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Osteoporosis detection using intraoral densitometry

¹Oral Imaging Center, Department of Dentistry, Faculty of Medicine, KU Leuven, Belgium; ²School of Dentistry, University of Manchester, UK; ³Leuven University Center for Metabolic Bone Diseases, University Hospital, KU Leuven, Belgium; ⁴Faculty of Odontology, Malmö University, Sweden; ⁵Dental School, University of Athens, Greece; ⁶Academic Centre for Dentistry, Amsterdam, The Netherlands; ⁷Imaging Science and Biomedical Engineering, University of Manchester, UK

*Correspondence to: Reinhilde Jacobs, Oral Imaging Centre, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium; E-mail: reinhilde.jacobs{at}med.kuleuven.be

Received 16 May 2007; revised 18 July 2007; accepted 3 August 2007

Objectives: To determine the diagnostic accuracy of mandibular and maxillary bone density in detecting osteoporosis using receiver operating characteristic (ROC) analysis.

Methods: 671 women between 45 years and 70 years of age underwent dual energy X-ray absorptiometry (DXA) of the hip and lumbar spine. This was the gold standard for diagnosing osteoporosis. Intraoral radiography of the upper and lower right premolar region was performed, using an aluminium wedge as a densitometric reference. Jaw bone density was determined using dedicated software. Observer differences and ROC curves were analysed.

Results: For detecting osteoporosis using jaw bone density, the area under the ROC curve (A_z) was 0.705. For separate analysis of mandibular and maxillary films, sensitivity varied from 33.9% to 38.7% and specificity from 83.5% to 85.3% when using a threshold of 4.3 mm Al equivalent.

Conclusions: Density of the premolar region reaches a fair diagnostic accuracy, which might improve when including additional factors in the analysis and refining the densitometric tool.

Keywords: osteoporosis; jaw bone; densitometry; intraoral radiography