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[en] Upper cervical vertebrae are commonly imaged together with the jaw bones in panoramic radiography. There have been many studies investigating the possible role of mandible as an indicator of osteoporosis. But the result doesn't show unanimity. This study measured bone densities of mandible and second and third cervical vertebrae to find out any relationship between these two areas. These results may contribute in panorama being used as a screening method in detecting possible osteoporotic patient. Randomly selected 226 digitized panoramic images with cervical vertebrae shadows from 156 dental patients between 5 to 80 years of age were used. And the bone densities of second and third cervical vertebrae, apical areas of first and second mandibular molars and interdental areas were measured. The bone density measurements were restricted to the cancellous bone and the average and standard deviations and paired t-tests were done to each measurements. All the measurements were statistically significantly related. The best relationship was found between the third cervical vertebrae and first and second mandibular apical areas. The average and standard deviations of the measured bone density ratios of these areas were 1.20 ± 0.45 and 1.34 ± 0.48 each. Patients whose panoramic bone density of the third cervical vertebrae are much below those of mandibular first or second molar apical areas may have osteoporosis.
[en] Osteoporosis is often diagnosed after fracture occurrence, when therapy is less effective. The dual photon densitometry has been the proposed method for osteoporosis early diagnosis. In the present study is presented our experience on the lumbar vertebral and femoral neck bone mass measurement by utilizing a Lunar DP-3 densitometer in normal young 82 volunteers and 103 women with radiologically and clinically diagnosed osteoporosis. The values found in osteoporotical patients were significantly lower when compared to those normals either in lumbar vertebrae (L2-L4) or in the femoral neck. The method's coefficient of variation was <0.5%, when determinated with a synthetic phanton aid and <1.5% repeating the exam in 10 normal volunteers. These results show that dual photon densitometry is a simple, sensitive and non-invasible method for early diagnosis and therapeutic follow-up of osteoporotical patients. (author)
[pt]A osteoporose e frequentemente diagnosticada somente apos o aparecimento de fraturas, quando a terapia e menos efetiva. A densitometria por dois fotons tem sido o metodo proposto para o diagnostico precoce dessa doenca. No presente estudo, relatamos nossa experiencia na medida de massa ossea das vertebras lombares e femur proximal utilizando um densitometro DP-3 Lunar em 82 voluntarias jovens normais e 103 mulheres com osteoporose diagnosticada clinica e radiologicamente. Os valores encontrados nas pacientes com osteoporose foram significativamente inferiores aos normais, tanto em coluna lombar (L2-L4) como em femur proximal. O coeficiente de variacao do metodo foi <0,5%, quando determinado com auxilio de um phantom sintetico, e <1,5%, repetindo-se o exame em dez voluntarias normais. Esses resultados confirmam que a densitometria por dois fotons e um metodo simples, nao invasivo e sensivel para diagnostico precoce e acompanhamento terapeutico de pacientes portadores de osteoporose. (autor)
[en] Highlights: • Fracture Liaison Service (FLS) is proven to be a good model for the prevention of secondary fractures. • The asymptomatic nature of vertebral fractures presents a challenge. • Non-standardised radiological reporting can compromise future care decisions. • Care providers lack a systematic approach to identify patients at risk. - Abstract: ObjectivesTo evaluate the current evidence for whether Fracture Liaison Services are being utilised effectively in the UK to aid in the prevention of fragility fractures.
[en] To purpose of this study was to investigate whether the fractal dimension and radiographic image brightness of periapical radiograph were useful in predicting osteoporosis. Ninety-two postmenopausal women were classified as normal, osteopenia and osteoporosis group according to the bone mineral density of lumbar vertebrae and periapical radiographs of both mandibular molar areas were taken. The ROIs of 358 areas were selected at periapical and interdental areas and fractal dimension and radiographic image brightness were measured. The fractal dimension in normal group was significantly higher than that in osteoporosis group at periapical ROI (p<0.05). The radiographic image brightness in normal group was higher than that in osteopenia and osteoporosis group. There was significant difference not only between normal and osteopenia group (p<0.05) but also within osteopenia and osteoporosis group (p<0.01) at periapical ROI. Significant difference was observed not only between normal and osteopenia group but also between normal and osteoporosis group at interdental ROI (p<0.01). Positive linear relationship was weakly shown at Pearson correlation analysis between fractal dimension and radiographic image brightness. BMD significantly correlated with fractal dimension at periapical ROI (p<0.01), and BMD and radiographic image brightness significantly correlated at both periapical and interdental ROIs (p<0.01). This study suggests that the fractal dimension and radiographic image brightness of periapical ROI may predict BMD.
[en] Purpose: The aim of this study was to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain from non-neoplastic vertebral fractures and improve functional outcomes. Materials and methods: We compared 30 patients treated by vertebroplasty for non-neoplastic vertebral fractures with 30 patients treated by kyphoplasty for the same condition. Pain was measured with a visual analogue scale (VAS) and functional outcome with the Oswestry disability index (ODI). Baseline data were compared with measurements on the day after the procedure (for pain alone) and at 1 month, 6 months, and 1 year. Results: The VAS pain score was reduced by 4-5 points on the day after either type of treatment, a statistically significant improvement. The global ODI was significantly improved (by 13-18 points) at 1 month after either procedure. These improvements persisted at 6 months and 1 year. No significant differences in functional outcome were observed between the techniques. Conclusion: Vertebroplasty and kyphoplasty obtain similar improvements in pain and functional outcomes in these patients. The choice of technique must therefore depend on other factors. An initial improvement with either technique is a good predictor of long-term improvement.
[en] Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare, but serious complication, which has recently been more frequently reported. However, this entity is unfamiliar to radiologists. We report a case of BRONJ complicated by actinomycosis following a tooth extraction in a 68-year-old woman who has been treated with oral bisphosphonate for treatment of osteoporosis over the last 3 years and 3 months
[en] The purpose of this study was to investigate whether panoramic radiographs were useful in predicting osteoporosis. 50 postmenopausal women between the age of 41.8 and 78.5 were classified as normal and osteoporosis groups according to the bone mineral density of lumbar vertebrae. Panoramic radiographs were taken. Age, body mass index, remaining mandibular teeth, mandibular cortical thickness and morphology, and fractal dimensions at periapical areas of mandibular first molars were evaluated to differentiate the two groups. The age of osteoporotic group was statistically significantly higher than that of normal group (p<0.05), but not the body mass index or number of remaining mandibular teeth. The mean fractal dimension of osteoporotic group was 1.391±0.085, and was significantly lower than that of the normal group, which was 1.523±0.725 (p<0.01). Thick mandibular cortical thickness was common in normal group, whereas thin or very thin mandibular cortical thickness was common in osteoporotic group and the difference was significant (p<0.05). C2 pattern was difference was statistically significant (p<0.01). Age, mandibular cortical thickness and shape, fractal dimension on panoramic radiographs were useful in predicting osteoporosis
[en] The purpose of this study was to investigate whether fractal analysis of periapical and panoramic radiographs was useful in predicting osteoporosis risk. 37 postmenoposal women between the age of 42 and 79 were classified as normal and osteoporosis group according to the bone mineral density of lumbar vertebrae and periapical and panoramic radiographs were taken. Fractal dimensions at periapical areas of mandibular first molars were calculated to differentiate the two groups. The mean fractal dimensions of normal group on periapical and panoramic radiographs were 1.413 ± 0.079, 1.517 ± 0.071 each. The mean fractal dimensions of osteoporotic group on periapical and panoramic radiographs were 1.498 ± 0.086, 1.388 ± 0.083 each. The mean fractal dimension from peripaical radiographs of osteoporotic group was statistically significantly higher than that of normal group. The mean fractal dimension from panoramic radiographs of osteoporotic group was statistically significantly lower than that of normal group. Fractal analysis using periapical and panoramic radiographs was useful in predicting osteoporosis.