Kan AI het risico op osteoporose inschatten op basis van routinematige tandröntgenfoto's van de kaakbotdichtheid ?

Osteoporose beïnvloedt vaak de kaakbotdichtheid voordat systemische symptomen optreden. AI getraind op tandheelkundige röntgenfoto’s zou de botmineraaldichtheid kunnen schatten zonder extra straling. Dit zou opportunistisch screenen tijdens tandartsbezoeken mogelijk kunnen maken. De nauwkeurigheid hangt af van de beeldkwaliteit en kalibratie tussen verschillende beeldvormingssystemen.

Background

Osteoporosis often affects jaw bone density before causing systemic symptoms, making opportunistic screening during dental visits attractive. Deep-learning models trained on panoramic dental radiographs (orthopantomograms) analyze trabecular bone microarchitecture to estimate systemic bone loss. Reported performance in validation cohorts reaches sensitivities around 80–90% for identifying low bone mineral density, approaching the accuracy of dual-energy X-ray absorptiometry (DEXA) scans. Variability in X-ray equipment, the absence of standardized acquisition and calibration protocols, and the need for broader validation across diverse populations currently limit clinical adoption. Current tools remain largely research-oriented, though several commercial dental AI platforms have begun to integrate osteoporosis risk-assessment features. AI training relies on large annotated datasets linking radiographic jaw features to DEXA-derived bone mineral density or clinical osteoporosis diagnoses, with cross-site validation essential to ensure generalizability. Calibration across different panoramic systems and patient subgroups is critical to reduce false positives and negatives. Future directions include federated learning to harmonize multi-vendor datasets and integration of AI outputs into electronic health records to facilitate clinician follow-up.