Objective
The aim of this study was to investigate the diagnostic efficacy of the radiomorphometric
indices of mandibular cortical width (MCW) and mandibular cortical index (MCI) of
cortical erosion for osteoporosis screening in adults (≥40 years) and older adults
(≥65 years) to determine whether adding a fracture risk assessment tool (FRAX) would
improve efficacy.
Study Design
One observer measured MCW and assessed MCI on dental panoramic radiographs acquired
for patients in the Tromsø study. These indices, alone and with FRAX scores, were
evaluated for efficacy in predicting osteoporosis, which was diagnosed by bone density
measurement at the femoral necks with dual-energy X-ray absorptiometry.
Results
MCW ≤3 mm and MCI indicating heavily eroded cortices (C3) had accuracies of 68.8%
and 83.6%, respectively, in identifying osteoporosis. In females >65 years, MCW ≤3
mm and C3 produced higher sensitivities but lower specificities, with slightly lower
accuracies (61.4% and 79.8%, respectively) compared with all females. The addition
of FRAX scores >15% improved the accuracy of MCW ≤3 mm (81.7%) and C3 (87.9%), resulting
in high specificity (86.6% and 95.4%). Combining MCW ≤3 mm or C3 with FRAX >15% increased
the probabilities of detecting osteoporosis by increasing positive likelihood ratios.
Conclusions
MCW ≤3 mm or MCI C3, when combined with FRAX >15%, showed superior diagnostic efficacy,
with high specificity in detecting females without osteoporosis.
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Article info
Publication history
Published online: October 31, 2022
Accepted:
October 22,
2022
Received in revised form:
September 22,
2022
Received:
April 8,
2022
Identification
Copyright
© 2022 Published by Elsevier Inc.
