Evaluation of panoramic radiography measures for identifying reduced bone mineral density in elderly

Abstract

Introduction: The purpose of this study was to assess the validity of panoramic based indices (Mandibular cortical index, cortical width, panoramic mandibular index, and mandibular ratio) and to determine whether they correlate with bone mineral density in elderly. Materials and Method: The participants of this study were 120 patients; 53 males (45-83 years old, mean: 61.6 +/- 10.02) and 67 females (42-81 years old, mean: 60.58 +/- 9.15). Mandibular indices and number of teeth were measured and evaluated from panoramic radiographs. Bone mineral density (BMD) at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values were categorized as normal (T-score greater than -1.0), and as indicative of osteopenia (T-score -1.0 to -2.5) or osteoporosis (T-score less than -2.5) according to the World Health Organization classification. Results: There were statistically significant correlations between bone mineral density and sex, cortical width, mandibular ratio and mandibular cortical index (p<0.05). However, there were no significant correlations between panoramic mandibular index and bone mineral density. Also, there were significant correlations between mandibular cortical index and panoramic mandibular index (p<0.01), cortical width (p<0.05), mandibular ratio (p<0.05) and the number of mandibular (p<0.01) and maxillary teeth (p<0.05). However, there was no statistical significant difference between the mandibular cortical index and age (p>0.05). Conclusion: Mandibular cortical index can be used for identifying subjects with low bone mass, allowing the dentists to have sufficient clinical and radiographic information to play a useful role in screening for individuals with osteoporosis.