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Evaluating trabecular microstructure of mandible and axis in osteoporosis, diabetes and chronic kidney disease using cone beam computed tomography



Like other bones, the mandible and cervical vertebrae are affected by several systemic diseases. The aim of this study is to evaluate the effects of osteoporosis (OP), diabetes mellitus (DM), and dialysis-indicated advanced chronic kidney disease (CKD), which are the most effective systemic diseases on the bone metabolism, on the trabecular microstructure of the mandible and cervical vertebrae using cone beam computed tomography (CBCT).


81 patients who signed our informed consent form are involved in the study. 18 of them were diagnosed with osteoporosis, 18 of them with diabetes mellitus, 18 of the patients had dialysis-indicated CKD, and 27 of them were in the control group without any systemic diseases. Nine patients in the control group, patients with CKD and patients with DM were men, and nine were women. All patients with osteoporosis and 18 of the patients in the control group were women. Using CBCT images, microstructural parameters of trabecular thickness (Tb.Th), trabecular spacing (Tb.Sp) and volume fraction (bone volume/total volume, BV/TV) were measured.


Tb.Th and BV/TV values were higher in the control group, while Tb.Sp was higher in the osteoporosis group. The difference in BV/TV parameters was statistically significant (p = 0.02). In the DM group, Tb.Th and BV/TV values were lower and Tb.Sp values were significantly higher than in the control group (p = 0.001). In patients with advanced CKD, Tb.Th and BV/TV values were lower, while Tb.Sp values were higher than in the control group. Differences in Tb.Sp parameters were statistically significant (0.004).


Systemic diseases affect bone tissue at different levels, and to evaluate these effects, cortical and trabecular bone parts must be investigated separately, and findings must be combined with patients' clinical symptoms. CBCT is suitable for microstructural evaluation of trabecular bone and the mandible carries valuable data for this purpose.

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This study is presented orally in International Congress of Oral and Maxillofacial Association in 2017.

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Correspondence to Ersen Bilgili.

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This article does not contain any studies with alive human or animal subjects performed by any of the authors. In vitro study has ethical approval from Non-invasive Clinical Studies Ethical Commitee of Yüzüncü Yıl University Faculty of Medicine in Turkey in 18/12/2015 with decision number 01.

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This study has been presented orally in Oral Diagnosis and Maxillofacial Radiology Society 2nd International Congress, 2017, Eskişehir, 13–15 April 2017.

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Bilgili, E., Üçok, C.Ö. Evaluating trabecular microstructure of mandible and axis in osteoporosis, diabetes and chronic kidney disease using cone beam computed tomography. Oral Radiol (2022).

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  • Mandible
  • Vertebra
  • Trabecular bone
  • Osteoporosis
  • Diabetes mellitus
  • Kidney diseases