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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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All bones comprise an outer layer of compact bone, and an interior made up of spongy bone tissue, also called cancellous or trabecular bone. In long bones, spongy bone tissue is mainly found in the interior of the epiphyses (broad ends of the bone).
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The bones of the human skeletal system are of varied shapes, sizes, and functions. They can be classified based on their shape and function into four major classes: long bones, short bones, flat bones, and irregular bones. Some classifications include a fifth type, the sesamoid bones, as a separate class, whereas others categorize them under short bones.
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Imaging of the Microstructural Failure Mechanism in the Human Hip
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Trabecular bone patterns as a fracture risk predictor: a systematic review.

Astera Johanen1,2, Grethe Jonasson1,3, Henrik Lund4

  • 1Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Acta Odontologica Scandinavica
|March 2, 2021
PubMed
Summary

Dental radiographs may help predict fracture risk in adults without osteoporosis. However, evidence is limited, and predicting osteoporosis itself using these methods remains uncertain.

Keywords:
Cancellous bonedental radiographyosteoporosisskeletal fracturesystematic review

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Area of Science:

  • Dentistry
  • Radiology
  • Osteoporosis Research

Background:

  • Trabecular bone patterns in dental radiographs are being explored as a method for fracture risk prediction.
  • Current diagnostic methods for fracture risk and osteoporosis include Dual X-ray Absorptiometry (DXA) and Fracture Risk Assessment Tool (FRAX).

Purpose of the Study:

  • To systematically review and evaluate the use of trabecular bone patterns in dental radiographs for predicting fracture risk.
  • To compare the efficacy of trabecular bone pattern assessment with existing diagnostic methods for osteoporosis and fracture prediction.

Main Methods:

  • A systematic literature search was conducted following PRISMA guidelines.
  • Studies were included if they analyzed trabecular bone patterns in dental radiographs and compared them with DXA and/or FRAX for fracture prediction or osteoporosis diagnosis.
  • Included studies were assessed for quality using QUADAS-2 and certainty of evidence using GRADE.

Main Results:

  • Three studies met the inclusion criteria out of 2913 articles identified.
  • Two longitudinal cohort studies indicated that sparse trabecular bone patterns on dental radiographs were associated with a significantly higher risk of fracture.
  • A cross-sectional study reported a sensitivity of 0.70 and specificity of 0.69 for digital analysis of trabecular bone patterns in relation to osteoporosis.

Conclusions:

  • Trabecular bone evaluation on dental radiographs shows potential for predicting fractures in adults without a prior osteoporosis diagnosis, though the evidence certainty is low.
  • The certainty of evidence is very low regarding the ability of digital image analyses of trabecular bone to predict osteoporosis.