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Dentomaxillofacial Radiology (2009) 38, 431-437
© 2009 British Institute of Radiology
doi: 10.1259/dmfr/55502190

RESEARCH

Prediction of osteoporosis with dental radiographs and age

JGC Verheij*,1, WGM Geraets1, PF van der Stelt1, K Horner2, C Lindh3, K Nicopoulou-Karayianni4, R Jacobs5, EJ Marjanovic6, JE Adams6 and H Devlin2

1Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands; 2School of Dentistry, University of Manchester, Manchester, UK; 3Department of Oral Radiology, Malmö University, Malmö, Sweden; 4Department of Oral Diagnosis and Radiology, University of Athens, Athens, Greece; 5Oral Imaging Centre, University of Leuven, Leuven, Belgium; 6Department of Imaging Science and Biomedical Engineering, University of Manchester, Manchester, UK

*Correspondence to: JGC Verheij, Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam, Louwesweg 1, 1066 EA Amsterdam The Netherlands; E-mail: H.Verheij{at}acta.nl

Received 13 June 2008; revised 23 September 2008; accepted 6 October 2008

Objectives: In this study age and the trabecular pattern present on dental radiographs were used to predict the presence of osteoporosis. The objective was to evaluate the contribution of the trabecular pattern to the prediction.

Methods: In this project, 671 women between 45 and 71 years of age were recruited. Medical history was obtained and dental radiographs were made. Bone mineral density (BMD) was measured at three sites to assess the presence of osteoporosis according to the World Health Organization criteria. The radiographs were subjected to image analysis methods yielding measurements of the trabecular pattern. Thereafter, discriminant analysis was used to predict the presence of osteoporosis by means of the trabecular pattern and age. Sensitivity and specificity of age and the trabecular pattern were compared. Also, it was checked whether the inclusion of the trabecular pattern improved the sensitivity and specificity that were obtained when only age was used as the predictor.

Results: The sensitivity and specificity of the trabecular pattern present on dental radiographs were almost equal to those of age. However, combining age with the trabecular pattern increased the sensitivity from 0.71 to 0.75 and the specificity from 0.72 to 0.78; the latter increase was statistically significant.

Conclusions: The trabecular pattern predicts the presence of osteoporosis just as well as age does. When combining the trabecular pattern with age, the sensitivity and specificity increased. Only the latter increase was statistically significant.

Keywords: osteoporosis; sensitivity; specificity; trabecular pattern






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