The relation between bone mineral density in the heel and pixel intensity in the mandibular jaw bone among elderly women

Abstract

Objectives: The purpose of this study was to investigate the correlation between pixel intensity (PI) in digital radiographs of the lower jaw and bone mineral density (BMD) in the heels of post-menopausal women (as measured with DXL, a combination of dual energy Xray absorptiometry and lasers). Methods: Two intraoral periapical digital radiographs were taken in the right and left mandible premolar region, and the digital images were analysed by a computer program (Dimaxis) regarding PI. As the radiographs were taken, the BMD of the patient's left heel was measured via a portable Calscan device. The patient answered a questionnaire concerning risk factors. The correlation between variables was analysed using statistical tests. Results: A significant correlation was found between the PI in the left (P 5 0.001) and right (P 5 0.004) mandible and the BMD of the left heel for the whole group. A pronounced correlation was found to exist for women . 70 years old. Based on a cut-off value of the PI, to differentiate between healthy individuals and those who required further analysis for osteoporosis, the following values were obtained: sensitivity 0.74, specificity 0.50, positive predictive value 0.77 and negative predictive value 0.46. Conclusion: A positive correlation was found between PI in digital radiographs of the mandible and the BMD of the heel. The low predictive value does not allow any definite conclusions to be drawn from the present study. A reasonable recommendation could be for future studies to employ a larger study population to explore the effect on this value.

Digital orthopantomograms in osteoporosis detection: mandibular density and mandibular radiographic indices as skeletal BMD predictors

“…Other investigators also found a correlation between mandibular density and skeletal BMD. [20][21][22] Another interesting finding of our study was that mandibular density showed a significant square trend in relation to age. The density decreased until the age of 54 years and became constant until age of 64 years.…”

Estimating age from digital radiographic images of lumbar vertebrae in a Thai population using an image analysis technique

“…36 Hedström et al found the pixel intensity of mandible radiograph image shows the strongest correlation to BMD in 70-74-year age group. 27 Furthermore, Jonasson et al who investigate alveolar bone mass on digital radiographs using pixel intensity distribution, reported that BMD in women correlated with bone mass by assessing the pixel intensity. 37 In present study, the black pixel values are associated with marrow space of trabecular structure.…”

“…25,26 According to Hedström et al, pixel intensity value in digital mandible radiographs has positive correlation with BMD from the heel. 27 The pixel intensity is a measurement on a grayscale image between zero (black) to 255 (white), it is a useful method to assess bone mass. 28,29 As X-rays pass through the bone, they are influenced by the distribution of the trabeculae structure.…”

IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

“…Although the results of the relevant studies remain contradictory, measuring radiographic density appears to be a promising approach for predicting osteoporosis. Indices using CBCT 35 and periapical radiographs 53 54 for this purpose had the third-highest and the fifth-highest IDIOS scores (10.25 [68.33%] and 9.02 [60.11%], respectively). This approach was not thoroughly evaluated in the literature for panoramic radiography (no study reported the SN and SP of radiographic density assessed using panoramic radiography), hence its IDIOS score was low (1 [6.7%]).…”