Use of digital panoramic radiography as an auxiliary means of low bone mineral density detection in post-menopausal women

Abstract

Objectives: To correlate the radiomorphometric indices obtained using digital panoramic radiography (DPR) with bone mineral densities, evaluated by the dual-energy X-ray absorptiometry test, in a population of post-menopausal females to identify patients with asymptomatic low bone mineral densities. Methods: The morphology of the mandibular cortex was evaluated using the mandibular cortical index (MCI) and the inferior mandibular cortex width was evaluated using the mental index (MI) in 64 female patients who had undergone dual-energy X-ray absorptiometry assessment. Of these patients, 21 were diagnosed with osteopaenia and 20 with osteoporosis, and 23 were normal. Three new indices for evaluating the inferior mandibular cortex width were designed: the mental posterior index 1 (MPI1), MPI2 and MPI3. Statistical analyses were performed using the x 2 and Kruskal-Wallis tests and the receiver operating characteristic curve. Results: There were significant differences between the normal and lower bone mineral density groups (osteopaenia and osteoporosis) for MCI (p , 0.01). In the osteoporosis group, the MI, MPI1, MPI2 and MPI3 were significantly different from the normal and osteopaenia groups (p , 0.05). The MI, MPI1, MPI2 and MPI3 showed that there is an area in the mandibular cortex, located between the mental foramen and the antegonial region, which is valid for identifying females at high risk for osteoporosis. Conclusions: The MCI, MI, MPI1, MPI2, and MPI3 radiomorphometric indices evaluated using DPR can be used to identify post-menopausal females with low bone densities and to provide adequate medical treatment for them.

Sensitivity and Specificity of Radiographic Methods for Predicting Insertion Torque of Dental Implants

“…Despite the fact that MCI is an indicator for peripheral bone quality, 28 it has also been found to play a decisive role in the diagnostic performance of the present classification, according to the sensitivity and specificity analyses presented in Table 3. Furthermore, the correlation among MCI and MCW and patient age observed in this study supports results from studies that validated these indices to predict bone alterations such as osteoporosis because bone density is expected to decrease as the patient grows older 26 …”

“…Images were taken using 60 kV, 4 mA, 0.5‐mm copper filter exposure conditions and were analyzed using imaging processing software § . The mandibular cortical width (MCW) was measured at both mental foramen regions according to previous methodology 26 . Briefly, images were corrected using a magnification factor of 1.3.…”

“…Panoramic radiographs are useful to diagnose systemic 26 and alveolar 27 bone quality by assessing the width and shape of the inferior mandibular cortex. These measurements have been described as indices to predict osteoporosis because they are correlated with systemic bone mineral density (BMD) values measured with dual‐energy x‐ray absorptiometry (DXA) 28 .…”

Decrease in Mandibular Cortical in Patients With Type 1 Diabetes Mellitus Combined with Poor Glycemic Control

“…Much has been studied about bone quality of dental structures of individuals with systemic conditions that may result in decreased BMD, such as osteoporosis (4), postmenopause (10), celiac disease (11) and osteogenesis imperfect (12). However, there are no studies with radiomorphometric analysis in individuals with T1DM.…”

The use of panoramic radiographs modified by an open access software to determine Mandibular Cortical Index

“…Many researchers advocate its use for screening for osteoporosis [4,8,[15][16][17][18][19][20][21][22][23][24] by the fact that the mandibular cortical bone may reflect changes in bone architecture of other sites from skeleton [4,12,15].…”