the mandibular cortical index (MCI) and the panoramic mandibular index (PMI). Correlations of MCI and PMI with BMD were analyzed statistically with SPSS (version 16.0; SPSS, Chicago, IL). In the osteoporotic group, there was no subject with MCI finding of C1, and 77.42% prevalence of C3 finding was found. C2 finding was in highest proportion in the osteopenic group (p<0.05). Normal BMD group was associated with the C1 finding of 76.47%. Almost 48% of the osteoporotic group had a PMI score of <0.40, whereas 50% of osteopenic subjects had a PMI score of 0.4-0.44. Normal subjects having a PMI score of >0.44 constituted 49.1% of the population. Mean BMD scores decreased significantly with increasing MCI stage and increased significantly with increasing PMI (p<0.05). Significant correlations between PMI and MCI were obtained with DXA BMD. Digital OPGs may provide an economical and reliable diagnostic tool to rule out osteoporosis or osteopenia in undiagnosed patients, where DXA screening may not be available or is financially nonviable.
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Affiliation(s)
- Saumyendra V Singh
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University UP, Lucknow, Uttar Pradesh, India
| | - Himanshi Aggarwal
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University UP, Lucknow, Uttar Pradesh, India.
| | - Vaibhav Gupta
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University UP, Lucknow, Uttar Pradesh, India
| | - Pradeep Kumar
- Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University UP, Lucknow, Uttar Pradesh, India
| | - Arvind Tripathi
- Department of Prosthodontics, Saraswati Dental College, Lucknow, Uttar Pradesh, India
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ALONSO MBCC, VASCONCELOS TV, LOPES LJ, WATANABE PCA, FREITAS DQ. Validation of cone-beam computed tomography as a predictor of osteoporosis using the Klemetti classification. Braz Oral Res 2016; 30:S1806-83242016000100263. [DOI: 10.1590/1807-3107bor-2016.vol30.0073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/30/2016] [Indexed: 11/22/2022] Open
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Camargo AJ, Côrtes ARG, Aoki EM, Baladi MG, Arita ES, Watanabe PCA. Analysis of Bone Quality on Panoramic Radiograph in Osteoporosis Research by Fractal Dimension. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/am.2016.74035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Güngör E, Yildirim D, Çevik R. Evaluation of osteoporosis in jaw bones using cone beam CT and dual-energy X-ray absorptiometry. J Oral Sci 2016; 58:185-94. [DOI: 10.2334/josnusd.15-0609] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Enes Güngör
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Zirve University
| | - Derya Yildirim
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Süleyman Demirel University
| | - Remzi Çevik
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Dicle University
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Shakeel MK, Daniel MJ, Srinivasan SV, Koliyan R, Kumar JV. Comparative Analysis of Linear and Angular Measurements on Digital Orthopantomogram with Calcaneus Bone Mineral Density. J Clin Diagn Res 2015; 9:ZC12-6. [PMID: 26393197 DOI: 10.7860/jcdr/2015/13606.6163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/24/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bone remodeling is a continuous and complex process which occurs throughout life. Radiomorphometric and radioangular indices on the orthopantomogram are the predictors of bone remodeling associated with mandible. Bone mineral density is the amount of calcified tissue in a certain volume of the bone. MATERIALS AND METHODS Fifty normal healthy individuals within the age range of 25-55 years were included in the study. Linear measurements including mandibular cortical width (MCW) and panoramic mandibular index (PMI); and angular measurements including mandibular angle (MA) and antegonial angle (AGA) were recorded. Quantitative ultrasound bone mineral density (BMD) scan of the heel bone (calcaneus) of the same patient were also performed. RESULTS In our study, for both males and females, antegonial angle (AGA) had highest correlation with calcaneus bone mineral density. In the age group of less than 35 years, PMI in males, and AGA in females had highest correlation. In the age range of more than 35 years, MA in males and AGA in females had highest correlation. CONCLUSION There is a correlation between the mandibular bone remodelling changes and calcaneal bone mineral density in case of elder subjects and thus these parameters may be used as an inexpensive alternative screening method to assess the bone mineral density and identify individuals at risk for osteoporosis and fractures and also for dental treatment planning.
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Affiliation(s)
- Mohammed Kamran Shakeel
- Post Graduate Resident, Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences , Pondicherry, India
| | - Mariappan Jonathan Daniel
- Professor and Head, Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences , Pondicherry, India
| | - Subramaniam Vasudevan Srinivasan
- Associate Professor, Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences , Pondicherry, India
| | - Ramadoss Koliyan
- Associate Professor, Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences , Pondicherry, India
| | - Jimsha Vannathan Kumar
- Assistant Professor, Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences , Pondicherry, India
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Graham J. Detecting low bone mineral density from dental radiographs: a mini-review. CLINICAL CASES IN MINERAL AND BONE METABOLISM : THE OFFICIAL JOURNAL OF THE ITALIAN SOCIETY OF OSTEOPOROSIS, MINERAL METABOLISM, AND SKELETAL DISEASES 2015; 12:178-82. [PMID: 26604946 PMCID: PMC4625777 DOI: 10.11138/ccmbm/2015.12.2.178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over a number of years researchers have reported associations between osteoporosis or low bone mineral density and signs that can be detected on dental radiographs, particularly in the width of the inferior mandibular cortex and the texture of the trabecular bone. As patients visit the dentist more regularly than they visit their doctor, there is the possibility that such signs could be used as a means of identifying individuals at risk of developing osteoporosis or suffering from consequent fracture. This paper reviews the historical background behind this research and the current status, including recent developments in automation of measurement using computer image analysis.
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Affiliation(s)
- James Graham
- Centre for Imaging Science, Institute of Population Health, Faculty of Medicine and Human Sciences, The University of Manchester, United Kingdom
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Kavitha MS, An SY, An CH, Huh KH, Yi WJ, Heo MS, Lee SS, Choi SC. Texture analysis of mandibular cortical bone on digital dental panoramic radiographs for the diagnosis of osteoporosis in Korean women. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:346-56. [DOI: 10.1016/j.oooo.2014.11.009] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/26/2014] [Accepted: 11/17/2014] [Indexed: 11/28/2022]
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Predictive value of masseter muscle thickness and bite force on Class II functional appliance treatment: a prospective controlled study. Eur J Orthod 2015; 37:570-7. [DOI: 10.1093/ejo/cju089] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Assaf AT, Klatt JC, Blessmann M, Kohlmeier C, Friedrich RE, Pohlenz P, May A, Heiland M, Jürgens TP. Value of intra- and post-operative cone beam computed tomography (CBCT) for positioning control of a sphenopalatine ganglion neurostimulator in patients with chronic cluster headache. J Craniomaxillofac Surg 2015; 43:408-13. [PMID: 25648069 DOI: 10.1016/j.jcms.2014.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 11/19/2014] [Accepted: 12/29/2014] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION The objective of this study was to determine whether postoperative control of the neurostimulator placement within the pterygopalatine fossa (PPF) by means of 3-dimensional (3D) cone beam computed tomography (CBCT) was of therapeutic relevance compared to intraoperative CBCT imaging alone. MATERIAL AND METHODS Immediately after implantation of the sphenopalatine ganglion (SPG) neurostimulator, intraoperative CBCT datasets were generated in order to visualize the position of the probe within the PPF. Postoperatively, all patients received a CBCT for comparison with intraoperatively acquired radiographs. RESULTS Twenty-four patients with cluster headache (CH) received an SPG neurostimulator. In 4 patients, postoperative CBCT images detected misplacement not found in intraoperative CBCT. In 3 cases, electrode tips were misplaced into the maxillary sinus and in 1 case into the apex of the PPF superior to the suspected location of the SPG. Immediate revision with successful repositioning within 3 days was done in 2 patients and a deferred reimplantation in 1 patient within 6 months. One patient declined revision. CONCLUSION We were able to demonstrate the clinical value of postoperative dental CBCT imaging with a wide region of interest (ROI) due to a superior image quality compared with that achieved with intraoperative medical CBCT. Although intraoperative 3D CBCT imaging of electrode placement is helpful in the acute surgical setting, resolution is, at present, too low to safely exclude misplacement, especially in the maxillary sinus. High-resolution postoperative dental CBCT allows rapid detection and revision of electrode misplacement, thereby avoiding readmission and recurrent tissue trauma.
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Affiliation(s)
- Alexandre T Assaf
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany.
| | - Jan C Klatt
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Marco Blessmann
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Carsten Kohlmeier
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Philipp Pohlenz
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Max Heiland
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
| | - Tim P Jürgens
- Department of Systems Neuroscience, University Medical Center Hamburg Eppendorf, University of Hamburg, Martinistr. 52, 20246 Hamburg, Germany
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Geary S, Selvi F, Chuang SK, August M. Identifying dental panoramic radiograph features for the screening of low bone mass in postmenopausal women. Int J Oral Maxillofac Surg 2014; 44:395-9. [PMID: 25480009 DOI: 10.1016/j.ijom.2014.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 11/04/2014] [Accepted: 11/12/2014] [Indexed: 11/16/2022]
Abstract
A retrospective cohort study was performed to evaluate the use of panoramic radiographs as a screening tool for low bone mass in postmenopausal women. Female subjects aged ≥50 years were included. The predictor variables were gonial angle, antegonial angle, mandibular cortical bone integrity, periodontal disease status, and number of remaining teeth. The primary outcome variable was bone mineral density status. Descriptive and logistic regression statistics were computed; P<0.05 was considered significant. The sample was composed of 273 subjects, aged 50-89 years. Visual assessment of mandibular cortical bone integrity demonstrated a statistically significant correlation with low bone mass diagnosis on univariate logistic regression (P=0.019), but lost significance on multivariate analysis with age, body mass index, and number of remaining teeth (P=0.6). A visual estimation of the mandibular cortical bone integrity from panoramic radiographs may be useful for identifying postmenopausal women at high risk for osteoporosis.
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Affiliation(s)
- S Geary
- Harvard School of Dental Medicine, Boston, MA, USA
| | - F Selvi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - S-K Chuang
- Harvard School of Dental Medicine, Boston, MA, USA
| | - M August
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.
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Savic Pavicin I, Dumancic J, Jukic T, Badel T, Badanjak A. Digital orthopantomograms in osteoporosis detection: mandibular density and mandibular radiographic indices as skeletal BMD predictors. Dentomaxillofac Radiol 2014; 43:20130366. [PMID: 24969554 DOI: 10.1259/dmfr.20130366] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To determine the correlation of skeletal bone mineral density (BMD) with mandibular density and mandibular radiographic indices estimated on digital panoramic radiographs. METHODS Study comprised 112 female subjects older than 45 years. Digital panoramic radiographs were taken, and patients were referred to densitometric measuring (dual energy X-ray absorptiometry) of BMD in the hip bones and lumbar spine regions (L1-L4). On the radiographs, mandibular bone density was estimated and the following indices were measured by the DIGORA(®) software (Soredex, Tuusula, Finland): mental index (MI), gonial index (GI), antegonial index (AI), panoramic mandibular index (PMI) and alveolar crest resorption degree (M/M). Mandibular cortical index (MCI) was visually estimated. RESULTS Mandibular density and visual index MCI are significant predictors of hip and spine BMD. Mandibular density was marked by a significant square trend: it decreased until the age of 54 years and remained constant until the age of 64 years when it started to increase. Significant correlations were found between MI, AI and PMI values and BMD in the hip but not in the lumbar spine region. The GI and M/M values did not show statistically significant correlations with BMD of either region. CONCLUSIONS Mandibular bone density and mandibular radiographic indices are useful in detecting patients with decreased BMD. The applicability of orthopantomograms in diagnosing osteoporosis/osteopenia should be recognized as the potential greatest benefit of this everyday diagnostic method in dental practice.
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Affiliation(s)
- I Savic Pavicin
- 1 Department of Dental Anthropology, University of Zagreb, School of Dental Medicine, Zagreb, Croatia
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El Zuki M, Omami G, Horner K. Assessment of trabecular bone changes around endosseous implants using image analysis techniques: A preliminary study. Imaging Sci Dent 2014; 44:129-35. [PMID: 24944962 PMCID: PMC4061296 DOI: 10.5624/isd.2014.44.2.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 02/13/2014] [Accepted: 02/22/2014] [Indexed: 11/30/2022] Open
Abstract
Purpose The objective of this study was to assess the trabecular bone changes that occurred around functional endosseous dental implants by means of radiographic image analysis techniques. Materials and Methods Immediate preoperative and postoperative periapical radiographs of de-identified implant patients at the University Dental Hospital of Manchester were retrieved, screened for specific inclusion criteria, digitized, and quantified for structural elements of the trabecular bone around the endosseous implants, by using image analysis techniques. Data were analyzed using SPSS version 11.5. P values of less than 0.05 were considered statistically significant. Results A total of 12 implants from 11 patients were selected for the study, and 26 regions of interest were obtained. There was a significant increase in the bone area in terms of the mean distance between nodes (p=0.006) and a significant decrease in the marrow area in terms of the bone area (p=0.006) and the length of marrow spaces (p=0.032). Conclusion It appeared that the bone around the implant underwent remodeling that resulted in a net increase in bone after implant placement.
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Affiliation(s)
- Mervet El Zuki
- Department of Oral Medicine and Radiology, Benghazi University College of Dentistry, Benghazi, Libya
| | - Galal Omami
- Oral Diagnosis and Polyclinics, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Keith Horner
- Department of Oral Radiology, University Dental Hospital of Manchester, Manchester, United Kingdom
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Kim OS, Shin MH, Song IH, Lim IG, Yoon SJ, Kim OJ, Lee YH, Kim YJ, Chung HJ. Digital panoramic radiographs are useful for diagnosis of osteoporosis in Korean postmenopausal women. Gerodontology 2014; 33:185-92. [PMID: 24913816 DOI: 10.1111/ger.12134] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether digital panoramic radiographs could be used for the diagnosis of osteoporosis through evaluation of the radiographs based on the correlation with bone mineral density (BMD). METHODS One hundred and ninety-four post-menopausal women were selected from participants who had participated in the Dong-gu study. Panoramic radiographic indices measured are mental index (MI), mandibular cortical index (MCI) and simple visual estimation (SVE). BMD at the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry (DXA). The Pearson's correlation test was performed to analyse the correlation between MI and age and BMD at the lumbar spine, femoral neck and total hip. Multiple linear regression analysis was performed to analyse the association of MI, MCI and SVE with BMD after adjusting for age, height and weight. To determine the optimal cut-off point of MI for the diagnosis of osteoporosis, the receiver operating characteristic analysis was performed. RESULTS The MI was positively correlated with BMDs: lumbar spine: r = 0.36, femoral neck: r = 0.59 and total hip: r = 0.58 (p < 0.001). As age increased, MI decreased (r = -0.46). BMD at the lumbar spine and total hip were significantly lower in participants with reduction of mandibular width, thinning and resorption of mandibular cortex by the MI, SVE and MCI, respectively. The optimal cut-off value of MI for the diagnosis of spinal osteoporosis was 2.22 mm. CONCLUSION Thickness and morphological changes of mandibular inferior cortical bone are associated with BMD, independent of age, height and weight. These results suggest that MI, MCI and SVE may be useful indices for the diagnosis of osteoporosis in a Korean population.
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Affiliation(s)
- Ok-Su Kim
- Department of Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University, Medical School, Hak1dong, Donggu, Gwangju, Korea
| | - In-Hwa Song
- Department of Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Il-Gu Lim
- Department of Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Suk-Ja Yoon
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Science Research Institute, Chonnnam National University, Gwangju, Korea
| | - Ok-Joon Kim
- Department of Oral Pathology, School of Dentistry, Dental Science Research Institute, Chonnnam National University, Gwangju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine and Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea
| | - Young-Joon Kim
- Department of Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
| | - Hyun-Ju Chung
- Department of Periodontology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju, Korea
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Lee IJ, Lee JJ, Bae JH, Hwang E, Lee S, Cho M, Kim JH, Kim HJ. Significance of osteoporosis in facial bone density using computed tomography. J Craniofac Surg 2014; 24:428-31. [PMID: 23524708 DOI: 10.1097/scs.0b013e3182801333] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The objectives of this study were to compare the variations of bone density in the midfacial bones as measured by computed tomography (CT) scans between the osteoporosis and control groups and to evaluate the regions that facial trauma and iatrogenic problem often occur in the midface. METHODS The 96 patients who underwent both osteomeatal unit CT scans and dual-energy x-ray absorptiometry at our hospital were included in this study retrospectively. Seven skeletal regions were chosen for evaluation: group A (orbital floor, nasal bone), group B (zygomaticomaxillary suture, zygomatic arch, zygomaticofrontal suture), and group C (anterior wall of the maxillary sinus, maxillary process). Forty-seven patients were in the osteoporosis group, and 49 patients were in the control group. On a PACS (picture archiving communication system), the region of interest was analyzed, and the Hounsfield units were measured. RESULTS There was a significant difference in the mean bone density of the midfacial bones between the osteoporosis group and the control group (P < 0.01). For both groups, each of comparison of the 7 skeletal regions was greater as group A < group B < group C in this order (P < 0.01). CONCLUSIONS We can see the independent effects of osteoporosis on the midfacial bones using CT scans. Estimated Hounsfield unit through CT scan is able to explain osteoporosis, which may be useful in the clinical fields in the future.
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Affiliation(s)
- Il Jae Lee
- Department of Plastic and Reconstructive Surgery, Ajou University Hospital, Suwon City, Gyeonggi Province, Republic of Korea
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Ling H, Yang X, Li P, Megalooikonomou V, Xu Y, Yang J. Cross gender-age trabecular texture analysis in cone beam CT. Dentomaxillofac Radiol 2014; 43:20130324. [PMID: 24597910 DOI: 10.1259/dmfr.20130324] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate whether multiple texture features in different regions of interest (ROIs) on cone beam CT (CBCT) are correlated with gender-age variation of trabecular patterns. METHODS CBCT volumes from 96 subjects were used. The data set was divided into four gender-age subgroups, including males younger than 40 years, males older than 40 years, females younger than 40 years and females older than 40 years. For each volume, cubes containing trabecular patterns at four ROIs in the jaws were manually cropped. 18 distinct texture features were calculated and their correlation with gender-age variations at different ROIs was studied through t-test statistical analysis. RESULTS For the 432 test pairs with different gender-age groups at different ROIs and texture features tested, 149 of them were shown to be statistically different at the 0.05 significance level and 60 of them at the 0.001 significance level. These features can therefore capture changes in trabecular patterns and have the potential to be used for trabecular analysis. Furthermore, fractal features were found to be better than intensity features in separating different gender-age groups. Trabecular patterns in the body of the mandible were more correlated with gender-age changes than other ROIs. CONCLUSIONS Multiple texture features on CBCT were found to be correlated with the cross gender-age variation of trabecular patterns. The results support the use of CBCT for advanced trabecular analysis, including osteoporosis screening tools in the jaws.
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Affiliation(s)
- H Ling
- Department of Computer and Information Sciences, Temple University, Philadelphia, PA, USA
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Berg BI, Juergens P, Soerensen Y, Savic M, Zeilhofer HF, Schwenzer-Zimmerer K. Traumatology of the facial skeleton in octogenarian patients: a retrospective analysis of 96 cases. J Craniomaxillofac Surg 2014; 42:870-3. [PMID: 24513308 DOI: 10.1016/j.jcms.2013.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 09/11/2013] [Accepted: 12/27/2013] [Indexed: 11/25/2022] Open
Abstract
AIM The aim of this retrospective study was to evaluate the frequency and distribution of maxillofacial trauma patients over 80 years, with regard to type and environment of accidents as well as treatment and complications. PATIENTS AND METHODS Data for 94 patients (96 cases; aged 80-94 years) with maxillofacial fractures were retrospectively analysed. RESULTS Data of 30 male and 64 female patients with an average age of 85 years were analysed. In 90% of the study population, the cause of fractures was a fall, followed by traffic accidents (9%) and assault (1%). Seventy-two patients had fractures of the midface, 10 had factures of the mandible, 9 had fractures of both the midface and mandible and 5 had fractures of the neurocranium and midface. Surgical intervention was required in 57% of the patients. Post-operative complications were: four cases of diplopia, two cases of infected plates, four cases of lower eyelid ectropion and in one case a retrobulbar haematoma. CONCLUSION Facial trauma in the elderly can often be treated conservatively unless the patient complains of functional problems. Due to co-morbidities, special attention should be paid to hypertension, anticoagulant agents and the surgical approach.
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Affiliation(s)
- B-I Berg
- Dept. of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University Hospital Basel, Basel, Switzerland; Hightech Research Center of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University of Basel, Basel, Switzerland.
| | - P Juergens
- Dept. of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University Hospital Basel, Basel, Switzerland; Hightech Research Center of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University of Basel, Basel, Switzerland
| | - Y Soerensen
- Krankenhaus Reinbek, Dept. of Surgery (Head: Prof. Dr. T. Strate), Hamburg, Germany
| | - M Savic
- Dept. of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University Hospital Basel, Basel, Switzerland; Hightech Research Center of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University of Basel, Basel, Switzerland
| | - H-F Zeilhofer
- Dept. of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University Hospital Basel, Basel, Switzerland; Hightech Research Center of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University of Basel, Basel, Switzerland
| | - K Schwenzer-Zimmerer
- Dept. of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University Hospital Basel, Basel, Switzerland; Hightech Research Center of Cranio-Maxillofacial Surgery (Head: Prof. Dr. Dr. H.-F. Zeilhofer), University of Basel, Basel, Switzerland
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Systemic Diseases. Oral Radiol 2014. [DOI: 10.1016/b978-0-323-09633-1.00025-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Valerio CS, Trindade AM, Mazzieiro ET, Amaral TP, Manzi FR. Use of digital panoramic radiography as an auxiliary means of low bone mineral density detection in post-menopausal women. Dentomaxillofac Radiol 2013; 42:20120059. [PMID: 24005062 DOI: 10.1259/dmfr.20120059] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To correlate the radiomorphometric indices obtained using digital panoramic radiography (DPR) with bone mineral densities, evaluated by the dual-energy X-ray absorptiometry test, in a population of post-menopausal females to identify patients with asymptomatic low bone mineral densities. METHODS The morphology of the mandibular cortex was evaluated using the mandibular cortical index (MCI) and the inferior mandibular cortex width was evaluated using the mental index (MI) in 64 female patients who had undergone dual-energy X-ray absorptiometry assessment. Of these patients, 21 were diagnosed with osteopaenia and 20 with osteoporosis, and 23 were normal. Three new indices for evaluating the inferior mandibular cortex width were designed: the mental posterior index 1 (MPI1), MPI2 and MPI3. Statistical analyses were performed using the χ(2) and Kruskal-Wallis tests and the receiver operating characteristic curve. RESULTS There were significant differences between the normal and lower bone mineral density groups (osteopaenia and osteoporosis) for MCI (p < 0.01). In the osteoporosis group, the MI, MPI1, MPI2 and MPI3 were significantly different from the normal and osteopaenia groups (p < 0.05). The MI, MPI1, MPI2 and MPI3 showed that there is an area in the mandibular cortex, located between the mental foramen and the antegonial region, which is valid for identifying females at high risk for osteoporosis. CONCLUSIONS The MCI, MI, MPI1, MPI2, and MPI3 radiomorphometric indices evaluated using DPR can be used to identify post-menopausal females with low bone densities and to provide adequate medical treatment for them.
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Affiliation(s)
- C S Valerio
- Department of Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Zhou Q, Lu Z, Ueno N, Doi S, Maeda H. Investigation of Characteristic Indeices Related to Temporomandibular Joint Osteoarthrosis. J HARD TISSUE BIOL 2013. [DOI: 10.2485/jhtb.22.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Oliveira ML, Pedrosa EFNC, Cruz AD, Haiter-Neto F, Paula FJA, Watanabe PCA. Relationship between bone mineral density and trabecular bone pattern in postmenopausal osteoporotic Brazilian women. Clin Oral Investig 2012; 17:1847-53. [PMID: 23239088 DOI: 10.1007/s00784-012-0882-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 11/19/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study is to evaluate the relative efficacy of the mandibular trabecular bone in detecting osteoporotic-associated bone changes in Brazilian women. MATERIALS AND METHODS Seventy-three digital panoramic radiographs of healthy and osteoporotic postmenopausal women were used. Regions of interest were selected in the mandibular angle and body of the panoramic images, which were analyzed for fractal dimension (FD) and pixel intensity (PI). Statistical analysis evaluated the distribution pattern, compared normal with osteoporotic patients and the right with the left mandible, and assessed the relationship between FD and PI. The significance level was set at 0.05. RESULTS FD and PI values were significantly different (p < 0.05) between normal and osteoporotic patients for the right and left mandibular angle and for the left mandibular body. There was no significant difference (p > 0.05) between the right and left mandibular angle for FD and PI, but a significant difference (p < 0.05) was observed on the mandibular body for PI values. FD and PI values presented positive correlation. CONCLUSIONS The mandibular trabecular bone was effective in detecting osteoporotic changes, with the exception of the right mandibular body. CLINICAL RELEVANCE Mandibular trabecular bone shows a promising attempt of accurate detection of osteoporotic changes in some regions of the jaws. Fractal analysis and pixel intensity had strong positive correlation.
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Affiliation(s)
- Matheus Lima Oliveira
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas-UNICAMP, P.O. Box 52, 13414-903, Piracicaba, São Paulo, Brazil,
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López-López J, Alvarez-López JM, Jané-Salas E, Estrugo-Devesa A, Ayuso-Montero R, Velasco-Ortega E, Segura-Egea JJ. Computer-aided system for morphometric mandibular index computation. (Using dental panoramic radiographs). Med Oral Patol Oral Cir Bucal 2012; 17:e624-32. [PMID: 22322489 PMCID: PMC3476026 DOI: 10.4317/medoral.17637] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Accepted: 09/03/2011] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We propose and validate a computer-aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index. STUDY DESIGN Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes. RESULTS The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually. CONCLUSIONS We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs.
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Affiliation(s)
- Jose López-López
- School of Dentistry, Department of Odonto-stomatology, University of Barcelona, Barcelona, Spain.
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Lurie A, Tosoni GM, Tsimikas J, Walker F. Recursive hierarchic segmentation analysis of bone mineral density changes on digital panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:549-58.e1. [PMID: 22668434 DOI: 10.1016/j.oooo.2011.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 10/18/2011] [Accepted: 10/27/2011] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The aim of this study was to demonstrate that histogram analysis and mathematical modeling of digital panoramic images (DPIs) processed using recursive hierarchic segmentation (RHSEG) discriminates normal, osteopenic, and osteoporotic cancellous bone. STUDY DESIGN Forty-seven DPIs of postmenopausal women were grouped into normal, osteopenic, and osteoporotic; dual-energy x-ray absorptiometry was the reference standard. RHSEG of the mandibular angle and canine/premolar trabecular regions of interest was performed. After histogram and histogram bin analysis and generation of relative intensity functions, generalized linear mixed model analysis was used to model the data and likelihood ratio testing used to assess group differences. RESULTS Histogram analyses discriminated among the groups. Receiver operating characteristic analysis of the canine/premolar data yielded area-under-the-curve accuracies of 0.78 for osteoporosis and 0.74 for osteopenia. Discrimination of osteoporosis required cubic analysis, discrimination of osteopenia required quartic analysis, and neither model alone discriminated among all groups. CONCLUSIONS Analyses and mathematical modeling of mandibular trabecular bone on RHSEG-processed DPIs discriminated normal, osteoporotic, and osteopenic patients.
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Affiliation(s)
- Alan Lurie
- Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, Connecticut 06030-1605, USA.
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Pham D, Kiliaridis S. Evaluation of changes in trabecular alveolar bone during growth using conventional panoramic radiographs. Acta Odontol Scand 2012; 70:127-32. [PMID: 21793639 DOI: 10.3109/00016357.2011.600706] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess changes of the alveolar trabecular bone during growth using panoramic radiographs and to detect possible differences in trabecular bone patterns when comparing individuals of various ages and genders. MATERIALS AND METHODS Conventional panoramic radiographs of 18 young (eight females, 10 males) and 21 adult (12 females, nine males) subjects were taken at 2 years (T1) and 10 years (T2) after the end of orthodontic treatment. At T1, mean ages were 15.6 ± 0.9 years and 31.3 ± 9.7 years in the young and the adult groups, respectively. A three-scale visual analysis was used to evaluate bilaterally the alveolar bone trabeculation in the interdental spaces, from the distal side of the first mandibular premolar to the mesial side of the second lower molar. An analysis of variance (ANOVA), associated with t-tests whenever significance was found, was used to appraise the role of the age, the extent of the follow-up period and the gender on trabecular bone structure. RESULTS The adult group had a denser alveolar bone trabeculation, compared to the young group. This was also observed in the 8 years follow-up recordings among the adults, but no statistically significant differences were found in the growing individuals. No gender discrepancy was detected. CONCLUSIONS From puberty to the middle age adulthood, denser alveolar bone trabeculation in the mandible seems to be related to the age. No differences were found between male and female subjects in the sample.
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Affiliation(s)
- Diane Pham
- Department of Orthodontics, University of Geneva, Geneva, Switzerland.
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Geraets WGM, Lindh C, Verheij H. Sparseness of the trabecular pattern on dental radiographs: visual assessment compared with semi-automated measurements. Br J Radiol 2012; 85:e455-60. [PMID: 22374281 DOI: 10.1259/bjr/32962542] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE In diagnostic imaging; human perception is the most prominent, yet least studied, source of error. A better understanding of image perception will help to improve diagnostic performance. This study focuses on the perception of coarseness of trabecular patterns on dental radiographs. Comparison of human vision with machine vision should yield knowledge on human perception. METHOD In a study on identifying osteoporotic patients, dental radiographs were made from 505 post-menopausal women aged 45-70 years. Intra-oral radiographs of the lower and upper jaws were made. Five observers graded the trabecular pattern as dense, sparse or mixed. The five gradings were combined into a single averaged observer score per jaw. The radiographs were scanned and a region of interest (ROI) was indicated on each. The ROIs were processed with image analysis software measuring 25 image features. Pearson correlation and multiple linear regression were used to compare the averaged observer score with the image features. RESULTS 14 image features correlated significantly with the observer judgement for both jaws. The strongest correlation was found for the average grey value in the ROI. Other features, describing that osteoporotic patients have fewer but bigger marrow spaces than controls, correlated less with the sparseness of the trabecular pattern than a rather crude measure for structure such as the average grey value. CONCLUSION Human perception of the sparseness of trabecular patterns is based more on average grey values of the ROI than on geometric details within the ROI.
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Affiliation(s)
- W G M Geraets
- Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands.
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Jonasson G, Sundh V, Ahlqwist M, Hakeberg M, Björkelund C, Lissner L. A prospective study of mandibular trabecular bone to predict fracture incidence in women: a low-cost screening tool in the dental clinic. Bone 2011; 49:873-9. [PMID: 21777710 DOI: 10.1016/j.bone.2011.06.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/07/2011] [Accepted: 06/27/2011] [Indexed: 11/28/2022]
Abstract
Bone structure is the key to the understanding of fracture risk. The hypothesis tested in this prospective study is that dense mandibular trabeculation predicts low fracture risk, whereas sparse trabeculation is predictive of high fracture risk. Out of 731 women from the Prospective Population Study of Women in Gothenburg with dental examinations at baseline 1968, 222 had their first fracture in the follow-up period until 2006. Mandibular trabeculation was defined as dense, mixed dense plus sparse, and sparse based on panoramic radiographs from 1968 and/or 1980. Time to fracture was ascertained and used as the dependent variable in three Cox proportional hazards regression analyses. The first analysis covered 12 years of follow-up with self-reported endpoints; the second covered 26 years of follow-up with hospital verified endpoints; and the third combined the two follow-up periods, totaling 38 years. Mandibular trabeculation was the main independent variable predicting incident fractures, with age, physical activity, alcohol consumption and body mass index as covariates. The Kaplan-Meier curve indicated a graded association between trabecular density and fracture risk. During the whole period covered, the hazard ratio of future fracture for sparse trabeculation compared to mixed trabeculation was 2.9 (95% CI: 2.2-3.8, p<0.0001), and for dense versus mixed trabeculation was 0.21 (95% CI: 0.1-0.4, p<0.0001). The trabecular pattern was a highly significant predictor of future fracture risk. Our findings imply that dentists, using ordinary dental radiographs, can identify women at high risk for future fractures at 38-54 years of age, often long before the first fracture occurs.
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Affiliation(s)
- Grethe Jonasson
- Research & Development Unit in Southern Alvsborg County, Sven Eriksonplatsen 4, SE-503 38 Borås, Sweden.
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Koh KJ, Kim KA. Utility of the computed tomography indices on cone beam computed tomography images in the diagnosis of osteoporosis in women. Imaging Sci Dent 2011; 41:101-6. [PMID: 22010066 PMCID: PMC3189533 DOI: 10.5624/isd.2011.41.3.101] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 03/10/2011] [Accepted: 05/12/2011] [Indexed: 11/25/2022] Open
Abstract
Purpose This study evaluated the potential use of the computed tomography indices (CTI) on cone beam CT (CBCT) images for an assessment of the bone mineral density (BMD) in postmenopausal osteoporotic women. Materials and Methods Twenty-one postmenopausal osteoporotic women and 21 postmenopausal healthy women were enrolled as the subjects. The BMD of the lumbar vertebrae and femur were calculated by dual energy X-ray absorptiometry (DXA) using a DXA scanner. The CBCT images were obtained from the unilateral mental foramen region using a PSR-9000N™ Dental CT system. The axial, sagittal, and coronal images were reconstructed from the block images using OnDemend3D™. The new term "CTI" on CBCT images was proposed. The relationship between the CT measurements and BMDs were assessed and the intra-observer agreement was determined. Results There were significant differences between the normal and osteoporotic groups in the computed tomography mandibular index superior (CTI(S)), computed tomography mandibular index inferior (CTI(I)), and computed tomography cortical index (CTCI). On the other hand, there was no difference between the groups in the computed tomography mental index (CTMI: inferior cortical width). Conclusion CTI(S), CTI(I), and CTCI on the CBCT images can be used to assess the osteoporotic women.
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Affiliation(s)
- Kwang-Joon Koh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju, Korea
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