The role of the dental surgeon in detecting osteoporosis: the OSTEODENT study

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The role of the dental surgeon in detecting osteoporosis: the OSTEODENT study

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Publication Article, other
Title The role of the dental surgeon in detecting osteoporosis: the OSTEODENT study
Author(s) Devlin, Hugh ; Allen, Philip ; Graham, Jim ; Jacobs, Reinhilde ; Nicopoulou-Karayianni, Katy ; Lindh, Christina ; Marjanovic, Elizabeth ; Adams, Judith ; Pavitt, Susan ; van der Stelt, Paul F ; Horner, Keith
Date 2008
English 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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Host/Issue British dental journal;10
Volume 204
ISSN 0007-0610
Pages E16; discussion 560-1
Language eng (iso)
Subject(s) Medicine
Research Subject Categories::ODONTOLOGY
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