Use of digital panoramic radiographs as a screening tool for diagnosis of osteoporosis in Thai postmenopausal women

Abstract

Purpose: To investigate the correlation between panoramic radiographic indices and osteoporosis, and to determine whether digital panoramic radiographs could be used as a screening tool for the diagnosis of osteoporosis in Thai postmenopausal women. Materials and Methods: A cross-sectional study of sixty Thai postmenopausal women with and without osteoporosis. The subjects were divided into three groups based on diagnosis by dual-energy X-ray absorptiometry (DXA): normal, osteopenia, and osteoporosis equally in each group. The panoramic radiographic indices measured were mental index (MI) and mandibular cortical index (MCI). Pearson’s correlation test was performed to analyze any correlation between MI, MCI, and BMD (Bone Mineral Density) T-scores. To determine the ability of the indices to classify disease and investigate the cut-off value of MI for diagnosis of osteoporosis, the receiver operating characteristic analysis was performed. The P value was set at 0.05. Results: The MCI was significantly different in the 3 different groups (p<0.001). There were correlations between the panoramic radiographic indices and BMD in the regions of the hip bone and the lumbar spine. MI was positively correlated with BMDs: lumbar spine: r=0.566, femoral neck: r= 0.554, and total hip: r= 0.524 (p<0.001). The MCI was negatively correlated with BMDs: lumbar spine: r= -0.514, femoral neck: r= -0.507, total hip: r=-0.513 (p<0.001). The cut-off value of MI for the reduced skeletal bone mineral density groups (both osteopenia and osteoporosis groups) was 3.9 mm and for the diagnosis of osteoporosis was 3.8 mm. Conclusion: The results of this study suggest that MI and MCI can be used as a screening tool for diagnosis of osteoporosis in postmenopausal women.