Dental X-rays can detect the risk of fractures

18-04-13

In a research project, Charlotta Elleby, a dentist at Folktandvården Stockholm and postgraduate at Karolinska Institutet, studied X-ray images to investigate the connection between the structure of the lower jaw bone and increased risk of osteoporosis fractures.

Osteoporosis fractures are fractures that occur after what is commonly called low energy trauma, for example when falling from a standing hight. It mainly affects the hips, vertebrae and forearm. Charlotta Elleby wants to find a reliable method that can be used by general dentists to find high-risk patients and thereby prevent fractures.

– Can we detect increased risk of osteoporosis fractures with the help of dental x-rays? By examining whether the structure of the lower jaw bone can be connected directly to the occurrence of osteoporosis fractures, we hope to get answers and in the future be able to prevent fractures, says Charlotta Elleby, dentist at Folktandvården Stockholm and postgraduate at Karolinska Institutet.

Osteoporosis a major social problem

Scandinavia has the highest incidence of osteoporosis fractures and it is expected that every other woman and every fifth man will suffer during their lifetime. The risk increases with increasing age. Osteoporosis fractures cause great suffering for those affected and cost society more than SEK 10 billion each year. Osteoporosis does not show any symptoms before a fracture occurs, so the patient group is difficult to identify.

Previous studies of X-ray images have shown a correlation between sparse structure of the lower jaw trabecular bone, a type of porous bone that constitutes approximately 20 percent of the human skeleton, and increased risk of osteoporosis fractures. A large part of the population in Sweden regularly goes to the dentist, which could provide the opportunity for a possible screening or as a research basis. Charlotta Elleby’s purpose of the study is to find a reliable method that can be used by general dentists to identify these high-risk patients before a fracture occurs, and then be able to refer them further in the care for any treatment.

X-rays are examined using digital technology

The research group uses intraoral X-rays to make an assessment of trabecular structure. The X-rays were taken between 1970 and 1990 in the so-called REBUS study, a large study of rehabilitation needs in the population, on a sample of the population in Stockholm County which in 1970 was 18-65 years. The sample of approximately 1,250 people is part of a more than 30,000 large cohorts who answered questionnaires about their health and socio-economic situation in the survey.

The imagery will be examined visually and with the help of two different computer programs for automatic calculation of osteoporosis risk. The researchers will also use fracture data from the National Board of Health and Welfare from 1970 until today and link these to the results of the measurements of trabecular structure made with the various methods. This gives the opportunity for a follow-up time of over 40 years.

Furthermore, the research group will study the questionnaire responses from the large cohort and link these to data from the National Board of Health and Welfare on fractures and general fragility.

The first results are expected to be ready in 2019.

Read the the article from Folktandvården Stockholms Län here: Tandröntgen kan upptäcka risk för frakturer

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