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Trabecular pattern in the mandible as bone fracture predictor.

Journal article
Authors Grethe Jonasson
Torgny Alstad
Flor Vahedi
Ingvar Bosaeus
Lauren Lissner
Magnus Hakeberg
Published in Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics
Volume 108
Issue 4
Pages e42-51
ISSN 1528-395X
Publication year 2009
Published at Institute of Odontology
Institute of Medicine, Department of Public Health and Community Medicine
Institute of Medicine, Department of Clinical Nutrition
Pages e42-51
Language en
Keywords Absorptiometry, Photon, Aged, Aged, 80 and over, Alveolar Bone Loss, classification, Bone Density, physiology, Bone Diseases, Metabolic, radiography, Cross-Sectional Studies, Dental Caries, classification, Dental Restoration, Permanent, Female, Forecasting, Fractures, Bone, etiology, Humans, Image Processing, Computer-Assisted, Male, Mandible, radiography, Medical History Taking, Middle Aged, Osteoporosis, radiography, Periodontal Attachment Loss, classification, Radiography, Bitewing, Radiography, Dental, Digital, Risk Assessment, Sex Factors
Subject categories Odontological behavioural science


OBJECTIVE: This investigation analyzed the use of mandibular sparse trabeculation as a fracture risk indicator. STUDY DESIGN: Trabeculation was classified as sparse, alternating dense and sparse, or dense using intraoral radiographs from 274 men and women (50-87 years old) including 56 with previous reported fractures. Mandibular bone texture was assessed on digitized radiographs. RESULTS: Forty-eight percent of subjects with sparse trabeculation reported fractures, compared with 19% with alternating sparse and dense trabeculation and 2% with dense trabeculation (Kruskal-Wallis test: P < .00001). Logistic regression analysis showed that sparse trabeculation (odds ratio [OR] = 5.9; 95% CI 3.0-11.1; P < .0001) and lowest bone texture classes (OR = 2.2; 95% CI 1.0-4.5; P = .04) were associated with an increased fracture risk, especially for subjects > or =75 years (OR = 7.1; 95% CI 2.5-20.0; P = .0002). CONCLUSIONS: Fracture risk was increased in subjects with sparse alveolar trabecular pattern. Dentists may be able to identify high-risk subjects before fracture.

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