Department of Oral Oncology, Oral and Maxillofacial Surgery, Tokyo Dental College, 5-11-13, Sugano, Ichikawa, Chiba, Tokyo, 272-8513, Japan.
Oral Cancer Center, Tokyo Dental College, Chiba, Japan.
Oral Radiol. 2022 Oct;38(4):550-557. doi: 10.1007/s11282-022-00596-0. Epub 2022 Feb 6.
The diagnostic criteria for osteoporosis are based on the bone mineral density (BMD) level in the lumbar spine and femur bone. Patients with osteoporotic fractures were diagnosed with osteoporosis. While systemic BMD and mandibular cortical bone morphology are correlated, this has not been studied in patients with a history of osteoporotic fractures. Therefore, purpose of this study was researching the mandibular cortical bone morphology in patients with osteoporotic fractures.
The subjects were 55 female and 20 male patients with osteoporotic fractures. Patients were divided into 30 primary osteoporosis patients and 45 secondary osteoporosis patients according to the medical history. Patients underwent BMD and panoramic radiography examinations during orthopedic treatment for fractures. A dual-energy X-ray absorptiometry system was used to measure BMD. Mandibular cortex index (MCI) and mandibular cortex width (MCW) were evaluated using machine-learning measurement software.
In the analysis of MCI, the ratio of class 2 and 3 was 73% of both primary osteoporosis and secondary osteoporosis. The average MCW was 2.19 mm for primary osteoporosis and 2.30 mm for secondary osteoporosis. The sensitivity values by MCI and MCW were 73% and 76% for both primary and secondary osteoporosis, which were similar detection powers. In addition, the false-negative rates by MCI and MCW were 27% and 24%.
We suggested that MCI and MCW are indicators of osteoporotic conditions in patients with primary and secondary osteoporosis. Our results show that MCI and MCW are non-inferior to the sensitivity values for lumbar BMD in patients with osteoporotic fractures.
骨质疏松症的诊断标准基于腰椎和股骨的骨密度(BMD)水平。患有骨质疏松性骨折的患者被诊断为骨质疏松症。虽然全身 BMD 和下颌骨皮质骨形态相关,但这在有骨质疏松性骨折病史的患者中尚未得到研究。因此,本研究的目的是研究骨质疏松性骨折患者的下颌骨皮质骨形态。
研究对象为 55 名女性和 20 名男性骨质疏松性骨折患者。根据病史,患者分为原发性骨质疏松症 30 例和继发性骨质疏松症 45 例。在骨折的骨科治疗期间,患者接受了 BMD 和全景放射照相检查。双能 X 射线吸收仪用于测量 BMD。使用机器学习测量软件评估下颌皮质指数(MCI)和下颌皮质宽度(MCW)。
在 MCI 分析中,原发性和继发性骨质疏松症的 2 类和 3 类的比例分别为 73%。原发性骨质疏松症的平均 MCW 为 2.19 毫米,继发性骨质疏松症为 2.30 毫米。MCI 和 MCW 的灵敏度值在原发性和继发性骨质疏松症中分别为 73%和 76%,具有相似的检测能力。此外,MCI 和 MCW 的假阴性率分别为 27%和 24%。
我们认为 MCI 和 MCW 是原发性和继发性骨质疏松症患者骨质疏松状况的指标。我们的结果表明,MCI 和 MCW 在骨质疏松性骨折患者中与腰椎 BMD 的灵敏度值相当。