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The diagnostic validity of dental radiography techniques for identifying osteoporotic patients (OSTEODENT)

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Spongy bones diagnosis more accessible

Osteoporosis is a chronic, yet in most cases, curable and preventable condition which often manifests itself at a later stage as a fracture. As a novel means of early diagnosis, researchers have measured bone porosity in the jawbone and compiled a database.

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Osteoporosis is a bone disease in which the amount of bone mineral density (BMD) is decreased and the structural integrity of trabecular bone is impaired. Trabecular bone is the low density, low strength bone that forms the core of long bones. The high-density cortical bone also becomes more porous and thinner. This makes the bone weaker and more likely to fracture. In the EU alone, osteoporosis patients account for some half a million hospital days each year, a figure that could double during the next 50 years. Despite these grim statistics, osteoporosis is a condition that remains largely undiagnosed in much of the population. Early diagnosis and therapy can mean that many of the serious repercussions of the condition can be avoided. Methods to identify the onset of the disease included dual-energy X-ray absorptiometry which scans the entire body, quantitative computed tomography for hip and spine and peripheral bone density testing for heel or hand. For a variety of reasons, access to these can be limited. Project partners in the European consortium OSTEODENT, aware that dental radiography is more accessible, investigated this as a means of diagnosis. At the University of Manchester, the project team compiled a database of the results. Female subjects ranged from 45 to 70 years of age and were selected from four European centres. Dental Panoramic Radiographs were examined by a team of oral radiologists who made measurements of a section of the width of the lower border of the jaw cortex. They also estimated the porosity of the cortex using the Klemetti index. Statistical reliability of the data was assessed on the basis of repeatability made by any pair of observers. Results showed that around 20% of the subjects had osteoporosis. An added bonus of this means of diagnosis is that it can also be used as an indication of the suitability of the bone quality for implant planning. Potential applications include use of the database as a foundation for further research into this often curable and unnecessary source of suffering. The dental industry is the other obvious beneficiary.

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