形态测定分析法表达下颌骨骨密度的初步研究
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Assessing mandibular bone mineral density with morphometric analysis
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    摘要:

    目的:以双能X线吸收测量法(DXA)为金标准,评价形态测定分析法表达下颌骨骨密度的有效性和可靠性。方法:选择牙列完整、身体发育良好、无肝肾疾病等影响骨代谢系统疾病的受试者共20人(男8人,女12人),年龄11~26岁。DXA法采用双能X线骨密度仪给每一位受试者测量第1~4腰椎前后骨密度,结果判定以面密度(g/cm2)为依据。形态测定分析法采用意大利生产的RTG230/EnR型全景片机给每一位受试者拍颌骨全景片,在全景片上定点、作线,测得下颌骨左右两侧下缘的骨皮质厚度(MCT)及全景指数(PMI)。DXA结果与MCT、PMI之间的关系用线性相关分析,MCT、PMI测量的有效性和可靠性通过灵敏度和特异度来评价。结果:MCT、PMI与DXA具有显著正相关关系(r=0.268, P<0.05;r=0.251 3, P<0.05);形态分析法(MCT、PMI)的敏感性均为50%,特异性分别为93.75%、87.50%,Youden指数分别为0.437 5、0.375。结论:MCT、PMI在一定程度上可以表达下颌骨骨密度,在临床中不失为一种简单易行的评价骨密度的方法。

    Abstract:

    Objective:To determine the effectiveness and validity of morphometric analysis made from dental panoramic tomograms (DPTs) for predicting mandibular bone mineral density (BMD) while taking the result of dual energy Xray absorptiometry (DXA) as gold standard. Methods: Twenty healthy subjects (8 male, 12 female) with intact dentition, aged from 1126 years old, were included in the present study. The BMD of each patient was measured at the lumbar spine (L1L4) by DXA; the results were obtained based on the density of surface (g/cm2). Dental panoramic radiography was carried out using dental panoramic tomography (RTG230/ENR, made in Italy). Mandibular cortical thickness (MCT) and panoramic mandibular index (PMI) values were calculated and their relationship with DXA measurements were subjected to correlation analysis. The validity of MCT and PMI measurements were assessed by sensitivity and specificity. Results: We found mandibular BMD was positively correlated with MCT (r=0.268, P<0.05) and PMI (r=0.251 3, P<0.05).The sensitivity,specificity and Youden index of MCT were 50%, 93.75%, and 0.437 5, respectively; the numbers of PMI were 50%, 87.50%, and 0.375, respectively.Conclusion: MCT and PMI might be potential indicators for mandibular BMD; they are simple and applicable in clinic.

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