Digital Orthopantomograms in Osteoporosis Detection: Mandibular Density and Mandibular Radiographic Indices As Skeletal BMD Predictors

Overview

Journal Dentomaxillofac Radiol

Publisher Oxford University Press

Date 2014 Jun 28

PMID 24969554

Citations 13

Authors

I Savic Pavicin

J Dumancic

T Jukic

T Badel

A Badanjak

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine the correlation of skeletal bone mineral density (BMD) with mandibular density and mandibular radiographic indices estimated on digital panoramic radiographs.

Methods: Study comprised 112 female subjects older than 45 years. Digital panoramic radiographs were taken, and patients were referred to densitometric measuring (dual energy X-ray absorptiometry) of BMD in the hip bones and lumbar spine regions (L1-L4). On the radiographs, mandibular bone density was estimated and the following indices were measured by the DIGORA(®) software (Soredex, Tuusula, Finland): mental index (MI), gonial index (GI), antegonial index (AI), panoramic mandibular index (PMI) and alveolar crest resorption degree (M/M). Mandibular cortical index (MCI) was visually estimated.

Results: Mandibular density and visual index MCI are significant predictors of hip and spine BMD. Mandibular density was marked by a significant square trend: it decreased until the age of 54 years and remained constant until the age of 64 years when it started to increase. Significant correlations were found between MI, AI and PMI values and BMD in the hip but not in the lumbar spine region. The GI and M/M values did not show statistically significant correlations with BMD of either region.

Conclusions: Mandibular bone density and mandibular radiographic indices are useful in detecting patients with decreased BMD. The applicability of orthopantomograms in diagnosing osteoporosis/osteopenia should be recognized as the potential greatest benefit of this everyday diagnostic method in dental practice.

Citing Articles

Effectiveness of Orthopantomograms as a Screening Tool for Osteoporosis: A Case-Control Study.

M D, Kumar J, Ramalingam K Cureus. 2023; 15(9):e45702.

PMID: 37868467 PMC: 10590166. DOI: 10.7759/cureus.45702.

The Asymmetry of the Mandible in Patients with Unilateral Temporomandibular Joint Disc Displacement Confirmed by Magnetic Resonance Imaging.

Badel T, Vojnovic S, Bukovic D, Zadravec D, Anic Milosevic S, Smoljan Basuga M Acta Stomatol Croat. 2023; 57(2):167-176.

PMID: 37427358 PMC: 10323934. DOI: 10.15644/asc57/2/7.

Oral and craniofacial research in the Generation R study: an executive summary.

van Meijeren-van Lunteren A, Liu X, Veenman F, Grgic O, Dhamo B, van der Tas J Clin Oral Investig. 2023; 27(7):3379-3392.

PMID: 37301790 PMC: 10329569. DOI: 10.1007/s00784-023-05076-1.

Evaluation of the effect of antiepileptic drugs on mandibular bone quality by fractal analysis.

Ustdal B, Soydan Cabuk D, Cosgunarslan A, Evlice B, Evlice A Oral Radiol. 2023; 39(3):563-569.

PMID: 36786955 DOI: 10.1007/s11282-023-00671-0.

The effect of Rutin hydrate on Glucocorticoids induced osteoporosis in mandibular alveolar bone in Albino rats (Radiological, histological and histochemical study).

Abdul-Fattah Baraka N, Ahmed N, Hussein S Saudi Dent J. 2022; 34(6):464-472.

PMID: 36092520 PMC: 9453515. DOI: 10.1016/j.sdentj.2022.06.009.

References

Drozdzowska B, Pluskiewicz W, Tarnawska B . Panoramic-based mandibular indices in relation to mandibular bone mineral density and skeletal status assessed by dual energy X-ray absorptiometry and quantitative ultrasound. Dentomaxillofac Radiol. 2002; 31(6):361-7. DOI: 10.1038/sj.dmfr.4600729. View

Buyukkaplan U, Tonguc M, Guldag M, Yildiz M, Gumus B . Comparison of mandibular bone mineral densities in dentate and edentulous patients. J Prosthodont. 2012; 22(1):23-7. DOI: 10.1111/j.1532-849X.2012.00908.x. View

Kingsmill V, Boyde A . Variation in the apparent density of human mandibular bone with age and dental status. J Anat. 1998; 192 ( Pt 2):233-44. PMC: 1467757. DOI: 10.1046/j.1469-7580.1998.19220233.x. View

Compston J, Bowring C, Cooper A, Cooper C, Davies C, Francis R . Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas. 2013; 75(4):392-6. DOI: 10.1016/j.maturitas.2013.05.013. View

Knezovic Zlataric D, celebic A . Clinical bone densitometric evaluation of the mandible in removable denture wearers dependent on the morphology of the mandibular cortex. J Prosthet Dent. 2003; 90(1):86-91. DOI: 10.1016/s0022-3913(03)00171-9. View

Klemetti E, Kolmakov S, Kroger H . Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res. 1994; 102(1):68-72. DOI: 10.1111/j.1600-0722.1994.tb01156.x. View

Jonasson G, Jonasson L, Kiliaridis S . Changes in the radiographic characteristics of the mandibular alveolar process in dentate women with varying bone mineral density: a 5-year prospective study. Bone. 2005; 38(5):714-21. DOI: 10.1016/j.bone.2005.10.008. View

Shintaku W, Enciso R, Covington J, Migliorati C . Can dental students be taught to use dental radiographs for osteoporosis screening?. J Dent Educ. 2013; 77(5):598-603. View

Yasar F, Akgunlu F . The differences in panoramic mandibular indices and fractal dimension between patients with and without spinal osteoporosis. Dentomaxillofac Radiol. 2006; 35(1):1-9. DOI: 10.1259/dmfr/97652136. View

10.

Klemetti E, Kolmakow S . Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofac Radiol. 1997; 26(1):22-5. DOI: 10.1038/sj.dmfr.4600203. View

11.

Horner K, Devlin H . The relationship between mandibular bone mineral density and panoramic radiographic measurements. J Dent. 1998; 26(4):337-43. DOI: 10.1016/s0300-5712(97)00020-1. View

12.

Devlin H, Karayianni K, Mitsea A, Jacobs R, Lindh C, van der Stelt P . Diagnosing osteoporosis by using dental panoramic radiographs: the OSTEODENT project. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104(6):821-8. DOI: 10.1016/j.tripleo.2006.12.027. View

13.

Klemetti E, Vainio P, Lassila V, Alhava E . Cortical bone mineral density in the mandible and osteoporosis status in postmenopausal women. Scand J Dent Res. 1993; 101(4):219-23. DOI: 10.1111/j.1600-0722.1993.tb01108.x. View

14.

Hastar E, Yilmaz H, Orhan H . Evaluation of mental index, mandibular cortical index and panoramic mandibular index on dental panoramic radiographs in the elderly. Eur J Dent. 2011; 5(1):60-7. PMC: 3019752. View

15.

Lopez-Lopez J, Estrugo-Devesa A, Jane-Salas E, Ayuso-Montero R, Gomez-Vaquero C . Early diagnosis of osteoporosis by means of orthopantomograms and oral x-rays: a systematic review. Med Oral Patol Oral Cir Bucal. 2011; 16(7):e905-13. DOI: 10.4317/medoral.17304. View

16.

Ledgerton D, Horner K, Devlin H, Worthington H . Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol. 2000; 28(3):173-81. DOI: 10.1038/sj/dmfr/4600435. View

17.

Dervis E . Oral implications of osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100(3):349-56. DOI: 10.1016/j.tripleo.2005.04.010. View

18.

Kribbs P . Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent. 1990; 63(2):218-22. DOI: 10.1016/0022-3913(90)90108-o. View

19.

White S, Taguchi A, Kao D, Wu S, Service S, Yoon D . Clinical and panoramic predictors of femur bone mineral density. Osteoporos Int. 2005; 16(3):339-46. DOI: 10.1007/s00198-004-1692-4. View

20.

Devlin H, Horner K . Mandibular radiomorphometric indices in the diagnosis of reduced skeletal bone mineral density. Osteoporos Int. 2002; 13(5):373-8. DOI: 10.1007/s001980200042. View