The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project.
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.
Lindh
Christina
C
Department of Oral Radiology, Faculty of Odontology, Malmö University, Sweden. christina.lindh@mah.se
Horner
Keith
K
Jonasson
Grethe
G
Olsson
Peter
P
Rohlin
Madeleine
M
Jacobs
Reinhilde
R
Karayianni
Kety
K
van der Stelt
Paul
P
Adams
Judith
J
Marjanovic
Elizabeth
E
Pavitt
Sue
S
Devlin
Hugh
H
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