The accuracy of panoramic radiography as a screening of bone mineral density in women: a systematic review

Objectives: A systematic review and meta-analysis of diagnostic test accuracy studies was conducted to assess if the radiomorphometric indexes observed in panoramic radiographies could estimate reduced bone mineral density (BMD) similarly to standard technique the bone densitometry (dual energy X-ray absorptiometry) in females older than 30 years. Methods: A systematic search in four databases was conducted until January 2019. Two evaluators performed data extraction and evaluation of risk of bias independently, and agreement was achieved by consensus. Data were synthesized on a subgroup meta-analysis with a random effect model and the hierarchical summary receiver-operating characteristic curve was used to calculate pooled estimates of studies. Results: Thirty three studies were included and 12 different radiomorphometric indexes identified, including Mandibular Cortical Index (MCI). The final number of cases pooled for the analysis was 5266 females.The MCI for BMD loss (osteopenia) presented values of sensitivity 0.81 [95% confidence interval (CI), 0.78–0.84] and specificity 0.48 (95% CI, 0.45–0.50), while for osteoporosis sensitivity 0.35 (95% CI, 0.30–0.40) and specificity 0.88 (95% CI, 0.86–0.90). The mandibular cortical width presented values of sensitivity 0.58 (95% CI, 0.40–0.73), specificity 0.73 (95% CI, 0.60–0.83) for osteopenia, while for osteoporosis sensitivity 0.57 (95% CI, 0.36–0.76) and specificity 0.83 (95% CI, 0.68–0.92). Due to the high sensitivity, MCI presented a potential value as a screening tool for initial BMD loss (osteopenia), once tests presenting high sensitivity are described as rarely missing subjects with the disease. To the other hand, MCI to osteoporosis and Mandibular Cortical Width for both conditions are not recommended because presented specificity higher than sensitivity. Conclusion: The MCI can be recommended as a feasible tool to screen initial BMD loss (osteopenia) in females above 30 years old using panoramic radiography exams.

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Effects of Recreational Small-Sided Soccer Games on Bone Mineral Density in Untrained Adults: A Systematic Review and Meta-Analysis

Healthcare ◽

10.3390/healthcare9040457 ◽

2021 ◽

Vol 9 (4) ◽

pp. 457

Author(s):

Filipe Manuel Clemente ◽

Rodrigo Ramirez-Campillo ◽

Hugo Sarmento ◽

Daniel Castillo ◽

Javier Raya-González ◽

...

Keyword(s):

Bone Mineral Density ◽

Systematic Review ◽

Active Control ◽

Bone Mineral ◽

Meta Analysis ◽

Adult Population ◽

Noncommunicable Disease ◽

Lower Limbs ◽

Mineral Density ◽

Control Groups

This systematic review with meta-analysis was conducted to assess the effects of small-sided games (SSG)-based training programs on bone mineral density (BMD) in untrained adults. The data sources utilized were Cochrane, Embase, Medline (PubMed), Scopus, SPORTDiscus, and Web of Science. The study eligibility criteria were: (i) untrained adults (>18 years old) of any sex, with or without a noncommunicable disease; (ii) SSG-based programs with a minimum duration of four weeks and no restrictions regarding frequency (number of sessions per week); (iii) passive or active control groups; (iv) pre-post values of BMD; (v) only randomized controlled trials; and (vi) only original and full-text studies written in English. The database search initially yielded 374 titles. From those, nine articles were eligible for the systematic review and meta-analysis. The age of included population varied from a minimum of 20 and a maximum of 71 years old. Non-significant differences between SSG and passive and active control groups on total BMD (ES = 0.14; p = 0.405 and ES = 0.28; p = 0.05, respectively). Meanwhile, significant differences in favor of SSGs vs. passive and control groups were detected, evidencing an improvement of BMD in lower limbs of the adult population for both sexes (ES = 0.26; p = 0.05 and ES = 0.28; p = 0.156, respectively). As conclusions, SSGs can be used as a non-pharmacological alternative to increase the BMD in the lower limbs despite having no significant impact on total body BMD. Careful generalization should be done of the level of heterogeneity.

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