Is jaw fractal dimension a reliable biomarker for osteoporosis screening? A systematic review and meta-analysis of diagnostic test accuracy studies

Author:

Cavalcante Davi de Sá1,Silva Paulo Goberlânio de Barros2,Carvalho Francisco Samuel Rodrigues3ORCID,Quidute Ana Rosa Pinto4,Kurita Lúcio Mitsuo1,Cid Adília Mirela Pereira Lima1,Ribeiro Thyciana Rodrigues5,Gurgel Marcela Lima1,Kurita Bianca Moreira6,Costa Fábio Wildson Gurgel1

Affiliation:

1. Division of Radiology, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil

2. Division of Oral Pathology, Christus Center University (UNICHRISTUS), Fortaleza, Ceará, Brazil

3. Division of Oral and Maxillofacial Surgery, Federal University of Ceará – campus Sobral, Sobral, Ceará, Brazil

4. Division of Endocrinology and Diabetology, Walter Cantídio University Hospital, Fortaleza, Ceará, Brazil

5. Division of Patient with Special Needs, Postgraduate Program in Dentistry, Federal University of Ceará, Fortaleza, Ceará, Brazil

6. Division of Pharmacology, Maurício de Nassau Center University, Fortaleza, Ceará, Brazil

Abstract

Objectives: To summarize the evidence on the feasibility of maxillomandibular imaging exams-related fractal dimension (FD) in screening patients with osteoporosis. Methods: This registered systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy statement. High sensitivity search strategies were developed for six primary databases and grey literature. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) items evaluated the risk of bias, and the GRADE approach assessed the evidence certainty. Results: From 1034 records initially identified through database searching, four studies were included (total sample of 747 patients [osteoporosis, 136; control group, 611]). The meta-analysis showed that the overall sensitivity and specificity of the FD were 86.17 and 72.68%, respectively. In general, all studies showed low RoB and applicability concern. The certainty of the evidence was very low to moderate. Conclusions: This systematic review showed that the jaw-related FD presented sensitivity and specificity values higher than 70%, and its sensitivity in osteoporosis screening was a better parameter than specificity.

Publisher

British Institute of Radiology

Subject

General Dentistry,Radiology, Nuclear Medicine and imaging,General Medicine,Otorhinolaryngology

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