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- Lindh, Christina, et al.
(författare)
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Mandibular cortical index for osteoporosis diagnosis : the OSTEODENT project
- 2006
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Konferensbidrag (refereegranskat)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.
(författare)
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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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Konferensbidrag (refereegranskat)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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- Nackaerts, Olivia, et al.
(författare)
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Accuracy and precision of a densitometric tool for jaw bone
- 2006
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Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 35:4, s. 244-248
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To develop a digital densitometric tool for jaw bone to analyse intraoral radiographs. To assess precision and accuracy for this tool and determine the minimal detection threshold for density changes. METHODS: Bone samples deriving from the premolar region of 47 human mandibles were selected for analysis. The samples were obtained from adult cadavers in the department of anatomy (Faculty of Medicine, KULeuven) with ethical approval. Digital radiography was performed on all bone samples. Direct volumetric measurements served as gold standard density values and allowed determination of accuracy. Dual-energy X-ray absorptiometry (DXA) scans were performed on all specimens. For all radiographs, density in mm Al eq was calculated using custom-made software, Osteop. Precision and intraobserver and interobserver reliability of this method were assessed. The bone specimens were progressively decalcified. At standard time intervals the percentage of decalcification was calculated. At each decalcification step, radiographs were taken and analysed. RESULTS: CV was always lower than 3%, which points to a good precision of the method. Correlation between the density measurements in mm Al eq and the DXA results was 0.9, for the density measurements in mm Al eq and the direct density measurements r was 0.5. The custom-made software was able to detect a change in bone mineralization of 6.6%. CONCLUSIONS: The present method for bone densitometric analysis offers potentials for clinical evaluation of bone density and minute bone density changes in the jaw bone.
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- Taguchi, Akira, et al.
(författare)
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Visual assessment of non-eroded thin cortex on panoramic radiographs in identifying women with osteoporosis : Osteoporosis Screening Project in Dentistry (OSPD)
- 2009
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Ingår i: Programme and abstract book. ; , s. 65-65
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction The presence of an eroded or thinned cortex of the mandible on panoramic radiographs may be useful in identifying women with osteoporosis. However, little is known as to whether a non-eroded thin cortex predicts osteoporosis. Objective To clarify whether visual assessment of non-eroded thin cortex increases the diagnostic efficacy of identifying women with osteoporosis. Materials and methods Of 60 observers who participated in OSPD (Taguchi et al., Bone, 2008), 41 observers visually assessed non-eroded thin cortex in addition to Klemetti’s index (KI) for 100 panoramic radiographs on the OSPD website via the Internet twice with approximately a two-week interval. The area under the receiver operating characteristics curves (AUROC) in identifying women with osteoporosis by both KI and non-eroded thin cortex was calculated on two occasions; non-eroded thin cortex was included in “class 1 of KI (decreased probability of osteoporosis)” or “class 3 of KI (increased probability of osteoporosis)”. Mean AUROC was compared between these two occasions with paired ttest. Results In the first series of observations, the mean AUROC significantly increased when noneroded thin cortex was considered as a sign of increased probability of osteoporosis (mean +/- SD, 0.68 +/- 0.08 vs. 0.70 +/- 0.07, P=0.011). In the second set of observations, the result was unchanged (0.68 +/- 0.09 vs. 0.71 +/- 0.08, P<0.001). Conclusions and discussion Visual identification of a non-eroded thin cortex on panoramic radiographs may increase the diagnostic efficacy of identifying women with osteoporosis.
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