Utility of Cone-Beam Computed Tomography in the Detection of Low Bone Mass—A Systematic Review
Abstract
1. Introduction
2. Materials and Methods
2.1. Inclusion Criteria
2.2. Exclusion Criteria
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Nr. Crt | Study Details | Year | No. Pax. | Sex | Type of Patients | Measurement (Quantified) | Relevant Findings | Limitations |
---|---|---|---|---|---|---|---|---|
1. | (Bilgili and Üçok, 2023) [14] | 2023 | 18/27 | W | OP/Normal | Microstructural parameters of trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp), and volume fraction (bone volume/total volume, BV/TV) | Trabecular spacing was higher in OP compared to the control (p = 0.004). Tb.Th and BV/TV values were higher in the control group. | Low number of patients; BV/TV and Tb.Th correlations in OP versus the control group are not statistically significant. |
2. | (Carvalho et al., 2022) [1] | 2022 | 103 | W | Normal/OP | FD values of the second vertebra and mandible | Different FD values between women with normal BMD and those with osteoporosis at mandibular sites, but with low accuracy and reliability (AUC of 0.644). | FD measurements were performed on a 2-dimensional reconstruction. |
3. | (Barra et al., 2021) [17] | 2020 | 48 | W | Normal/ osteopenia/OP | Symphysis (S) cross-sectional image equidistant from the centers of the right and left mental foramina (MF); anterior (A): 10 mm anterior to the MF; molar (M): 10 mm posterior to the MF; and posterior (P): 25 mm posterior to the MF | All indexes were lower in OP/osteopenia compared to patients with normal BMD (p < 0.001). | Low specificity (37.5%), high sensitivity. |
4. | (de Castro et al., 2020) [2] | 2020 | 52/51 | W | Normal BMD/OP | Mandibular cortical width (MCW) | Postmenopausal women with osteoporosis were 8 times more likely to have the cortex classified as C3, and 2.4 times more likely to have MCW thinner than 2.75 mm. | Reliability of the qualitative index, low reproducibility. Moderate intraobserver agreement (kappa = 0.6), moderate interobserver agreement for the qualitative analysis (kappa = 0.4). |
5. | (Shokri et al., 2019) [18] | 2019 | 61 | W | N/osteopenia/OP | CBCT GV of the maxilla | The clear definition of the cut-off points of GV for different parts of the jaw; significant correlations were found between the T-scores of the femoral neck and the GV of cancellous bone (p = 0.042) and those of cancellous and cortical bones (p = 0.045) segments at the site of the maxillary incisors, the cancellous and cortical bone segments at the site of the maxillary premolars (p = 0.043), and the cancellous bone segment (p = 0.003) and the cancellous and cortical bone segments (p = 0.001) at the maxillary tuberosity. Significant correlations were found between the T-scores of the lumbar spine and the GV of the cancellous bone segment of maxillary incisors (p = 0.046) and the cancellous bone segment (p = 0.008) and the cancellous and cortical bone segments (p = 0.003) at the maxillary tuberosity. Excellent predictive value of the variables. | Calculating the RD as gray (voxel) values; densities of different parts of the mandible were not correlated with DXA bone density; the osteoporotic group also included an osteopenia group. |
6. | (Albayati, Saliem and Al Nakib, 2018) [19] | 2018 | 60 | W | Normal BMD/OP | Posterior mandibular first molar radiographic density (RD) and alveolar bone height | RD in the posterior mandible first molar area is significantly affected in OP patients; this can be used as a predictor for the presence of OP using CBCT. | Patients with osteopenia were included in the control group; patients were not divided by their dental condition |
7. | (Kato et al., 2019) [20] | 2018 | 54 | W | Normal/low BMD | Mandibular bone cortex | The panoramic reconstruction of CBCT with 25 mm slice thickness seems to be the most accurate with a Sn of 52.6% and Sp of 62.5% and AUC of 57.6%. | Low sensitivity and specificity. |
8. | (Brasileiro et al., 2017) [21] | 2017 | 60 | W | Normal/osteopenia/OP | CTI, CTMI | Mean values of CTMI, CTI (S), and CTI (I) were lower in the osteoporosis group than in osteopenia and normal patients (p < 0.05). | No statistically significant difference in CTI (I) between normal BMD and osteopenia group. |
9. | (Barngkgei et al., 2016) [22] | 2016 | 38 | W | Normal BMD/OP | Trabecular bone structure: trabecular thickness (Tb.Th), trabecular separation (Tb.S), bone volume fraction (BS/TV), specific bone surface (BS/TV), and connective density | The first study to evaluate TBS, Tb.Th and BS/TV of the dens, with high accuracy in predicting osteoporosis (p = 0.014); Relatively large voxel size. | No statistically significant in almost all jaw-bone variables. |
10. | (Güngör, Yildirim and Çevik, 2016) [23] | 2016 | 90 | W, M | Normal/osteopenia/OP | CTI (S), CTI (I), CTMI, CT values, FD, HA | OP caused significant changes in radio morphometric indexes and CT values in the jaw bones; left maxilla FD measurements in osteoporosis patients were significantly lower than in the control (p ≤ 0.05) and osteopenia (p ≤ 0.05) groups; HA measurements from left maxilla, left & right mandible significantly lower in the OP group. | No significant differences In the index measurements in the osteopenia and control group; a correlation only of CTMI index with the BMD of the femoral head. |
11. | (Mostafa, Arnout and Abo El-Fotouh, 2016) [11] | 2016 | 50 | W | Normal BMD/OP | CTI, CTMI, CTCI, FD | Positive correlation between CTMI and CTI with lumbar spine BMD ensured by DXA (p < 0.001); significant negative correlation between CTCI scores and BMD of the lumbar spine. | Only normal BMD and OP patients were included (no evaluation of osteopenia). |
12. | (Geibel, Löffler and Kildal, 2016) [24] | 2016 | 16 | W, M | Normal BMD/OP | CTI (computed tomography mandibular index, S-superior, I-inferior), CTMI (computed tomography mental index) | CTMI values located < 3.0 mm (80% sensitivity and 57.1% specificity) can be suggestive of OP for the female subject group. | Low number of patients; low specificity; only 6 patients with osteoporosis; CBCT was up to 2 years older than DXA measurements. |
13. | (Barngkgei, Joury and Jawad, 2015) [25] | 2015 | 38 | W | Normal BMD/OP | RD values of the first and second vertebrae | RD values of the dens and the left part of the first cervical vertebra showed the strongest correlation coefficients (r = 0.7, 0.6; p < 0.001) and the highest sensitivity (76.9%, 70%), specificity (92%, 92.9%), and accuracy (90.8%, 86.4%) in predicting OP in the lumbar vertebrae and the femoral neck; the cervical vertebrae RD values are more strongly correlated with lumbar and femoral neck T-scores. | RD calculated as gray (voxel) values. |
14. | (Springe et al., 2014) [26] | 2014 | 45 | W | N/osteopenia/OP | Mandibular residual ridge (height, width) | The statistically significant relationship between BMD and two width measurements performed in the midline edentulous women. | No statistically significant relationship |
15. | (Barngkgei, Al Haffar and Khattab, 2014) [27] | 2014 | 38 | W | Normal BMD/OP | RD of the mandible | Lumbar vertebrae and femoral neck OP can be predicted with high accuracy from the RD value of the body of the mandible by using CBCT. | Calculating the RD as gray (voxel) values, the cervical vertebrae RD values are more strongly correlated with lumbar and femoral neck T-scores. |
16. | (Koh and Kim, 2011) [28] | 2011 | 42 | W | Normal BMD/OP | CTI (S), CTI (I), CTMI, CTCI | CTI (S) and CTI (I) were significantly different between the normal and osteoporotic groups (p < 0.05). | No correlation between the intra-observer agreement regarding CTMI. |
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Poiana, I.R.; Dobre, R.; Popescu, R.-I.; Pituru, S.-M.; Bucur, A. Utility of Cone-Beam Computed Tomography in the Detection of Low Bone Mass—A Systematic Review. J. Clin. Med. 2023, 12, 5890. https://doi.org/10.3390/jcm12185890
Poiana IR, Dobre R, Popescu R-I, Pituru S-M, Bucur A. Utility of Cone-Beam Computed Tomography in the Detection of Low Bone Mass—A Systematic Review. Journal of Clinical Medicine. 2023; 12(18):5890. https://doi.org/10.3390/jcm12185890
Chicago/Turabian StylePoiana, Ioana Ruxandra, Ramona Dobre, Razvan-Ionut Popescu, Silviu-Mirel Pituru, and Alexandru Bucur. 2023. "Utility of Cone-Beam Computed Tomography in the Detection of Low Bone Mass—A Systematic Review" Journal of Clinical Medicine 12, no. 18: 5890. https://doi.org/10.3390/jcm12185890
APA StylePoiana, I. R., Dobre, R., Popescu, R.-I., Pituru, S.-M., & Bucur, A. (2023). Utility of Cone-Beam Computed Tomography in the Detection of Low Bone Mass—A Systematic Review. Journal of Clinical Medicine, 12(18), 5890. https://doi.org/10.3390/jcm12185890