Dental imaging of trabecular bone structure for systemic disorder screening: A systematic review

The purpose of this systematic review was to evaluate the potential use of dental imaging assessment of trabecular bone structure in the maxillomandibular complex as an adjuvant screening tool to identify systemic disorders. Five electronic databases and grey literature were searched. Studies were included if they investigated subjects with altered trabecular bone determined by dental radiographs. The QUADAS-2 assessed the risk of bias (RoB) among the studies, while the GRADE determined the strength of evidence. A total of 14 studies that included 1,466 individuals were considered eligible for the qualitative analysis. All studies presented an overall low RoB and low concern regarding applicability. Systemic disorders such as osteoporosis, osteogenesis imperfecta, diabetes, and primary hyperparathyroidism, with their respective control groups, were analyzed among the included studies. Osteoporosis was the condition presenting the most significant results, and 72% of the studies detected changes in the maxillomandibular trabecular bone structure. Studies exploring diabetic edentulous patients found less dense trabecular bone pattern (p < 0.05). In summary, periapical and panoramic radiographs, computed tomography, and cone beam computed tomography imaging could be considered useful for the assessment of the mandibular trabecular bone structure of patients affected by osteoporosis and patients with diabetes.