Dental X-rays
Low cost, widely available osteoporosis assessment
ImaTx DX provides an automated computer based technique to estimate the bone mineral density of hip and spine using digitized, calibrated, periapical dental x-rays.
The ImaTx DX screening method does not require specialized and expensive capital investment. Dental x-rays regularly taken during a dental exam identify women with low bone mineral density before they suffer from osteoporotic fractures enabling early therapeutic intervention.
Why use dental x-rays?
Comparison to current techniques
How it's done
Details of clinical study
Current use and availability
Why use dental x-rays?
The mandible is a site consisting predominantly of trabecular bone. Trabecular bone is clearly visible on dental radiographs thus lending itself to quantitative analysis of bone mineral density. Recent studies have demonstrated a significant correlation between bone mineral density in the mandible or maxilla and that in the axial skeleton such as the spine and hip. The earliest bone loss in osteoporosis patients occurs in areas of trabecular bone. The metabolic turnover of trabecular bone is approximately eight times greater than that of cortical bone. This is the reason why areas of predominantly trabecular bone such as the vertebral body have been preferred sites for measuring bone mineral density.
Comparison to current technology
Unlike current techniques, this test will not require the use of specialized and expensive capital equipment. Instead, it uses existing x-ray equipment in the dental office and inexpensive digitizing equipment. The ImaTx DX test will allow dentists to perform simple, quick, and low-cost assessment of dental radiographs to screen for patients with osteoporosis.
In a clinical study designed to develop ImaTx DX, 48 post-menopausal women had their dental x-ray taken using the ImaTx DX protocol. Eleven subjects (25%) in the group were osteoporotic. They had BMD T-scores of less or equal to -2.5 as measured using DXA of the hip or spine. Using a leave-one-out cross-validation test, ImaTx DX correctly identified 80% of the osteoporotic subjects. This performance is comparable to other screening tests such as a calcaneal ultrasound or a peripheral BMD measurement. The advantage of ImaTx DX is that it can be done impromptu during a regular visit to the dentist. A clinical trial involving a larger population is in progress to further validate the accuracy and reproducibility of ImaTx DX.
How it's done
During a regular dental exam that includes x-ray imaging, patients can opt to have the ImaTx DX. One of the lower front teeth x-rays would then be taken with a calibration scale. If a conventional x-ray film is used, the developed dental film is then digitized using a film digitizer. The image is then analyzed using the ImaTx DX software that generates the Mandibular Index, which could indicate if a patient is likely to have low bone mineral density. Patients with a low Mandibular Index are strongly advised to seek further evaluation by their physician. Patients with normal values are also given information about osteoporosis and preventive measures.
