Diagnosis of Osteoporosis in Dental Patients

Overview

Journal J Frailty Sarcopenia Falls

Date 2020 Apr 18

PMID 32300679

Citations 9

Authors

Theodora S Tounta

Affiliations

Soon will be listed here.

Abstract

Osteoporosis is a severe skeletal disease that leads to bone fractures, even disability, if it remains undetected. However, osteoporosis remains frequently unnoticed until a fracture occurs. It is possible for dental practitioners to screen patients at risk of osteoporosis and refer them for an osteoporosis evaluation. Screening can be achieved mainly through dental radiographs and especially panoramic x-rays, where several radiographic indices, such as Mandibular Cortical Width (MCW), Mandibular Cortical Index (MCI), Gonial Index (GI), Antigonial Index (AI), Panoramic Mandibular Index (PMI) and alveolar crest resorption degree (M/M ratio) can be assessed. Furthermore, patients with osteoporosis develop changes in the trabecular bone of their jaws and those alternations can be detected by dentists through periapical and panoramic x-rays. Moreover, periodontitis, which is a major reason for tooth loss, deteriorates when the patient also suffers from osteoporosis. Dentists can thus screen their patients who are possibly unaware of their osteoporosis, and refer them further for dual-energy X-ray absorptiometry (DXA) examination. However, all the above indices are merely indicative of low skeletal bone mineral density and the dentist must always take into account the medical history and clinical risk factors of osteoporosis before further referring to an osteoporosis specialist.

Citing Articles

Association Between Mandibular Cortical Erosion and Bone Mineral Density Assessed by Phalangeal Ultrasound and Dual Energy X-Ray Absorptiometry in Spanish Women.

Canal-Macias M, Vera-Rodriguez V, Leal-Hernandez O, Calderon-Garcia J, Roncero-Martin R, Garcia-Blazquez F Diagnostics (Basel). 2025; 15(4).

PMID: 40002658 PMC: 11854751. DOI: 10.3390/diagnostics15040507.

Assessment of the occurrence of apical periodontitis and endodontically treated/non-treated teeth in a Lower Austrian patient population treated for osteoporosis: a cohort study.

Grun P, Meier M, Dittrich J, Gjergjindreaj A, Strobele D, Pfaffeneder-Mantai F Ann Med Surg (Lond). 2024; 86(9):5049-5057.

PMID: 39239028 PMC: 11374243. DOI: 10.1097/MS9.0000000000002443.

Influence of Osteoporosis on the Course of Apical Periodontitis.

Stanev E, Vasileva R Eur J Dent. 2024; 18(4):997-1003.

PMID: 38759999 PMC: 11479746. DOI: 10.1055/s-0044-1785533.

Unraveling the Relationship Between Osteoporosis, Treatment Modalities, and Oral Health: A Comprehensive Review.

Sharma N, Reche A Cureus. 2023; 15(11):e49399.

PMID: 38146583 PMC: 10749737. DOI: 10.7759/cureus.49399.

Cinobufotalin prevents bone loss induced by ovariectomy in mice through the BMPs/SMAD and Wnt/β-catenin signaling pathways.

Lu D, Zeng L, Li Y, Gu R, Hu M, Zhang P Animal Model Exp Med. 2023; 7(3):208-221.

PMID: 38013618 PMC: 11228090. DOI: 10.1002/ame2.12359.

References

Devlin H, Horner K . Diagnosis of osteoporosis in oral health care. J Oral Rehabil. 2008; 35(2):152-7. DOI: 10.1111/j.1365-2842.2007.01791.x. View

Darcey J, Horner K, Walsh T, Southern H, Marjanovic E, Devlin H . Tooth loss and osteoporosis: to assess the association between osteoporosis status and tooth number. Br Dent J. 2013; 214(4):E10. DOI: 10.1038/sj.bdj.2013.165. View

Lopez-Lopez J, Alvarez-Lopez J, Jane-Salas E, Estrugo-Devesa A, Ayuso-Montero R, Velasco-Ortega E . Computer-aided system for morphometric mandibular index computation. (Using dental panoramic radiographs). Med Oral Patol Oral Cir Bucal. 2012; 17(4):e624-32. PMC: 3476026. DOI: 10.4317/medoral.17637. View

Erdogan O, Incki K, Benlidayi M, Seydaoglu G, Kelekci S . Dental and radiographic findings as predictors of osteoporosis in postmenopausal women. Geriatr Gerontol Int. 2009; 9(2):155-64. DOI: 10.1111/j.1447-0594.2009.00518.x. View

Nackaerts O, Jacobs R, Pillen M, Engelen L, Gijbels F, Devlin H . Accuracy and precision of a densitometric tool for jaw bone. Dentomaxillofac Radiol. 2006; 35(4):244-8. DOI: 10.1259/dmfr/71134064. View

Taguchi A, Tanimoto K, Suei Y, Otani K, Wada T . Oral signs as indicators of possible osteoporosis in elderly women. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 80(5):612-6. DOI: 10.1016/s1079-2104(05)80158-1. View

Horner K, Devlin H . The relationship between mandibular bone mineral density and panoramic radiographic measurements. J Dent. 1998; 26(4):337-43. DOI: 10.1016/s0300-5712(97)00020-1. View

Vlasiadis K, Skouteris C, Velegrakis G, Fragouli I, Neratzoulakis J, Damilakis J . Mandibular radiomorphometric measurements as indicators of possible osteoporosis in postmenopausal women. Maturitas. 2007; 58(3):226-35. DOI: 10.1016/j.maturitas.2007.08.014. View

Nackaerts O, Jacobs R, Devlin H, Pavitt S, Bleyen E, Yan B . Osteoporosis detection using intraoral densitometry. Dentomaxillofac Radiol. 2008; 37(5):282-7. DOI: 10.1259/dmfr/30424604. View

10.

Lindh C, Horner K, Jonasson G, Olsson P, Rohlin M, Jacobs R . The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106(2):285-93. DOI: 10.1016/j.tripleo.2007.09.008. View

11.

Geraets W, Verheij J, van der Stelt P, Horner K, Lindh C, Nicopoulou-Karayianni K . Selecting regions of interest on intraoral radiographs for the prediction of bone mineral density. Dentomaxillofac Radiol. 2008; 37(7):375-9. DOI: 10.1259/dmfr/29966973. View

12.

Lopez-Lopez J, Estrugo-Devesa A, Jane-Salas E, Ayuso-Montero R, Gomez-Vaquero C . Early diagnosis of osteoporosis by means of orthopantomograms and oral x-rays: a systematic review. Med Oral Patol Oral Cir Bucal. 2011; 16(7):e905-13. DOI: 10.4317/medoral.17304. View

13.

Taguchi A . Triage screening for osteoporosis in dental clinics using panoramic radiographs. Oral Dis. 2009; 16(4):316-27. DOI: 10.1111/j.1601-0825.2009.01615.x. View

14.

Inagaki K, Kurosu Y, Yoshinari N, Noguchi T, Krall E, Garcia R . Efficacy of periodontal disease and tooth loss to screen for low bone mineral density in Japanese women. Calcif Tissue Int. 2005; 77(1):9-14. DOI: 10.1007/s00223-004-0275-x. View

15.

. Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med. 1991; 90(1):107-10. DOI: 10.1016/0002-9343(91)90512-v. View

16.

Devlin C, Horner K, Devlin H . Variability in measurement of radiomorphometric indices by general dental practitioners. Dentomaxillofac Radiol. 2001; 30(2):120-5. DOI: 10.1038/sj/dmfr/4600594. View

17.

Devlin H, Allen P, Graham J, Jacobs R, Karayianni K, Lindh C . Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis. Bone. 2006; 40(4):835-42. DOI: 10.1016/j.bone.2006.10.024. View

18.

Geraets W, Verheij J, van der Stelt P, Horner K, Lindh C, Nicopoulou-Karayianni K . Osteoporosis and the general dental practitioner: reliability of some digital dental radiological measures. Community Dent Oral Epidemiol. 2007; 35(6):465-71. DOI: 10.1111/j.1600-0528.2006.00357.x. View

19.

Ledgerton D, Horner K, Devlin H, Worthington H . Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol. 2000; 28(3):173-81. DOI: 10.1038/sj/dmfr/4600435. View

20.

Geraets W, Verheij J, van der Stelt P, Horner K, Lindh C, Nicopoulou-Karayianni K . Prediction of bone mineral density with dental radiographs. Bone. 2007; 40(5):1217-21. DOI: 10.1016/j.bone.2007.01.009. View