title: The mandibular cortex on radiographs as a tool for osteoporosis risk assessment: the OSTEODENT Project.
abstract: The aim of this study was to measure the accuracy of porosity of the mandibular cortex on dental panoramic radiographs (DPRs) in diagnosis of osteoporosis, alone and in combination with a clinical risk index. Six hundred seventy-one women (45-70yr) were recruited in the study, and dual-energy X-ray absorptiometry of the hip and lumbar spine was performed. A clinical index of osteoporosis risk (OSIRIS) and a DPR were obtained for each subject. The cortical appearance on the DPR was classified using the mandibular cortical index (MCI) by 5 observers. receiver operating characteristic (ROC) curve analysis was performed with calculation of area under the ROC curve (AUC) and sensitivity and specificity at various thresholds. Complete data were available for 653 subjects, of whom 21.6% had osteoporosis. The AUC for OSIRIS was 0.838. When used alone as the diagnostic test, MCI AUC for the 5 observers ranged from 0.560 to 0.670, significantly less than OSIRIS. Intraobserver and interobserver repeatability of MCI assessment was inconsistent. We conclude that MCI has limited value for osteoporosis diagnosis, being most appropriate as a method of fortuitous case-finding.
authors: School of Dentistry, University of Manchester, Manchester, UK. keith.horner@manchester.ac.uk
authors: Keith
authors: K
authors: Horner
authors: Kety
authors: K
authors: Karayianni
authors: Anastasia
authors: A
authors: Mitsea
authors: Leonidas
authors: L
authors: Berkas
authors: Michael
authors: M
authors: Mastoris
authors: Reinhilde
authors: R
authors: Jacobs
authors: Christina
authors: C
authors: Lindh
authors: Paul
authors: P
authors: van der Stelt
authors: Elizabeth
authors: E
authors: Marjanovic
authors: Judith
authors: J
authors: Adams
authors: Susan
authors: S
authors: Pavitt
authors: Hugh
authors: H
authors: Devlin
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D015519:Bone Density / Q000502:physiology*; D003937:Diagnosis, Differential; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008334:Mandible / Q000000981:diagnostic imaging* / Q000378:metabolism; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000378:metabolism; D012372:ROC Curve; D011862:Radiography, Panoramic / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology