%0 Journal Article
%T Is jaw fractal dimension a reliable biomarker for osteoporosis screening? A systematic review and meta-analysis of diagnostic test accuracy studies.
%A Cavalcante DS
%A Silva PGB
%A Carvalho FSR
%A Quidute ARP
%A Kurita LM
%A Cid AMPL
%A Ribeiro TR
%A Gurgel ML
%A Kurita BM
%A Costa FWG
%J Dentomaxillofac Radiol
%V 51
%N 4
%D May 2022 1
%M 34767466
%F 3.525
%R 10.1259/dmfr.20210365
%X <B>OBJECTIVE: </B>To summarize the evidence on the feasibility of maxillomandibular imaging exams-related fractal dimension (FD) in screening patients with osteoporosis.<BR><B>METHODS: </B>This registered systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy statement. High sensitivity search strategies were developed for six primary databases and grey literature. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) items evaluated the risk of bias, and the GRADE approach assessed the evidence certainty.<BR><B>RESULTS: </B>From 1034 records initially identified through database searching, four studies were included (total sample of 747 patients [osteoporosis, 136; control group, 611]). The meta-analysis showed that the overall sensitivity and specificity of the FD were 86.17 and 72.68%, respectively. In general, all studies showed low RoB and applicability concern. The certainty of the evidence was very low to moderate.<BR><B>CONCLUSIONS: </B>This systematic review showed that the jaw-related FD presented sensitivity and specificity values higher than 70%, and its sensitivity in osteoporosis screening was a better parameter than specificity.