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Diagnostic efficacy of radiomorphometric indices for predicting osteoporosis in a Norwegian population in the Tromsø Study: Tromsø7

  • Anna Teterina
    Affiliations
    Doctoral Research Fellow, Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, PO Box 6050 Langnes N-9037, Tromsø, Norway
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  • Sanyalak Niratisairak
    Affiliations
    Ph.D., Senior Engineer, Department of Orthopedics, Institute for clinical medicine, Faculty of Medicine, University of Oslo. Department of Orthopaedics, Rikshospitalet, Oslo universitetssykehus HF, Postboks 4950 Nydalen, 0424 Oslo, Norway
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  • Bente Morseth
    Affiliations
    Ph.D., Professor, School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, PO Box 6050 Langnes N-9037, Tromsø, Norway
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  • Napat Bolstad
    Correspondence
    Corresponding author:
    Affiliations
    Associate Professor in Oral and Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, PO Box 6050 Langnes N-9037, Tromsø, Norway
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Published:October 31, 2022DOI:https://doi.org/10.1016/j.oooo.2022.10.039

      Abstract

      Objectives

      : 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 the elderly (≥65 years), and 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 population-based 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 over 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. Addition of FRAX® scores >15% improved accuracy of MCW ≤3 mm (81.7%) and C3 (87.9%) and resulted in high specificity (86.6% and 95.4%). Combining MCW ≤3 mm or C3 with FRAX>15% increased 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 and high accuracy in detecting females without osteoporosis.

      Keywords

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