Quantitative and qualitative index for diagnosing osteopenia and osteoporosis in post-menopausal women

Authors

  • Lituânia Fialho de Miranda Discipline of Oral Radiology, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
  • Denise Sabbagh Haddad Discipline of Oral Radiology, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
  • Emiko Saito Arita Discipline of Oral Radiology, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
  • Plauto Christopher Aranha Watanabe Discipline of Oral Radiology, Department of Stomatology, School of Dentistry, University of São Paulo (FORP), Ribeirão Preto, SP, Brazil

DOI:

https://doi.org/10.11606/issn.2357-8041.clrd.2015.90130

Keywords:

Panoramic radiography, bone mineral density, osteopenia, osteoporosis.

Abstract

Objective: The objective of this study was to devise a qualitatively and quantitatively reliable index for screening changes in mandibular bone density based on digital panoramic radiographs.

Methods: A total of 252 panoramic radiographs and forearm bone densitometry scans of menopausal and post-menopausal women were examined. Diagnosis of osteopenia or osteoporosis was confirmed by comparing forearm densitometry diagnostic reports against diagnoses from radiographs.

Results: Pearson’s tests showed a significant association between assessments by the Quantitative and Qualitative Panoramic Index (QQPI) based on panoramic radiography of the mandible and by densitometry (p < 0.001). The Kappa statistic also revealed significant agreement between the two methods of assessment (p < 0.001). A significant association was also found between results of panoramic radiographic assessments of left and right mandible sides (Kappa = 0.676; p < 0.001).

Conclusion: These results allowed confirmation of panoramic radiography as a useful method for detecting morphologic age-related changes in the mandible and creation of a single Quantitative and Qualitative Panoramic Index (QQPI) to aid the diagnosis of mandibular osteopenia/osteoporosis.

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References

Jiang X, Schnatz PF. Denosumab: an antifracture therapy for postmenopausal women with osteoporosis. Menopause. Feb 2013;20(2):117-119.

Passos JS, Gomes Filho IS, Sarmento VA, et al. Women with low bone mineral density and dental panoramic radiography. Menopause. Jun 2012;19(6):704-709.

Kribbs PJ, Chesnut CH, Ott SM, Kilcoyne RF. Relationships between mandibular and skeletal bone in a population of normal women. J Prosthet Dent. Jan 1990;63(1):86-89.

Groen JJ, Menczel J, Shapiro S. Chronic destructive periodontal disease in patients with presenile osteoporosis. J Periodontol. Jan 1968;39(1):19-23.

Elders PJ, Habets LL, Netelenbos JC, van der Linden LW, van der Stelt PF. The relation between periodontitis and systemic bone mass in women between 46 and 55 years of age. J Clin Periodontol. Aug 1992;19(7):492-496.

Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res. Feb 1994;102(1):68-72.

Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994;843:1-129.

Benson BW, Prihoda TJ, Glass BJ. Variations in adult cortical bone mass as measured by a panoramic mandibular index. Oral Surg Oral Med Oral Pathol. Mar 1991;71(3):349-356.

Fleiss JL. The statistical basis of meta-analysis. Stat Methods Med Res. 1993;2(2):121-145.

Taguchi A, Suei Y, Ohtsuka M, Otani K, Tanimoto K, Ohtaki M. Usefulness of panoramic radiography in the diagnosis of postmenopausal osteoporosis in women. Width and morphology of inferior cortex of the mandible. Dentomaxillofac Radiol. Nov 1996;25(5):263-267.

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. Mar 1977;33(1):159-174.

Taguchi A, Ohtsuka M, Nakamoto T, Tanimoto K. [Screening for osteoporosis by dental panoramic radiographs]. Clin Calcium. Feb 2006;16(2):291-297.

Taguchi A, Tsuda M, Ohtsuka M, et al. Use of dental panoramic radiographs in identifying younger postmenopausal women with osteoporosis. Osteoporos Int. 2006;17(3):387-394.

Kim IH, Mupparapu M. Dental radiographic guidelines: a review. Quintessence Int. May 2009;40(5):389-398.

Devlin H, Karayianni K, Mitsea A, et al. Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Dec 2007;104(6):821-828.

Kleerekoper M. Extensive personal experience: the clinical evaluation and management of osteoporosis. J Clin Endocrinol Metab. Mar 1995;80(3):757-763.

Horner K, Allen P, Graham J, et al. The relationship between the OSTEODENT index and hip fracture risk assessment using FRAX. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Aug 2010;110(2):243-249.

Horner K, Devlin H, Alsop CW, Hodgkinson IM, Adams JE. Mandibular bone mineral density as a predictor of skeletal osteoporosis. Br J Radiol. Nov 1996;69(827):1019-1025.

Horner K, Devlin H. The relationship between mandibular bone mineral density and panoramic radiographic measurements. J Dent. May 1998;26(4):337-343.

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Published

2015-12-18

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Section

Original Research