RADIOMORFOMETRIC INDICATORS AND THE RISK OF OSTEOPOROTIC FRACTURE IN ELDERLY
Elderly, panoramic radiography, clinical risk fractures, radiomorphometric indices
One of the main causes of mortality and morbidity in individuals aged 60 years and over is bone fracture as a consequence of osteoporosis. It is known that low bone mineral density (BMD) is a risk factor for these fractures, with bone densitometry being the gold standard test for the diagnosis of BMD. Since the exam is expensive and not accessible for most of the Brazilian population, alternative methods such as radiomorphometric indices obtained by the panoramic radiographs analysis have been used to aid in the early identification of the low BMD, acting as a possible screening of patients with high risk of osteoporotic bone fracture. In this perspective, this research aimed to evaluate the risk of bone fracture in the elderly through the validated FRAX (fracture risk assessment tool) algorithm, as well as to measure the radiomorphometric indices in panoramic related to the BMD of these patients. It is an observational cross-sectional and association study, in which the association between the radiomorphometric indices and the FRAX tool. The sample consisted of elderly men and women who underwent digital panoramic radiograph at the Dental Imaging Service of the Department of Dentistry of UFRN, through which the radiomorphometric indexes were evaluated by an experienced radiologist. A clinical questionnaire was applied, verified weight and height, and calculated the risk of osteoporotic bone fracture. In the sample of 70 elderly, the median age was 68.5, there was a predominance of women in the sample (67.1%), the median risk of major osteoporotic fracture (MOF) was 4,2 (%),hip fracture (HF) risk was 1.3 (%),the mental index (MI) had a mean of 3.29 mm. The mean of panoramic mandibular index was 0.40 and the most prevalent cortical qualitative classification was moderate erosion (C2), in 57.1% of the cases. The intraclass correlation (ICC) performed with the panoramic radiographs exhibited high agreement. Through the Pearson's correlation test it was verified that MI, age of menopause and time of menopause were correlated with the risk of MOF.The time of Menopause also correlated with HF risk. The other independent variables analyzed by the Mann-Whitney test showed no association with the risks of MOF and HF. The results allow to conclude that mandibular cortices with thinner thicknesses measured on panoramic radiographs by radiologists, can perform as a radiographic finding for higher risks of osteoporotic bone fracture in the elderly attended at the Department of Dentistry of UFRN.