Using Dental X-rays To Detect Osteoporosis

Researchers in the
Academic Center for Dentistry Amsterdam have created a unique way of
identifying patients at risk of osteoporosis by using ordinary dental
x-rays. Professor Paul F. van der Stelt and his team developed the largely
automated approach to detecting the disease during a three-year, EU-funded
collaboration with the Universities of Manchester, Athens, Leuven, and
Malmo. They will present their findings today during the 85th General
Session of the International Association for Dental Research.


Osteoporosis affects almost 15% of Western women in their fifties, 22%
in their sixties, and 38.5% in their seventies. As many as 70% of women
over 80 are at risk, and the condition carries a high risk of bone
fractures, with over a third of adult women falling victim at least once in
their lifetime. Wide-scale screening for the disease is not currently
viable, largely due to the cost and scarcity of specialist equipment and
staff.



The team has therefore developed an innovative software-based approach
to detecting osteoporosis using routine dental x-rays, by automatically
analyzing specific characteristics of the radiographic trabecular bone
pattern. These features include, among others, the thickness, the amount of
fragmentation, and the main orientation of the structure of the trabecular
bone.



In four clinical centers, 671 women with an average age of 55 years
were recruited. To obtain the "gold standard", the team measured bone
thickness at the femur, hip, and spine, using the technique that is common
for this kind of expensive examination (Bone Mass Density, BMD). In
addition, one panoramic and two intra-oral radiographs were made.



X-rays are used widely in dental practice for several reasons. Using
the image information from these radiographs to detect patients at risk for
osteoporosis involves no extra radiation and almost no extra cost, while
undetected osteoporotic patients can incur bone fractures and suffer from
other problems, reducing the quality of life.



By analyzing a small area depicting the trabecular bone on the ordinary
dental radiographs, dentists can predict the osteoporotic condition of the
patients to the same extent as the BMD measurements.



The image analysis can be automated and does not require extra time on
the part of the dentist. The newly developed technique means that patients
who are identified as being at risk can be referred for more thorough
appropriate examinations.



These findings are published online by the Elsevier journal Bone and
will appear in print soon.



This work was supported by a research and technological development
project grant from the European Commission Fifth Framework Program,
'Quality of Life and Management of Living Resources', QLK6-2002-02243,
'Osteodent'.



This is a summary of an abstract entitled, "Osteoporosis: Sensitivity
and Specificity of Dental Radiographs", by P. van der Stelt et al., of the
Academic Center for Dentistry-Amsterdam, Netherlands, to be presented at
11:30 a.m. on Thursday, March 22, 2007, in Room 387 of the Ernest N. Morial
Convention Center, during the 85th General Session of the International
Association for Dental Research.


International Association for Dental Research

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