Oral radiographic predictors of osteoporosis

Osteoporosis is a systemic skeletal disease characterized by low bone mass and micro architectural deterioration of the bone scaffold that result in increased bone fragility and susceptibility to fracture. It is one of the most common disorders of the elderly and is estimated to effect 75 million people in Europe, Japan and the USA. The purpose of screening for osteoporosis is to identify individuals who are likely to benefit from treatment. The fact that dental radiographs are regularly made on a large fraction of the adult population makes their potential use as a marker of skeletal health an exciting avenue of research. In the last four decades numerous research teams have reported oral radiographic findings associated with osteoporosis. The preponderance of the evidence shows that the jaws of subjects with osteoporosis show reduced bone mass and altered morphology. Clinically useful predictions of individuals most likely to develop osteoporotic fractures will require a multifactorial model including both radiographic and clinical findings. Future efforts should continue to search for oral radiographic signs with high sensitivity and specificity for osteoporosis, identify clinical signs available in the dental office associated with osteoporosis, develop multidisciplinary classification methods including both radiographic and clinical parameters, and automate radiographic and clinical analyses as much as possible to minimize the involvement of the dentist as well as to standardize data collection.