| 1. |
- Lindh, Christina, et al.
(author)
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Tooth loss and osteoporosis
- 2006
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Conference paper (peer-reviewed)abstract
- Objectives: To test the relationship between the number of existing teeth (3rd molars and impacted teeth excluded) and the Bone Mineral Density (BMD). Methods: The study entailed perimenopausal and postmenopausal subjects (age 45-70 years). The BMD at three different sites (standardized total hip t-score, standardized femoral neck t-score and standardized lumbar spine t-score) was measured using DXA. The subjects received a panoramic radiograph and their medical history was evaluated. The number of existing teeth was calculated using the panoramic radiographs and the relation between the BMD and the number of existing teeth in different age groups of the subjects was examined.The equation introduced by Taguchi et al (1995) for calculating the probability of osteoporosis using two variables (age and number of existing teeth) Pv =1/(1+e-z) was also applied and assessed. Results: Data of 178 subjects (mean age 54,38 y; sd =6,32y) were available for analysis. Patients with a standardized t-score value less than -2.5 at any of the three sites were classified as osteoporotic. Those with a score above this were classified as normal or osteopenic. When osteoporosis was diagnosed at any of the three sites, there were fewer existing teeth (mean 18,47 ,95% CI;15,89 to 21,05) compared with normal (mean 21,24, 95% CI; 19.96 to 22,53) and osteopenic subjects (mean 19,97 95% CI;18,58 to 21,37). The results approaches statistical significance. Conclusions: It seems that there is a relationship between the number of remaining teeth and BMD.This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).
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| 2. |
- Lindh, Christina, et al.
(author)
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Mandibular cortical index for osteoporosis diagnosis : the OSTEODENT project
- 2006
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Conference paper (peer-reviewed)abstract
- Objectives: to determine the diagnostic validity of the mandibular cortical index (MCI) for the diagnosis of osteoporosis in peri- and post-menopausal women. Methods: Volunteer female subjects in the 45 to 70 year age band, recruited from four European centres, underwent dual x-ray energy absorptiometry of the hip and lumbar spine, to provide a gold standard diagnosis of osteoporosis, and a DPR examination. Five observers, all oral radiologists but of different experience, made an assessment of porosity of the cortex of the lower border of the mandible using MCI. Results: Data of 661 subjects (mean age 54.8y; sd = 6.19y) were available for analysis, with 140 (21.2%) being classified as having osteoporosis. MCI data for each observer were dichotomosed so that MCI grade 3 indicated a positive test result and grades 1 and 2 a negative test result. The sensitivities and specificties of MCI for osteoporosis diagnosis were determined: Osteoporosis at any site Osteoporosis at femoral neck Observer Sensitivity (%) Specificity (%) Sensitivity (%) Specificity (%) 1 24.8 93.3 27.3 91.3 2 23.4 93.2 24.2 91.3 3 23.4 91.5 24.2 89.8 4 20.6 99.8 22.7 91.8 5 19.1 91.1 22.7 90.3 Interobserver repeatability (using weighted Kappa) showed a range of 0.183 to 0.780, with a median value of 0.467. This median indicated moderate agreement. Conclusions: MCI had low sensitivity but high specificity for diagnosis of osteoporosis. This high specificity might prove to be more appropriate for use in primary dental care than using a different diagnostic threshold. This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).
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| 3. |
- Lindh, Christina, et al.
(author)
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ROC analysis of directly measured mandibular cortical width from panoramic radiogarphs for diagnosis of osteoporosis : the OSTEODENT study
- 2006
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Conference paper (peer-reviewed)abstract
- Objectives: To determine the diagnostic validity of the width of the inferior mandibular cortex on dental panoramic radiographs (DPRs), as measured directly by observers, for the diagnosis of osteoporosis in peri- and post-menopausal women. Methods: Volunteer female subjects in the 45 to 70 year age band, recruited from four European centres, underwent dual x-ray energy absorptiometry of the hip and lumbar spine, to provide a gold standard diagnosis of osteoporosis, and a DPR examination. Five observers, all oral radiologists but of different experience, made manual measurements of width of the mandibular lower border cortex below the mental foramina bilaterally. Results: Data of 661 subjects (mean age 54.8y; sd = 6.19y) were available for analysis, with 140 (21.2%) being classified as having osteoporosis. Az values are given below: Osteoporosis at any site Osteoporosis at femoral neck Observer Az (se) 95% CI Az (se) 95% CI 1 0.782 0.748-0.813 0.804 0.771-0.833 2 0.766 0.731-0.799 0.757 0.722-0.791 3 0.756 0.721-0.788 0.790 0.757-0.821 4 0.746 0.711-0.779 0.762 0.727-0.794 5 0.710 0.673-0.744 0.752 0.718-0.785 A diagnostic threshold of 3mm resulted in a sensitivity of 50.7% and a specificity of 80.4% (data for median observer, 2). Mean within-subject variance for the five observers was 0.126mm (sd = 0.355mm). Repeatability is the difference between two measurements made by any pair of observers for the same subject and was expected to be less than 0.983 mm for 95% of pairs of observations. Conclusions: Direct measurement of mandibular cortical width was diagnostically effective in diagnosis of osteoporosis. However, repeatability may be a problem in clinical use. This work was supported by a research and technological development project grant from the European Commission FP5 'Quality of Life and Management of Living Resources' (QLK6-2002-02243).
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