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

Grethe Jonasson,Azar Hassani-Nejad,Magnus Hakeberg

doi:10.1186/s12903-021-01829-0

Grethe Jonasson, Azar Hassani-Nejad + Show 1 more

Open Access

https://doi.org/10.1186/s12903-021-01829-0

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Abstract

ObjectiveTo investigate the association between mandibular cortex parameters and fracture in a group of 286 men and women, 79–80 years of age.Study designIn 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.ResultsA 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.ConclusionsAmong old women, the cortical parameters were significantly associated with prevalent fracture. In old men, other circumstances may be more important.

Highlights

Osteoporotic fractures are associated with an increased risk of future fractures, a high rate of mortality, and considerable medical costs
The odds ratio (OR) for severely eroded cortex as fracture risk predictor was significant (2.32; 95% CI 1.3–4.2), when the female group was evaluated separately
Among old women, the cortical parameters were significantly associated with prevalent fracture

Summary

Introduction

Osteoporotic fractures are associated with an increased risk of future fractures, a high rate of mortality, and considerable medical costs. Many women and men will suffer fragility fractures that could be prevented if those at risk were identified at an early stage. Bone quality and bone strength are not defined They are dependent on bone mass, structure, size, and microstructural features (e.g., collagen fibres, crystal size), and on bone turnover rate, microdamage and the degree of secondary mineralisation [1]. A T-score less than − 2.5 is the WHO definition of osteoporosis It is closely associated with fragility fractures; 73% of all new fractures the following six years occurred in individuals with normal BMD or osteopenia [2]. Up to 96% of new fragility fractures in the ten-year period occurred in women without osteoporosis at baseline [3]. Other risk variables, with or without BMD, are considered when

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