ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Cone Beam Computed Tomography Can be Used as an Auxiliary Diagnostic Tool for Osteoporosis
Clinical Question Can cone beam computed tomography be considered a helpful tool in predicting osteoporosis?
Clinical Bottom Line Cone beam computed tomography imaging is a promising technique to predict osteoporosis. For patients who have osteoporosis, CBCT radiodensity can be a predictor of low bone mineral density (BMD). Dentists can use this as a tool to help in early diagnosis and referral of the patient to a physician to manage the case before deterioration.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 28555506Guerra/20176 studies, 220 patientsSystematic review of nonrandomized trials
Key resultsDespite the shortage of studies pertaining to this systematic review, the included studies indicate that CBCT is a promising modality in predicting osteoporosis. The inferior cortex measurements are thinner in patients with osteoporosis. In addition, using the software of CBCT viewers can improve the image quality to diagnose the bone mineralization density.
#2) 26453386Barngkgei/201538 menopausal and postmenopausal womenObservational cross-sectional study
Key resultsThe radiodensities of vertebrae were derived from CBCT scans. The radiodensity of the dens and the left part of the first cervical vertebra showed a strong correlation coefficient (r = 0.7, 0.6 respectively; P < .001) and high sensitivity (76.9% and 70%, respectively), specificity (92%, 92.9%), and accuracy (90.8%, 86.4%) in predicting osteoporosis in the lumbar vertebrae and the femoral neck, respectively.
Evidence Search cbct[All Fields] AND ("osteoporosis, postmenopausal"[MeSH Terms] OR ("osteoporosis"[All Fields] AND "postmenopausal"[All Fields]) OR "postmenopausal osteoporosis"[All Fields] OR "osteoporosis"[All Fields] OR "osteoporosis"[MeSH Terms])
Comments on
The Evidence
Validity: Radiographic density values derived from CBCT scans may be a promising method for screening bone mineral density in the future. However, the included studies in the systematic review (Guerra/2017) represent a small patient sample that may limit the strength of the conclusions. In addition, a large discrepancy was noted in the selection criteria of different studies. Some local factors such as occlusal forces and muscles tensions were not taken into consideration when the mandible was screened. Moreover, a lack of intra- and/or inter-examiner reliability was observed in some of the included studies, which would have an effect on the results' accuracy and reproducibility. Perspective: In dental practice, CBCT scans are frequently used for implant planning, especially in edentulous patients who are potentially at risk of osteoporosis. Therefore, CBCT could be a helpful tool for early detection of low BMD, allowing dentists to refer the affected patient for proper management before deterioration.
Applicability CBCT can be useful in the dental practice to predict osteoporosis and refer suspected cases to be evaluated by an orthopedist before bone deterioration or fracture.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords CBCT, osteoporosis
ID# 3302
Date of submission: 11/28/2017spacer
E-mail almeshari@uthscsa.edu
Author Ahmed Ali Almeshari
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