Servicio de Información Comunitario sobre Investigación y Desarrollo - CORDIS

Database of subjectively assessed trabecular pattern from radiographs of study subjects

Intraoral radiographs from the > 600 subjects in the project were used to assess the trabecular pattern. Radiographs from the upper and lower premolar region were used. Reference radiographs were obtained from three patients in the study. These patients were diagnosed as osteoporotic, osteopenic or normal, respectively, from DEXA measurements of the hip and lumbar spine. The reference radiographs were not used for assessments of the trabecular pattern. The trabecular pattern in the radiographs was assessed according to three classes describing the trabecular pattern as dense, heterogeneous or sparse.

Five observers assessed all radiographs and three observers assessed 10% of the radiographs twice. Before the assessments started the observers met for discussion and calibration. Intraobserver agreement calculated as kappa index showed moderate or good agreement while interobserver agreement was fair. The sensitivity for five observers’ assessments of the intraoral radiographs with sparse trabecular pattern as indicative of osteoporosis at either hip or spine varied between 13.2 and 39.1. The specificity varied between 82.4 and 95.6.

Assessment of sparse trabecular pattern on intraoral radiographs offered a combination of low sensitivity but high specificity for osteoporosis diagnosis. If it is assumed that high specificity is preferred for osteoporosis assessment by dentists, then this method may have potential for clinical use, although inter-observer variability may be a problem.

Reported by

Faculty of Odontology, Dept. Oral Radiology
205 06 MALMO
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