title: Early diagnosis of osteoporosis by means of orthopantomograms and oral x-rays: a systematic review.
abstract: Osteoporosis is a systemic bone disease that is characterized by a generalized reduction of the bone mass. It is the main cause of fractures in elderly women. Bone densitometry is used in the lumbar spine and hip in order to detect osteoporosis in its early stages. Different studies have observed a correlation between the bone mineral density of the jaw (BMD) and that of the lumbar spine and/or hip. On the other hand, there are studies that evaluate the findings in the orthopantomograms and perapical X-rays, correlating them with the early diagnosis of osteoporosis and highlighting the role of the dentist in the early diagnosis of this disease.
  
  
  METHODS
  A search was carried out in the Medline-Pubmed database in order to identify those articles that deal with the association between the X-ray findings observed in the orthopantomograms and the diagnosis of the osteoporosis, as well as those that deal with the bone mineral density of the jaw.
  
  
  RESULTS
  There were 406 articles, and with the limits established, this number was reduced to 21. Almost all of the articles indicate that when examining oral X-rays, it is possible to detect signs indicative of osteoporosis.
  
  
  CONCLUSIONS
  The radiomorphometric indices use measurements in orthopantomograms and evaluate possible loss of bone mineral density.  They can be analyzed alone or along with the visual indices. In the periapical X-rays, the photodensimetric analyses and the trabecular pattern appear to be the most useful. There are seven studies that analyze the densitometry of the jaw, but only three do so independently of the photodensitometric analysis.
  
  
  CONCLUSIONS
  The combination of mandibular indices, along with surveys on the risk of fracture, can be useful as indicators of early diagnosis of osteoporosis. Visual and morphometric indices appear to be especially important in the orthopantomograms. Photodensitometry indices and the trabecular pattern are used in periapical X-rays. Studies on mandibular dual-energy X-ray absorptiometry are inconclusive.
authors: Bellvitge University Campus, Department of Odontostomatology, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. 18575jll@gmail.com
authors: José
authors: J
authors: López-López
authors: Albert
authors: A
authors: Estrugo-Devesa
authors: Enric
authors: E
authors: Jane-Salas
authors: Raúl
authors: R
authors: Ayuso-Montero
authors: Carmen
authors: C
authors: Gómez-Vaquero
mesh_terms: D042241:Early Diagnosis; D006801:Humans; D008336:Mandibular Diseases / Q000000981:diagnostic imaging*; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D011862:Radiography, Panoramic