title: Accuracy and precision of a densitometric tool for jaw bone.
abstract: OBJECTIVE
  To develop a digital densitometric tool for jaw bone to analyse intraoral radiographs. To assess precision and accuracy for this tool and determine the minimal detection threshold for density changes.
  
  
  METHODS
  Bone samples deriving from the premolar region of 47 human mandibles were selected for analysis. The samples were obtained from adult cadavers in the department of anatomy (Faculty of Medicine, KULeuven) with ethical approval. Digital radiography was performed on all bone samples. Direct volumetric measurements served as gold standard density values and allowed determination of accuracy. Dual-energy X-ray absorptiometry (DXA) scans were performed on all specimens. For all radiographs, density in mm Al eq was calculated using custom-made software, Osteop. Precision and intraobserver and interobserver reliability of this method were assessed. The bone specimens were progressively decalcified. At standard time intervals the percentage of decalcification was calculated. At each decalcification step, radiographs were taken and analysed.
  
  
  RESULTS
  CV was always lower than 3%, which points to a good precision of the method. Correlation between the density measurements in mm Al eq and the DXA results was 0.9, for the density measurements in mm Al eq and the direct density measurements r was 0.5. The custom-made software was able to detect a change in bone mineralization of 6.6%.
  
  
  CONCLUSIONS
  The present method for bone densitometric analysis offers potentials for clinical evaluation of bone density and minute bone density changes in the jaw bone.
authors.affiliation: Oral Imaging Center, Faculty of Medicine, Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium. olivia.nackaerts@med.kuleuven.be
authors.forename: O
authors.initials: O
authors.lastname: Nackaerts
authors.forename: R
authors.initials: R
authors.lastname: Jacobs
authors.forename: M
authors.initials: M
authors.lastname: Pillen
authors.forename: L
authors.initials: L
authors.lastname: Engelen
authors.forename: F
authors.initials: F
authors.lastname: Gijbels
authors.forename: H
authors.initials: H
authors.lastname: Devlin
authors.forename: C
authors.initials: C
authors.lastname: Lindh
authors.forename: K
authors.initials: K
authors.lastname: Nicopoulou-Karayianni
authors.forename: P
authors.initials: P
authors.lastname: van der Stelt
authors.forename: S
authors.initials: S
authors.lastname: Pavitt
authors.forename: K
authors.initials: K
authors.lastname: Horner
mesh_terms: D015502:Absorptiometry, Photon / Q000592:standards*; D000328:Adult; D015519:Bone Density; D002102:Cadaver; D006801:Humans; D016014:Linear Models; D008334:Mandible / Q000000981:diagnostic imaging*; D008336:Mandibular Diseases / Q000000981:diagnostic imaging; D015588:Observer Variation; D010024:Osteoporosis / Q000000981:diagnostic imaging; D011857:Radiographic Image Interpretation, Computer-Assisted; D019252:Radiography, Dental, Digital / Q000592:standards*; D012015:Reference Standards; D012680:Sensitivity and Specificity; D012984:Software