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Latimer JM, Maekawa S, Shiba T, Fretwurst T, Chen M, Larsson L, Sugai JV, Kostenuik P, Mitlak B, Lanske B, Giannobile WV. Healing sequelae following tooth extraction and dental implant placement in an aged, ovariectomy model. JBMR Plus 2024; 8:ziae113. [PMID: 39347482 PMCID: PMC11427826 DOI: 10.1093/jbmrpl/ziae113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/26/2024] [Accepted: 08/29/2024] [Indexed: 10/01/2024] Open
Abstract
At present, a lack of consensus exists regarding the clinical impact of osteoporosis on alveolar bone metabolism during implant osseointegration. While limited preclinical and clinical evidence demonstrates a negative influence of osteoporosis on dental extraction socket healing, no preclinical studies offer data on the results of implant placement in 6-mo-old, ovariectomized (OVX) Sprague-Dawley rats. This study aimed to investigate the outcomes of dental tooth extraction socket healing and implant placement in a rodent model of osteoporosis following daily vehicle (VEH) or abaloparatide (ABL) administration. Micro-CT and histologic analysis demonstrated signs of delayed wound healing, consistent with alveolar osteitis in extraction sockets following 42 d of healing in both the VEH and ABL groups. In a semiquantitative histological analysis, the OVX-ABL group demonstrated a tendency for improved socket regeneration with a 3-fold greater rate for moderate socket healing when compared to the OVX-VEH group (43% vs 14%), however, this finding was not statistically significant (p=.11). No significant differences were observed between vehicle and test groups in terms of implant outcomes (BMD and bone volume/total volume) at 14- and 21-d post-implant placement. Abaloparatide (ABL) significantly increased BMD of the femoral shaft and intact maxillary alveolar bone sites in OVX animals, demonstrating the therapeutic potential for oral hard tissue regeneration. The present model involving estrogen-deficiency-induced bone loss demonstrated an impaired healing response to dental extraction and implant installation.
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Affiliation(s)
- Jessica M Latimer
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Shogo Maekawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Takahiko Shiba
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Tobias Fretwurst
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Oral and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg 79106, Germany
| | - Michael Chen
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
| | - Lena Larsson
- Department of Oral Biochemistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg 413 90, Sweden
| | - James V Sugai
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, United States
| | - Paul Kostenuik
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI 48109, United States
- Phylon Pharma Services, Thousand Oaks, CA 91320, United States
| | - Bruce Mitlak
- Radius Health Inc., Boston, MA 02210, United States
| | - Beate Lanske
- Radius Health Inc., Boston, MA 02210, United States
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, United States
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Suzuki T, Katsumata A, Mastumoto Y, Komatu M, Oomura Y, Okamura M, Mizuno S, Anazawa U, Nomura T. Features of mandibular cortical bone morphology in osteoporotic fracture patients. Oral Radiol 2022; 38:550-557. [PMID: 35124765 DOI: 10.1007/s11282-022-00596-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE The diagnostic criteria for osteoporosis are based on the bone mineral density (BMD) level in the lumbar spine and femur bone. Patients with osteoporotic fractures were diagnosed with osteoporosis. While systemic BMD and mandibular cortical bone morphology are correlated, this has not been studied in patients with a history of osteoporotic fractures. Therefore, purpose of this study was researching the mandibular cortical bone morphology in patients with osteoporotic fractures. METHODS The subjects were 55 female and 20 male patients with osteoporotic fractures. Patients were divided into 30 primary osteoporosis patients and 45 secondary osteoporosis patients according to the medical history. Patients underwent BMD and panoramic radiography examinations during orthopedic treatment for fractures. A dual-energy X-ray absorptiometry system was used to measure BMD. Mandibular cortex index (MCI) and mandibular cortex width (MCW) were evaluated using machine-learning measurement software. RESULTS In the analysis of MCI, the ratio of class 2 and 3 was 73% of both primary osteoporosis and secondary osteoporosis. The average MCW was 2.19 mm for primary osteoporosis and 2.30 mm for secondary osteoporosis. The sensitivity values by MCI and MCW were 73% and 76% for both primary and secondary osteoporosis, which were similar detection powers. In addition, the false-negative rates by MCI and MCW were 27% and 24%. CONCLUSION We suggested that MCI and MCW are indicators of osteoporotic conditions in patients with primary and secondary osteoporosis. Our results show that MCI and MCW are non-inferior to the sensitivity values for lumbar BMD in patients with osteoporotic fractures.
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Affiliation(s)
- Taiki Suzuki
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, Tokyo, 272-8513, Japan. .,Oral Cancer Center, Tokyo Dental College, Chiba, Japan.
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, Gifu, Japan
| | - Yusuke Mastumoto
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, Tokyo, 272-8513, Japan
| | - Masumi Komatu
- Department of Oral Medicine, Hospital Dentistry, Tokyo Dental College, Chiba, Japan
| | - Yusuke Oomura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, Tokyo, 272-8513, Japan
| | - Masahiro Okamura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, Tokyo, 272-8513, Japan
| | - Sakiko Mizuno
- Department of Orthopedic Surgery, Ichikawa General Hospital Tokyo Dental College, Chiba, Japan
| | - Ukei Anazawa
- Department of Orthopedic Surgery, Ichikawa General Hospital Tokyo Dental College, Chiba, Japan
| | - Takeshi Nomura
- Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, Tokyo, 272-8513, Japan.,Oral Cancer Center, Tokyo Dental College, Chiba, Japan
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Jonasson G, Hassani-Nejad A, Hakeberg M. Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women. BMC Oral Health 2021; 21:468. [PMID: 34560860 PMCID: PMC8461912 DOI: 10.1186/s12903-021-01829-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80 years of age. Study design In a cross-sectional study, the mandibular cortex was evaluated with Klemetti’s index for cortical erosion. The cortical thickness was measured with a ruler adjusting for the magnification factor. The odds ratio (OR) for fracture when having a severely eroded cortex or a cortex thickness < 3 mm was calculated. Results A normal cortex was found in 65% of men, whereas only 7% had a severely eroded cortex. The OR for severely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), also when the female group was evaluated separately. A significant difference was found between the mean thickness for men (3.96 mm) and women (2.92 mm), respectively. The OR for cortical thickness < 3 mm was significant (2.00; 95% CI 1.1–3.6) in the total group, but not when men and women were evaluated separately. Conclusions Among old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.
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Affiliation(s)
- Grethe Jonasson
- Department of Behavioral and Community Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Gothenburg, Sweden. .,Research and Development Centre, Sven Eriksonplatsen 4, 50338, Borås, Sweden.
| | - Azar Hassani-Nejad
- Clinic of Oral and Maxillofacial Radiology, Public Dental Service, P.O.Box 7163, SE-402 33SE-402 33163, Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Box 450, 405 30, Gothenburg, Sweden
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Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis. Oral Radiol 2021; 37:189-208. [PMID: 33620644 DOI: 10.1007/s11282-021-00518-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Osteoporotic fractures are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. We undertook a worldwide literature survey and present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. In addition, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. These incidental findings on panoramic radiographs, when used for identifying asymptomatic postmenopausal female patients at risk of having osteoporosis in general dental practice, may be helpful in reducing the incidence of first fractures, with a consequent reduction in the secondary fractures, medical costs, and mortality associated with osteoporotic fragility fractures, without incurring any additional cost.
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Wani IM, Arora S. Computer-aided diagnosis systems for osteoporosis detection: a comprehensive survey. Med Biol Eng Comput 2020; 58:1873-1917. [PMID: 32583141 DOI: 10.1007/s11517-020-02171-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 03/26/2020] [Indexed: 12/18/2022]
Abstract
Computer-aided diagnosis (CAD) has revolutionized the field of medical diagnosis. They assist in improving the treatment potentials and intensify the survival frequency by early diagnosing the diseases in an efficient, timely, and cost-effective way. The automatic segmentation has led the radiologist to successfully segment the region of interest to improve the diagnosis of diseases from medical images which is not so efficiently possible by manual segmentation. The aim of this paper is to survey the vision-based CAD systems especially focusing on the segmentation techniques for the pathological bone disease known as osteoporosis. Osteoporosis is the state of the bones where the mineral density of bones decreases and they become porous, making the bones easily susceptible to fractures by small injury or a fall. The article covers the image acquisition techniques for acquiring the medical images for osteoporosis diagnosis. The article also discusses the advanced machine learning paradigms employed in segmentation for osteoporosis disease. Other image processing steps in osteoporosis like feature extraction and classification are also briefly described. Finally, the paper gives the future directions to improve the osteoporosis diagnosis and presents the proposed architecture. Graphical abstract.
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Affiliation(s)
- Insha Majeed Wani
- School of Computer Science and Engineering, SMVDU, Katra, J&K, India
| | - Sakshi Arora
- School of Computer Science and Engineering, SMVDU, Katra, J&K, India.
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Shen H, Wang S, Zhi Y, Si J, Shi J. Effects of inferior alveolar nerve rupture on bone remodeling of the mandible: A preliminary study. Medicine (Baltimore) 2019; 98:e16897. [PMID: 31464921 PMCID: PMC6736463 DOI: 10.1097/md.0000000000016897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Although various animal studies have indicated that sensory nerves played an important role in bone metabolism and nerve injury could impair the process of bone remodeling, the actual effect of sensory nerve rupture on human bones remains unclear. The aim of this preliminary study was to investigate the effect of inferior alveolar nerve (IAN) rupture on mandibular bone remodeling of patients underwent bilateral sagittal split ramus osteotomy (BSSRO).Ten patients with unilateral IAN rupture during BSSRO were involved in this study. Neurosensory examinations were employed to assess the sensory function of bilateral IAN. The remodeling process of the post-operational mandible was evaluated by panoramic radiographs and computed tomography (CT) scans.Neurosensory examinations indicated that nerve rupture resulted in significant hypoesthesia at the IAN-rupture side. Assessment of panoramic radiographs showed no evident alterations of bone structure at the IAN-rupture side of mandible. Evaluation of CT images also indicated no statistical difference in bone density and thickness between IAN-rupture side and contralateral side.Accordingly, our study indicated that IAN rupture may not significantly impair the short-term bone remodeling process of human mandible.
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Effect of bisphosphonate treatment on the jawbone: an exploratory study using periapical and panoramic radiographic evaluation. Oral Radiol 2018; 35:159-170. [DOI: 10.1007/s11282-018-0358-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/13/2018] [Indexed: 11/30/2022]
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Barngkgei I, Khattab R. Detecting the effect of bisphosphonates during osteoporosis treatment on jawbones using multidetector computed tomography: The
OSTEOSYR
project. ACTA ACUST UNITED AC 2018; 9:e12332. [DOI: 10.1111/jicd.12332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/19/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Imad Barngkgei
- Department of Oral MedicineFaculty of DentistrySyrian Private University Damascus Syria
- Department of Oral MedicineFaculty of DentistryDamascus University Damascus Syria
| | - Razan Khattab
- Department of PeriodontologyFaculty of DentistryDamascus University Damascus Syria
- Department of PeriodontologyFaculty of DentistryAlsham Private University Damascus Syria
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9
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Munhoz L, Aoki EM, Cortes ARG, de Freitas CF, Arita ES. Osteoporotic alterations in a group of different ethnicity Brazilian postmenopausal women: An observational study. Gerodontology 2018; 35:101-109. [PMID: 29380906 DOI: 10.1111/ger.12322] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To compare peripheral bone mineral density alterations among Brazilian postmenopausal women from three ethnic groups considering age and body mass index influence; to correlate their bone mineral density with the mandibular cortical index (MCI); and to evaluate the influence of age, body mass index and ethnicity in the MCI using risk factor analysis. BACKGROUND Osteoporosis risk is known to have ethical influences. However, little is known about the differences in ethnicity in radiomorphometric indices. MATERIALS AND METHODS A total of 150 postmenopausal women with different ethnicities (Caucasian, Asian and Afro-descendant) who underwent peripheral dual X-ray absorptiometry and panoramic examination were included. Bone mineral density and MCI were assessed. Adjusted odds ratio analyses were performed on bone density and MCI considering the effect of age, ethnicity and body mass index. The correlations between the MCI and the dual X-ray absorptiometry results were made. RESULTS Old age, low body mass index and non-Afro-descendant were associated with low bone density. Compared with Afro-descendants, Asians and Caucasians have higher chances of having decreased bone mass. For the MCI, statistical analysis showed that age is the only variable associated with osteoporotic alterations in the mandible. Furthermore, an inverse correlation was found between the MCI and the T-scores. CONCLUSION Bone density is higher in Brazilian Afro-descendant women than in Caucasians and Asians. Patient's age is associated with bone density and the MCI. The mandibular cortical index is inversely correlated with the peripheral densitometry results within the study ethnic population.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Eduardo M Aoki
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Arthur R G Cortes
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cláudio F de Freitas
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Emiko S Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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10
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Jonasson GB, Sundh V, Hakeberg M, Ahlqwist M, Lissner L, Hange D. Evaluation of clinical and radiographic indices as predictors of osteoporotic fractures: a 10-year longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:487-494. [PMID: 29273194 DOI: 10.1016/j.oooo.2017.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 10/23/2017] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate 2 radiographic and 3 clinical indices as predictors of future osteoporotic fractures. STUDY DESIGN 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). RESULTS 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 3 mm, 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. CONCLUSIONS FRAX and severely eroded cortices predicted fracture but cortical thickness, OSIRIS, and OST did not.
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Affiliation(s)
- Grethe B Jonasson
- Department of Behavioral and Community Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Research & Development Unit, Sven Eriksonplatsen 4, Borås, Sweden.
| | - Valter Sundh
- Department of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margareta Ahlqwist
- Department of Oral and Maxillofacial Radiology, Institute of Odontology at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Dominique Hange
- Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Piezoelectric Trapezoidal Osteotomy for the Retrieval of a Displaced Dental Implant in the Osteoporotic Mandibular Body. IMPLANT DENT 2017; 25:703-6. [PMID: 27571351 DOI: 10.1097/id.0000000000000464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A female patient in her mid-seventies was referred to our department for the removal of a displaced implant within the right posterior mandible. A trapezoidal window was made using a piezoelectric device. The implant was extracted, and the osteotomized window was replaced without fixation. Caution should be exercised during implant placement in patients with osteoporosis because of the risk of implant displacement. Displaced implants can be easily retrieved by piezoelectric trapezoidal osteotomy.
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Sundh V, Hange D, Ahlqwist M, Hakeberg M, Lissner L, Jonasson G. FRAX and mandibular sparse trabeculation as fracture predictors: a longitudinal study from 1980 to 2002. Eur J Oral Sci 2017; 125:135-140. [DOI: 10.1111/eos.12341] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Valter Sundh
- Section for Epidemiology and Social Medicine; Institute of Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Primary Health Care Unit; Institute of Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Dominique Hange
- Primary Health Care Unit; Institute of Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Research & Development Unit in Southern Alvsborg County; Boras Sweden
| | - Margareta Ahlqwist
- Department of Oral and Maxillofacial Radiology; Institute of Odontology at the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry; Institute of Odontology at the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine; Institute of Medicine; Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Grethe Jonasson
- Research & Development Unit in Southern Alvsborg County; Boras Sweden
- Department of Behavioral and Community Dentistry; Institute of Odontology at the Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Kavitha MS, Park SY, Heo MS, Chien SI. Distributional Variations in the Quantitative Cortical and Trabecular Bone Radiographic Measurements of Mandible, between Male and Female Populations of Korea, and its Utilization. PLoS One 2016; 11:e0167992. [PMID: 28002443 PMCID: PMC5176279 DOI: 10.1371/journal.pone.0167992] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 11/24/2016] [Indexed: 11/18/2022] Open
Abstract
It is important to investigate the irregularities in aging-associated changes in bone, between men and women for bone strength and osteoporosis. The purpose of this study was to characterize the changes and associations of mandibular cortical and trabecular bone measures of men and women based on age and to the evaluation of cortical shape categories, in a large Korean population. Panoramic radiographs of 1047 subjects (603 women and 444 men) aged between 15 to 90 years were used. Mandibular cortical width (MCW), mandibular cortical index (MCI), and fractal dimensions (FD) of the molar, premolar, and anterior regions of the mandibular trabecular bone were measured. Study subjects were grouped into six 10-years age groups. A local linear regression smoothing with bootstrap resampling for robust fitting of data was used to estimate the relationship between radiographic mandibular variables and age groups as well as genders. The mean age of women (49.56 ± 19.5 years) was significantly higher than that of men (45.57 ± 19.6 years). The MCW of men and women (3.17mm and 2.91mm, respectively, p < 0.0001) was strongly associated with age and MCI. Indeed, trabecular measures also correlated with age in men (r > −0.140, p = 0.003), though not as strongly as in women (r > −0.210, p < 0.0001). In men aged over 55 years, only MCW was significantly associated (r = −0.412, p < 0.0001). Furthermore, by comparison of mandibular variables from different age groups and MCI categories, the results suggest that MCW was detected to be strongly associated in both men and women for the detection of bone strength and osteoporosis. The FD measures revealed relatively higher association with age among women than men, but not as strong as MCW.
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Affiliation(s)
- Muthu Subash Kavitha
- Department of Computer Vision and Image Processing, School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
| | - Soon-Yong Park
- Department of Computer and Robot Vision, School of Computer Science and Engineering, Kyungpook National University, Daegu, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National niversity, Seoul, South Korea
- * E-mail: (MSH); (SIC)
| | - Sung-Il Chien
- Department of Computer Vision and Image Processing, School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
- * E-mail: (MSH); (SIC)
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14
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Barngkgei I, Halboub E, Almashraqi AA, Khattab R, Al Haffar I. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices. Imaging Sci Dent 2016; 46:185-202. [PMID: 27672615 PMCID: PMC5035724 DOI: 10.5624/isd.2016.46.3.185] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 10/13/2015] [Accepted: 12/11/2015] [Indexed: 01/10/2023] Open
Abstract
Purpose The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. Materials and Methods A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. Results The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). Conclusion IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.
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Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria.; Department of Oral Medicine, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abeer Abdulkareem Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Razan Khattab
- Department of Periodontology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
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Factors affecting observer agreement in morphological evaluation of mandibular cortical bone on panoramic radiographs. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0253-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Iwamoto Y, Uchida K, Sugino N, Kuroiwa H, Kitamura Y, Udagawa N, Shinohara A, Higashi Y, Taguchi A. Osteoporosis, osteoporotic fractures, and carotid artery calcification detected on panoramic radiographs in Japanese men and women. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:673-80. [PMID: 27055732 DOI: 10.1016/j.oooo.2016.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 02/01/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We investigated the association among diagnosed osteoporosis, osteoporotic fractures, and carotid artery calcification (CAC) detected on panoramic radiographs. Additionally, we assessed whether osteoporosis or fractures could be predicted by an incidental finding of CAC. STUDY DESIGN One thousand twenty-one patients participated in this study. Patients completed a structured questionnaire. Logistic regression analysis adjusted for covariates was used to calculate the odds ratio (95% confidence interval) for diagnosed osteoporosis or fractures according to the presence of CAC. Extended receiver operating characteristic (ROC) curve analysis was used to clarify whether osteoporosis or fractures were predicted by the detection of CAC. RESULTS The odds ratios for diagnosed osteoporosis or fracture associated with CAC were 1.82 (1.02-3.24) and 0.77 (0.33-1.77), respectively. The areas under the ROC curves for identifying patients with osteoporosis or fractures according to the detection of CAC were 0.54 and 0.50, respectively. CONCLUSIONS CAC may not be useful for identifying Japanese individuals with osteoporosis or those at risk of fracture, although the presence of CAC was significantly associated with a history of diagnosed osteoporosis without osteoporotic fractures.
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Affiliation(s)
- Yae Iwamoto
- Doctoral Student, Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, Nagano, Japan
| | - Keiichi Uchida
- Associate Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Nagano, Japan
| | - Noriyuki Sugino
- Assistant Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Nagano, Japan
| | - Hiroko Kuroiwa
- Assistant Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Nagano, Japan
| | - Yutaka Kitamura
- Director, Center of Oral and Maxillofacial Surgery and Dental Implant, Nagano, Japan
| | - Nobuyuki Udagawa
- Professor and Chair, Department of Biochemistry, School of Dentistry, Matsumoto Dental University, Nagano, Japan
| | - Atsushi Shinohara
- Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Matsumoto Dental University, Nagano, Japan
| | - Yukihito Higashi
- Professor, Department of Regeneration and Medicine, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Professor and Chair, Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Nagano, Japan.
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Ohashi Y, Ariji Y, Katsumata A, Fujita H, Nakayama M, Fukuda M, Nozawa M, Ariji E. Utilization of computer-aided detection system in diagnosing unilateral maxillary sinusitis on panoramic radiographs. Dentomaxillofac Radiol 2016; 45:20150419. [PMID: 26837670 DOI: 10.1259/dmfr.20150419] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES It is unclear whether computer-aided detection (CAD) systems for panoramic radiography can help inexperienced dentists to diagnose maxillary sinusitis. The aim of this study was to clarify whether a CAD system for panoramic radiography can contribute to improved diagnostic performance for maxillary sinusitis by inexperienced dentists. METHODS The panoramic radiographs of 49 patients with maxillary sinusitis and 49 patients with healthy sinuses were evaluated in this study. The diagnostic performance of the CAD system was determined. 12 inexperienced dentists and 4 expert oral and maxillofacial radiologists observed the total of 98 panoramic radiographs and judged the presence or absence of maxillary sinusitis, under conditions with and without the support of the CAD system. The receiver operating characteristic curves of the two groups were compared. RESULTS The CAD system provided sensitivity of 77.6%, specificity of 69.4% and accuracy of 73.5%. The diagnostic performance of the inexperienced dentists increased with the support of the CAD system. When the inexperienced dentists diagnosed maxillary sinusitis with CAD support, the area under the curve (AUC) was significantly higher than that without CAD support. When the focus was only on panoramic radiographs in which CAD support led to a correct diagnosis, the AUC of the inexperienced dentists increased to an equivalent level to that of the experienced radiologists. CONCLUSIONS The CAD system supported the inexperienced dentists in diagnosing maxillary sinusitis on the panoramic radiographs. If the accuracy of the CAD system can be increased, the benefits of CAD support will be further enhanced.
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Affiliation(s)
- Yasufumi Ohashi
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Yoshiko Ariji
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Akitoshi Katsumata
- 2 Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
| | - Hiroshi Fujita
- 3 Department of Intelligent Image Information, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Miwa Nakayama
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Motoki Fukuda
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Michihito Nozawa
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
| | - Eiichiro Ariji
- 1 Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Nagoya, Japan
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Abstract
Osteoporosis is a major health problem affecting one in three women over the age of 50 and may not be detected until fractures occur. Since osteoporotic fractures are a health burden worldwide, identifying subjects with a high risk of osteoporosis and preventing osteoporosis-related mortality and morbidity are a very important health strategy. Women show an estrogen-related bone loss starting at menopause, predominantly occurring in trabecular bone. Diagnosis of osteoporosis is usually based on the bone mineral density measurement, but this is not a practical and economical technique for early detection. Therefore, investigators are interested in the possibility of detecting osteoporosis from the panoramic radiographs. Mandibular cortical bone undergoes resorptive activity in osteoporotic patients, leading to a decreased thickness and more porous inferior border. Therefore, studies have demonstrated the usefulness of cortical width and shape, determined from panoramic radiographs, in identifying elderly individuals with undetected osteoporosis, especially postmenopausal women. In conclusion, postmenopausal women with C3 category, Mental Index (MI) <3 mm, and panoramic mandibular index (PMI) <0.3 may be considered for further osteoporosis investigation.
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Affiliation(s)
- Ayse Gulsahi
- Department of Dentomaxillofacial Radiology, Baskent University, Ankara, Turkey
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Recent developments in metabolic bone diseases: a gnathic perspective. Head Neck Pathol 2014; 8:475-81. [PMID: 25409845 PMCID: PMC4245412 DOI: 10.1007/s12105-014-0580-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/29/2014] [Indexed: 10/24/2022]
Abstract
Metabolic bone diseases often are asymptomatic and progress sub clinically. Many patients present at a late stage with catastrophic skeletal and extra skeletal complications. In this article, we provide an overview of normal bone remodeling and a synopsis of recent developments in the following conditions: osteoporosis, rickets/osteomalacia, endocrine-induced bone disease, chronic kidney disease-mineral bone disorder and Paget's disease of bone. Our discussion will emphasize the clinical and microscopic manifestations of these diseases in the jaws.
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