Diagnostic efficacy of radiomorphometric indices for predicting osteoporosis in a Norwegian population in the Tromso Study: Tromso7

Objective. The aim of this study was to investigate the diagnostic efficacy of the radiomorphometric indices of mandibular corti-cal width (MCW) and mandibular cortical index (MCI) of cortical erosion for osteoporosis screening in adults (>40 years) and older adults (>65 years) to determine whether adding a fracture risk assessment tool (FRAX) would improve efficacy. Study Design. One observer measured MCW and assessed MCI on dental panoramic radiographs acquired for patients in the Tromso study. These indices, alone and with FRAX scores, were evaluated for efficacy in predicting osteoporosis, which was diagnosed by bone density measurement at the femoral necks with dual-energy X-ray absorptiometry. Results. MCW <3 mm and MCI indicating heavily eroded cortices (C3) had accuracies of 68.8% and 83.6%, respectively, in identifying osteoporosis. In females >65 years, MCW <3 mm and C3 produced higher sensitivities but lower specificities, with slightly lower accuracies (61.4% and 79.8%, respectively) compared with all females. The addition of FRAX scores >15% improved the accuracy of MCW <3 mm (81.7%) and C3 (87.9%), resulting in high specificity (86.6% and 95.4%). Combining MCW <3 mm or C3 with FRAX >15% increased the probabilities of detecting osteoporosis by increasing positive likelihood ratios. Conclusions. MCW <3 mm or MCI C3, when combined with FRAX >15%, showed superior diagnostic efficacy, with high speci-ficity in detecting females without osteoporosis. (Oral Surg Oral Med Oral Pathol Oral Radiol 2023;135:444-455)

Automated summary

The aim of this study was to investigate the diagnostic efficacy of the radiomorphometric indices of mandibular cortical width (MCW) and mandibular cortical index (MCI) for osteoporosis screening. The results showed that MCW <3 mm and C3 type MCI had accuracies of 68.8% and 83.6% in identifying osteoporosis. The addition of FRAX >15% improved the accuracy of MCW <3 mm and C3 type MCI, resulting in high specificity.