Trabecular pattern in the mandible as bone fracture predictor.
OBJECTIVE
This investigation analyzed the use of mandibular sparse trabeculation as a fracture risk indicator.


METHODS
Trabeculation was classified as sparse, alternating dense and sparse, or dense using intraoral radiographs from 274 men and women (50-87 years old) including 56 with previous reported fractures. Mandibular bone texture was assessed on digitized radiographs.


RESULTS
Forty-eight percent of subjects with sparse trabeculation reported fractures, compared with 19% with alternating sparse and dense trabeculation and 2% with dense trabeculation (Kruskal-Wallis test: P < .00001). Logistic regression analysis showed that sparse trabeculation (odds ratio [OR] = 5.9; 95% CI 3.0-11.1; P < .0001) and lowest bone texture classes (OR = 2.2; 95% CI 1.0-4.5; P = .04) were associated with an increased fracture risk, especially for subjects > or =75 years (OR = 7.1; 95% CI 2.5-20.0; P = .0002).


CONCLUSIONS
Fracture risk was increased in subjects with sparse alveolar trabecular pattern. Dentists may be able to identify high-risk subjects before fracture.
Jonasson
Grethe
G
Research and Development Center in Southern Alvsborg County, Borås, Sweden. grethe.jonasson@gmail.com
Alstad
Torgny
T
Vahedi
Flor
F
Bosaeus
Ingvar
I
Lissner
Lauren
L
Hakeberg
Magnus
M
D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000145:classification; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000145:classification; D003793:Dental Restoration, Permanent; D005260:Female; D005544:Forecasting; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D008487:Medical History Taking; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging; D017622:Periodontal Attachment Loss / Q000145:classification; D016300:Radiography, Bitewing; D019252:Radiography, Dental, Digital; D018570:Risk Assessment; D012737:Sex Factors