LAUSR

Background: Screening for osteoporosis is paramount in the prevention of fragility fractures in older adults, with Quantitative Ultrasound (QUS) offering a portable, easy to use, relatively low cost, non-ionising alternative to Dual Energy X-ray Absorptiometry (DEXA) scans. QUS offers the potential for screening in non-traditional health care settings e.g. Dental practice. However there is limited literature on the effect of osteoporosis on the facial skeleton and its use as a screening site for osteoporosis. Here we aimed to investigate the suitability of QUS of the mandible as tool for screening for osteoporosis. Methods: Female Caucasian participants (n = 127;age range 22 88 years) were assessed for osteoporotic status using DEXA and the FRAX Osteoporosis assessment tool. Axial Transmission QUS (Omnisense) was employed to assess speed of sound (SOS) of the mandible. Measurement reliability was initially determined in n = 10 healthy pre-menopausal women. ANOVA was used to compare SOS between 3 groups (healthy pre-menopausal women; healthy post-menopausal women; women with osteoporosis). Logistic regression models were used to assess the predictive power of SOS in detecting osteoporosis. Results: The parasymphysis of the mandible SOS measurements demonstrated the lowest root mean squared coefficient of variation of 0.74%. Both healthy groups had significantly higher mean SOS measurements than the osteoporotic subjects, with means of 3683 m/s (210), 3514 m/s (221), and 3312 m/s (264)respectively (p < 0.001). Increased mandible SOS was associated with a decreased odds (0.97;p < 0.01) of having osteoporosis after correction for other covariates. There was only a moderate correlation found between total hip BMD and mandible SOS (r = 0.35;p < 0.05). Conclusion: This is the first study to employ axial transmission QUS to assess mandible bone strength, with mandible QUS a demonstrated screening approach for osteoporosis detection. Involvement of the dental profession in osteoporosis screening could enable detection of otherwise silent osteoporosis in the community.