Information about methodology and scientific studies


In the field of dentistry, many have studied the bone quality of the jaw bone of the over the years. Generally, dentists have high skills and good habits in assessing bone structure on X-rays, both intraoral and on panoramic images.

In a major European study from 2007, “The Osteodent Study”, funded by the EU, a link between the bone structure of the jaws and the BMD in hip and vertebra was clearly shown.

Several studies and dissertations show the same as unequivocal evidence of the relationship between the trabeculae structure of the lower jaw and the prevalence of future fractures.

Based on data from the Osteodent study and in cooperation with the Faculty of Odontology at Malmö University, a program and method has been developed, where dentists on a digital x-ray image of the premolar area of the lower jaw can automatically evaluate the trabecular structure in a ROI (Region of Interest). Together with questions from the record of early fragility fractures, heredity and medication, the patient may be notified if he / she is in the risk zone of having osteoporosis and thus having an increased risk of fracture.

The Method

Boneprox makes a computerized digital image analysis which provides a standardized and operator-independent bone quality analysis. The software uses intraoral X-rays from a defined region of the lower jaws (mandible) premolar region to measure trabecular density and indicate the risk of having osteoporosis.

The software uses digital image algorithms in combination with artificial intelligence to automatically place the region of interest in the optimal area and analyze the trabecular structure of the selected region.

Boneprox’s vision is to detect the risk of osteoporosis before the first fracture occurs. Boneprox Cut-off points for risk are thus based on T-score <- 1 (osteopenia).

Boneprox cut-off-point:

< 6,3 healthy bone = negative result (n) 

> 6,3 for sparse bone = positive result (p)

The dentist does not provide a diagnosis or treatment proposal but only makes a statement based on a x-ray image and a few anamnestic questions and reports this result and asks the patient to contact his GP or send the patient to the healthcare. Several dental clinics now open up to give their patients this opportunity.

The service may under no circumstances be used instead of contact, examination or treatment by a doctor. Our analysis is, despite a high degree of accuracy, a recommendation tool, therefore gives no diagnosis. Positive analysis results may be the basis for further investigation.


  1. ”The use of visual assessment of dental radiographs for identifying women at risk of having osteoporosis:The OSTEODENT project.”
    Lindh C, Horner K, Jonasson G, Olsson P, Rohlin M, Jacobs R, Karayianni K, van der Stelt P, Adams J, Marjanovic E, Pavitt S, Devlin H.
    Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008 Feb 23
  2. ”Trabecular pattern in the mandible as bone fracture predictor.”
    Jonasson Grethe, Alstad Torgny, Vahedi Flor, Bosaeus Ingvar, Lissner Lauren, Hakeberg Magnus.
    Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 2009:108(4):e42-51
  3. ”A prospective study of mandibular trabecular bone to predict fracture incidence in women: A lowcost screening tool in the dental clinic.”
    Jonasson G, et al,
    Bone Oct.2011.
  4. ”Mandibular bone structure, bone mineral density, and clinical variables as fracture predictors: a 15-year follow-up of female patients in a dental clinic.”
    Grethe Jonasson, PhD,a,b and Annika Billhult, PhD.
    ORAL AND MAXILLOFACIAL RADIOLOGY, Vol. 116 No. 3 September 2013
  5. ”Att upptäcka benskörhet med digital röntgen – en odontologisk åtgärd?” En klinisk studie.
    Regionala Etikprövningsnämnden i Stockholm. Diarienummer:2007/602-31/4
    Redovisat vid Odontologiska Riksstämman 2010 i Vetenskapligt Program och granskat av Svenska Tandläkare-Sällskapet.
  6. ”Mandibular trabecular bone as fracture indicator in 80-year-old men and women”
    Hassani-Nejad A, Ahlqwist M, Hakeberg M, Jonasson G.
    Eur J Oral Sci 2013; 121: 525–531. © 2013
  7. ”Mandibular trabecular bone structure in adults with Crohn’s disease”
    Grethe Jonasson & Fredrik Lindberg & Alberto Jorge & Torgny Alstad & Hossein Kashani

Ongoing studies:

”Påverkan på käkarnas benvävnad hos kvinnor med endokrint responsiv bröstcancer i tidigt stadium under behandling med aromatashämmare” Dnr 2014/285-31

”Prognostic value of intraoral radiograph estimating osteoporosis and risk for bonefracture.” Project number : 233191