title: Digital orthopantomograms in osteoporosis detection: mandibular density and mandibular radiographic indices as skeletal BMD predictors.
abstract: OBJECTIVE
  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.
authors: 1 Department of Dental Anthropology, University of Zagreb, School of Dental Medicine, Zagreb, Croatia.
authors: I
authors: I
authors: Savic Pavicin
authors: J
authors: J
authors: Dumancic
authors: T
authors: T
authors: Jukic
authors: T
authors: T
authors: Badel
authors: A
authors: A
authors: Badanjak
keywords: bone density; mandible; osteoporosis; panoramic radiography; radiographic indices