Taguchi Akira, Sanada Mitsuhiro, Krall Elizabeth, Nakamoto Takashi, Ohtsuka Masahiko, Suei Yoshikazu, Tanimoto Keiji, Kodama Ichiro, Tsuda Mikio, Ohama Koso
Department of Oral and Maxillofacial Radiology, Hiroshima University Dental Hospital, Hiroshima, Japan.
J Bone Miner Res. 2003 Sep;18(9):1689-94. doi: 10.1359/jbmr.2003.18.9.1689.
We investigated whether mandibular cortical measures on dental panoramic radiographs are associated with biochemical markers of bone turnover in 82 postmenopausal women. Mandibular cortical shape was significantly associated with biochemical markers and spinal BMD. Our results suggest that dentists may be able to identify postmenopausal women with low BMD by using dental panoramic radiographs.
Recent studies suggest that mandibular inferior cortical shape and width on dental panoramic radiographs may be useful screening tools for low skeletal bone mineral density (BMD) or increased risk of osteoporotic fracture. However, little is known as to whether these measures are associated with bone turnover. We investigated relationships among dental panoramic radiographic findings, spine BMD, and biochemical markers of bone turnover in postmenopausal women.
Of 609 women who visited our clinic for BMD assessment between 1996 and 2002, 82 Japanese postmenopausal women, 46-68 years of age (54.1 +/- 4.9 years), were recruited for this study. Mandibular inferior cortical shape (normal, mild/moderate erosion, severe erosion) and width were evaluated on dental panoramic radiographs. BMD at the lumbar spine (L2-L4) was measured by DXA and categorized as normal (T-score > -1.0), osteopenia (T-score, -1.0 to -2.5), or osteoporosis (T-score < -2.5). Bone turnover was estimated by serum total alkaline phosphatase (ALP) and urinary N-telopeptide cross-links of type I collagen (NTx), corrected for creatinine.
The odds of low spine BMD in subjects with any cortical erosion were 3.8 (95% CI, 1.2-12.5). Mandibular cortical erosion was significantly associated with increased NTx (p < 0.001) and ALP (p < 0.05) levels. The associations of spine BMD with NTx and ALP were similar. Mandibular cortical width was significantly associated with spine BMD but not with NTx and ALP levels.
Our results suggest that mandibular inferior cortical shape on dental panoramic radiographs may be an indicator of bone turnover and spine BMD in postmenopausal women. Dentists may be able to identify postmenopausal women with increased risk of osteopenia and osteoporosis on routine dental panoramic radiographs.
我们调查了82名绝经后女性牙科全景X线片上的下颌骨皮质测量值是否与骨转换的生化标志物相关。下颌骨皮质形态与生化标志物及脊柱骨密度显著相关。我们的研究结果表明，牙医或许能够通过牙科全景X线片识别出骨密度低的绝经后女性。
近期研究表明，牙科全景X线片上的下颌骨下缘皮质形态和宽度可能是筛查低骨骼骨密度（BMD）或骨质疏松性骨折风险增加的有用工具。然而，对于这些测量值是否与骨转换相关却知之甚少。我们调查了绝经后女性牙科全景X线片检查结果、脊柱骨密度和骨转换生化标志物之间的关系。
在1996年至2002年间到我们诊所进行骨密度评估的609名女性中，招募了82名年龄在46 - 68岁（平均54.1±4.9岁）的日本绝经后女性参与本研究。在牙科全景X线片上评估下颌骨下缘皮质形态（正常、轻度/中度侵蚀、重度侵蚀）和宽度。采用双能X线吸收法（DXA）测量腰椎（L2 - L4）的骨密度，并将其分类为正常（T值> -1.0）、骨量减少（T值，-1.0至 -2.5）或骨质疏松（T值< -2.5）。通过血清总碱性磷酸酶（ALP）和经肌酐校正的尿I型胶原N - 端肽交联物（NTx）评估骨转换。
存在任何皮质侵蚀的受试者脊柱骨密度低的几率为3.8（95%置信区间，1.2 - 12.5）。下颌骨皮质侵蚀与NTx水平升高（p < 0.001）和ALP水平升高（p < 0.05）显著相关。脊柱骨密度与NTx和ALP的关联相似。下颌骨皮质宽度与脊柱骨密度显著相关，但与NTx和ALP水平无关。
我们的研究结果表明，牙科全景X线片上的下颌骨下缘皮质形态可能是绝经后女性骨转换和脊柱骨密度的一个指标。牙医或许能够在常规牙科全景X线片上识别出骨量减少和骨质疏松风险增加的绝经后女性。
