1.Orthopedic referral rates following osteoporosis screening using dental panoramic radiography in female patients: A three-year prospective study
Noriyuki SUGINO ; Hiroko KUROIWA ; Hizuru OSANAI ; Shinichiro YAMADA ; Kozue MORI ; Hirokazu KOBAYASHI ; Daisuke HIGUCHI ; Nobuyuki UDAGAWA ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2025;11(4):121-126
Objectives:
Although osteoporosis affects approximately 15.9 million people in Japan, screening rates remain low.Dental panoramic radiographs (DPRs), routinely used in general dental practice, may facilitate opportunistic screening, yet referrals based on these images are not widely implemented. This study evaluated referral rates to orthopedic departments of patients with suspected osteoporosis identified using DPRs.
Methods:
Among 3237 female patients aged ≥ 50 who underwent DPRs between February 2022 and October 2024, 328 without a prior osteoporosis diagnosis were identified as suspected cases. Their primary dentists referred these patients to our hospital’s orthopedic department. Additionally, trained oral radiologists optionally provided information on osteoporosis. We assessed (1) the overall referral rate, (2) differences in referral rates based on whether an explanation by oral radiologist was provided, (3) referral rates stratified by age group, and (4) the prevalence of osteoporosis, osteopenia, and asymptomatic vertebral fractures among referred patients.
Results:
Of the 328 patients, 53 (16.2%) visited the orthopedic department. Referral rates were significantly higher among patients who received explanations from trained oral radiologists (50.9%) than among patients who did not (9.1%). Referral rates peaked among patients in their 60s (23.7%). Among referred patients, 60.4% were diagnosed with osteoporosis and 37.7% with osteopenia; five patients had asymptomatic vertebral fractures.
Conclusions
Despite easy access to orthopedic care, referral rates remained low, likely due to limited awareness.Explanations by trained oral radiologists significantly improved referral rates, highlighting the importance of dentist-led education and interdisciplinary collaboration in promoting osteoporosis screening in general dental practice.
2.Screening ability of dental students to detect osteoporosis on dental panoramic radiographs
Hizuru OSANAI ; Hiroko KUROIWA ; Shinichiro YAMADA ; Noriyuki SUGINO ; Takashi NAKAMOTO ; Masahiko OHTSUKA ; Yoshikazu SUEI ; Naoya KAKIMOTO ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2024;10(4):145-150
Objectives:
Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs.
Methods:
A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA).
Results:
Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively.
Conclusions
Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.
3.Screening ability of dental students to detect osteoporosis on dental panoramic radiographs
Hizuru OSANAI ; Hiroko KUROIWA ; Shinichiro YAMADA ; Noriyuki SUGINO ; Takashi NAKAMOTO ; Masahiko OHTSUKA ; Yoshikazu SUEI ; Naoya KAKIMOTO ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2024;10(4):145-150
Objectives:
Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs.
Methods:
A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA).
Results:
Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively.
Conclusions
Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.
4.Screening ability of dental students to detect osteoporosis on dental panoramic radiographs
Hizuru OSANAI ; Hiroko KUROIWA ; Shinichiro YAMADA ; Noriyuki SUGINO ; Takashi NAKAMOTO ; Masahiko OHTSUKA ; Yoshikazu SUEI ; Naoya KAKIMOTO ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2024;10(4):145-150
Objectives:
Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs.
Methods:
A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA).
Results:
Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively.
Conclusions
Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.
5.Screening ability of dental students to detect osteoporosis on dental panoramic radiographs
Hizuru OSANAI ; Hiroko KUROIWA ; Shinichiro YAMADA ; Noriyuki SUGINO ; Takashi NAKAMOTO ; Masahiko OHTSUKA ; Yoshikazu SUEI ; Naoya KAKIMOTO ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2024;10(4):145-150
Objectives:
Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs.
Methods:
A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA).
Results:
Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively.
Conclusions
Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.
6.Screening ability of dental students to detect osteoporosis on dental panoramic radiographs
Hizuru OSANAI ; Hiroko KUROIWA ; Shinichiro YAMADA ; Noriyuki SUGINO ; Takashi NAKAMOTO ; Masahiko OHTSUKA ; Yoshikazu SUEI ; Naoya KAKIMOTO ; Akira TAGUCHI
Osteoporosis and Sarcopenia 2024;10(4):145-150
Objectives:
Postmenopausal women with osteoporosis are frequently underdiagnosed. In Japan, general dental practitioners have begun using the cortical shape of the mandible on dental panoramic radiographs (PRs) to identify and refer women at risk of osteoporosis to medical professionals. It remains unclear whether dental students, after relevant education, possess the ability to identify these at-risk individuals. This study evaluated the ability of dental students to screen for osteoporosis on PRs.
Methods:
A cohort of 113 fifth-year dental students participated in a lecture on osteoporosis screening using PRs.The students then categorized the mandibular inferior cortex on PRs from 30 postmenopausal women (11 with osteoporosis) as normal, mildly to moderately eroded, or severely eroded. Interobserver agreement between the students and an expert oral radiologist using two cortical groups (normal to moderately eroded and severely eroded) was assessed through kappa statistics. Screening ability for osteoporosis detection by identifying severely eroded cortices was calculated and compared with that of the Osteoporosis Self-assessment Tool for Asians (OSTA).
Results:
Twenty-one (18.6%) students demonstrated moderate to substantial agreement with the expert. The mean sensitivity, specificity, and positive and negative predictive values for these students in identifying osteoporosis were 60.2%, 88.0%, 76.3%, and 80.0%, respectively. For the OSTA, sensitivity, specificity, and positive and negative predictive values were 27.3%, 68.4%, 33.3%, and 61.9%, respectively.
Conclusions
Even with minimal education, approximately one-fourth of dental students may accurately identify postmenopausal women with osteoporosis on PRs, outperforming questionnaire-based screening tools.
8.Dynamic three-dimensional shoulder kinematics in patients with massive rotator cuff tears: a comparison of patients with and without subscapularis tears
Yuji YAMADA ; Yoshihiro KAI ; Noriyuki KIDA ; Hitoshi KODA ; Minoru TAKESHIMA ; Kenji HOSHI ; Kazuyoshi GAMADA ; Toru MORIHARA
Clinics in Shoulder and Elbow 2022;25(4):265-273
Background:
Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined.
Methods:
This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared.
Results:
The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. −1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles.
Conclusions
In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.
9.Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications
Akinori HATA ; Yoshitake YAMADA ; Rie TANAKA ; Mizuki NISHINO ; Tomoyuki HIDA ; Takuya HINO ; Masako UEYAMA ; Masahiro YANAGAWA ; Takeshi KAMITANI ; Atsuko KUROSAKI ; Shigeru SANADA ; Masahiro JINZAKI ; Kousei ISHIGAMI ; Noriyuki TOMIYAMA ; Hiroshi HONDA ; Shoji KUDOH ; Hiroto HATABU
Korean Journal of Radiology 2021;22(4):634-651
Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD).This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.
10.Dynamic Chest X-Ray Using a Flat-Panel Detector System: Technique and Applications
Akinori HATA ; Yoshitake YAMADA ; Rie TANAKA ; Mizuki NISHINO ; Tomoyuki HIDA ; Takuya HINO ; Masako UEYAMA ; Masahiro YANAGAWA ; Takeshi KAMITANI ; Atsuko KUROSAKI ; Shigeru SANADA ; Masahiro JINZAKI ; Kousei ISHIGAMI ; Noriyuki TOMIYAMA ; Hiroshi HONDA ; Shoji KUDOH ; Hiroto HATABU
Korean Journal of Radiology 2021;22(4):634-651
Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD).This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

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