title: Visual assessment of the mandibular cortex on panoramic radiographs to identify postmenopausal women with low bone mineral densities.
abstract: OBJECTIVE
  The purpose of this study was to determine whether simple visual estimation of the mandibular inferior cortex width on panoramic radiographs is useful for identifying postmenopausal women with low skeletal bone mineral density (BMD).
  
  
  METHODS
  Panoramic radiographs were made on 100 women aged 50-84 years who also had BMD assessment of the lumbar spine and femoral neck by dual-energy x-ray absorptiometry. The panoramic images were examined twice by 4 observers to evaluate the thickness of the mandibular inferior cortex.
  
  
  RESULTS
  Intraobserver agreement varied from moderate to almost perfect. Interobserver agreements varied from fair to almost perfect. Overall mean sensitivity, specificity and positive predictive value in identifying women with low BMD were 54.7%, 82.0%, and 72.5% in the lumbar spine and 51.8%, 82.2%, and 75.7% in the femoral neck, respectively.
  
  
  CONCLUSIONS
  Our results suggest that simple visual estimation of the mandibular inferior cortex on panoramic radiographs may be useful for identifying postmenopausal women with low BMD.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Hiroshima University, Hiroshima, Japan. klee@hiroshima-u.ac.jp
authors.forename: Kaoru
authors.initials: K
authors.lastname: Lee
authors.forename: Akira
authors.initials: A
authors.lastname: Taguchi
authors.forename: Kodo
authors.initials: K
authors.lastname: Ishii
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Suei
authors.forename: Minoru
authors.initials: M
authors.lastname: Fujita
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Sanada
authors.forename: Mikio
authors.initials: M
authors.lastname: Tsuda
authors.forename: Koso
authors.initials: K
authors.lastname: Ohama
authors.forename: Keiji
authors.initials: K
authors.lastname: Tanimoto
authors.forename: Stuart C
authors.initials: SC
authors.lastname: White
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D016013:Likelihood Functions; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008334:Mandible / Q000000981:diagnostic imaging*; D008336:Mandibular Diseases / Q000000981:diagnostic imaging*; D008875:Middle Aged; D015588:Observer Variation; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging*; D012372:ROC Curve; D011862:Radiography, Panoramic; D012680:Sensitivity and Specificity