Quantitative ultrasound of the mandible as a novel screening tool for osteoporosis

Abstract

Osteoporosis is a largely silent disease with many patients only diagnosed when presenting with fragility fractures. There is an increasing body of research examining the use of Quantitative Ultrasound (QUS) for assessing bone strength. QUS avoids the high capital cost and ionising radiation related risks associated with Dual Energy X-ray Absorptiometry (DEXA) scans. QUS devices are portable and relatively easy to use, offering the potential for use across a broader spectrum of health care professionals. There is also limited literature on the effect osteoporosis may have on the facial skeleton and, thus, there is a need to understand the relationship between low bone density and both osteointegration. Female Caucasian subjects (between 22 and 88 years or age) were assessed for osteoporotic status using DEXA and the FRAX® Osteoporosis assessment tool. Axial Transmission QUS was also employed to assess mandible bone speed of sound (SOS). Regression models suggest that increased mandible SOS significantly associated with a decreased odds of having osteoporosis, while accounting for patient age. There was only a moderate correlation found between total hip BMD and mandible SOS. The use of axial transmission mandible QUS as a screening tool for osteoporosis is demonstrated. This is the first study of its kind employing axial transmission QUS to assess mandible bone strength.The involvement of the dental profession in screening for risk factors for osteoporosis could allow access to a patient cohort which may not otherwise be accessed.