| 1. |
- Al-Okshi, Ayman, et al.
(författare)
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A meta-review of effective doses in dental and maxillofacial cone beam CT using the ROBIS tool.
- 2021
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 94:1123
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To apply the ROBIS tool for assessment of risk of bias (RoB) in systematic reviews (SRs) in a meta-review on effective doses (EDs) in dental and maxillofacial cone beam CT.METHODS: Three electronic databases and reference lists of included SRs were searched. Eligible SRs were classified as having low, high or unclear RoB. Findings of SRs were synthesised and data from primary studies combined to relate ED to field of view (FOV) and operating potential (kV).RESULTS: Seven SRs were included: three displayed low RoB, three high and one had unclear RoB. Only one SR related ED to image quality. Deficiencies in reporting of eligibility criteria, study selection and synthesis of results in SRs were identified. FOV height had a significant relationship with ED, explaining 27.2% of its variability. Median ED for three FOV categories differed significantly. Operating potential had a weak relationship with ED, with no significant difference in median ED between three operating potential groups.CONCLUSION: The ROBIS tool should have a role for meta-reviews of different aspects of radiology. The disappointing results for RoB might be remedied by developing standards to improve the quality of reporting of primary dosimetry studies and of SRs. Future dosimetry studies should always relate ED to image quality or diagnostic accuracy.ADVANCES IN KNOWLEDGE: This meta-review is the first to implement ROBIS for SRs of ED and identified that trustworthiness of some SRs is questionable. The percentage change in average ED per cm increase in FOV height could be calculated, emphasizing the importance of FOV as a determinant of ED in CBCT.
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| 2. |
- Alissa, Rami, et al.
(författare)
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The influence of platelet-rich plasma on the healing of extraction sockets: an explorative randomised clinical trial
- 2010
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Ingår i: European journal of oral implantology. - 1756-2406. ; 3:2, s. 121-134
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the effect of platelet-rich plasma (PRP) on the healing of hard and soft tissues of extraction sockets with a pilot study. MATERIAL AND METHODS: Patients undergoing tooth extraction under intravenous sedation were asked to participate in the trial. Autologous platelet concentrates were prepared from the patients' blood and autologous thrombin was produced. Outcome measures were: pain level, analgesic consumption, oral function (ability to eat food, swallowing, mouth opening and speech), general activity, swelling, bruising, bleeding, bad taste or halitosis, food stagnation, patient satisfaction, healing complications, soft tissue healing, trabecular pattern of newly formed bone in extraction sockets, trabecular bone volume, trabecular separation, trabecular length, trabecular width, and trabecular number. Patients were followed up to 3 months post-extraction. RESULTS: Twelve patients (15 sockets) were randomly allocated to the PRP group and 11 patients (14 sockets) to the control group. Two patients from the control group did not attend any of the scheduled appointments following tooth extraction, and were considered dropouts. Additionally, one more patient from the control group and four patients from the PRP group did not attend their 3-month radiographic assessment appointments. Statistically significantly more pain was recorded in the control group for the first (P=0.02), second (P=0.02) and third (P=0.04) post-operative days for Visual Analogue Scale scores, whereas no differences were observed for the fourth (P=0.17), fifth (P=0.38), sixth (P=0.75) and seventh (P=0.75) post-operative days. There was a statistically significantly higher analgesic consumption for the first (P=0.03) and second (P=0.02) post-operative days in the control group and no differences thereafter. Differences in patients' responses in the health-related quality of life questionnaire were statistically significant in favour of PRP treatment only for the presence of bad taste or bad smell in the mouth (P=0.03), and food stagnation in the operation area (P=0.03). The difference between groups was not statistically significant for patient satisfaction with the treatment (P=0.31). Regarding complications, two dry sockets and one acutely inflamed alveolus occurred in patients of the control group, which determined a borderline statistically significant difference in favour of the PRP group (P=0.06). Soft tissue healing was significantly better in patients treated with PRP (P=0.03). Radiographic evaluation carried out by the two blinded examiners revealed a statistically significant difference (P=0.01) for sockets with dense homogeneous trabecular pattern, a borderline statistically significant difference in the trabecular pattern for bone volume (P=0.06) favouring PRP use, and no significant differences for trabecular separation (P=0.66), trabecular length (P=0.16), trabecular width (P=0.16) and trabecular number (P=0.38). CONCLUSIONS: PRP may have some benefits in reducing complications such as alveolar osteitis and improving healing of soft tissue of extraction sockets. There were insufficient data to support the use of PRP to promote bone healing or to enhance the quality of life of patients following tooth extraction, although the sample size was too small to detect statistically significant differences.
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| 3. |
- Allen, P Danny, et al.
(författare)
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Detecting reduced bone mineral density from dental radiographs using statistical shape models
- 2007
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Ingår i: IEEE transactions on information technology in biomedicine. - : Institute of Electrical and Electronics Engineers (IEEE). - 1089-7771 .- 1558-0032. ; 11:6, s. 601-610
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Tidskriftsartikel (refereegranskat)abstract
- We describe a novel method of estimating reduced bone mineral density (BMD) from dental panoramic tomograms (DPTs), which show the entire mandible. Careful expert width measurement of the inferior mandibular cortex has been shown to be predictive of BMD in hip and spine osteopenia and osteoporosis. We have implemented a method of automatic measurement of the width by active shape model search, using as training data 132 DPTs of female subjects whose BMD has been established by dual-energy X-ray absorptiometry. We demonstrate that widths measured after fully automatic search are significantly correlated with BMD, and exhibit less variability than manual measurements made by different experts. The correlation is highest towards the lateral region of the mandible, in a position different from that previously employed for manual width measurement. An receiver-operator characterstic (ROC) analysis for identifying osteopenia (T < -1: BMD more than one standard deviation below that of young healthy females) gives an area under curve (AUC) value of 0.64. Using a minimal interaction to initiate active shape model (ASM) search, the measurement can be made at the optimum region of the mandible, resulting in an AUC value of 0.71. Using an independent test set, AUC for detection of osteoporosis (T < -2.5) is 0.81.
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| 4. |
- Christell, Helena, et al.
(författare)
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A framework for costing diagnostic methods in oral health care : an application comparing a new imaging technology with the conventional approach for maxillary canines with eruption disturbances
- 2012
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 40:4, s. 351-361
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aims were (i) to propose a framework for costing diagnostic methods in oral health care and (ii) to illustrate the application of the framework to the radiographic examination of maxillary canines with eruption disturbances. Methods: The framework for costing, following Drummond et al.(2005), includes three elements: (i) identification of different resources used in producing and delivering the service, (ii) measurement of the amount of each resource required and (iii) valuation of the resources in monetary terms. Four data collection instruments were designed – a protocol for apportioning the cost of capital equipment to each diagnostic procedure, separate forms for recording consumable items, for the time of different health care providers used for a diagnostic examination and a patient survey for calculation of the total cost to the patient associated with the examination. The framework was applied to the radiographic examination of maxillary canines with eruption disturbances comparing two imaging methods: (i) a new method with cone beam computed tomography and panoramic radiography and (ii) a conventional method using intraoral and panoramic radiography. The primary analysis was performed from the perspective of the health care system. A separate analysis included patient costs with health care system costs to provide a societal perspective. Comparison of the two perspectives allows consideration of whether any costs savings to the health care system are generated at the expense of greater costs for patients and their families. Data for the cost-analysis were retrieved from 47 patients (mean age 14 years) referred to a department of radiology for examination of maxillary canines. Results:Application of the framework for costing allowed us to compare the resources used to perform examinations of the two methods. The mean total cost per examination for the new method was 128.38€ and 81.80€ for the conventional method, resulting in an incremental cost per examination of the new method of 46.58€. Conclusions: The application of the framework demonstrates the feasibility of measuring and comparing the total costs as well as the distribution of total costs between providers and patients for different approaches to this common examination.
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| 5. |
- Christell, Helena, et al.
(författare)
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Economic evaluation in oral health care
- 2009
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Ingår i: Programme and abstract book. ; , s. 70-70
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction Economic evaluation attempts to weigh costs and effects of alternative interventions with the goal that available resources are used to achieve maximum benefits for patients in terms of health and quality of life. In emerging technologies this is particularly important to avoid inappropriate and excessive use. Objectives To analyse evidence on economic evaluation in oral health care, particularly on diagnostic imaging methods, by systematic review. Material and methods A search for literature was made starting with a hand made search according to the pearl growing model. This search strategy means that articles and relevant literature are retrieved by talking to renowned specialists in the subject area and by finding indexing and MeSH terms by looking at those articles and their reference lists. From seven articles indexing terms and MeSH terms were chosen and searches were made from PubMed, the Cochrane Library and Science Citations Index. The retrieved primary studies that according to the abstract contained a cost-effectiveness analysis were interpreted by two reviewers using a check-list for assessing economic evaluations (Drummond et al. 2005). Results The literature search yielded 258 titles and abstracts. Out of these, 93 studies were selected and read in full text. There was a vast heterogeneity in study design. No clear evidence was found. Methodology regarding the odontological part was acceptable in a few studies but the methodology for the economic evaluation was insufficient. Conclusions and discussion This review reveals a need for studies with improved quality in economic evaluation in oral health care. We will propose and discuss a model for economic evaluation of diagnostic methods that will contain information of how to (i) identify costs (ii) categorise costs and (iii) value costs. This model will be applied in the SEDENTEXCT project on Cone Beam Computed Tomography. Reference: Drummond MF, Sculpher MJ, Torrance GW, O´Brian BJ, Stoddart GL. Methods for the economic evaluation of health care programmes, Oxford, 2005, Oxford Medical Publications, 3rd ed. The research leading to these results has received funding from the European Atomic Energy Community’s Seventh Framework Programme FP7/2007-2011 under grant agreement no 212246 (SEDENTEXCT: Safety and Efficacy of a New and Emerging Dental X-ray Modality).
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| 6. |
- Christell, Helena, et al.
(författare)
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Economic evaluation of diagnostic methods used in dentistry : a systematic review
- 2014
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Ingår i: Journal of Dentistry. - : Elsevier. - 0300-5712 .- 1879-176X. ; 42:11, s. 1361-1371
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVES: To review the literature of economic evaluations regarding diagnostic methods used in dentistry. DATA SOURCES: Four databases (MEDLINE, Web of Science, The Cochrane library, the NHS Economic Evaluation Database) were searched for studies, complemented by hand search, until February 2013. STUDY SELECTION: Two authors independently screened all titles or abstracts and then applied inclusion and exclusion criteria to select full-text publications published in English, which reported an economic evaluation comparing at least two alternative methods. Studies of diagnostic methods were assessed by four reviewers using a protocol based on the QUADAS tool regarding diagnostic methods and a check-list for economic evaluations. The results of the data extraction were summarized in a structured table and as a narrative description. RESULTS: From 476 identified full-text publications, 160 were considered to be economic evaluations. Only 12 studies (7%) were on diagnostic methods, whilst 78 studies (49%) were on prevention and 70 (40%) on treatment. Among studies on diagnostic methods, there was between-study heterogeneity methodologically, regarding the diagnostic method analysed and type of economic evaluation addressed. Generally, the choice of economic evaluation method was not justified and the perspective of the study not stated. Costing of diagnostic methods varied. CONCLUSIONS: A small body of literature addresses economic evaluation of diagnostic methods in dentistry. Thus, there is a need for studies from various perspectives with well defined research questions and measures of the cost and effectiveness. CLINICAL SIGNIFICANCE: Economic resources in healthcare are finite. For diagnostic methods, an understanding of efficacy provides only part of the information needed for evidence-based practice. This study highlighted a paucity of economic evaluations of diagnostic methods used in dentistry, indicating that much of what we practise lacks sufficient evidence.
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| 7. |
- Christell, Helena, et al.
(författare)
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The impact of Cone Beam CT on financial costs and orthodontists' treatment decisions in the management of maxillary canines with eruption disturbance
- 2018
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; :1, s. 65-73
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Tidskriftsartikel (refereegranskat)abstract
- Background: Examination with Cone Beam CT (CBCT) is common for localizing maxillary canines with eruption disturbance. The benefits and costs of these examinations are unclear. Objectives: To measure: 1. the proportion of orthodontists' treatment decisions that were different based on intraoral and panoramic radiography (M1) compared with CBCT and panoramic radiography (M2); and 2. the costs of producing different treatment plans, regarding patients with maxillary canines with eruption disturbance. Subjects and methods: Orthodontists participated in a web-based survey and were randomly assigned to denote treatment decisions and the level of confidence in this decision for four patient cases presented with M1 or M2 at two occasions for the same patient case. Results: One hundred and twelve orthodontists made 445 assessments based on M1 and M2, respectively. Twenty-four per cent of the treatment decisions were different depending on which method the raters had access to, whereof one case differed significantly from all other cases. The mean total cost per examination was €99.84 using M1 and €134.37 using M2, resulting in an incremental cost per examination of €34.53 for M2. Limitations: Benefits in terms of number of different treatment decisions must be considered as an intermediate outcome for the effectiveness of a diagnostic method and should be interpreted with caution. Conclusions: For the patient cases presented in this study, most treatment decisions were the same irrespective of radiological method. Accordingly, this study does not support routine use of CBCT regarding patients with maxillary canine with eruption disturbance.
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| 8. |
- Christell, Helena, et al.
(författare)
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Variation in costs of cone beam CT examinations among health care systems
- 2012
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Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 41:7, s. 571-577
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To analyse the costs of cone beam CT (CBCT) in different healthcare systems for patients with different clinical conditions. Methods: Costs were calculated for CBCT performed in Cluj (Romania), Leuven (Belgium), Malmö (Sweden) and Vilnius (Lithuania) on patients with (i) a maxillary canine with eruption disturbance, (ii) an area with tooth loss prior to implant treatment or (iii) a lower wisdom tooth planned for removal. The costs were calculated using an approach based on the identification, measurement and valuation of all resources used in the delivery of the service that combined direct costs (capital equipment, accommodation, labour) with indirect costs (patients’ and accompanying persons’ time, ‘‘out of pocket’’ costs for examination fee and visits). Results: The estimates for direct and indirect costs varied among the healthcare systems, being highest in Malmö and lowest in Leuven. Variation in direct costs was mainly owing to different capital costs for the CBCT equipment arising from differences in purchase prices (range J148 000–227 000). Variation in indirect costs were mainly owing to examination fees (range J0–102.02). Conclusions: Cost analysis provides an important input for economic evaluations of diagnostic methods in different healthcare systems and for planning of service delivery. Additionally, it enables decision-makers to separate variations in costs between systems into those due to external influences and those due to policy decisions. A cost evaluation of a dental radiographic method cannot be generalized from one healthcare system to another, but must take into account these specific circumstances.
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| 9. |
- Devlin, Hugh, et al.
(författare)
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Automated osteoporosis risk assessment by dentists : a new pathway to diagnosis
- 2007
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Ingår i: Bone. - : Elsevier BV. - 8756-3282 .- 1873-2763. ; 40:4, s. 835-842
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Tidskriftsartikel (refereegranskat)abstract
- General dental practitioners use a vast amount of panoramic radiography in their routine clinical work, but valuable information about patients' osteoporotic status is not collected. There are many reasons for this, but one of the prime reasons must be the disruption involved in clinical routine with lengthy manual radiographic assessment. We have developed computer software, based on active shape modeling that will automatically detect the mandibular cortex on panoramic radiographs, and then measure its width. Automatic or semi-automatic measurement of the cortical width will indicate the osteoporotic risk of the patient. The aim of our work was to assess the computer search technique's ability to measure the mandibular cortical width and to assess its potential for detection of osteoporosis of the hip, spine and femoral neck. Mandibular cortical width was measured using the manually initialized (semi-automatic) method and, when assessed for diagnosing osteoporosis at one of the three measurement sites, gave an area under the ROC curve (A(z))=0.816 (95% CI=0.784 to 0.845) and for the automatically initialized searches, A(z)=0.759 (95% CI=0.724 to 0.791). The difference between areas=0.057 (95% Confidence interval=0.025 to 0.089), p<0.0001. For diagnosing osteoporosis at the femoral neck, mandibular cortical width derived from the manually initialized fit gave an area under the ROC curve (A(z))=0.835 (95% CI=0.805 to 0.863) and for the automatically initialized searches A(z)=0.805 (95% CI=0.773 to 0.835). The difference in A(z) values between active shape modeling search methods=0.030 (95% CI=-0.010 to 0.070), and this was not significant, p=0.138. We concluded that measurement of mandibular cortical width using active shape modeling is capable of diagnosing skeletal osteoporosis with good diagnostic ability and repeatability. PMID: 17188590 [PubMed - indexed for MEDLINE]
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| 10. |
- Devlin, Hugh, et al.
(författare)
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Diagnosing osteoporosis by using dental panoramic radiographs : the OSTEODENT project
- 2007
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Ingår i: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. - : Elsevier BV. - 1079-2104 .- 1528-395X. ; 104:6, s. 821-828
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Measurement of cortical thickness and subjective assessment of cortical porosity on panoramic radiographs are methods previously reported for diagnosing osteoporosis. The aims of this study were to determine the relative efficacy of the mandibular cortical index and cortical width in detecting osteoporosis, both alone and in combination, and to determine the optimal cortical width threshold for referral for additional osteoporosis investigation. STUDY DESIGN: Six hundred seventy-one postmenopausal women 45 to 70 years of age were recruited for this study. They received dual energy x-ray absorptiometry (DXA) scans of the left hip and lumbar spine (L1 to L4), and dental panoramic radiographic examinations of the teeth and jaws. Three observers separately assessed the mandibular cortical width and porosity in the mental foramen region of the mandible. Cortical width was corrected for magnification errors. Chi-squared automatic interaction detection analysis (CHAID) software was used (SPSS AnswerTree, version 3.1, SPSS Inc., Chicago, IL). RESULTS: Chi-squared automatic interaction detection analysis showed that the cortical porosity was a poorer predictor of osteoporosis than mandibular cortical width. For the 3 observers, a mandibular cortical width of <3 mm provided diagnostic odds ratios of 6.51, 6.09, and 8.04. The test is therefore only recommended in triage screening of individuals by using radiographs made for purposes other than osteoporosis. CONCLUSION: When evaluating panoramic radiographs, only those patients with the thinnest mandibular cortices (i.e., <3 mm) should be referred for further osteoporosis investigation. PMID: 17428694 [PubMed - in process]
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| 11. |
- Devlin, Hugh, et al.
(författare)
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The role of the dental surgeon in detecting osteoporosis : the OSTEODENT study
- 2008
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Ingår i: British Dental Journal. - : Springer Science and Business Media LLC. - 0007-0610 .- 1476-5373. ; 204:10
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- OBJECTIVE: To determine if thinning (<3 mm width) of the lower cortical border of the mandible on dental panoramic radiographs, as well as other clinical risk factors, may provide a useful diagnostic test for osteoporosis in young postmenopausal women. DESIGN: Six hundred and fifty-two subjects (age range 45-70 years) were involved in this multi-centre, cross-sectional study. SETTING: Patients were recruited from centres in Leuven (Belgium), Athens (Greece), Manchester (UK), and Malmo (Sweden). SUBJECTS AND METHODS: The subject's age, body weight, whether the patient took hormone replacement therapy or had a history of low trauma fracture were used to form a clinical osteoporosis risk assessment (the OSteoporosis Index of RISk or OSIRIS index). Each patient also received a dental panoramic radiographic examination. RESULTS: One hundred and forty subjects had osteoporosis involving at least one of the measurement sites (lumbar spine, femoral neck or total hip). Those with osteoporosis tended to have a low OSIRIS score and a thinned cortical mandibular border. The area under the ROC curve for using both cortical width and OSIRIS to predict osteoporosis was 0.90 (95% CI = 0.87 to 0.92). There was a significant improvement in the diagnostic ability of the combined OSIRIS and cortical width test over both tests applied separately (p <0.001). The cost effectiveness of the cortical width and OSIRIS model was improved by using a high specificity threshold rather than high sensitivity. However, this analysis ignores the costs associated with missed cases of osteoporosis. CONCLUSION: Dentists have a role to play in the detection and referral of patients at high risk of osteoporosis.
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| 12. |
- Geraets, Wil G, et al.
(författare)
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Osteoporosis and the general dental practitioner : reliability of some digital dental radiological measures
- 2007
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Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661 .- 1600-0528. ; 35:6, s. 465-471
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Dental radiographs are relatively inexpensive and are regularly made of a large fraction of the adult population; therefore, they represent an enormous potential as a screening tool for osteoporosis. Monitoring the population by means of dual X-ray absorptiometry (DXA), which is currently the most accepted method for diagnosing osteoporosis, involves enormous costs and facilities. In previous studies, it was shown that the radiographic trabecular pattern shows correlations with the bone mineral density (BMD) as measured by DXA. The objective of this study was to assess the reproducibility of the quantitative analysis of the trabecular pattern on dental radiographs. METHODS: Six regions of interest were selected manually on three digital radiographic images of 20 women. This process was performed 10 times resulting in 1200 image samples. For each image sample 26 parameters were measured. The reliability of the parameters was evaluated by means of Cronbach's alpha. RESULTS: Of the values of Cronbach's alpha 83% is at least 0.9 and 99% is at least 0.8. CONCLUSIONS: The measurements of the parameters used in this study are very reproducible. Therefore, the manual selection of the regions of interest does not introduce large amounts of noise. The imaging parameters potentially offer an accurate tool for the prediction of BMD values. PMID: 18039288 [PubMed - in process]
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| 13. |
- Geraets, Wil G, et al.
(författare)
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Prediction of bone mineral density with dental radiographs
- 2007
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Ingår i: Bone. - : Elsevier BV. - 8756-3282 .- 1873-2763. ; 40:5, s. 1217-1221
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Tidskriftsartikel (refereegranskat)abstract
- There is consensus to use the bone mineral density (BMD) for the operational definition of the degree of osteoporosis and the risk of osteoporotic fractures. Dual X-ray absorptiometry (DXA) is the common technique to determine BMD. Because of high costs and limited availability of DXA equipment it is worthwhile to look for alternative diagnostic techniques. As part of a larger study, the Osteodent project, we investigated if the trabecular pattern on dental radiographs can be used to predict BMD and to identify the subjects with osteoporosis and increased risk of osteoporotic fractures. In four clinical centers 671 women with an average age of 55 years were recruited. BMD values were measured by DXA equipment at the femoral neck, total hip, and spine. One panoramic and two intraoral radiographs were made. From 525 women a complete set of BMD values and radiographs was obtained. Four regions of interest on the radiographs were selected manually and then processed automatically. On all regions of interest mean and standard deviation of the gray values were measured and several features describing the shape of the binarized trabecular pattern. Multiple regression was used to predict BMD of total hip and spine by means of the radiographic measurements combined with age. It was found that age accounts for 10% of the variation in total hip BMD and 14% of the variation in spinal BMD. When all measurements on the dental radiographs are used the explained variation increases to 22% and 23%. The areas under the ROC curves are comparable to those of commonly used screening instruments for osteoporosis. It is concluded that prediction of DXA measurements of BMD by means of quantitative analysis of the trabecular pattern on dental radiographs is feasible. PMID: 17317351 [PubMed - indexed for MEDLINE]
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| 14. |
- Geraets, Wil GM, et al.
(författare)
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Selecting regions of interest on intraoral radiographs for the prediction of bone mineral density
- 2008
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Ingår i: Dento-Maxillo-Facial Radiology. - : Oxford University Press (OUP). - 0250-832X .- 1476-542X. ; 37:7, s. 375-379
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: A previous study showed that the trabecular pattern on dental radiographs correlates with femoral and spinal bone mineral density (BMD). The objective of this study was to determine if the correlation is affected by the size and location of the region of interest (ROI). METHODS: In a European research project on osteoporosis, BMD was measured at the left hip and the lumbar spine of 525 women. From all subjects, intraoral radiographs were made of the premolar region in the upper and lower jaws. Two ROIs were indicated manually on each scanned image. The smallest region involved only trabecular bone and the largest also included parts of the neighbouring teeth. The ROIs were subjected to automatic image analysis, yielding 26 measurements per ROI. Stepwise linear regression was used to predict femoral and spinal BMD. RESULTS: Inner and outer regions predicted BMD equally well. The radiographs of lower and upper jaw also predicted BMD equally well. Combining inner and outer regions did not improve the prediction of femoral and spinal BMD, but combining lower and upper jaws did. CONCLUSIONS: This study shows that it is possible to include parts of neighbouring teeth in the ROI used to assess the trabecular pattern and predict BMD. This simplifies the process of selecting the ROIs because no efforts have to be made to exclude neighbouring teeth. Combining ROIs of lower and upper jaws significantly improves the prediction of BMD.
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| 15. |
- Gullberg, Joanna, et al.
(författare)
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Osteoporosis risk assessment in primary dental care-The attitudes of Swedish dentists, patients and medical specialists
- 2020
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Ingår i: Gerodontology. - : John Wiley & Sons. - 0734-0664 .- 1741-2358. ; 37:2, s. 208-216
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Tidskriftsartikel (refereegranskat)abstract
- Objective To explore and identify the attitudes of dentists, patients and medical specialists regarding implementation of osteoporosis risk assessment into Swedish primary dental care. Background Osteoporosis is a major health problem leading to fragility fractures. As shown in academic-based research, dental radiological examination can be used for osteoporosis risk assessment. A substantial number of patients undergo radiographic examinations in primary dental care each year, but little is known about implementation of osteoporosis risk assessment in this setting. Materials and methods A qualitative research approach using focus group discussions and manifest content analysis was applied. Five focus groups with dentists and representatives from patient support groups and a single individual interview with one medical specialist were included in the sample. Results From the manifest content analysis, three categories emerged: (a) barriers to change in practice, (b) benefits to change in practice, and (c) needs and requirements prior to change in practice. Most participants felt that there was insufficient knowledge of osteoporosis as well as a heavy existing workload. A concern was expressed about medical practitioners' willingness to take on responsibility for patients referred by dentists. Representatives from patient support groups highlighted a lack of knowledge about osteoporosis among both the general public and the medical professionals. Clear guidelines and improved communication channels between stakeholders would have to be established to ensure a smooth treatment path for patients. Conclusion Despite interest in osteoporosis risk assessment in primary dental care, there are political, workflow and educational barriers that must be overcome for successful implementation.
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| 16. |
- Gustafsson, Pernilla, et al.
(författare)
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Will image quality influence diagnostic accuracy efficacy when diagnosing osteoporosis by intraoral radiography?
- 2009
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Ingår i: Programme and abstract book. ; , s. 67-67
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction In 2003-2005, the OSTEODENT study was performed with the aim of identifying the most valid and effective radiographic index for diagnosis of osteoporosis to be used in oral health care. One of the proposed indices was based on visual assessment of the trabecular pattern in intraoral periapical radiographs. Although strict quality criteria were used, the quality of the intraoral radiographs differed due to film placement and projection errors (Lindh et al 2008). Objectives To investigate if the diagnostic accuracy of visual assessment of the trabecular pattern to diagnose osteoporosis in intraoral radiography increased for images with optimal image quality. Material and methods One hundred intraoral radiographs of the upper and lower premolar regions with optimal image quality were chosen from the original sample of 600 images. The trabecular pattern was assessed by four observers and classified into one of three groups (i) dense homogenous trabecular patter, (ii) heterogeneous trabecular pattern, or (iii) sparse homogenous trabecular pattern. The criterion standard was comprised of osteoporosis as measured by DXA. Sensitivity, specificity, odds ratio, and inter- and intra-observer agreement for the assessment of the 100 images with optimal quality were compared to the values obtained from the assessment of the original sample. Results Sensitivity of images of optimal quality increased in the upper jaw as compared to that of the original sample. The odds ratios of images with optimal image quality were higher for both the upper and the lower jaw. The median intraobserver agreement (weighted Kappa) was also slightly higher for both jaws whilst the median interobserver agreement was comparable for the two samples. Conclusions and discussion Although image quality of intraoral radiography influenced the diagnostic accuracy efficacy in osteoporosis diagnosis to some extent, optimal image quality might not be necessary for the usability of the proposed classification in clinical practice. Reference: Lindh C, Horner K, Jonasson G, Olsson P, Rohlin M, Jacobs R , Karayianni K, van der Stelt P, Adams J, Marjanovic E, Pavitt S, Devlin H. The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project. Oral Surg, Oral Med, Oral Pathol, Oral Radiol Endod 2008;106:285- 93
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| 17. |
- Haas, Brian J., et al.
(författare)
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Genome sequence and analysis of the Irish potato famine pathogen Phytophthora infestans
- 2009
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 461:7262, s. 393-398
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Tidskriftsartikel (refereegranskat)abstract
- Phytophthora infestans is the most destructive pathogen of potato and a model organism for the oomycetes, a distinct lineage of fungus-like eukaryotes that are related to organisms such as brown algae and diatoms. As the agent of the Irish potato famine in the mid-nineteenth century, P. infestans has had a tremendous effect on human history, resulting in famine and population displacement(1). To this day, it affects world agriculture by causing the most destructive disease of potato, the fourth largest food crop and a critical alternative to the major cereal crops for feeding the world's population(1). Current annual worldwide potato crop losses due to late blight are conservatively estimated at $6.7 billion(2). Management of this devastating pathogen is challenged by its remarkable speed of adaptation to control strategies such as genetically resistant cultivars(3,4). Here we report the sequence of the P. infestans genome, which at similar to 240 megabases (Mb) is by far the largest and most complex genome sequenced so far in the chromalveolates. Its expansion results from a proliferation of repetitive DNA accounting for similar to 74% of the genome. Comparison with two other Phytophthora genomes showed rapid turnover and extensive expansion of specific families of secreted disease effector proteins, including many genes that are induced during infection or are predicted to have activities that alter host physiology. These fast-evolving effector genes are localized to highly dynamic and expanded regions of the P. infestans genome. This probably plays a crucial part in the rapid adaptability of the pathogen to host plants and underpins its evolutionary potential.
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| 18. |
- Horner, Keith, et al.
(författare)
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The mandibular cortex on radiographs as a tool for osteoporosis risk assessment : the OSTEODENT Project
- 2007
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Ingår i: Journal of clinical densitometry. - : Elsevier BV. - 1094-6950 .- 1559-0747. ; 10:2, s. 138-146
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to measure the accuracy of porosity of the mandibular cortex on dental panoramic radiographs (DPRs) in diagnosis of osteoporosis, alone and in combination with a clinical risk index. Six hundred seventy-one women (45-70yr) were recruited in the study, and dual-energy X-ray absorptiometry of the hip and lumbar spine was performed. A clinical index of osteoporosis risk (OSIRIS) and a DPR were obtained for each subject. The cortical appearance on the DPR was classified using the mandibular cortical index (MCI) by 5 observers. receiver operating characteristic (ROC) curve analysis was performed with calculation of area under the ROC curve (AUC) and sensitivity and specificity at various thresholds. Complete data were available for 653 subjects, of whom 21.6% had osteoporosis. The AUC for OSIRIS was 0.838. When used alone as the diagnostic test, MCI AUC for the 5 observers ranged from 0.560 to 0.670, significantly less than OSIRIS. Intraobserver and interobserver repeatability of MCI assessment was inconsistent. We conclude that MCI has limited value for osteoporosis diagnosis, being most appropriate as a method of fortuitous case-finding. PMID: 17449308 [PubMed - in process]
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| 19. |
- Horner, Keith, et al.
(författare)
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The relationship between the OSTEODENT index and hip fracture risk assessment using FRAX
- 2010
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Ingår i: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. - : Elsevier BV. - 1079-2104 .- 1528-395X. ; 110:2, s. 243-249
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The OSTEODENT index is a predicted probability of osteoporosis derived from a combination of an automated analysis of a dental panoramic radiograph and clinical information. This index has been proposed as a suitable case-finding tool for identification of subjects with osteoporosis in primary dental care; however, no data exist on the relationship between OSTEODENT index and fracture risk. The aims of this study were to assess the relationship between the OSTEODENT index and hip fracture risk as determined by FRAX and to compare the performance of the OSTEODENT index and FRAX (without femoral BMD data), in determining the need for intervention as recommended in UK national treatment guidance. STUDY DESIGN: The study was a retrospective analysis of data from 339 female subjects (mean age 55.3 years), from 2 centers: Manchester (UK) and Leuven (Belgium). Clinical information and femoral neck BMD were available for FRAX, and dental panoramic radiographic data and clinical information were available to calculate the OSTEODENT index. Subjects were classified into "treat" or "lifestyle advice and reassurance" categories using the National Osteoporosis Guideline Group (NOGG) threshold. RESULTS: The OSTEODENT index result was significantly related to the 10-year probability of hip fracture derived from the reference standard FRAX tool (Rs = 0.67, P < .0001); 84 patients (24.8%) were allocated to the "treat" category on the basis of FRAX and the UK national guidance. Using this "treatment/no treatment" classification as the reference standard, ROC analysis showed no significant difference between areas under the curves for the OSTEODENT index (0.815) and the 10-year probability of hip fracture derived from the FRAX index without BMD (0.825) when used as tests for determining therapeutic intervention. CONCLUSION: The results suggest that the OSTEODENT index has value in prediction of hip fracture risk. Prospective trials are needed to confirm this finding and to examine the feasibility for its use in primary dental care.
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| 20. |
- Karayianni, Kety, et al.
(författare)
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Accuracy in osteoporosis diagnosis of a combination of mandibular cortical width measurement on dental panoramic radiographs and a clinical risk index (OSIRIS) : the OSTEODENT project
- 2007
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Ingår i: Bone. - : Elsevier. - 8756-3282 .- 1873-2763. ; 40:1, s. 223-229
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Tidskriftsartikel (refereegranskat)abstract
- Clinical questionnaires and dental radiographic findings have both been suggested as methods of identifying women at risk of having osteoporosis and who might benefit from bone densitometry. The aim of this study was to measure the diagnostic accuracy of a combination of mandibular cortical width (MCW) measured from dental panoramic radiographs (DPRs) and the osteoporosis index of risk (OSIRIS) in the diagnosis of osteoporosis. 653 women (age range 45-70 years, mean age 54.95 years) in four European centres underwent standardised dual X-ray energy absorptiometry (DXA) to provide reference data on osteoporosis status. Each subject was interviewed to derive OSIRIS scores and underwent DPR examination. MCW was measured directly by five observers. Receiver Operating Characteristic (ROC) curve analysis was used to calculate sensitivities and specificities of the clinical and radiographic tests for the diagnosis of osteoporosis. 512 (78.4%) of the study population were classified as having normal BMD and 141 (21.6%) as having osteoporosis. Using ROC analysis, OSIRIS gave a ROC curve area (A(z)) of 0.838, with a sensitivity of 70.9% and a specificity of 79.5% at a diagnostic threshold of
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| 21. |
- Lindh, Christina, et al.
(författare)
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A comparison of manual and computer-assessed measurements of mandibular cortical width as predictiors of osteoporsis : the OSTEODENT project
- 2006
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Konferensbidrag (refereegranskat)abstract
- Objective: Manual measurement of mandibular cortical width has been shown to be significantly correlated with bone mineral density (BMD) at the hip,spine and forearm.These latter sites are fracture-prone in post-menopausal osteoporosis. We have developed computer software technology, based on active shape modelling, that will automatically detect the mandibular cortex on panoramic radiographs and then measure its width. We wanted to compare manual measurement of mandibular cortical width with semi-automated constrained fit and automated unconstrained fit methods. Material and Methods:The diagnostic ability of these different methods at detecting osteoporosis of the femoral neck was compared using dual energy X-ray absorptiometry as the “gold standard “at these sites. 671 subjects were recruited and their BMD measured at the femoral neck.143 (21.4%) subjects were osteoporotic, classified as a standardized t-score of <-2.5 at any site. The ability of one observer’s manual measurement of mandibular cortical width to act as a diagnostic test for detecting osteoporosis at the femoral neck was assessed using ROC analysis. The AUC under the ROC curve was = 0.748, (se = 0.027; 95% CI = 0.713 to 0.780). Using a previous training set of 132 DPR images, a point distribution model (PDM) was created of the inferior mandibular cortex. Two experts performed this task independently using a graphical user interface, outlining the inferior mandibular cortex by placing equally spaced points on the computer images between the mental foramen and antegonial region. In the constrained fit, four manually defined reference points were placed on the inferior mandibular surface of the images at the left and right antegonial and mental foramen regions. These points served as starting points for the active shape model and the point distribution model was stretched and positioned to match these points. Results:As a diagnostic test in detecting osteoporosis at the hip, the semi- automated constrained fit produced an AUC of 0.755 (se= 0.026; 95% CI = 0.721 – 0.788). In detecting osteoporosis at the hip, the automated unconstrained fit produced an AUC of 0.739 (se = 0.028; 95% CI = 0.704 to 0.772). There were no significant differences in AUC between the manual, and either the constrained or unconstrained fits (p>0.05).
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| 22. |
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| 23. |
- 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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| 24. |
- Nackaerts, Olivia, et al.
(författare)
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Bone density measurements in intra-oral radiographs.
- 2007
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Ingår i: Clinical Oral Investigations. - : Springer Science and Business Media LLC. - 1432-6981 .- 1436-3771. ; 11:3, s. 225-229
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Tidskriftsartikel (refereegranskat)abstract
- Oral Imaging Center, Department of Dentistry, Faculty of Medicine, KU Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium. Jaw bone density measurements are applicable in many clinical situations to assess bone tissue. To be able to implement research findings in clinical reality, tools must be simple and low cost. Intra-oral radiographs including a reference material perform well as a densitometric tool. However, the inclusion of a reference material, usually in the form of a metal wedge, is an additional burden for the dentist. The aim of this study was to evaluate whether a reference step wedge is required for accurate densitometric results. Dual energy X-ray absorptiometry measurements and densitometric measurements on intra-oral radiographs using a custom-made software were performed on bone samples from the premolar region of the mandible. Observer agreement of bone density expressed as grey value was high. The correlation between mandibular bone mineral density and the densitometric values on intra-oral radiographs was substantially higher when the aluminium step wedge was included. The Wilcoxon test revealed no significant difference between the density measurements using nine or three steps of the Al reference wedge. Density determination of grey value and mm Aleq thickness value both have good intra- and inter-observer agreement. However, jaw bone densitometry is far more accurate when including a reference wedge. PMID: 17668257 [PubMed - indexed for MEDLINE]
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| 25. |
- Nackaerts, Olivia, et al.
(författare)
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Is self-reported alcohol consumption associated with osteoporotic mandibular bone loss in women?
- 2009
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Ingår i: European Journal of Oral Sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 117:1, s. 7-12
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine whether alcohol consumption would predict mandibular bone quality and quantity in a large European female population. In total, 672 middle-aged and elderly women (45-70 yr of age; standard deviation = 6) were recruited in the study. Alcohol consumption was recorded through a self-reported questionnaire. Mandibular cortical width was measured, by five observers, in the mental foramen region on panoramic radiographs. Mandibular bone density, expressed as aluminium thickness, was recorded on intra-oral radiographs. Alcohol consumption was associated with a reduction of mandibular bone density and cortical width. This association was higher in subjects with excessive alcohol consumption, defined in the present study as > 14 units consumed per week. This study showed reduced jaw-bone quality in older individuals and in those with increased alcohol consumption.
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| 26. |
- Nackaerts, Olivia, et al.
(författare)
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Osteoporosis detection using intraoral densitometry
- 2008
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Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 37:5, s. 282-287
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the diagnostic accuracy of mandibular and maxillary bone density in detecting osteoporosis using receiver operating characteristic (ROC) analysis. METHODS: 671 women between 45 years and 70 years of age underwent dual energy X-ray absorptiometry (DXA) of the hip and lumbar spine. This was the gold standard for diagnosing osteoporosis. Intraoral radiography of the upper and lower right premolar region was performed, using an aluminium wedge as a densitometric reference. Jaw bone density was determined using dedicated software. Observer differences and ROC curves were analysed. RESULTS: For detecting osteoporosis using jaw bone density, the area under the ROC curve (A(z)) was 0.705. For separate analysis of mandibular and maxillary films, sensitivity varied from 33.9% to 38.7% and specificity from 83.5% to 85.3% when using a threshold of 4.3 mm Al equivalent. CONCLUSIONS: Density of the premolar region reaches a fair diagnostic accuracy, which might improve when including additional factors in the analysis and refining the densitometric tool.
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| 27. |
- Nicopoulou-Karayianni, Kety, et al.
(författare)
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Tooth loss and osteoporosis : the OSTEODENT Study
- 2009
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 36:3, s. 190-197
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To determine the cross-sectional association of the osteoporotic status of patients with the number of their teeth, with and without taking into account age and/or smoking. MATERIAL & METHODS: At four centres, the study recruited 665 females aged 45-70 years and the number of teeth was counted for 651 subjects. Bone density was measured at the total hip, femoral neck and lumbar spine. RESULTS: The mean number of teeth in the osteoporotic subjects was 3.3 fewer than normal subjects and 2.1 fewer if those with no teeth were excluded. The association between osteoporosis and having 0, three clusters were identified corresponding to different degrees of tooth loss. The overall effect of osteoporosis was as follows: -1.8 teeth before and after adjusting for smoking, -1.2 teeth after adjusting for age, and -1.1 teeth after adjusting for both age and smoking. CONCLUSIONS: We have established a significant association between osteoporosis and tooth loss after adjusting the effect for age and smoking.
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| 28. |
- Rohlin, Madeleine, et al.
(författare)
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Through the quality kaleidoscope : reflections on research in dentomaxillofacial imaging
- 2020
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Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 49:6
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Tidskriftsartikel (refereegranskat)abstract
- The REduce research Waste And Reward Diligence statement has highlighted how weaknesses in health research can produce misleading results and waste valuable resources. Research on diagnostic efficacy in the field of dentomaxillofacial radiology (DMFR) is no exception to these criticisms and could be strengthened by more robust study designs, consistent use of a core set of outcome measures and completeness in reporting. Furthermore, we advocate that everyone participating in collaborative research on clinical interventions subscribes to the importance of methodological quality in how imaging methods are used. The aim of this paper, therefore, is to present a guide to conducting high-quality research on diagnostic efficacy in DMFR.We initially propose a framework inspired by the hierarchical model of efficacy of Fryback and Thornbury, highlighting study designs, measures of analysis, completeness of reporting and established guidelines to assist in these aspects of research. Bias in research, and measures to prevent or limit it, are then described.It is desirable to climb the Fryback and Thornbury "ladder" from technical efficacy, via accuracy and clinical efficacy, to societal efficacy of imaging methods. Efficacy studies on the higher steps of the ladder may be difficult to perform, but we must strive to answer questions of how useful our methods are in patient management and assess benefits, risks, costs, ethical and social issues. With the framework of six efficacy levels as the structure and based on our experience, we present information that may facilitate quality enhancement of diagnostic efficacy research in DMFR.
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| 29. |
- 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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| 30. |
- Verheij, Johannes GC, et al.
(författare)
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Prediction of osteoporosis with dental radiographs and age
- 2009
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Ingår i: Dento-Maxillo-Facial Radiology. - : British Institute of Radiology. - 0250-832X .- 1476-542X. ; 38:7, s. 431-437
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In this study age and the trabecular pattern present on dental radiographs were used to predict the presence of osteoporosis. The objective was to evaluate the contribution of the trabecular pattern to the prediction. METHODS: In this project, 671 women between 45 and 71 years of age were recruited. Medical history was obtained and dental radiographs were made. Bone mineral density (BMD) was measured at three sites to assess the presence of osteoporosis according to the World Health Organization criteria. The radiographs were subjected to image analysis methods yielding measurements of the trabecular pattern. Thereafter, discriminant analysis was used to predict the presence of osteoporosis by means of the trabecular pattern and age. Sensitivity and specificity of age and the trabecular pattern were compared. Also, it was checked whether the inclusion of the trabecular pattern improved the sensitivity and specificity that were obtained when only age was used as the predictor. RESULTS: The sensitivity and specificity of the trabecular pattern present on dental radiographs were almost equal to those of age. However, combining age with the trabecular pattern increased the sensitivity from 0.71 to 0.75 and the specificity from 0.72 to 0.78; the latter increase was statistically significant. CONCLUSIONS: The trabecular pattern predicts the presence of osteoporosis just as well as age does. When combining the trabecular pattern with age, the sensitivity and specificity increased. Only the latter increase was statistically significant.
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| 31. |
- Niemi, MEK, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 32. |
- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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