Osteoporosis screening with dental alveolar bone density evaluation system

Objectives:In order to prevent and treat osteoporosis, a global health problem threatening millions with impending fracture a simple and readily accessible screening method is required.We considered whether a new volumetric method of alveolar bone mineral density is useful for an osteoporotic screening. Methods:In 33 postmenopausal females with a mean age of 59.6 years (50 - 69), alveolar bone mineral density (alBMD) was measured by Bone Right System (Dentalgraphic.Com, Himeji, Japan) at a site 6 mm lower than neck of the right mandibular first premolar along with lumbar BMD (LBMD) measurement by DXA (Hologic 4500 W, USA) and survey on history of fracture. Volumetric alveolar BMD was measured by dividing conventional two dimensional BMD by the bucco-lingual distance at 6 mm lower than the cement-enamel junction of the right mandibular first premolar (T) to be expressed as alveolar BMD / T (ValBMD)and alveolar BMD x T (TalBMD). Results:Even within the narrow age range of postmenopausal period, a significant negative correlation was found between age and alBMD (r = -0.417, p<0.05). A significant positive correlation was noted between alBMD and LBMD (r = -0.703, p<0.01). Fracture increased with age exhibiting a significant positive correlation (r = 0.383, p<0.05). Negative correlation was noted between fracture and LBMD (r = -0.485, p<0.01), alBMD(r = -0.631, p<0.01), TalBMD (r = -0.669, p<0.01), and ValBMD (r = -0.484, p<0.01). In ROC curves, alBMD, TalBMD and ValBMD exhibited AUC (0.940, 0.917 and 0.857) better than those by lumbar bone mineral density (LBMD) (0.801) indicating a high capability of alBMD, TalBMD and ValBMD in fracture prediction. Conclusions:Alveolar bone mineral density showed a much higher predictability of spinal compression fracture than lumber bone mineral density.