title: Validation of cone-beam computed tomography as a predictor of osteoporosis using the Klemetti classification.
abstract: This study aimed at evaluating the validity of cone-beam computed tomography (CBCT) for assessing mandibular bone quality using the Klemetti classification. The morphology of the endosteal mandibular cortex of 30 (60 hemi-mandibles) postmenopausal women between the ages of 45 and 80 years was evaluated based on the Klemetti classification in panoramic radiographs used as reference images. Afterwards, panoramic reconstruction and cross-sectional slices of CBCT examinations of these patients were analyzed and categorized according to the same classification. All the images were assessed by two oral radiologists. The McNemar-Bowker test compared the agreement between the CBCT images and the reference images. No differences were found between the diagnostic results based on panoramic radiography and panoramic reconstruction. However, the mean scores for the cross-sectional evaluation were higher, and the results, statistically different from the others. Based on the disagreement found between the panoramic radiographs and the CBCT cross-sectional slices, the Klemetti classification is not an adequate means of assessing bone quality with CBCT. On the other hand, the higher values found for the cross-sectional slices could be associated with better visibility on the CBCT images.
authors.affiliation: Universidade Estadual de Campinas, Universidade de Campinas, Department of Oral Diagnosis, Piracicaba Dental School, Piracicaba SP , Brazil, Universidade de Campinas - UNICAMP, Department of Oral Diagnosis, Oral Radiology Area, Piracicaba Dental School, Piracicaba, SP, Brazil.
authors.forename: Maria Beatriz Carrazzone Cal
authors.initials: MB
authors.lastname: Alonso
authors.affiliation: Universidade Estadual de Campinas, Universidade de Campinas, Department of Oral Diagnosis, Piracicaba Dental School, Piracicaba SP , Brazil, Universidade de Campinas - UNICAMP, Department of Oral Diagnosis, Oral Radiology Area, Piracicaba Dental School, Piracicaba, SP, Brazil.
authors.forename: Taruska Ventorini
authors.initials: TV
authors.lastname: Vasconcelos
authors.affiliation: Universidade Estadual de Campinas, Universidade de Campinas, Department of Oral Diagnosis, Piracicaba Dental School, Piracicaba SP , Brazil, Universidade de Campinas - UNICAMP, Department of Oral Diagnosis, Oral Radiology Area, Piracicaba Dental School, Piracicaba, SP, Brazil.
authors.forename: Luciana Jácome
authors.initials: LJ
authors.lastname: Lopes
authors.affiliation: Universidade de São Paulo, Universidade de São Paulo, Ribeirão Preto School of Dentistry, Department of Stomatology, Ribeirão Preto SP , Brazil, Universidade de São Paulo - USP, Ribeirão Preto School of Dentistry, Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto, SP, Brazil.
authors.forename: Plauto Christopher Aranha
authors.initials: PC
authors.lastname: Watanabe
authors.affiliation: Universidade Estadual de Campinas, Universidade de Campinas, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba SP , Brazil, Universidade de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil.
authors.forename: Deborah Queiroz
authors.initials: DQ
authors.lastname: Freitas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D008334:Mandible / Q000000981:diagnostic imaging*; D008336:Mandibular Diseases / Q000145:classification / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D015663:Osteoporosis, Postmenopausal / Q000145:classification / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011862:Radiography, Panoramic / Q000379:methods*; D015203:Reproducibility of Results