Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis

Taguchi, Akira; Tanaka, Ray; Kakimoto, Naoya; Morimoto, Yasuhiro; Arai, Yoshinori; Hayashi, Takafumi; Kurabayashi, Tohru; Katsumata, Akitoshi; Asaumi, Junichi

doi:10.1007/s11282-021-00518-6

Cited by 37 publications

(24 citation statements)

References 91 publications

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“…The choice between high sensitivity or high specificity will probably depend on the health system in the specific country. Taguchi et al [4] concluded that postmenopausal women with a severely eroded mandibular inferior cortex may have an increased risk of having osteoporosis/fragility fractures. Both Taguchi et al [4] and Devlin et al [38] recommend that only those patients with the thinnest mandibular cortices; i.e., 3 mm or less, should be referred for further osteoporosis investigation.…”

Section: Discussionmentioning

confidence: 99%

“…Taguchi et al [4] concluded that postmenopausal women with a severely eroded mandibular inferior cortex may have an increased risk of having osteoporosis/fragility fractures. Both Taguchi et al [4] and Devlin et al [38] recommend that only those patients with the thinnest mandibular cortices; i.e., 3 mm or less, should be referred for further osteoporosis investigation. In countries like the UK and Sweden, where health care is free or extremely cheap, the workload for primary care is heavy, and a high specificity is thus warranted for dentists involved in identifying individuals at risk, thereby avoiding unnecessary referrals to physicians.…”

Section: Discussionmentioning

confidence: 99%

“…The thickness was measured slightly distally of the mental foramen as a small area (1-3 mm) of the cortex just below the foramen is often clearly thicker than the rest of the distal cortex. This small area corresponds to the phenomenon called trabecular bone tail connected to the cortical bone [4,10].…”

Section: The Mandibular Cortical Index (Mci) and Cortical Thicknessmentioning

confidence: 99%

“…Cortical bone is well presented on panoramic radiographs and trabecular bone better imaged on periapical radiographs. In a new article regarding clinical guidelines for use of panoramic radiographs in screening for osteoporosis, Taguchi et al 2021 stated that postmenopausal women with a severely eroded cortex have an increased risk of having low skeletal BMD, as well as fragility fractures [4], whereas women with a mandibular cortical width of < 3 mm may be at risk of having low skeletal bone mineral density (BMD) but not fragility fractures [4].…”

Section: Introductionmentioning

confidence: 99%

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Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women

2021

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Objective To investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80 years of age. Study design In a cross-sectional study, the mandibular cortex was evaluated with Klemetti’s index for cortical erosion. The cortical thickness was measured with a ruler adjusting for the magnification factor. The odds ratio (OR) for fracture when having a severely eroded cortex or a cortex thickness < 3 mm was calculated. Results A normal cortex was found in 65% of men, whereas only 7% had a severely eroded cortex. The OR for severely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), also when the female group was evaluated separately. A significant difference was found between the mean thickness for men (3.96 mm) and women (2.92 mm), respectively. The OR for cortical thickness < 3 mm was significant (2.00; 95% CI 1.1–3.6) in the total group, but not when men and women were evaluated separately. Conclusions Among old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: The Mandibular Cortical Index (Mci) and Cortical Thicknessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women

2021

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“…Bone loss in the jaw is involved in osteoporosis and may act as a screening predictor for osteoporosis and fracture risk. The mandibular cortical index, mandibular inferior cortical width below the mental foramen, and alveolar trabecular bone pattern of the mandible are useful for screening of low skeletal bone mineral density (BMD) and osteoporosis ( 323 ). The relative risk of future fracture of the sparse trabecular pattern of the mandible is higher than that of cortical erosion in perimenopausal and older women ( 324 ).…”

Section: Inflammasomes In Inflammatory Osteolysis Of the Alveolar Bone And Jawsmentioning

confidence: 99%

Inflammasomes in Alveolar Bone Loss

2021

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Bone remodeling is tightly controlled by osteoclast-mediated bone resorption and osteoblast-mediated bone formation. Fine tuning of the osteoclast–osteoblast balance results in strict synchronization of bone resorption and formation, which maintains structural integrity and bone tissue homeostasis; in contrast, dysregulated bone remodeling may cause pathological osteolysis, in which inflammation plays a vital role in promoting bone destruction. The alveolar bone presents high turnover rate, complex associations with the tooth and periodontium, and susceptibility to oral pathogenic insults and mechanical stress, which enhance its complexity in host defense and bone remodeling. Alveolar bone loss is also involved in systemic bone destruction and is affected by medication or systemic pathological factors. Therefore, it is essential to investigate the osteoimmunological mechanisms involved in the dysregulation of alveolar bone remodeling. The inflammasome is a supramolecular protein complex assembled in response to pattern recognition receptors and damage-associated molecular patterns, leading to the maturation and secretion of pro-inflammatory cytokines and activation of inflammatory responses. Pyroptosis downstream of inflammasome activation also facilitates the clearance of intracellular pathogens and irritants. However, inadequate or excessive activity of the inflammasome may allow for persistent infection and infection spreading or uncontrolled destruction of the alveolar bone, as commonly observed in periodontitis, periapical periodontitis, peri-implantitis, orthodontic tooth movement, medication-related osteonecrosis of the jaw, nonsterile or sterile osteomyelitis of the jaw, and osteoporosis. In this review, we present a framework for understanding the role and mechanism of canonical and noncanonical inflammasomes in the pathogenesis and development of etiologically diverse diseases associated with alveolar bone loss. Inappropriate inflammasome activation may drive alveolar osteolysis by regulating cellular players, including osteoclasts, osteoblasts, osteocytes, periodontal ligament cells, macrophages, monocytes, neutrophils, and adaptive immune cells, such as T helper 17 cells, causing increased osteoclast activity, decreased osteoblast activity, and enhanced periodontium inflammation by creating a pro-inflammatory milieu in a context- and cell type-dependent manner. We also discuss promising therapeutic strategies targeting inappropriate inflammasome activity in the treatment of alveolar bone loss. Novel strategies for inhibiting inflammasome signaling may facilitate the development of versatile drugs that carefully balance the beneficial contributions of inflammasomes to host defense.

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Mandibular cortical morphology in patients with osteoporosis using computer‐aided detection with dental panoramic imaging: A pilot study of the relation to age and bone‐modifying agents

Shirai,

Ogawa,

Kobayashi

et al. 2024

Oral Science International

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AimMandibular cortical morphology with panoramic radiography is considered to be a useful technique for identifying at risk of osteoporosis. The aim of the study was to investigate the mandibular cortical morphology in patients with osteoporosis using computer‐aided detection (CAD) with dental panoramic imaging, especially the relation to age and bone‐modifying agents.MethodsOne hundred and thirteen patients with osteoporosis were underwent panoramic radiography. The mandibular cortical morphology, such as mandibular cortical index (MCI) and degree of deformation of mandibular inferior cortex, was analyzed automatically with a CAD with dental panoramic imaging “PanoSCOPE.” Those were analyzed in relation to age and bone‐modifying agents.ResultsRegarding Class 3 (severely eroded) of the MCI classifications, the frequency in 61–70, 71–80, and 81–90 years were 22.2%, 38.6%, and 26.3%, respectively, and the MCI in bisphosphonate and denosumab were 29.8% and 42.1%, respectively. The degree of deformation in 61–70, 71–80, and 81–90 years were 45.9 ± 22.6, 58.8 ± 20.0, and 52.6 ± 21.5, respectively, and those in bisphosphonate and denosumab were 54.1 ± 20.6 and 57.5 ± 25.0, respectively. The MCI and degree of deformation in patients with osteoporosis were not significant differences for age and bone‐modifying agents.ConclusionThis study suggests that the CAD using PanoSCOPE can perform a quantitative analysis of mandibular cortical morphology in patients with osteoporosis.

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Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis

Cited by 37 publications

References 91 publications

Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women

Mandibular cortical bone structure as risk indicator in fractured and non-fractured 80-year-old men and women

Inflammasomes in Alveolar Bone Loss

Mandibular cortical morphology in patients with osteoporosis using computer‐aided detection with dental panoramic imaging: A pilot study of the relation to age and bone‐modifying agents

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