Assessment of jawbone trabecular bone structure amongst osteoporotic women by cone-beam computed tomography: the OSTEOSYR project

J Investig Clin Dent. 2016 Nov;7(4):332-340. doi: 10.1111/jicd.12170. Epub 2015 Jun 19.

Abstract

Objective: To assess the trabecular bone structure of jawbones and the dens (the odontoid process of the second cervical vertebra) amongst osteoporotic and nonosteoporotic women using cone-beam computed tomography (CBCT). Analysis of the dens trabecular bone structure aimed to test the validity of CBCT in such analysis.

Methods: Thirty-eight women who went under dual-energy X-ray absorptiometry (DXA) examination were scanned by CBCT. Cuboids from different areas of jawbones and the dens were extracted from each scan. Trabecular thickness (Tb.Th), trabecular separation (Tb.S), bone volume fraction (BV/TV), specific bone surface (BS/TV) and connectivity density were calculated. Student's t-test, Pearson correlation, and logistic regression analysis were used to explore differences in these measures between groups.

Results: Jawbone-derived measures showed insignificant differences (P > 0.05) between osteoporotic and non-osteoporotic groups, and weak correlations with femoral neck and lumbar vertebrae T-scores (r ≤ 0.4). Dens-derived measures, however, resulted in the opposite (r = 0.34-0.38 [P value = 0.02-0.036] and r = 0.48-0.61 [P value ≤ 0.003]) and the highest accuracy of osteoporosis prediction: 84.2% and 78.9% respectively.

Conclusion: Trabecular bone structure of the mandible and maxilla is not affected in osteoporosis as assessed by CBCT. Dens trabecular bone analysis revealed the opposite, so some trabecular bone measures may be assessed by CBCT, which may aid in predicting osteoporosis.

Keywords: DXA scan; cone beam CT; mandible; osteoporosis; postmenopause.

MeSH terms

  • Absorptiometry, Photon / methods
  • Aged
  • Bone Density
  • Cancellous Bone / anatomy & histology*
  • Cancellous Bone / diagnostic imaging*
  • Cancellous Bone / pathology
  • Computer-Aided Design
  • Cone-Beam Computed Tomography / methods
  • Cone-Beam Computed Tomography / statistics & numerical data*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Imaging, Three-Dimensional
  • Jaw / anatomy & histology*
  • Jaw / diagnostic imaging*
  • Jaw / pathology
  • Logistic Models
  • Lumbar Vertebrae / anatomy & histology
  • Mandible
  • Maxilla
  • Middle Aged
  • Osteoporosis / complications*
  • Tomography, X-Ray Computed / methods