Recentemente, a osteoporose tem sido apontada como fator associado a manifestações bucais representadas pela perda óssea, especialmente na mandíbula. Entretanto, as técnicas de avaliação direta da densidade mineral óssea mandibular ainda não demonstraram boa precisão e acurácia. O presente trabalho teve como objetivo avaliar, por meio de um estudo descritivo-analítico, a possibilidade da utilização das radiografias panorâmicas, como um método capaz de expressar as alterações morfológicas da mandíbula decorrentes da idade e estabelecer um único índice quantitativo e qualitativo, para identificar os casos de osteopenia e osteoporose. A pesquisa ocorreu em mulheres em período de menopausa e pós-menopausa em tratamento odontológico nas clínicas odontológicas da faculdade de Odontologia da Universidade de São Paulo, no município de São Paulo SP. A confirmação do diagnóstico da osteoporose foi estabelecida mediante verificação dos relatórios da densitometria de antebraço obtidos, e comparados aos diagnósticos obtidos nas radiografias panorâmicas para o estabelecimento de um único índice quantitativo e qualitativo que considere a reabsorção e a baixa espessura da cortical na avaliação. O novo Índice Panorâmico Quantitativo e Quantitativo (IPQQ) foi determinado. A concordância entre as duas avaliações, calculada como razoável, reflete sensibilidade (moderada) de 56%, especificidade (satisfatória) de 82% e VPN (Valor Preditivo Negativo) de 68%. O IPQQ apresentou associação e concordância significativa com a densitometria (padrão ouro) podendo ser utilizado como teste para o rastreamento, porém cuidados ou algumas restrições deverão ser tomados em sua utilização, pois a intensidade de concordância razoável foi devida a uma moderada sensibilidade deste teste em relação ao padrão ouro. / Recently, osteoporosis has been implicated as being associated with oral manifestations represented by bone loss, especially in the jaw. However, the techniques of direct assessment of mandibular bone mineral density has not demonstrated good accuracy and precision. This study aimed to evaluate, through a descriptive and analytical study, the possibility of the use of panoramic radiographs as a method to express the morphological changes of the jaw due to age and to establish a single index quantitatively and qualitatively, to identify cases of osteopenia and osteoporosis. The research period occurred in women in menopause and postmenopause in dental treatment in dental clinics of the Faculty of Dentistry, University of São Paulo, in São Paulo - SP. Confirmation of the diagnosis of osteoporosis was established by scanning densitometry reports obtained from the forearm, and compared the diagnoses obtained from panoramic radiographs for the establishment of a single index that considers both quantitative and qualitative resorption and lower cortical thickness in the assessment. The new Quantitative and Quantitative Panoramic Index (QQPI) was determined. The agreement between the two assessments, calculated as reasonable, reflects sensitivity (moderate) 56%, specificity (satisfactory) to 82% and NPV (Negative Predictive Value) of 68%. The QQPI showed significant association and agreement with densitometry (gold standard) can be used as a test for the screening, but some restrictions or care should be taken into use, because the intensity of reasonable agreement was due to a moderate sensitivity of this test in compared to the gold standard.

We analyze data on bone mineral density (BMD) and age for white females age 20+ in the third National Health and Nutrition Examination Survey. For the sample the age of each individual is known, but some individuals did not have their BMD measured, mainly because they did not show up in the mobile examination centers. We have data from 35 counties, the small areas. We use two types of models to analyze the data. In the ignorable nonresponse model, BMD does not depend on whether an individual responds or not. In the nonignorable nonresponse model, BMD is related to whether he/she responds. We incorporate this relationship in our model by using a Bayesian approach. We further divide these two types of models into continuous and categorical data models. Our nonignorable nonresponse models have one important feature: They are ``close' to the ignorable nonresponse model thereby reducing the effects of the untestable assumptions so common in nonresponse models. In the continuous data models, because the age of all nonrespondents are known and there is a relation between BMD and age, age is used as a covariate. In the categorical data models BMD has three levels (normal, osteopenia, osteoporosis) and age has two levels (younger than 50 years, at least 50 years). Thus, age is a supplemental margin for the $2 imes 3$ categorical table. Our research on the categorical models is much deeper than on the continuous models. Our models are hierarchical, a feature that allows a ``borrowing of strength' across the counties. Individual inference for most of the counties is unreliable because there is large variation. This ``borrowing of strength' is therefore necessary because it permits a substantial reduction in variation. The joint posterior density of the parameters for each model is complex. Thus, we fit each model using Markov chain Monte Carlo methods to obtain samples from the posterior density. These samples are used to make inference about BMD and age, and the relation between BMD and age. For the continuous data models, we show that there is an important relation between BMD and age by using a deviance measure, and we show that the nonignorable nonresponse models are to be preferred. For the categorical data models, we are able to estimate the proportion of individuals in each BMD and age cell of the categorical table, and we can assess the relation between BMD and age using the Bayes factor. A sensitivity analysis shows that there are differences, typically small, in inference that permits different levels of association between BMD and age. A simulation study shows that there is not much difference in inference between the ignorable nonresponse models and the nonignorable nonresponse models. As expected, BMD depends on age and this inference can be obtained for some small counties. For the data we use, there are virtually no young individuals with osteoporosis. The nonignorable nonresponse models generalize the ignorable nonresponse models, and therefore, allow broader inference.

Recentemente, a osteoporose tem sido apontada como fator associado a manifestações bucais representadas pela perda óssea, especialmente na mandíbula. Entretanto, as técnicas de avaliação direta da densidade mineral óssea mandibular ainda não demonstraram boa precisão e acurácia. O presente trabalho teve como objetivo avaliar, por meio de um estudo descritivo-analítico, a possibilidade da utilização das radiografias panorâmicas, como um método capaz de expressar as alterações morfológicas da mandíbula decorrentes da idade e estabelecer um único índice quantitativo e qualitativo, para identificar os casos de osteopenia e osteoporose. A pesquisa ocorreu em mulheres em período de menopausa e pós-menopausa em tratamento odontológico nas clínicas odontológicas da faculdade de Odontologia da Universidade de São Paulo, no município de São Paulo SP. A confirmação do diagnóstico da osteoporose foi estabelecida mediante verificação dos relatórios da densitometria de antebraço obtidos, e comparados aos diagnósticos obtidos nas radiografias panorâmicas para o estabelecimento de um único índice quantitativo e qualitativo que considere a reabsorção e a baixa espessura da cortical na avaliação. O novo Índice Panorâmico Quantitativo e Quantitativo (IPQQ) foi determinado. A concordância entre as duas avaliações, calculada como razoável, reflete sensibilidade (moderada) de 56%, especificidade (satisfatória) de 82% e VPN (Valor Preditivo Negativo) de 68%. O IPQQ apresentou associação e concordância significativa com a densitometria (padrão ouro) podendo ser utilizado como teste para o rastreamento, porém cuidados ou algumas restrições deverão ser tomados em sua utilização, pois a intensidade de concordância razoável foi devida a uma moderada sensibilidade deste teste em relação ao padrão ouro. / Recently, osteoporosis has been implicated as being associated with oral manifestations represented by bone loss, especially in the jaw. However, the techniques of direct assessment of mandibular bone mineral density has not demonstrated good accuracy and precision. This study aimed to evaluate, through a descriptive and analytical study, the possibility of the use of panoramic radiographs as a method to express the morphological changes of the jaw due to age and to establish a single index quantitatively and qualitatively, to identify cases of osteopenia and osteoporosis. The research period occurred in women in menopause and postmenopause in dental treatment in dental clinics of the Faculty of Dentistry, University of São Paulo, in São Paulo - SP. Confirmation of the diagnosis of osteoporosis was established by scanning densitometry reports obtained from the forearm, and compared the diagnoses obtained from panoramic radiographs for the establishment of a single index that considers both quantitative and qualitative resorption and lower cortical thickness in the assessment. The new Quantitative and Quantitative Panoramic Index (QQPI) was determined. The agreement between the two assessments, calculated as reasonable, reflects sensitivity (moderate) 56%, specificity (satisfactory) to 82% and NPV (Negative Predictive Value) of 68%. The QQPI showed significant association and agreement with densitometry (gold standard) can be used as a test for the screening, but some restrictions or care should be taken into use, because the intensity of reasonable agreement was due to a moderate sensitivity of this test in compared to the gold standard.

High impact loading activities such as jumping, performed during childhood is advocated as one preventive method for increasing peak bone mass. Thus, we conducted a randomized intervention to examine the effect of high impact loading on bone mass in 34 pre-pubescent boys and girl over a seven month period. Participants meeting all inclusion criteria were randomized into either a jumping (n=18) or stretching group (n=16), both of which exercised three times per week for 15 minutes. The jumping group completed 100 jumps off 24-inch boxes each session, while the stretching group performed low impact flexibility exercises. Attrition was 85% (6 drop outs), with an overall attendance rate of 95%. Bone area and bone mineral content (BMC) was assessed using dual energy x-ray absorptiometery (Ho logic QDR 1000/W) for the left hip (femoral neck, greater trochanter, total hip), and lumbar spine (L[subscript 2-4]). Other measures were body composition (Lang skinfold calipers); physical activity (self-report questionnaire); and calcium intake (food survey). All measurements were assessed at baseline and 7 months. Significance is denoted as p<.05. Analysis of variance (ANOVA) revealed no baseline difference between groups for age, height, weight, body fat, physical activity, or calcium intake (p>.05); however, gender differences were found for FN BMC at baseline (p<.05). Repeated measures ANOVA identified significant group differences for FN BMC (p=.015), with a trend for significance for FN area (p=.055). No significant differences in BMC or bone area were found at all other skeletal sites (p>.05). No group by gender interactions were found at baseline or at the completion of the seven month intervention. No significant differences between groups were identified for body composition, physical activity, or calcium intake in repeated measures ANOVA analyses (p>.05). In conclusion, 100 jumps performed 3 times per week at approximately 8x body weight were sufficient to stimulate an osteogenic response at the femoral neck in pre-pubescent boys and girls. Implementing jumping exercises into regular physical activity programs during pre-pubescent growing years may increase peak bone mass and potentially reduce the onset of osteoporosis. / Graduation date: 1999

Thesis (M.S.)--Oregon State University, 2004. / Includes bibliographical references.

Not available / text

Thesis (M.S.)--University of Michigan, 1987.

Thesis (M.S.)--University of Michigan, 1987.

Thesis (MSc. (Physiology)--Faculty of Health Sciences) - University of Pretoria, 2008. / Includes bibliographical references.

Thesis (M.S.)--University of British Columbia, 2003. / Includes bibliographical references (leaves 100-108).