Indices in dental image exams for bone mineral density evaluation of aromatase inhibitor users

• Published in: Brazilian oral research Vol. 36; p. e138
• Main Authors: Barra, Sâmila Gonçalves, de Arruda, José Alcides Almeida, Souza, Alessandra Figueiredo, Brasileiro, Cláudia Borges, Camargos, Bruno Muzzi, Lima, Enaldo Melo de, Souza, Leandro Napier, Oliveira, Marina Chaves de, Macari, Soraia, Silva, Tarcília Aparecida, Abreu, Lucas Guimaraes, Mesquita, Ricardo Alves
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Pesquisa Odontológica - SBPqO 01-01-2022; Sociedade Brasileira de Pesquisa Odontológica
• Subjects: Aromatase Inhibitors; Bone Density; Cone-Beam Computed Tomography; DENTISTRY, ORAL SURGERY & MEDICINE; Female; Humans; Aromatase Inhibitors; Bone Density; Cone-Beam Computed Tomography
• ISSN: 1806-8324; 1807-3107; 1807-3107
• DOI: 10.1590/1807-3107bor-2022.vol36.0138

We evaluated the accuracy of radiomorphometric indices (RI) and fractal dimension (FD) for screening bone mineral density (BMD) in postmenopausal patients who had breast cancer and were using aromatase inhibitors (AI). The sample consisted of 40 participants. Digital panoramic radiography (DPR) and cone beam computed tomography (CBCT) were evaluated along with dual-energy X-ray absorptiometry (DXA), which is the gold standard for detecting low BMD. According to the T-scores of DXA, the subjects were assigned into two groups: with normal BMD and with low BMD (osteopenia and osteoporosis). The area under the curve (AUC), sensitivity, and specificity with their respective confidence intervals were determined for DPR and CBCT. For DPR indices, AUC ranged from 52.6 to 75.8%. The mandibular cortical width (MCW) had the highest AUC. For FD, the total trabecular index had the highest sensitivity, while the index anterior to the mental foramen (MF) had the highest specificity. In CBCT, the AUC ranged from 51.8 to 62.0%. The indices with the highest AUC were the molar (M) and anterior (A). The symphysis (S) index had the highest sensitivity and the posterior (P) index had the highest specificity. Sensitivity and specificity were adequate for the computed tomography index (Inferior; CTI [I]). Therefore, MCW, FD of the mandible angle, and total trabecular ROI in DPR and the CTI (I), M, P, and A indices in CBCT proved to be promising tools in distinguishing individuals with low BMD. Cutoff point for these indices could be a useful tool to investigate low BMD in postmenopausal women taking AI.