Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.05022
Revista de Odontologia da UNESP
Original Article

Digital panoramic radiography as a tool for analyzing the quality of trabecular bone microarchitecture

Radiografia panorâmica digital como ferramenta de análise da qualidade da microarquitetura óssea trabecular

Gustavo Azevedo PITOL; Rosângela Pereira de ALMEIDA; Ester Victorino COSER; Ben-Hur ALBERGARIA; Tânia Regina GRÃO-VELLOSO

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Abstract

Abstract: Introduction: Osteoporosis is a metabolic disease characterized by reduced bone mineral density, often accompanied by loss of quality of trabecular bone microarchitecture.

Objective: To assess the quality or degradation of trabecular bone microarchitecture in digital panoramic radiography to better predict the risk of fragility fractures.

Material and method: The sample included 68 female patients, age-matched, and divided into three groups according to densitometric results. Trabecular Bone Score values were measured and digital panoramic radiographs were taken. Fractal analysis with box counting was conducted in the region of premolars and angle of the mandible, with regions of interest measuring 64×64 and 80×120 pixels. In the statistical analysis, Pearson’s correlation was applied between the Trabecular Bone Score and fractal analysis results obtained in each group, using age as a control variable and assigning individualized age ranges within groups.

Result: A moderate correlation was identified in the regions of interest of 64×64 and 80×120 pixels at the angle of the mandible in the osteoporosis group and in the normal group. A moderate correlation was also obtained using age as a control variable in the 64x64 pixel regions of interest in the premolar region. Considering age range, the within-group analysis presented a strong correlation in the osteoporosis group and moderate correlation in the osteopenia and normal groups.

Conclusion: Fractal analysis in digital panoramic radiographs was shown to be a promising predictive instrument of bone microarchitecture quality.

Keywords

Digital panoramic radiography, bone densitometry, bone quality, fragility fracture

Resumo

Resumo: Introdução: A osteoporose é uma doença metabólica caracterizada pela redução da densidade mineral óssea, muitas vezes acompanhada da perda de qualidade da microarquitetura óssea trabecular.

Objetivo: Avaliar a qualidade da microarquitetura óssea trabecular em radiografia panorâmica digital a fim de identificar precocemente a sua degradação, possibilitando melhor predição do risco de fraturas por fragilidade.

Material e método: A amostra consistiu de 68 pacientes do sexo feminino, pareadas por idade, e divididas em 3 grupos conforme resultado densitométrico. Foram aferidos os valores de Trabecular Bone Score e realizadas radiografias panorâmicas digitais. A análise fractal com box counting foi feita na região de pré-molares e ângulo da mandíbula, com regiões de interesse medindo 64x64 e 80x120 pixels. Na análise estatística utilizou-se a correlação de Pearson entre os resultados de Trabecular Bone Score e de análise fractal obtidos em cada grupo, utilizando-se a idade como variável de controle e através de atribuição de grupos etários individualizados intragrupos.

Resultado: Identificou-se correlação moderada nas regiões de interesse de 64x64 e 80x120 pixels, em ângulo da mandíbula no grupo Osteoporose e no grupo normal. Também se obteve correlação moderada utilizando a idade como variável de controle nas regiões de interesse de 64x64 pixels, em região de pré-molares. A análise intragrupos, considerando a faixa etária, resultou em correlação forte, no grupo osteoporose e moderada nos grupos osteopenia e normal.

Conclusão: A análise fractal em radiografias panorâmicas digitais se mostrou promissora como instrumento preditivo da qualidade de microarquitetura óssea.
 

Palavras-chave

Radiografia panorâmica digital, densitometria óssea, qualidade óssea, fratura por fragilidade

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Submitted date:
11/29/2022

Accepted date:
11/30/2022

63b4666ca953957a3359e743 rou Articles
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