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Diagnostic capabilities of fractal dimension and mandibular cortical width to identify men and women with decreased bone mineral density

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Abstract

Summary

Dental panoramic radiographs could be used to screen for osteopenia. We found the fractal dimension to be a good discriminator of osteopenia in both men and women but that the mandibular cortical width (MCW) did not perform as well in men. The fractal dimension may be a valid screening tool.

Introduction

The aim of this study was to assess the diagnostic capability of the fractal dimension and MCW measured from dental panoramic radiographs in identifying men and women with decreased bone mineral density (BMD).

Methods

The MCW and fractal dimension were measured from dental panoramic radiographs as surrogates for BMD. These measures were then compared to the results from dual-energy X-ray absorptiometry (DXA) performed for clinical purposes. A total of 56 subjects with the panoramic radiograph taken within 6 months of the DXA exam were used in the analysis for this study.

Results

The area under the curve of the fractal dimension for identifying low BMD (T-score <−1.0) was 0.81 (0.67, 0.95) and 0.78 (0.49, 1.00) for men and women, respectively. For the MCW, the area under the curve was found to be 0.53 (0.34, 0.72) and 0.80 (0.58, 1.00) for men and women, respectively.

Conclusions

In this largely male study population, the fractal dimension was found to be a good discriminator of low BMD in both men and women. The MCW did not perform as well in men.

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References

  1. White SC, Taguchi A, Kao D, Wu S, Service SK, Yoon D, Suei Y, Nakamoto T, Tanimoto K (2005) Clinical and panoramic predictors of femur bone mineral density. Osteoporos Int 16(3):339–346. doi:10.1007/s00198-004-1692-4

    Article  PubMed  Google Scholar 

  2. Bollen AM, Taguchi A, Hujoel PP, Hollender LG (2000) Case–control study on self-reported osteoporotic fractures and mandibular cortical bone. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90(4):518–524. doi:10.1067/moe.2000.107802

    Article  PubMed  CAS  Google Scholar 

  3. Klemetti E, Kolmakov S, Heiskanen P, Vainio P, Lassila V (1993) Panoramic mandibular index and bone mineral densities in postmenopausal women. Oral Surg Oral Med Oral Pathol 75(6):774–779

    Article  PubMed  CAS  Google Scholar 

  4. Devlin H, Horner K (2002) Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density. Osteoporos Int 13(5):373–378

    Article  PubMed  CAS  Google Scholar 

  5. Taguchi A, Suei Y, Sanada M, Higashi Y, Ohtsuka M, Nakamoto T, Tsuda M, Ohama K, Tanimoto K (2003) Detection of vascular disease risk in women by panoramic radiography. J Dent Res 82(10):838–843

    Article  PubMed  CAS  Google Scholar 

  6. Horner K, Devlin H, Harvey L (2002) Detecting patients with low skeletal bone mass. J Dent 30(4):171–175. doi:S0300571202000106

    Article  PubMed  Google Scholar 

  7. Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, Kudo Y, Tanimoto K (2006) Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int 17(5):753–759. doi:10.1007/s00198-005-0045-2

    Article  PubMed  CAS  Google Scholar 

  8. Tanaka T, Morimoto Y, Ansai T, Okabe S, Yamada K, Taguchi A, Awano S, Kito S, Takata Y, Takehara T, Ohba T (2006) Can the presence of carotid artery calcification on panoramic radiographs predict the risk of vascular diseases among 80-year-olds? Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101(6):777–783. doi:10.1016/j.tripleo.2005.10.035

    Article  PubMed  Google Scholar 

  9. Okabe S, Morimoto Y, Ansai T, Yoshioka I, Tanaka T, Taguchi A, Kito S, Wakasugi-Sato N, Oda M, Kuroiwa H, Ohba T, Awano S, Takata Y, Takehara T (2008) Assessment of the relationship between the mandibular cortex on panoramic radiographs and the risk of bone fracture and vascular disease in 80-year-olds. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106(3):433–442. doi:10.1016/j.tripleo.2007.09.013

    Article  PubMed  Google Scholar 

  10. Demirbas AK, Ergun S, Guneri P, Aktener BO, Boyacioglu H (2008) Mandibular bone changes in sickle cell anemia: fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106(1):e41–e48. doi:10.1016/j.tripleo.2008.03.007

    Article  PubMed  Google Scholar 

  11. Tosoni GM, Lurie AG, Cowan AE, Burleson JA (2006) Pixel intensity and fractal analyses: detecting osteoporosis in perimenopausal and postmenopausal women by using digital panoramic images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102(2):235–241. doi:10.1016/j.tripleo.2005.08.020

    Article  PubMed  Google Scholar 

  12. Prouteau S, Ducher G, Nanyan P, Lemineur G, Benhamou L, Courteix D (2004) Fractal analysis of bone texture: a screening tool for stress fracture risk? Eur J Clin Invest 34(2):137–142. doi:1300

    Article  PubMed  CAS  Google Scholar 

  13. Law AN, Bollen AM, Chen SK (1996) Detecting osteoporosis using dental radiographs: a comparison of four methods. J Am Dent Assoc 127(12):1734–1742

    PubMed  CAS  Google Scholar 

  14. Southard TE, Southard KA, Lee A (2001) Alveolar process fractal dimension and postcranial bone density. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91(4):486–491. doi:10.1067/moe.2001.112598

    Article  PubMed  CAS  Google Scholar 

  15. Southard TE, Southard KA, Krizan KE, Hillis SL, Haller JW, Keller J, Vannier MW (2000) Mandibular bone density and fractal dimension in rabbits with induced osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 89(2):244–249. doi:10.1067/moe.2000.102223

    Article  PubMed  CAS  Google Scholar 

  16. Taguchi A, Suei Y, Sanada M, Ohtsuka M, Nakamoto T, Sumida H, Ohama K, Tanimoto K (2004) Validation of dental panoramic radiography measures for identifying postmenopausal women with spinal osteoporosis. AJR Am J Roentgenol 183(6):1755–1760. doi:183/6/1755

    PubMed  Google Scholar 

  17. Taguchi A, Tsuda M, Ohtsuka M, Kodama I, Sanada M, Nakamoto T, Inagaki K, Noguchi T, Kudo Y, Suei Y, Tanimoto K, Bollen AM (2006) Use of dental panoramic radiographs in identifying younger postmenopausal women with osteoporosis. Osteoporos Int 17(3):387–394. doi:10.1007/s00198-005-2029-7

    Article  PubMed  Google Scholar 

  18. Lespessailles E, Poupon S, Niamane R, Loiseau-Peres S, Derommelaere G, Harba R, Courteix D, Benhamou CL (2002) Fractal analysis of trabecular bone texture on calcaneus radiographs: effects of age, time since menopause and hormone replacement therapy. Osteoporos Int 13(5):366–372

    Article  PubMed  CAS  Google Scholar 

  19. Cortet B, Dubois P, Boutry N, Palos G, Cotten A, Marchandise X (2002) Computed tomography image analysis of the calcaneus in male osteoporosis. Osteoporos Int 13(1):33–41

    Article  PubMed  CAS  Google Scholar 

  20. Benhamou CL, Poupon S, Lespessailles E, Loiseau S, Jennane R, Siroux V, Ohley W, Pothuaud L (2001) Fractal analysis of radiographic trabecular bone texture and bone mineral density: two complementary parameters related to osteoporotic fractures. J Bone Miner Res 16(4):697–704. doi:10.1359/jbmr.2001.16.4.697

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The work presented in this paper was performed as partial fulfillment of the requirements for the PhD in Epidemiology for the first author, Amy C. Alman. Dr. Alman would like to acknowledge her doctoral committee for their contributions to this work: John E. Hokanson, PhD; mentor, Dennis C. Lezotte, PhD; chair, Lonnie R. Johnson, DDS PhD; David C. Calverley, MD; Gary K. Grunwald, PhD

Conflicts of interest

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Authors and Affiliations

  1. Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, MS F542, 13001 E 17th Ave, Aurora, CO, 80045, USA

    A. C. Alman

  2. Department of Surgical Dentistry, University of Colorado School of Dental Medicine, MS F847, 13065 E. 17th Avenue, Aurora, CO, 80045, USA

    L. R. Johnson

  3. Division of Hematology and Medical Oncology, Oregon Health and Science University, Mail code L586, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    D. C. Calverley

  4. Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, MS B119, 13001 E 17th Ave, Aurora, CO, 80045, USA

    G. K. Grunwald & D. C. Lezotte

  5. Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, MS B119, 13001 E 17th Ave, Aurora, CO, 80045, USA

    J. E. Hokanson

Authors
  1. A. C. Alman
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  2. L. R. Johnson
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  3. D. C. Calverley
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  4. G. K. Grunwald
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  5. D. C. Lezotte
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  6. J. E. Hokanson
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Corresponding author

Correspondence to A. C. Alman.

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Alman, A.C., Johnson, L.R., Calverley, D.C. et al. Diagnostic capabilities of fractal dimension and mandibular cortical width to identify men and women with decreased bone mineral density. Osteoporos Int 23, 1631–1636 (2012). https://doi.org/10.1007/s00198-011-1678-y

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  • DOI: https://doi.org/10.1007/s00198-011-1678-y

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