title: Development of a prediction tool for low bone mass based on clinical data and periapical radiography.
abstract: OBJECTIVE
  This study aimed to develop and test a tool for low bone mass pre-screening by combining periapical radiographs with clinical risk factors.
  
  
  METHODS
  The study sample consisted of 60 post-menopausal women over 40 years of age who were referred for dental radiographs. These patients also had their bone mineral density measured at the lumbar spine and proximal femur using dual-energy X-ray absorptiometry. Radiographic density measurements and 14 morphological features were obtained from each dental radiograph using digital image processing software. The clinical variables considered were age and bone mass index. Classification and regression tree analysis (CART) was used to test the predictive power of clinical and radiographic risk factors for classifying individuals.
  
  
  RESULTS
  CART indicated that the most important variables for classifying patients were age, number of terminal points/periphery, periphery/trabecular area, radiographic density and bone mass index.
  
  
  CONCLUSIONS
  A combination of clinical and radiographic factors can be used to identify individuals with low bone mineral density, with higher accuracy than any one of these factors taken individually.
authors.affiliation: Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Licks
authors.forename: V
authors.initials: V
authors.lastname: Licks
authors.forename: F
authors.initials: F
authors.lastname: Ourique
authors.forename: H
authors.initials: H
authors.lastname: Radke Bittencourt
authors.forename: V
authors.initials: V
authors.lastname: Fontanella
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D001827:Body Height; D001835:Body Weight; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D005544:Forecasting; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging; D017698:Postmenopause; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement; D016300:Radiography, Bitewing; D012307:Risk Factors; D012984:Software
references.citation: Dentomaxillofac Radiol. 1996 Nov;25(5):263-7
references.pmid: 9161180
references.citation: AJR Am J Roentgenol. 1997 Apr;168(4):905-11
references.pmid: 9124138
references.citation: Bone. 1998 Feb;22(2):165-73
references.pmid: 9477240
references.citation: Osteoporos Int. 2002 Jul;13(7):593-9
references.pmid: 12111021
references.citation: Scand J Dent Res. 1994 Feb;102(1):68-72
references.pmid: 8153584
references.citation: Bone. 1995 Dec;17(6):527-32
references.pmid: 8835306
references.citation: Dentomaxillofac Radiol. 2006 Jan;35(1):1-9
references.pmid: 16421256
references.citation: J Dent. 2002 May;30(4):171-5
references.pmid: 12450724
references.citation: Osteoporos Int. 2001;12(7):519-28
references.pmid: 11527048
references.citation: Scand J Dent Res. 1993 Jun;101(3):166-70
references.pmid: 8322011
references.citation: N Engl J Med. 1995 Mar 23;332(12):767-73
references.pmid: 7862179
references.citation: Osteoporos Int. 2005 Aug;16(8):898-906
references.pmid: 15570415
references.citation: Stomatologija. 2008;10(2):72-5
references.pmid: 18708740
references.citation: Dentomaxillofac Radiol. 2008 Jul;37(5):282-7
references.pmid: 18606750
references.citation: Dentomaxillofac Radiol. 2008 Oct;37(7):375-9
references.pmid: 18812598
references.citation: Bone. 1993 Nov-Dec;14(6):859-64
references.pmid: 8155409
references.citation: Gynecol Endocrinol. 2002 Jun;16(3):245-50
references.pmid: 12192897
references.citation: Dentomaxillofac Radiol. 1999 May;28(3):173-81
references.pmid: 10740473
references.citation: Bone. 2007 May;40(5):1217-21
references.pmid: 17317351
references.citation: Mayo Clin Proc. 2002 Jul;77(7):629-37
references.pmid: 12108600
references.citation: Osteoporos Int. 2003 Aug;14(8):659-64
references.pmid: 12827223
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Jul;100(1):92-8
references.pmid: 15953922
references.citation: Dentomaxillofac Radiol. 1996 Jun;25(3):130-5
references.pmid: 9084261
references.citation: Osteoporos Int. 1999;9 Suppl 2:S33-9
references.pmid: 10525724
references.citation: Osteoporos Int. 2002 May;13(5):373-8
references.pmid: 12086347
references.citation: JAMA. 1984 Aug 10;252(6):799-802
references.pmid: 6748181
references.citation: Dentomaxillofac Radiol. 2002 Mar;31(2):84-92
references.pmid: 12076061
references.citation: Acta Radiol. 1996 Sep;37(5):618-24
references.pmid: 8915263
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Aug;102(2):235-41
references.pmid: 16876068
references.citation: Osteoporos Int. 2001;12(8):699-705
references.pmid: 11580084
references.citation: J Periodontol. 2000 Mar;71(3):335-40
references.pmid: 10776919
references.citation: Am J Manag Care. 1998 Jan;4(1):37-48
references.pmid: 10179905
references.citation: Dentomaxillofac Radiol. 2000 May;29(3):144-53
references.pmid: 10849540
references.citation: Bone. 1993 May-Jun;14(3):199-203
references.pmid: 8363857
references.citation: J Bone Miner Res. 1990 Mar;5(3):227-33
references.pmid: 2333781
references.citation: CMAJ. 2000 May 2;162(9):1289-94
references.pmid: 10813010
references.citation: J Int Med Res. 2008 Jul-Aug;36(4):792-9
references.pmid: 18652776
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Nov;88(5):628-35
references.pmid: 10556761
references.citation: Osteoporos Int. 1997;7(1):1-6
references.pmid: 9102057
references.citation: Scand J Dent Res. 1993 Aug;101(4):219-23
references.pmid: 8362200