Search Results (11)

Background/Objectives: Osteogenesis Imperfecta (OI) is a congenital disorder, in which the production of collagen, mainly type I, is altered, leading to a decrease in bone mineral density, increasing the risk of fracture with minimal trauma. Several studies have analyzed bone mineral density in osteoporotic patients based on linear measurements such as radiomorphometric indices measured with panoramic radiographs, although few studies have investigated bone trabeculation in children diagnosed with OI. Therefore, the aim of the present investigation was to analyze the dental panoramic indices in panoramic radiographs in the cortical and trabeculated bone of children with OI. Methods: Thus, 66 pediatric patients diagnosed with OI under antiresorptive treatment were compared with a sample of controls matched for sex and age. Using Image J software (version: 1.54d), three radiomorphometric indices were analyzed in orthopantomographies of the study and control groups, evaluating the influence of disease severity as well as the type of antiresorptive treatment administered. Results: Patients with OI had a higher presence of type C2 and C3 MCI (mandibular cortical index) than their matched controls (p < 0.05), although no differences were found for the visual estimation of cortical width (SVE) and mandibular cortical width (MCW). Treatment with zoledronic acid was associated with a higher number of cases of type C1 MCI, in terms of sample description, while patients treated with a combination of pamidronate and zoledronic acid had a higher rate of type C1 and C2 MCI, with no statistical differences. Conclusions: In the overall sample, most patients showed a thin SVE index (59.1%), a C2 or C1 type MCI (46.2% and 42.4%) and an MCW of 2.9 mm. Differences in bone mineral density were also observed throughout growth and the different antiresorptive treatments. Zoledronic acid has been associated with a higher percentage of C1 and C3 ICM, and pamidronate alone or in combination is associated with a C1 and C2 MCI index. Full article

Background/Objectives: To appraise the mandibular bone structure of patients with rheumatoid arthritis (RA) who were treated with different drugs using fractal dimension (FD) analysis and panoramic radiomorphometric indices and investigate the effects of RA on the jaw bone. Methods: A total of 90 panoramic radiographs were analyzed in this study: 30 were from patients with RA using conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and glucocorticoids, 30 were from patients with RA using tumor necrosis factor-alpha (TNF-α) inhibitors, and 30 were from systemically healthy individuals. In panoramic radiographs, panoramic mandibular index (PMI), mandibular cortical thickness measurements, mandibular cortical index (MCI), and FD analysis taken from four different regions were evaluated. Results: The lowest FD analysis value was observed in patients using csDMARDs and glucocorticoids and in the condyle region (p = 0.001). Although PMI and posterior index (PI) were found to be significantly lower in patients using csDMARDs and glucocorticoids compared with the others (p = 0.001), no significant difference was observed between the groups in terms of anterior index (AI), symphysis index (SI), and molar index (MI) values (p > 0.05). When MCI was analyzed, there was no significant difference between the groups (p > 0.05). Conclusions: It was observed that the trabecular structure in the condyle and posterior region of the mandible was negatively influenced by RA and csDMARD and glucocorticoid drug use. Radiomorphometric indices and FD analysis on panoramic radiographs can be used to evaluate osteoporotic alterations in individuals with RA. These assessments are valuable in predicting the prognosis of conditions such as bone healing after tooth extraction and other surgical procedures and osseointegration after implant surgery. Full article

Background: As implant treatment cases increase, many cases of failure/side effects also occur. Generally, dental clinics determine the density of the jawbone using cone beam CT (CBCT). Considering the known potential role of this tool for bone assessment in primary osteoporosis, this study evaluated patients with secondary endocrine causes of low bone mass. Methods: The study included 83 patients with endocrine causes of osteoporosis who were evaluated by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and mental foramen (MF) region CBCT. The following CBCT indices were measured: anterior (A)—thickness of inferior mandibular cortex 10 mm anterior from MF; molar (M)—thickness of inferior mandibular cortex 10 mm posterior from MF; posterior (P)—thickness of inferior mandibular cortex 25 mm posterior from MF; symphysis (S)—thickness of inferior mandibular cortex equidistant from the centers of right and left MF. Results: The highest correlation coefficient in the secondary causes group was between the A index and the lumbar BMD (r = 0.375, p = 0.001) and the P index and the femoral neck BMD (r = 0.38, p = 0.001). Hypercortisolism seems to be the most predictable cause of secondary osteoporosis using the A, M, and P indices. The A, M, and P indices showed predictive values of the bone micro-architecture that was evaluated using TBS score, and were statistically significant. The symphysis index does not significantly predict osteoporosis or impaired bone micro-architecture. Conclusions: These findings support the potential usefulness of A, M, and P CBCT-derived radiomorphometric mandibular indices in secondary osteoporosis, underlining the well-known effects of these pathologies on bone micro-architecture rather than bone quantity. Full article

Background: The present study examined the potential use of computed tomography radiomorphometric mandibular indices on cone beam CT (CBCT) for the assessment of bone density in postmenopausal women with low bone mass. Methods: We included 104 postmenopausal women who received dual-energy X-ray absorptiometry (DXA) using a DXA scanner and mental foramen (MF) region CBCT using a NewTom VGi EVO Cone Beam 3D system. We assessed the relationships between the following DXA parameters: lumbar, femoral neck, and total hip T-scores, bone mineral density (BMD), lumbar trabecular bone score (TBS), and mandibular inferior cortical bone thickness at 4 sites. The cross-sectional images were obtained, as follows: anterior (A)—10 mm anterior from the MF; molar (M)—10 mm posterior from the MF; posterior (P)—25 mm posterior from the MF; symphysis (S)—equidistant from the centers of the right and left MF. Results: We found that A and M indices showed statistically significant moderate positive correlations with lumbar spine, femoral neck, and total hip BMD, as well as TBS. The P index demonstrated moderate positive correlations with these measurements, while the S index did not show significant correlations with BMD or TBS in postmenopausal women. Conclusions: These findings support the potential usefulness of CBCT-derived radiomorphometric mandibular indices for non-invasive bone health assessment in clinical practice. Full article

This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8–18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner’s classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates’ impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates’ long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer. Full article

Osteogenesis imperfecta is a disorder characterized by osteopenia and bone fragility. Considering that orthopantomography is a routine diagnostic test in growing patients, it can be used to analyze bone density in these patients. The study sample consisted of 21 child patients diagnosed with OI, under medical treatment with antiresorptives and for whom orthopantomography was available, analyzed and compared with 20 healthy children. The panoramic radiographs were analyzed and the radiomorphometric indices and fractal dimension were measured after first selecting the areas of interest to be studied. The results showed that fractal dimension of the basal cortical bone was lower in the study group, and MCW was lower in patients with osteogenesis imperfecta. In addition, MCW and fractal dimension were lower with higher number of treatment cycles received. In light of the results obtained, we can conclude that panoramic radiography can be useful in analyzing changes in bone mineral density in these patients throughout the course of treatment. Full article

This study aimed to assess the relationship between skeletal malocclusion and radiomorphometric indices of the mandible in long face patients. This cross-sectional study evaluated 174 lateral cephalograms and panoramic radiographs of long face patients between the ages of 17 and 30 presenting at the Orthodontics Department of Qazvin Dental School. The gonial angle, antegonial angle, type of antegonial notch, and depth of antegonial notch were measured bilaterally on panoramic radiographs. The correlation between the radiomorphometric parameters and the type of occlusion was analyzed using one-way ANOVA, independent t-test, Chi-square test, and Fisher’s exact test (alpha = 0.05). The mean size of gonial angle was significantly different among the three classes of occlusion (p = 0.046), while the difference was not significant regarding the antegonial angle size and antegonial notch depth (p > 0.05). An independent t-test showed that the mean sizes of gonial angle (p = 0.026) and antegonial angle (p = 0.036), and the antegonial notch depth (p = 0.046) in males, were significantly greater than the values in females. According to the Chi-square and Fisher’s exact test, the right antegonial notch type was significantly different among the three classes of malocclusion (p = 0.006), while this difference was not significant in the left side (p = 0.318). The right antegonial notch type II was more common in males, while the right antegonial notch type I was more common in females (p = 0.014). According to the results, the indices of gonial angle and type of antegonial notch can be clinically useful for predicting the growth rate of the mandible and designing the appropriate treatment in long face patients. Full article

Introduction: Cone-beam computed tomography (CBCT) is widely used in the preoperative qualitative and quantitative assessment of dental implant sites, offering dimensional accuracy, spatial resolution, gray density, and contrast comparable to those of classical CT scan, yet with disputable ability to determine bone mass density. Materials and methods: A systematic review of the literature was performed using the PubMed and SCOPUS databases, with terms referring to low bone mass and cone-beam computed tomography (CBCT). Results: Sixteen studies were included in the review. The results show different perspectives, but the evidence favors the use of CBCT, combined with dual-energy X-ray absorptiometry bone density scan (DXA) evaluation, for the assessment of the osteoporosis status of the aging population and, more specifically, in postmenopausal women. Radiographic density (RD) values of the dens and the left part of the first cervical vertebra show the strongest correlation coefficients and the highest sensitivity, specificity, and accuracy for predicting osteoporosis (OP) in the lumbar vertebrae and the femoral neck. Conclusions: Our review suggests the potential of CBCT as a screening tool for patients with low bone mass using different radiomorphometric indices. Linear measurements of the inferior mandibular cortex were lower in osteoporotic individuals, indicating the perspective of CBCT also as a diagnostic tool for this disease. Full article

Congenital heart disease (CHD) has effects on growth and development. However, information on how the structure of the mandibular bone is affected is limited. In the present study, we aim to compare mandibular bone structures of children affected with CHD and healthy ones through the fractal analysis method and radiomorphometric indices based on panoramic radiographs. The study consisted of 80 children (20 with cyanotic CHD, 20 with acyanotic CHD, 40 control) who were diagnosed with CHD and were treated through interventional therapy or followed up through medical therapy. Fractal dimension (FD) was performed in three different areas (angulus, corpus, and interdental bone) on 80 panoramic radiographs. Additionally, we assessed various radiomorphometric indices: mandibular cortical width (MCW), panoramic mandibular index (PMI), mandibular cortical index (MCI), and simple visual estimation (SVE). p < 0.05 was accepted as statistically significant in the analysis. Values of mean MCW, PMI, MCI, SVE, and FD measurements in children affected with CHD were found to be similar to the control group, regardless of whether they were cyanotic or acyanotic (p > 0.05). In this study, fractal analysis and radiomorphometric indices revealed no trabecular structure and mineral density changes in mandibular bone of children and adolescents with CHD compared to healthy subjects. Full article

Purpose: Biomechanical, densitometric, and histological analyses have been the mainstay for reproducible outcome measures for investigation of new bone formation and osseous healing. Here we report the addition of radiomorphometric vascular analysis as a quantitative measure of vascularity in the murine mandible. To our knowledge this is the first description of using micro–computed tomography (micro-CT) to evaluate the temporal and spatial pattern of angiogenesis in the craniofacial skeleton. Methods: The vessel perfusion technique was performed on 10 Sprague-Dawley rats using Microfil (MV-122, Flow Tech; Carver, MA). After decalcification, hemimandibles were imaged using high-resolution micro-CT. Six separate radiomorphometric vascular metrics were calculated. Results: Radiomorphometric values were analyzed using three different thresholds on micro-CT. Experimentally, 1000 Hounsfield units was found to be the optimal threshold for analysis to capture the maximal vascular content of the bone. Data from seven hemimandibles were analyzed. Minimal statistical variance in each of the quantitative measures of vascularity resulted in reproducible metrics for each of the radiomorphometric parameters. Conclusions: We have demonstrated that micro-CT vascular imaging provides a robust methodology for evaluation of vascular networks in the craniofacial skeleton. This technique provides 3D quantitative data analysis that differs significantly from laser Doppler and microsphere methods, which simply measure flow. This technique is advantageous over labor-intensive 2D conventional analyses using histology and X-ray microangiography. Our data establish the appropriate thresholding for optimal vascular analyses and provide baseline measurements that can be used to analyze the role of angiogenesis in bone regeneration and repair in the craniofacial skeleton. Full article

Objective. The aim of the study was to determine the relationship between bone mineral density in the calcaneus measured using the dual x-ray and laser osteodensitometry technique and bone mineral density in the mandible calculated using the panoramic radiomorphometric indices obtained by applying linear measurements in panoramic radiograms of postmenopausal women.
Material and methods. The participants of this study were postmenopausal women (n=129) aged 50 and more. The subjects underwent panoramic radiography of the mandibles, followed by the calculation of the panoramic radiomorphometric indices indicating bone mineral density of the mandible. The dual x-ray and laser osteodensitometer DXL Calscan were used for the measurements of bone mineral density in the calcaneus. Statistical analysis was preformed to find the relationship between bone mineral density measurements in the two anatomically different bones.
Results. Following the diagnostic criteria for osteoporosis recommended by the World Health Organization (1994), the subjects were distributed according to the calcaneus bone mineral density T-score into the normal bone mineral density (group 1), osteopenia (group 2), and osteoporosis (group 3) groups. Mean bone mineral density in the calcaneus in the general studied population was 0.38±0.07; the mean value of bone mineral density of the calcaneus in the group 1 (n=34) was 0.47±0.04 (g/cm²), in the group 2 (n=65) was 0.37±0.03 (g/cm²), and in the group 2 (n=30) was 0.29±0.03 (g/cm²). Differences in bone mineral density between the groups were determined using the analysis of variance (ANOVA) F=285.31; df=2; P<0.001 (T1 vs. T2, P<0.001; T1 vs. T3, P<0.001; T2 vs. T3; P<0.001). A statistically significant correlation was found in the general group between the mental index and bone mineral density in the calcaneus (r=0.356, P<0.001), and between the panoramic mandibular index and bone mineral density in the calcaneus (r=0.397, P<0.001).
Conclusion. Bone mineral density in the calcaneus and the mandible measured using dual energy x-ray and laser osteodensitometer DXL Calscan and by applying panoramic radiography reflect general changes in the mineralization of these bones, characteristic of the postmenopausal period. Full article