Use of dental panoramic radiographs in identifying younger postmenopausal women with osteoporosis
Use of dental panoramic radiographs in identifying younger postmenopausal women with osteoporosis
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DOI：
10.1007/s00198-005-2029-7
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发表时间：
2006-03-01
影响因子：
4
通讯作者：
Bollen, AM
中科院分区：
文献类型：
--
作者：
Taguchi, A;Tsuda, M;Bollen, AM
在牙科全景x线片上检测到的下颌骨剥蚀或薄的下皮层可能有助于识别低骨密度（BMD）或骨质疏松症的绝经后妇女。本研究的目的是评估这些全景测量是否有助于识别年龄小于65岁的绝经后妇女的低骨密度或骨质疏松症。方法：对158名年龄在46岁至64岁的日本健康绝经后妇女，比较了全身性测量与骨质疏松自我评估工具（OST）对低骨密度（腰椎或股骨颈T评分为-2.0或以下）和骨质疏松症（T评分为-2.5或以下）的诊断效果。下颌皮质形状（糜烂）和宽度评估牙科全景x线片。采用受试者工作特征曲线分析确定皮质宽度和OST指数的最佳截止阈值。结果：OST指数、皮质宽度、皮质形状鉴别低骨密度女性的敏感性和特异性分别为82.3%和55.2%、79.0%和50.0%、72.6%和74.0%。鉴别骨质疏松女性的OST指数敏感性为86.7%，特异性为46.9%，皮质宽度敏感性为90.0%，特异性为45.3%，皮质形状敏感性为86.7%，特异性为65.6%。薄皮质宽度（< 3.0 mm）鉴别低骨密度女性的似然比为13.90，严重侵蚀皮质的似然比为10.84。识别骨质疏松症的女性，薄皮质宽度为6.40，严重侵蚀皮质为7.11。结论：根据牙科全景x线片的偶然发现，牙医可能会推荐年龄小于65岁的绝经后妇女进行骨密度测定。
Introduction: Eroded or thin inferior cortex of the mandible detected on dental panoramic radiographs may be useful for identifying postmenopausal women with low bone mineral density (BMD) or osteoporosis. The purpose of this study was to evaluate whether these panoramic measurements are useful for identifying low BMD or osteoporosis in postmenopausal women younger than 65 years. Methods: We compared the diagnostic performances of panoramic measurements with those of the osteoporosis self-assessment tool (OST) for identifying women with low BMD (T-score of -2.0 or less at either the lumbar spine or the femoral neck) and osteoporosis (T score of -2.5 or less) in 158 healthy Japanese postmenopausal women aged 46 years to 64 years. Mandibular cortical shape (erosion) and width were evaluated on dental panoramic radiographs. Receiver operating characteristic curve analysis was used to determine the optimal cutoff thresholds for cortical width and OST index. Results: The sensitivity and specificity, respectively, for identifying women with low BMD were 82.3% and 55.2% for OST index, 79.0% and 50.0% for cortical width, and 72.6% and 74.0% for cortical shape. The sensitivity and specificity, respectively, for identifying women with osteoporosis were 86.7% and 46.9% for OST index, 90.0% and 45.3% for cortical width, and 86.7% and 65.6% for cortical shape. Likelihood ratio for identifying women with low BMD was 13.90 for thin cortical width (< 3.0 mm) and 10.84 for severely eroded cortex. That for identifying women with osteoporosis was 6.40 for thin cortical width and 7.11 for severely eroded cortex. Conclusions: Dentists may be able to refer postmenopausal women younger than 65 years for bone densitometry on the basis of incidental findings on dental panoramic radiographs.