Abstract
ObjectiveThis study compared the capabilities of dual-energy X-ray absorptiometry (DXA) and dental cone-beam computed tomography (CBCT) for predicting the cortical bone strength of rat femurs and tibias.Materials and MethodsSpecimens of femurs and tibias obtained from 14 rats were first scanned with DXA to obtain the areal bone mineral density (BMD) of the midshaft cortical portion of the bones. The bones were then scanned using dental CBCT to measure the volumetric cortical bone mineral density (vCtBMD) and the cross-sectional moment of inertia (CSMI) for calculating the bone strength index (BSI). A three-point bending test was conducted to measure the fracture load of each femur and tibia. Bivariate linear Pearson analysis was used to calculate the correlation coefficients (r values) among the CBCT measurements, DXA measurements, and three-point bending parameters.ResultsThe correlation coefficients for the associations of the fracture load with areal BMD (measured using DXA), vCtBMD (measured using CBCT), CSMI (measured using CBCT), and BSI were 0.585 (p = 0.028) and 0.532 (p = 0.050) (for the femur and tibia, respectively), 0.638 (p = 0.014) and 0.762 (p = 0.002), 0.778 (p = 0.001) and 0.792 (p<0.001), and 0.822 (p<0.001) and 0.842 (p<0.001), respectively.ConclusionsCBCT was found to be superior to DXA for predicting cortical bone fracture loads in rat femurs and tibias. The BSI, which is a combined index of densitometric and geometric parameters, was especially useful. Further clinical studies are needed to validate the predictive value of BSI obtained from CBCT and should include testing on human cadaver specimens.
Highlights
The ability to measure bone strength using noninvasive methods is important for evaluating fracture risk according to the severity of osteoporosis [1,2], as well as to the early-stage stabilization of artificial implants after implantation in bone [3,4]
cone-beam computed tomography (CBCT) was found to be superior to dual-energy X-ray absorptiometry (DXA) for predicting cortical bone fracture loads in rat femurs and tibias
Further clinical studies are needed to validate the predictive value of bone strength index (BSI) obtained from CBCT and should include testing on human cadaver specimens
Summary
The ability to measure bone strength using noninvasive methods is important for evaluating fracture risk according to the severity of osteoporosis [1,2], as well as to the early-stage stabilization of artificial implants after implantation in bone (e.g., dental or orthopedic implants) [3,4]. Dual-energy X-ray absorptiometry (DXA) is one of the methods commonly used in the clinical field of orthopedics for evaluating bone mineral content (BMC) and bone mineral density (BMD) [5]. Bone quality cannot be determined using BMD since, in addition to the intrinsic mechanical quality of the bone, geometric characteristics (size, shape, and macroarchitecture) are important attributes influencing the strength of particular bones [9]. BMD obtained using DXA represents two-dimensional (2D) bone-density information that does not provide data regarding the structural stiffness characteristics, which are related to the bone’s shape [6,10]. Micro-CT provides three-dimensional (3D) images of bone architecture and various parameters that influence the strength of trabecular bone (e.g., trabecular bone volume, trabecular number, trabecular separation, trabecular thickness, and structure model index). Siu et al [6] and Moisio et al [10] suggested that bone strength can be predicted more accurately using pQCT than DXA
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
