Visual assessment of the mandibular cortex on panoramic radiographs to identify postmenopausal women with low bone mineral densities.
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.
Lee
Kaoru
K
Department of Oral and Maxillofacial Radiology, Hiroshima University, Hiroshima, Japan. klee@hiroshima-u.ac.jp
Taguchi
Akira
A
Ishii
Kodo
K
Suei
Yoshikazu
Y
Fujita
Minoru
M
Nakamoto
Takashi
T
Ohtsuka
Masahiko
M
Sanada
Mitsuhiro
M
Tsuda
Mikio
M
Ohama
Koso
K
Tanimoto
Keiji
K
White
Stuart C
SC
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