Avaliação radiomorfométrica em tomografias computadorizadas de pessoas com doenças cardiovasculares

Abstract

Cardiovascular disease, a leading cause of mortality worldwide, is primarily caused by atherosclerosis, a chronic inflammatory disease of blood vessels. Atherosclerotic cardiovascular disease (ASCVD) has been related to low bone mineral density (BMD) and systemic bone changes seem to be able to be evaluated on computed tomography (CT) scans of mandible. Thus, the objective of this study was to evaluate the mandibular bone quality of people with ASCVD through radiomorphometric indexes obtained from tomographic images. The sample consisted of 130 multislice CT scans of mandible of people with ASCVD. In cross-sections of mandible in the region of the mental foramen, bilaterally, the following radiomorphometric indexes were evaluated: Computed Tomography Mandibular index ((inferior) [CTI (I)], Computed Tomography Mandibular Index (superior) [CTI(S)], Computed Tomography Mental Index (CTMI), Computed Tomography Cortical Index (CTCI) and Mandibular Alveolar Resorption Index (MARI). Intra-examiner agreement was assessed using the Kappa test and intraclass correlation coefficient statistics, and the results between groups were compared using the Kruskal Wallis and Chi-square test for a 5% error probability. The results showed that the vast majority of patients with ASCVD presented CTMI, CTI (I) and CTI (S) below the values considered normal. The CTCI C3 category was the most prevalent in the sample (50%). The values of CTI (I), CTI (S) and CTMI were higher in categories C1 and C2 and gradually decreased in category C3 (p<0.01). Alcoholic individuals and aged 70 years old or older had a consistently lower CTMI, CTI (I) and CTI (S) than individuals in the other age groups (p<0.01). The number of teeth presented, and dental condition were significantly associated with MARI (p<0.01). Among all comorbidities, only malnutrition was significantly associated with CTCI (p<0.05). It can be concluded that the majority of individuals with ASCVD had thin and porous mandibular cortices, and this tendency was influenced by the variables malnutrition, alcohol consumption and advanced age.