Gomes C C, de Rezende Barbosa G L, Bello R P, Bóscolo F N, de Almeida S M
Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, 13414-903, São Paulo, Brazil,
Osteoporos Int. 2014 Jul;25(7):1885-90. doi: 10.1007/s00198-014-2696-3. Epub 2014 Mar 28.
Osteoporosis is a degenerative disease that primarily affects postmenopausal women. Based on panoramic radiographs, several assessment methods have been proposed for the diagnosis and evaluation of bone changes and as a predictor of osteoporosis for example the mandibular index.
The purpose of this study is to compare the assessment of mandibular indices on panoramic and cross-sectional images.
Forty-four cone beam computed tomography (CBCT) images from postmenopausal female subjects aged more than 45 years without systemic changes were selected for this study. From those images, cross-sectional and panoramic reconstruction images were assembled into a template for evaluation. The evaluation was conducted by observing the panoramic images and parasagittal sections. The appearance of the inferior cortex of the mandible was classified according to the mandibular index: C1, the endosteal margin of the cortex was even and sharp; C2, the endosteal margin presented semilunar defects or appeared to form endosteal cortical residues; or C3, the cortical layer formed heavy endosteal cortical residues and was clearly porous.
Based on Wilcoxon statistical test (p > 0.01), the data showed no statistically significant difference between the exams.
The mandibular index assigned in tomographic images is comparable to that obtained in panoramic images, indicating a valid use of the index in CBCT images, which can lead to the identification of patients with bone mass loss and a premature referral to further exams and treatment.
骨质疏松症是一种主要影响绝经后女性的退行性疾病。基于全景X线片,已经提出了几种评估方法用于诊断和评估骨质变化以及作为骨质疏松症的预测指标,例如下颌指数。
本研究的目的是比较全景图像和横断面图像上的下颌指数评估。
本研究选取了44例年龄超过45岁、无全身系统性改变的绝经后女性受试者的锥形束计算机断层扫描(CBCT)图像。从这些图像中,将横断面和全景重建图像组合成一个模板进行评估。通过观察全景图像和矢状旁切面进行评估。根据下颌指数对下颌骨下缘皮质的外观进行分类:C1,皮质的骨内膜边缘均匀且锐利;C2,骨内膜边缘呈现半月形缺损或似乎形成骨内膜皮质残留;或C3,皮质层形成大量骨内膜皮质残留且明显多孔。
基于Wilcoxon统计检验(p>0.01),数据显示检查之间无统计学显著差异。
断层图像中分配的下颌指数与全景图像中获得的指数相当,表明该指数在CBCT图像中的有效应用,这可导致识别骨质流失患者并提前转诊进行进一步检查和治疗。