Khojastehpour L, Afsa M, Dabbaghmanesh M H
Department of Maxillofacial Radiology, Dental School, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran Red Crescent Med J. 2011 Mar;13(3):181-6. Epub 2011 Mar 1.
In osteoporotic patients, inferior mandibular cortex undergoes resorption which its manifestations can be detected on dental panoramic radiographs as a simple and available method. The aim of this study was to evaluate the correlation between width and morphology of mandibular inferior cortex in digital panoramic radiography and postmenopausal osteoporosis.
Bone mineral density (BMD) of lumbar vertebrae and femural neck of 119 postmenopause women was assessed using DXA. Width [cortical index (CI)] and morphology [mandibular cortical index (MCI)] of inferior mandibular cortex were measured and the correlations between BMD and width and shape of the inferior mandibular cortex were evaluated.
The specificity and sensitivity in identifying women with low BMD of lumbar vertebrae by visual cortical estimation (normal or eroded) were 69.4% and 80.7% respectively. These results in identifying women with low BMD of femural neck were 67.7% and 81.5% respectively. For both sides, the threshold value that provided the highest validity (minimal false negative and false positive results) corresponded to cortical width of 4.29 mm. This threshold in lumbar vertebrae or femural neck provided a sensitivity of 81.4% (95% CI=69.1%-90.3%), specificity of 58.3% (95% CI=44.9%-70.9%), positive predictive value of 65.8% and likelihood ratio of 1.95. There were significant associations between BMD and CI and MCI.
Postmenopausal women with thin or eroded mandibular inferior cortex may have an increased risk for low BMD or osteoporosis.
在骨质疏松患者中，下颌骨下缘皮质会发生吸收，其表现可通过口腔全景X线片检测出来，这是一种简单且可行的方法。本研究的目的是评估数字化全景X线片中下颌骨下缘皮质的宽度和形态与绝经后骨质疏松之间的相关性。
采用双能X线吸收法（DXA）评估119名绝经后女性的腰椎和股骨颈骨密度。测量下颌骨下缘皮质的宽度[皮质指数（CI）]和形态[下颌骨皮质指数（MCI）]，并评估骨密度与下颌骨下缘皮质宽度和形态之间的相关性。
通过视觉皮质评估（正常或侵蚀）识别腰椎骨密度低的女性的特异性和敏感性分别为69.4%和80.7%。识别股骨颈骨密度低的女性的这些结果分别为67.7%和81.5%。对于双侧，提供最高有效性（最小假阴性和假阳性结果）的阈值对应于皮质宽度4.29mm。腰椎或股骨颈的这个阈值提供了81.4%（95%CI=69.1%-90.3%）的敏感性、58.3%（95%CI=44.9%-70.9%）的特异性、65.8%的阳性预测值和1.95的似然比。骨密度与CI和MCI之间存在显著关联。
下颌骨下缘皮质薄或有侵蚀的绝经后女性可能有较低骨密度或骨质疏松的风险增加。
