Osteoporosis and the general dental practitioner: Reliability of some digital dental radiological measures

Objectives: Dental radiographs are relatively inexpensive and are regularly made of a large fraction of the adult population; therefore, they represent an enormous potential as a screening tool for osteoporosis. Monitoring the population by means of dual X-ray absorptiometry (DXA), which is currently the most accepted method for diagnosing osteoporosis, involves enormous costs and facilities. In previous studies, it was shown that the radiographic trabecular pattern shows correlations with the bone mineral density (BMD) as measured by DXA. The objective of this study was to assess the reproducibility of the quantitative analysis of the trabecular pattern on dental radiographs. Methods: Six regions of interest were selected manually on three digital radiographic images of 20 women. This process was performed 10 times resulting in 1200 image samples. For each image sample 26 parameters were measured. The reliability of the parameters was evaluated by means of Cronbach's alpha. Results: Of the values of Cronbach's alpha 83% is at least 0.9 and 99% is at least 0.8. Conclusions: The measurements of the parameters used in this study are very reproducible. Therefore, the manual selection of the regions of interest does not introduce large amounts of noise. The imaging parameters potentially offer an accurate tool for the prediction of BMD values. © 2007 The Authors.