Radiation Diagnostics of the Maxillofacial Region and Skeleton Bone Density in the Case of Vitamin D Insufficiency: A Pilot Study

Abstract

(1) Background: A decrease in bone mineral density has been noted not only in at-risk patients (e.g., postmenopausal women) but also in young and middle-aged individuals due to changes in lifestyle. The aim of the study was to find a possible correlation for dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) with cone beam computed tomography (CBCT) of the jaws. (2) Methods: A total of 24 patients (14 women and 10 men aged 25 to 50 years) with partial secondary tooth loss and vitamin D insufficiency underwent cone beam computed tomography of the jaws and skeletal mineral density assessment using DXA (n = 12) and QCT (n = 12). (3) Results: When conducting CBCT of the jaws, a predominance of bone tissue type D3 (350-850 Hu) on the upper jaw (p > 0.05 (F = 0.68) and D2 (850-1350 Hu) on the lower jaw (p > 0.05 (F = 1) was revealed. According to the results of QCT densitometry of the skeleton, signs of osteopenia were found in four patients (with vitamin D3 deficiency) (33%) according to DXA; signs of osteopenia were found in six patients (with severe deficiency and deficiency of vitamin D3) (50%). The difference between QCT and DXA was not significant (p > 0.05) for each group. The significant strong correlation between CBCT and DXA or QCT was not found (p > 0.05). (4) Conclusions: Primary changes in bone density can be detected earlier in the dental system using cone beam computed tomography of the jaws. At the same time, the question of using a specific densitometry method-DXA or QCT-remains open, as their results correlating with CBCT optical density was not approved.

Keywords: DXA; QCT; cone beam computed tomography; densitometry; jawbone; radiology; skeleton; vitamin D insufficiency.

Figure 1

Patient’s CBCT example 6 years after operation. The D2-type bone density around dental implants has been shown in the presence of both types of bone (cortical and sponge) and the absence of pathological bone resorption signs (zone of interest is marked with cross of yellow and red lines).

Figure 2

Patient’s QCT example. Zone of scan and lines for bone mineral density assessment in the area of the left thigh (zone of interest is marked with red lines).

Figure 3

Patient’s DXA results example, with reference areas for mineral bone density assessment—the femur neck (left figure) and lumbar vertebrae 1st–4th (right figure).