Mandibular cortical shape index in non-standardised panoramic radiographs for identifying patients with osteoporosis as defined by the German Osteology Organization.
The aim of this prospective controlled study was to determine the validity of the mandibular cortical shape index (CI) on panoramic radiographs in distinguishing patients with osteoporosis as defined by the German Osteology Organization (Dachverbands der Deutschsprachigen Osteologischen Fachgesellschaften, DVO). The study group contained 50 patients (33 female, 17 male, mean age: 74.9 years), who had a high risk of osteoporosis. 50 young patients (33 female, 17 male, mean age: 37.9 years) with no anamnestic evidence of osteoporosis served as control. Three blinded observers evaluated panoramic views of the study and the control group in a mixed manner regarding the mandibular cortical shape index. The study group underwent bone mineral density measurement using dual energy X-ray absorptiometry and received a diagnosis according to the Organization's guidelines (normal, osteopenia, osteoporosis). The CI showed a high sensitivity of 72.2% and a high specificity of 93.9% with a highly significant predictive value (Chi-square = 22.96, p < 0.001), while the observer's agreement was moderate (kappa = 0.47). We concluded that patients with a cortical shape index of the category assessed as "severe" on non-standardised panoramic radiographs have a higher risk of suffering systemic osteoporosis. The CI in panoramic radiographs is a good screening tool, which could be implemented in the routine assessment of panoramic radiographs in elder patients.
Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Max Heiland), University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. Electronic address: a.al-dam@uke.de.
Ahmed
A
Al-Dam
Felix
F
Blake
Artun
A
Atac
Michael
M
Amling
Marco
M
Blessmann
Alexandre
A
Assaf
Henning
H
Hanken
Ralf
R
Smeets
Max
M
Heiland
D015502:Absorptiometry, Photon / Q000379:methods; D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000175:diagnosis; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D050723:Fractures, Bone / Q000145:classification; D006620:Hip Fractures / Q000145:classification; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011862:Radiography, Panoramic / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking; D055815:Young Adult
Bone density; Dental radiography; Osteopenia; Osteoporosis; Osteoporosis radiography; Radiography panoramic