title: The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project.
abstract: OBJECTIVE
  The objective of this study was to investigate the diagnostic accuracy of visual assessment of the trabecular pattern in intraoral periapical radiographs to identify female subjects at risk of having osteoporosis.
  
  
  METHODS
  Six hundred female subjects underwent intraoral periapical radiography of the maxillary and mandibular premolar region. Five observers assessed the trabecular pattern as dense, heterogeneous, or sparse, with the aid of reference images. All patients received a central dual energy x-ray absorptiometry (DXA) examination of the hip and lumbar spine.
  
  
  RESULTS
  With sparse trabecular pattern as indicative of osteoporosis, mean specificity was high (91.6 for the upper jaw and 90.8 for the lower jaw) while the sensitivity was low (28.2 for the upper and lower jaw). The mean intraobserver agreement was comparable for radiographs of the upper and lower jaw (median kappa(w) 0.53 and 0.57, respectively).
  
  
  CONCLUSIONS
  Visual assessment of the trabecular pattern in intraoral periapical radiographs of premolar regions is a potential method to identify women at risk of having osteoporosis.
authors.affiliation: Department of Oral Radiology, Faculty of Odontology, Malmö University, Sweden. christina.lindh@mah.se
authors.forename: Christina
authors.initials: C
authors.lastname: Lindh
authors.forename: Keith
authors.initials: K
authors.lastname: Horner
authors.forename: Grethe
authors.initials: G
authors.lastname: Jonasson
authors.forename: Peter
authors.initials: P
authors.lastname: Olsson
authors.forename: Madeleine
authors.initials: M
authors.lastname: Rohlin
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
authors.forename: Kety
authors.initials: K
authors.lastname: Karayianni
authors.forename: Paul
authors.initials: P
authors.lastname: van der Stelt
authors.forename: Judith
authors.initials: J
authors.lastname: Adams
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Marjanovic
authors.forename: Sue
authors.initials: S
authors.lastname: Pavitt
authors.forename: Hugh
authors.initials: H
authors.lastname: Devlin
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D001641:Bicuspid / Q000000981:diagnostic imaging; D015519:Bone Density / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008334:Mandible / Q000000981:diagnostic imaging*; D008437:Maxilla / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D016300:Radiography, Bitewing; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity