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- Bäck, Karin, et al.
(author)
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Occurrence of signs of osteoarthritis/arthrosis in the temporomandibular joint on panoramic radiographs in Swedish women
- 2017
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In: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 45:5, s. 478-484
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Journal article (peer-reviewed)abstract
- Objectives: To determine the prevalence and incidence of radiographic signs of osteoarthritis/osteoarthrosis (OA) in the temporomandibular joint (TMJ) among middle-aged and older women. Methods: Data were collected from ongoing representative, longitudinal and repeated cross-sectional studies in Gothenburg, Sweden. Panoramic radiographs (PAN) have been taken regularly since 1968. The cohorts were systematically selected from the female population at the ages of 38, 50, 62 and 74. Condylar alterations indicative of OA (flattening/osteophyte/erosion) were evaluated in a total of 5234 PANs by one examiner under standardized conditions. Intra-examiner reliability was good. Sensitivity was poor, and specificity was acceptable in relation to computed tomography. Results: The prevalence of signs of OA in the TMJ was 18% on panoramic radiographs at the age of 38, gradually increasing with age. At the age of 62, the prevalence was 38%, and it was stable around 45% in the older age groups. The highest incidence rate of OA was between the ages of 55 and 65. Bilateral OA was uncommon. Flattening was the most prominent finding. Conclusion: The prevalence of signs of OA in the TMJ, including remodeling, evaluated on panoramic radiographs in representative cohorts of women, increases substantially with age. Around one in every five middle-aged women and almost every second woman of older ages can be expected to have some radiographic alteration in the TMJ. The highest proportion with new findings of OA is to be found among older middle-aged women.
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2. |
- Bäck, Karin, et al.
(author)
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Relation between osteoporosis and radiographic and clinical signs of osteoarthritis/arthrosis in the temporomandibular joint: a population-based, cross-sectional study in an older Swedish population.
- 2017
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In: Gerodontology. - : Wiley. - 1741-2358 .- 0734-0664. ; 34:2, s. 187-194
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Journal article (peer-reviewed)abstract
- The aim was to elucidate the relation between osteoporosis and osteoarthritis/arthrosis (OA) in the temporomandibular joint (TMJ).General epidemiological data support the hypothesis that osteoporosis and OA are inversely correlated but is not conclusively investigated in the TMJ.A group of 114 representative elderly women and men, randomised from a comprehensive population study in Gothenburg, Sweden, had bone mineral density established with whole-body, dual-energy X-ray absorptiometry (DXA) as part of a health survey. In addition, dental examinations were performed, including panoramic radiographs exposed as an overview of the TMJ's and jaws. In 88 of the 80-year-old participants (48 women and 40 men), a clinical orofacial examination according to the RDC/TMD system was performed.A diagnosis of osteopenia/osteoporosis was found in 36% of the 114, with a statistically different greater proportion of women. Condylar alterations evaluated from panoramic radiographs were observed in 34%, with no significant gender difference. No significant differences were found in the proportion of individuals with osteopenia/osteoporosis and any condylar radiographic alteration or not. Forty-one of the clinically examined subjects, 47%, fulfilled the criteria for an RDC/TMD diagnosis with no gender difference. All participants graded the orofacial pain as low chronic pain. An opening capacity of <40 mm denoted a higher risk of having pain in the temporomandibular system. No association was found between clinical diagnosis of RDC/TMD and osteopenia/osteoporosis.The prevalence of osteopenia/osteoporosis appears not to be of importance for radiological or clinical findings of OA in the TMJ.
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3. |
- Jonasson, Grethe, 1945, et al.
(author)
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Evaluation of clinical and radiographic indices as predictors of osteoporotic fractures: a 10-year longitudinal study.
- 2018
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In: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier BV. - 2212-4411 .- 2212-4403. ; 125:5, s. 487-494
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Journal article (peer-reviewed)abstract
- The aim of the study was to evaluate 2 radiographic and 3 clinical indices as predictors of future osteoporotic fractures.In a prospective, longitudinal study with a 10-year fracture follow-up, the 2 radiographic indices mandibular cortical erosion (normal, mild/moderate erosion, and severe erosion of the inferior cortex) and cortex thickness were assessed using panoramic radiographs of 411 women, age 62 to 78 years. The clinical indices were the fracture assessment tool FRAX, the osteoporosis index of risk (OSIRIS), and the osteoporosis self-assessment tool (OST).The relative risks (RRs) for future fracture were significant for FRAX greater than 15%, 4.1 (95% confidence interval [CI] 2.4-7.2), and for severely eroded cortices, 1.7 (95% CI 1.1-2.8). Cortical thickness less than 3mm, OSIRIS, and OST were not significant fracture predictors (RR 1.1, 1.4, and 1.5, respectively). For the 5 tested fracture predictors, Fisher's exact test gave the following P values for differences between fracture and nonfracture groups: FRAX <.001, cortical erosion 0.023, OST 0.078, OSIRIS 0.206, and cortical thickness 0.678. The area under the curve was 0.69 for FRAX less than 15%, 0.58 for cortical erosion, and 0.52 for cortical thickness. Adding OSIRIS and OST did not change the area under the curve significantly.FRAX and severely eroded cortices predicted fracture but cortical thickness, OSIRIS, and OST did not.
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4. |
- Jonasson, Grethe, 1945, et al.
(author)
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Marginal bone levels and trabecular bone structure: a longitudinal population study of women
- 2016
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In: Journal of Ageing Research And Healthcare. - : Open Access Pub. - 2474-7785. ; 1:1, s. 31-38
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Journal article (peer-reviewed)abstract
- Bone quality is difficult to assess but the skeletal bone condition is reflected in mandibular trabecular bone, which is well imaged in periapical dental radiographs. The aim of this 12-year prospective cohort study was to test if marginal mandibular bone loss differs in women with varying trabecular bone structure. The sample consisted of 460 women (aged 38, 46, and 54 years) from the prospective population study of women in Gothenburg, Sweden. Marginal bone loss was assessed according to a five-graded scale in two surveys 12 years apart, and the mandibular bone structure was evaluated visually as sparse, mixed, and dense. The results showed that marginal bone loss was significantly correlated to mandibular bone structure (r= 0.20; p<0.001 at baseline, and r= 0.17; p<0.001 after 12 years). Significant differences in marginal bone loss between trabeculation groups were found, with the largest loss in the group with dense trabeculation. Age, smoking, number of missing teeth and trabecular bone structure explained 20-28% of the variation in marginal bone loss. The conclusion was that women with dense trabecular bone in the mandible suffered a stronger periodontal bone destruction when negative events occur, than the women with sparser trabeculation.
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5. |
- Sundh, Valter, 1950, et al.
(author)
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FRAX and mandibular sparse trabeculation as fracture predictors: a longitudinal study from 1980 to 2002.
- 2017
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In: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 125:2, s. 135-140
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Journal article (peer-reviewed)abstract
- The fracture assessment tool (FRAX) is widely used for predicting fractures, but better methods are needed. The aim of this study was to determine whether visual assessments of mandibular trabecular bone could improve FRAX predictions. Three age-cohorts of women were examined twice - 499 women in 1980/1981 and 412 women in 1992/1993; 397 participated in both examinations. Information on 10-yr fracture events was available, and bone trabeculation was assessed in radiographs as 'dense', 'mixed', or 'sparse'. Fracture assessment tool values, without bone mineral density (BMD), were calculated twice. Both sparse trabeculation and FRAX >15% were associated with a twofold higher risk for future fracture in the younger group and with a three- to fourfold higher risk for future fracture in the older group. For those with both FRAX >15% and sparse trabeculation, the relative risk (RR) for a fracture in the next 10yr was 5.9 (95% CI: 3.5-9.8) in the younger group and 22.7 (95% CI: 5.6-92) in the older group. If either FRAX >15% or sparse trabeculation was present, the RR was 2.6 (95% CI: 1.7-4.1) in the younger group and 15.7 (95% CI: 3.9-6.4) in the older group. We concluded that FRAX >15%, without BMD measurements, was an effective fracture predictor, and mandibular sparse trabeculation had a substantial additive effect. Together, FRAX plus mandibular sparse trabeculation predicts major osteoporotic fractures to approximately the same extent as does FRAX with BMD measurements.
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