Abstract
OBJECTIVE: to compare assessment of panoramic radiographs using Mandibular Cortical Index (MCI) by a radiologist with experience and two dentists with no experience in this index using original radiograph images and inverted images.METHODS: 64 panoramic radiographs were analyzed by three observers: a radiologist with previous experience in MCI and two trained dentists with no previous experience. First, the original images were assessed by the radiologist and defined as the gold standard. Then, dentists received training in the MCI. Assessment results obtained from the three observers were analyzed.RESULTS: When compared results from the experienced radiologist to positive and inverted images, no statistical significant difference was found. When considering the two trained observers, we found that inverted images had a lower agreement between the gold standard original images.CONCLUSION: We concluded that, within the limitations of this study, inverted radiographs are not recommended for MCI assessment.
Highlights
Systemic osteoporosis is a multi-cause metabolic bone disease characterized by progressive degenerative changes in bone microarchitecture, resulting in a higher fracture risk [1, 2]
Intraobserver reproducibility and interobserver reliability were confirmed for Mandibular Cortical Index (MCI) categorical measurements, using a subsample of 10 panoramic images in original
When comparing results from the experienced radiologist for positive and inverted images, we found no statistical significant difference between the analysis of positive and inverted images in different days, according to KruskalWallis test (p=0.8829)
Summary
Systemic osteoporosis is a multi-cause metabolic bone disease characterized by progressive degenerative changes in bone microarchitecture, resulting in a higher fracture risk [1, 2]. The prevalence of osteoporosis is predicted to rise dramatically with the increase in elderly population [4]; as well as the mortality risk after an osteoporotic fracture [5]. The gold standard method for diagnosing osteoporosis is dual energy X-ray absorptiometry (DXA), which measures bone mineral density (BMD) [6]; access to DXA is not widely available in many countries [7]. Many researchers advocate its use for screening for osteoporosis [4, 8, 15,16,17,18,19,20,21,22,23,24] by the fact that the mandibular cortical bone may reflect changes in bone architecture of other sites from skeleton [4, 12, 15]
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