title: Relationship between dental panoramic radiographic findings and biochemical markers of bone turnover.
abstract: We investigated whether mandibular cortical measures on dental panoramic radiographs are associated with biochemical markers of bone turnover in 82 postmenopausal women. Mandibular cortical shape was significantly associated with biochemical markers and spinal BMD. Our results suggest that dentists may be able to identify postmenopausal women with low BMD by using dental panoramic radiographs.
  
  
  BACKGROUND
  Recent studies suggest that mandibular inferior cortical shape and width on dental panoramic radiographs may be useful screening tools for low skeletal bone mineral density (BMD) or increased risk of osteoporotic fracture. However, little is known as to whether these measures are associated with bone turnover. We investigated relationships among dental panoramic radiographic findings, spine BMD, and biochemical markers of bone turnover in postmenopausal women.
  
  
  METHODS
  Of 609 women who visited our clinic for BMD assessment between 1996 and 2002, 82 Japanese postmenopausal women, 46-68 years of age (54.1 +/- 4.9 years), were recruited for this study. Mandibular inferior cortical shape (normal, mild/moderate erosion, severe erosion) and width were evaluated on dental panoramic radiographs. BMD at the lumbar spine (L2-L4) was measured by DXA and categorized as normal (T-score > -1.0), osteopenia (T-score, -1.0 to -2.5), or osteoporosis (T-score < -2.5). Bone turnover was estimated by serum total alkaline phosphatase (ALP) and urinary N-telopeptide cross-links of type I collagen (NTx), corrected for creatinine.
  
  
  RESULTS
  The odds of low spine BMD in subjects with any cortical erosion were 3.8 (95% CI, 1.2-12.5). Mandibular cortical erosion was significantly associated with increased NTx (p < 0.001) and ALP (p < 0.05) levels. The associations of spine BMD with NTx and ALP were similar. Mandibular cortical width was significantly associated with spine BMD but not with NTx and ALP levels.
  
  
  CONCLUSIONS
  Our results suggest that mandibular inferior cortical shape on dental panoramic radiographs may be an indicator of bone turnover and spine BMD in postmenopausal women. Dentists may be able to identify postmenopausal women with increased risk of osteopenia and osteoporosis on routine dental panoramic radiographs.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Hiroshima University Dental Hospital, Hiroshima, Japan. akiro@hiroshima-u.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Taguchi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Sanada
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Krall
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Suei
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanimoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kodama
authors.forename: Mikio
authors.initials: M
authors.lastname: Tsuda
authors.forename: Koso
authors.initials: K
authors.lastname: Ohama
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D016723:Bone Remodeling / Q000502:physiology*; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008334:Mandible / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D010455:Peptides / Q000652:urine; D011862:Radiography, Panoramic; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D003094:Collagen; D000469:Alkaline Phosphatase