Comparing the Diagnostic Accuracy of CBCT Grayscale Values with DXA Values for the Detection of Osteoporosis

Mohammed G Sghaireen,Santosh R Patil,Selham Al Habib,Saifulizan Ab Rahman,Kumar Chandan Srivastava,Kiran Kumar Ganji,Mohammad Khursheed Alam,Deepti Shrivastava

doi:10.3390/app10134584

Abstract

Cone beam computed tomography (CBCT) allows for the dimensional evaluation of jaw anatomic structures and the measurement of jawbone mineral density (BMD), to evaluate the relationship between the measured CBCT grayscale (GS) values and (dual X-ray absorptiometry) DXA scores among osteoporotic and normal dental implant participants. In addition, it can help to establish the CBCT GS values in different jaw regions that might indicate or associate osteoporosis. Eighty-one (81) participants (59 females and 22 males) were recruited into this clinical inquiry. Participants’ ages ranged between 36 and 75 years (mean age ± SD: 57.9 ± 9.3 years). The inclusion criteria included patients diagnosed with osteoporosis and were indicated for the dental implant-supported prosthesis.GS values were calculated for each participant using the CBCT radiograph and associated computer software. The average T values obtained from L1, L2, L3 and L4 were recorded and evaluated for one time only, and correlated with CBCT GS values at different jaw positions. Associations between age, gender, GS values, and T values were evaluated by Pearson correlation tests. The GS values at posterior maxilla were able to predict the presence of osteoporosis (P < 0.001, R square = 0.849). On the other hand, attempts to predict T value using GS at different jaw sites showed that GS values at posterior maxilla and anterior mandible were able to predict T value (P < 0.001, R square = 0.924). The CBCT GS values of BMD at different jaw bone regions are significantly related to the DXA T values in the presence of osteoporosis.

Highlights

Osteoporosis is a common disease that affects over two hundred million people worldwide [1].It is associated with bone fractures among men and women, especially hip and vertebral column bone fractures [2]
A stepwise regression analysis was carried out in an attempt to predict the presence of osteoporosis, using GS values at different jaw regions; this revealed that GS values at the posterior maxilla were able to predict the presence of osteoporosis (P < 0.001, R square = 0.849) (Table 6)
It would be useful to use Cone beam computed tomography (CBCT) scans obtained for dental implant purposes for predicting osteoporosis and refer suspected patients for further medical investigations

Summary

Introduction

Osteoporosis is a common disease that affects over two hundred million people worldwide [1] It is associated with bone fractures among men and women, especially hip and vertebral column bone fractures [2]. Dual X-ray absorptiometry(DXA) (previously known as DEXA) is a simple, safe and precise tool that uses two X-ray beams of different energy levels for the identification of peripheral and total body bone mineral density (BMD) [3] This technique attained its popularity and is considered the gold standard paradigm for bone quality and quantity assessment, because it allows high resolution images, precise short time scanning and, stability of calibration [3].

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