Can mandibular bone resorption predict hip fracture in elderly women? A systematic review of diagnostic test accuracy

Objectives The aim of this systematic review was to determine the diagnostic accuracy of the mandibular cortical width measurements and porosity in detecting hip osteoporosis. Background All of the included studies used measurements on panoramic radiographs. Materials and methods Studies were included if they compared the radiographic measurements (or index tests) with central dual energy X‐ray absorptiometry (DXA) of the hip as the reference standard. A measure of diagnostic accuracy such as sensitivity and specificity or area under the receiver operating characteristic curve was also required for inclusion. Results Seven studies were identified. Meta‐analysis was not possible because of the heterogeneity of the studies. The studies all demonstrated moderate diagnostic accuracy. Conclusion If a patient with a thin or porous mandibular cortex is identified by a chance radiographic finding, additional clinical risk factors need to be considered and the patient referred for further investigation with DXA where necessary.