Table 1.
Summary of descriptive characteristics of studies in included articles (n = 6)
| Study characteristics | Sample characteristics |
Intervention characteristics |
Outcomes | ||||
|---|---|---|---|---|---|---|---|
| Author, year, country | Case group | Control group | Mean age (SD) | Index test | Reference standard | Methods | Main conclusions |
| Koh and Kim14 2011, Republic of Korea | Postmenopausal osteoporotic females (n = 21) | Postmenopausal normal BMD females (n = 21) | 66.0(6.4)—K 60.0(5.7)—C |
CBCT (voxel size: 0.15 mm)—device PSR-9000N™ Dental CT system (Asahi Roentgen Ind. Co. Ltd, Kyoto, Japan) | DXA (LS and FN) | The relationship between CBCT measurements [CTI(S), CTI(I), CTCI and CTMI] and BMDs were assessed. The intraobserver agreement was determined | CTMI measurements showed no significant difference between the groups (p > 0.05); CTI(S), CTI(I) and CTCI on CBCT images can be used to assess osteoporosis |
| Barngkgei et al15 2014, Syrian Arab Republic | Post-menopausal osteoporotic females regarding LV T-score (n = 13) and FN T-score (n = 10) | Post-menopausal normal BMD females + osteopenic females regarding LV T-score (n = 25) and FN T-score (n = 28) | Groups according to LV T-score: normal BMD 52.3 (3.5); osteopenia 59.1 (7.2); osteoporosis 60.9 (7.1); Groups according to FN T-score: normal BMD 55.1 (4.6); osteopenia 58.1 (8.8); osteoporosis 62.6 (6.9) |
CBCT (FOV: 13 × 15 cm; voxel size: 0.25 mm)—device Whitefox Imaging v. 3 (Acteon Group) | DXA (LS and FN) |
Three groups for FN and LV were assessed; RD from the body and ramus of the mandible was evaluated |
Osteoporosis can be predicted with high accuracy (78.4% for the FN and 75% for the LV) from the RD by using CBCT |
| Barngkgei et al16 2016, Syrian Arab Republic | Post-menopausal osteoporotic females regarding LV T-score (n = 13) and FN T-score (n = 10) | Post-menopausal normal BMD females + osteopenic females regarding LV T-score (n = 25) and FN T-score (n = 28) | 57.9 (7.2)—mean age of total sample | CBCT (FOV: 13 × 15 cm; voxel size: 0.25 mm)—device Whitefox Imaging v. 3 (Acteon Group) | DXA (LS and FN) | Three groups for FN and LV were assessed; Cuboids from jawbones were extracted from CBCT scans; HA using ImageJ; Tb.Th, Tb.Ts, BV/TV, BS/TV and connectivity density calculated by BoneJ |
Jawbone-derived measurements did not differ significantly between osteoporotic and non-osteoporotic females (p > 0.05); Dens-derived measures showed high accuracy of osteoporosis prediction (84.2% for FN and 78.9% for LV) |
| Barngkgei et al17 2015, Syrian Arab Republic | Post-menopausal osteoporotic females regarding LV T-score (n = 13) and FN T-score (n = 10) and osteoporotic + osteopenic females regarding LV T-score (n = 28) and FN T-score (n = 21) | Post-menopausal normal BMD females + osteopenic females regarding LV T-score (n = 25) and FN T-score (n = 28) and normal BMD females regarding LV T-score (n = 10) and FN T-score (n = 17) | Groups according to LV T-score: normal BMD 52.3 (3.5); osteopenia 59.1 (7.2); osteoporosis 60.9 (7.1); Groups according to FN T-score normal BMD 55.1 (4.6); osteopenia 58.1 (8.8); osteoporosis 62.6 (6.9) |
CBCT (FOV: 13 × 15 cm; voxel size: 0.25 mm)—device Whitefox Imaging v. 3 (Acteon Group) | DXA (LS and FN) | RD values from the first and second vertebrae and the dens | CBCT-derived RD of cervical vertebrae showed highest sensitivity (76.9%, 70%), specificity (92%, 92.9%) and accuracy (90.8%, 86.4%) in predicting osteoporosis in the LV and FN, respectively |
| Güngör et al18 2016, Turkey | Osteoporotic patients (n = 26) Osteopenic patients (n = 33) |
Normal BMD patients (n = 31) | Osteoporotic group 58.5 (5.9); Osteopenic group 52.6 (8.6); Normal BMD group 49.8 (10.4) |
CBCT (FOV: 13 × 10 cm; voxel size: 0.3 mm)—device i-CAT (vision; Imaging Sciences International Inc., Hatfield, PA) |
DXA (LS or hip) | Radiomorphometric index measurements [CTI(S), CTI(I), CTMI]; CT values for bone density; HA and FD analysis using ImageJ | Changes in the jaw bone associated with osteoporosis can be defined by radiomorphometric index measurements, CT values, HA and FD analysis on CBCT images |
| Mostafa et al19 2016, Egypt | Osteoporotic females (n = 25) | Normal BMD females (n = 25) | Age of total sample ranging from 55 to 70 years old | CBCT (FOV: 8 × 8 cm; voxel size: 0.2 mm) device Planmeca ProMax® 3D Classic, Helsinki, Finland |
DXA (LS) | Radiomorphometric index measurements (CTCI, CTMI, CTI) and FD analysis using ImageJ | Radiomorphometric index measurements by CBCT can be used as an adjuvant tool to refer patients at risk of osteoporosis. No significant differences were found between the two groups for FD values (p = 0.52) |
BMD, bone mineral density; BS/TV, specific bone surface; BV/TV, bone volume fraction; C, control; CTCI, CT cortical index; CTI, CT mandibular index; CTI(I), CT mandibular index (inferior); CTI(S), CT mandibular index (superior); CTMI, CT mental index; dens, odontoid process; DXA, dual-energy X-ray absorptiometry; FD, fractal dimension; FN, femoral neck; FOV, field of view; HA, histomorphometric analysis; K, case; LS, lumbar spine; LV, lumbar vertebrae; RD, radiographic density; Tb.Th, trabecular thickness; Tb.Ts, trabecular separation.
T-score measures the difference between the patient's BMD and the mean BMD of the young normal population; group according T-score is normal BMD (T-score ≥ −1), osteopenia (−2.5 < T-score < −1) and osteoporosis (T-score ≤ −2.5).