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Multicenter Study
, 204 (10), E16; discussion 560-1

The Role of the Dental Surgeon in Detecting Osteoporosis: The OSTEODENT Study

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Multicenter Study

The Role of the Dental Surgeon in Detecting Osteoporosis: The OSTEODENT Study

H Devlin et al. Br Dent J.

Abstract

Objective: To determine if thinning (<3 mm width) of the lower cortical border of the mandible on dental panoramic radiographs, as well as other clinical risk factors, may provide a useful diagnostic test for osteoporosis in young postmenopausal women.

Design: Six hundred and fifty-two subjects (age range 45-70 years) were involved in this multi-centre, cross-sectional study.

Setting: Patients were recruited from centres in Leuven (Belgium), Athens (Greece), Manchester (UK), and Malmo (Sweden).

Subjects and methods: The subject's age, body weight, whether the patient took hormone replacement therapy or had a history of low trauma fracture were used to form a clinical osteoporosis risk assessment (the OSteoporosis Index of RISk or OSIRIS index). Each patient also received a dental panoramic radiographic examination.

Results: One hundred and forty subjects had osteoporosis involving at least one of the measurement sites (lumbar spine, femoral neck or total hip). Those with osteoporosis tended to have a low OSIRIS score and a thinned cortical mandibular border. The area under the ROC curve for using both cortical width and OSIRIS to predict osteoporosis was 0.90 (95% CI = 0.87 to 0.92). There was a significant improvement in the diagnostic ability of the combined OSIRIS and cortical width test over both tests applied separately (p <0.001). The cost effectiveness of the cortical width and OSIRIS model was improved by using a high specificity threshold rather than high sensitivity. However, this analysis ignores the costs associated with missed cases of osteoporosis.

Conclusion: Dentists have a role to play in the detection and referral of patients at high risk of osteoporosis.

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