Digital panoramic radiographs are useful for diagnosis of osteoporosis in Korean postmenopausal women

Radiomorphometric indices of the mandible as indicators of decreased bone mineral density and osteoporosis - meta-analysis and systematic review

This review aims to evaluate the accuracy of various mandibular radiomorphometric indices in comparison with DEXA BMD measurements in the diagnosis of osteopenia and osteoporosis based on a meta-analysis of the sensitivity and specificity of the indices. PRISMA statement was followed. The materials for analysis were collected in August 2023 by searching three databases: PubMed Central, Web of Science, and Scopus. The selection of studies consisted of three selection stages, and 64 articles were finally obtained. Quality assessment was performed with the QUADAS-2 tool, and the general methodological quality of retrieved studies was low. Statistical analysis was performed based on 2 × 2 tables and estimated sensitivity and specificity were obtained using SROC curves. The most used indices were MCI, MCW and PMI. The best results in detecting reduced BMD obtained for MCW ≤ 3 mm, estimated sensitivity and specificity were 0.712 (95% CI, 0.477-0.870) and 0.804 (95% CI, 0.589-0.921), respectively. The most prone to the risk of bias is the MCI due to the examiner's subjectivism. Radiomorphometric indices of the mandible can be useful as a screening tool to identify patients with low BMD, but should not be used as a diagnostic method. Further research needs to focus on analysing the ability of the indices to detect osteoporosis and also in combination the indices with clinical parameters.

Evaluation of mandibular cortical and trabecular radiomorphometry in familial Mediterranean fever patients

OBJECTIVE

The objective of this retrospective study was to evaluate the mandibular cortical and trabecular morphology and microarchitecture of patients with familial Mediterranean fever (FMF) and compare them to those of healthy individuals by examining radiomorphometric indices on panoramic radiographs.

STUDY DESIGN

We examined a group of 56 FMF patients aged 5 to 71 years and an age- and sex-matched control group of individuals with no systemic diseases. We classified the FMF and control groups according to age and sex and the FMF group according to colchicine use. We evaluated the quantitative radiomorphometic indices of gonial index, antegonial index, molar cortical thickness, mental index, panoramic mandibular index, and lacunarity, and the qualitative mandibular cortical index on all panoramic radiographs and performed between and within group analysis.

RESULTS

Mean gonial index, antegonial index, and molar cortical thickness values of the FMF group were significantly smaller than those of the control group. Significantly fewer patients in the FMF group were classified as mandibular cortical index type 1 compared to the control group. There were no significant differences in quantitative index values according to colchicine use in the FMF group or regarding the categorical parameters of age, sex, and mandibular cortical index classification.

CONCLUSIONS

Radiomorphometric values of the mandibular basal cortex posterior to the mental foramen differ significantly in FMF patients compared to healthy counterparts. Dentists should note mandibular morphologic changes indicative of low bone density when examining panoramic images of patients with this disease.

Osteoporosis Screening Using Dental Panoramic Radiographs and Age at Menarche

Since early detection of osteoporosis is essential, the development of an efficient and cost-effective screening model would be incredibly beneficial. The aim of this study was to evaluate the diagnostic accuracy of MCW and MCI indices from dental panoramic radiographs in combination with a new variable, age at menarche, for the detection of osteoporosis. The study enrolled 150 Caucasian women (aged 45 to 86) who met the eligibility criteria, had DXA scans of the left hip and lumbar spine (L2 to L4), and were classified as osteoporotic, osteopenic, or normal based on T-score. Two observers evaluated MCW and MCI indexes on panoramic radiographs. There was a statistically significant correlation between the T-score and MCI and MCW. In addition, age at menarche had a statistically significant correlation with T-score (p = 0.006). In conclusion, in the current study, MCW proved to be more effective in detecting osteoporosis when combined with age at menarche. Individuals with MCW less than 3.0 mm and age at menarche later than 14 years old should be referred for DXA since they present high risk of osteoporosis.

Prevalence of osteoporosis and incidence of related fractures in developed economies in the Asia Pacific region: a systematic review

Robust data on osteoporosis in the Asia Pacific region could improve healthcare decision-making. Osteoporosis affects 10-30% of women aged 40 + , and up to 10% of men in 7 developed economies in Asia Pacific. Fractures affect 500-1000 adults aged 50 + per 100,000 person-years. Policymakers and clinicians must address this problem.

PURPOSE

Osteoporosis and associated fractures result in considerable morbidity, loss of productivity, early mortality, and increased healthcare expenses. Many countries in the Asia Pacific (AP) region, especially middle- and higher-income economies, are faced with aging and increasingly sedentary populations. It is critical to consolidate and analyze the available information on the prevalence and incidence of the disease in these countries.

METHODS

We systematically reviewed articles and gray literature for Australia, China, Hong Kong, Japan, Singapore, South Korea, and Taiwan. We searched PubMed, ScienceDirect, JSTOR, Cochrane, Google Scholar, and other databases for data published 2009-2018. We included articles with prevalence or incidence estimates for adults with osteoporosis or related fractures.

RESULTS

All locations had data available, but of widely varying quantity and quality. Most estimates for osteoporosis prevalence ranged from 10 to 30% for women ages 40 and older, and up to 10% for men. Osteoporotic fracture incidence typically ranged between 500 and 1000 per 100,000 person-years among adults aged 50 and older. Both outcomes typically increased with age and were more common among women.

CONCLUSION

Osteoporosis and associated fractures affect significant portions of the adult population in developed economies in the AP region. Governments and healthcare systems must consider how best to prevent and diagnose osteoporosis, and manage affected individuals, to reduce healthcare costs and mortality associated with fractures.

Osteoporosis screening support system from panoramic radiographs using deep learning by convolutional neural network

OBJECTIVES

This study was performed to develop computer-aided screening systems that could predict osteoporosis. The systems were constructed using panoramic radiographs of women aged ≥ 50 years through three types of deep convolutional neural networks (CNNs): Alexnet, VGG-16, and GoogLeNet; the performances of the constructed systems were evaluated.

METHODS

One oral radiologist classified 1500 panoramic radiographs into three types. In C1, the endosteal margin of the cortex was smooth and sharp, whereas porosities were observed in C2 and C3. The risks of osteoporosis were higher in C2 and C3 than in C1; C3 had the highest risk. This information was included with the images as training data; three CNNs were transfer trained. Using each trained CNN, the diagnostic accuracy was assessed using panoramic radiographs and bone mineral density inspection findings in the lumbar spine and femoral neck of 100 additional patients.

RESULTS

All CNNs exhibited relatively good agreement with the oral radiologist's judgement (86.0%-90.7%). The predictive results of the three systems for osteoporosis of the lumbar spine showed sensitivities of 78.3%-82.6%, specificities of 71.4%-79.2%, and accuracies of 74.0%-79.0%. The predictive results for osteoporosis of the femoral neck showed sensitivities of 80.0%-86.7%, specificities of 67.1%-74.1%, and accuracies of 70.0%-75.0%.

CONCLUSIONS

The constructed systems were generally more accurate than the previously developed conventional system. The new systems may facilitate osteoporosis prediction and prevent subsequent fractures by encouraging patients with suspected osteoporosis to undergo further inspections (e.g., dual-energy X-ray absorptiometry) and treatment.

The temporomandibular joints disorders in patients with osteoporosis

Background:

Osteoporosis is a skeletal and progressive behavioral disease with physically and psychologically significant consequences.

Aims of the Study:

Evaluate the presence and effects of Temporomandibular Joints Disorders in osteoporotic patients.

Materials and Methods:

Fifty-eight (58) patients with osteoporosis participated in this study as they were already diagnosed by Rheumatologists, physical and sport Rehabilitation physicians in Merjan Medical city/Babylon – Iraq between period February and August 2019.

Results:

Twenty-seven (27) patients with T. M. J clicking as anterior disk displacements, Seventeen (17) patients with spasm in muscles of mastication, and then finally Fourteen (14) out of 58 patients with subluxation and dislocation.

Conclusions:

Osteoporosis can have a significant impact on oral health.

Mandibular cortical index in the screening of postmenopausal at low mineral density risk: a systematic review

OBJECTIVES

This systematic literature review addressed the use of mandibular cortical index (MCI), assessed by panoramic radiography, for the identification of postmenopausal women at risk of osteoporosis.

METHODS

Databases were searched for original research studies published from September 2010 to September 2020 using the following keywords: "postmenopausal osteoporosis" and synonyms combined with "panoramic radiography" and synonyms. Only English language manuscripts and studies pertaining to the MCI were selected.

RESULTS

A total of 24 studies were included. The publications were highly heterogeneous in terms of the subject of interest, i.e. the MCI, with some studies comparing the usefulness of the MCI using panoramic radiography and using cone beam computed tomography, and others comparing different radiomorphometric indexes developed for panoramic radiography.

CONCLUSIONS

Based on the literature included in this systematic review, we conclude that the MCI is useful as an auxiliary tool for identifying postmenopausal females at risk of low bone mineral density (BMD), as it correlates with skeletal BMD measured by dual X-ray absorptiometry. Nevertheless, other radiomorphometric indexes obtained from panoramic radiographs, such as panoramic mandibular index, mental index, and mandibular cortical width, are also valuable as auxiliary tools in the identification of postmenopausal females at risk, as they also correlate with BMD. Thus, it is not possible to affirm which index is the most reliable for the identification of postmenopausal females considering the literature screened. PROSPERO registration systematic review CRD42020208152.

Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis

Osteoporotic fractures are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. We undertook a worldwide literature survey and present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. In addition, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. These incidental findings on panoramic radiographs, when used for identifying asymptomatic postmenopausal female patients at risk of having osteoporosis in general dental practice, may be helpful in reducing the incidence of first fractures, with a consequent reduction in the secondary fractures, medical costs, and mortality associated with osteoporotic fragility fractures, without incurring any additional cost.

New mandibular indices in cone beam computed tomography to identify low bone mineral density in postmenopausal women

OBJECTIVE

The aim of this study was to evaluate new radiomorphometric indices in cone beam computed tomography (CBCT) for assessing bone mineral density (BMD) status in postmenopausal women.

STUDY DESIGN

Mandibular inferior cortical bone thickness was evaluated in 48 postmenopausal women in cross-sectional images at 4 sites: (1) symphysis (S): cross-sectional image equidistant from the centers of the right and left mental foramina (MF); (2) anterior (A): 10 mm anterior to the MF; (3) molar (M): 10 mm posterior to the MF; and (4) posterior (P): 25 mm posterior to the MF. Participants underwent dual-energy x-ray absorptiometry and were divided into normal, osteopenia, and osteoporosis groups. In the study, t tests with Bonferroni correction were conducted. Statistical significance was set at P < .017. Receiver operator characteristic (ROC) analyses were performed.

RESULTS

Mean S index was significantly lower in osteoporosis than in osteopenia (P = .005). Mean M index was significantly lower in osteopenia (P < .001) and osteoporosis (P = .001) than in normal individuals. Mean P index was significantly lower in osteoporosis than in normal patients (P = .008). ROC values ranged between 0.643 and 0.740. Cortical thicknesses separating normal from abnormal varied from 1.73 mm to 3.37 mm.

CONCLUSIONS

M and P indices in CBCT may be useful for identifying low BMD in postmenopausal women.

Digital panoramic radiography and cone-beam CT as ancillary tools to detect low bone mineral density in post-menopausal women

OBJECTIVES

To evaluate the usefulness of the mandibular cortical index (MCI) obtained by digital panoramic radiography (DPR) and by panoramic reconstruction (PR) of cone-beam CT (CBCT) with three different slice thicknesses for the screening of low bone mineral density (BMD) in post-menopausal women.

METHODS

Two trained oral and maxillofacial radiologists assessed the MCI based on the morphology of the mandibular bone cortex (classified as C1, C2 or C3). The DPR and PR of CBCT with slice thicknesses of 5, 15 or 25 mm were compared to the BMD obtained by dual-energy X-ray absorptiometry (DXA) in post-menopausal women. Measures related to accuracy were calculated with MedCalc software. The confidence interval was set at 95%.

RESULTS

54 women (mean age 58.70 ± 7.35 years) participated in the study. The sensitivity and specificity values obtained for DPR were 52.6% and 56.2%, respectively, and values for PR of CBCT with 5, 15, and 25 mm slice thicknesses were 63.1% and 43.7%, 50.0% and 50.0%, and 52.6% and 62.5%, respectively. For the tools evaluated, the positive likelihood ratio ranged from 1.00 to 1.40 and negative likelihood ratio from 0.76 to 1.00. The positive predictive value (PPV) ranged from 70.4 to 76.9% and the negative predictive value (NPV) from 29.6 to 35.7%. Among the examinations, the highest value for area under the curve (AUC) was obtained for CBCT with 25 mm slice thickness (57.6%).

CONCLUSIONS

The MCI calculated by DPR and CBCT differed with regard to accuracy. Within the limitations of this study, the PR of CBCT with 25 mm slice thicknesses seems to be the most accurate among the examinations evaluated. Should the dentist be attentive, DPR and CBCT may be useful tools for the screening of low BMD in post-menopausal women, facilitating their timely referral for further assessment.

Usefulness of measuring radiographic density of axis vertebra in patients at risk of osteoporosis: A cone-beam computed tomography study

Objective:

Using cone-beam computed tomography (CBCT) images, the aim of the study was to evaluate the usefulness of measuring radiographic density of the axis vertebra (RDAV) in patients at risk of osteoporosis.

Materials and Methods:

Two hundred and forty-seven old patients (109 males and 138 females) aged between 50 and 80 years (mean age: 59.68 ± 7.27) were examined by CBCT. Using InVivoDental, v. 5.0 (Anatomage Inc., San Jose, CA), RDAV and mental index (MI) were measured twice and correlated using Pearson's correlation coefficients. Patients were divided into two categories: high risk and low risk of osteoporosis using 3.1 mm of MI as a cutoff value, and the mean value of RDAV was compared and correlated using independent samples’ t-test and regression analysis. Receiver-operating characteristic (ROC) curve analysis was also used to examine the predictive power of RDAV.

Results:

The mean value of RDAV was moderately correlated with MI (r = 0.32), and in patients at low risk of osteoporosis, the mean value of RDAV was significantly higher than in patients at high risk of osteoporosis. In multivariate binary logistic regression, the odds of being at risk of osteoporosis decreased by 1% with one unit increase in RDAV (odds ratio = 0.988, 95% confidence interval: 0.983–0.993; P < 0.005). ROC analysis showed that the mean value of RDAV had a high predictive power for predicting patients at risk of osteoporosis (area under the curve = 0.761 for females and 0.649 for males).

Conclusions:

Measuring RDAV is considered useful in predicting patients at risk of osteoporosis.

Usefulness of measuring bone density of mandibular condyle in patients at risk of osteoporosis: A cone beam computed tomography study

Objective:

Using cone beam computed tomography (CBCT) images, the aim of the study was to evaluate the usefulness of measuring bone density of mandibular condyle (BDMC) in patients at risk of osteoporosis.

Materials and Methods:

Two hundred and four mandibular condyles (46 condyles from males and 158 condyles from females) were examined by CBCT. Using inVivo software (Anatomage, San Jose, Calif), BDMC and mental index (MI) were measured by two observers and correlated using Pearson's correlation coefficients. Patients were divided into high risk and low risk of osteoporosis using 3.1 mm of MI as a cutoff value, and the mean value of BDMC was compared and correlated using independent samples t-test and regression analysis. Receiver-operating characteristic (ROC) curve analyses were also used to examine the predictive power of BDMC.

Results:

The mean value of BDMC was moderately correlated with MI (r = 0.38), and in female patients at low risk of osteoporosis, the mean value of BDMC was significantly higher than in patients at high risk of osteoporosis. In multivariate linear regression analysis, being at risk of osteoporosis is significantly affected by BDMC, age, and gender. ROC analysis showed that the mean value of BDMC had a moderate predictive power for predicting patients at risk of osteoporosis (area under the curve = 0.621 for females and 0.649 for males).

Conclusions:

Measuring BDMC is considered useful in predicting patients at risk of osteoporosis.

Osteoporosis and Jaw Abnormalities in Panoramic Radiography of Chronic Liver Failure Patients

INTRODUCTION

Patients with chronic liver failure (CLF) are faced with many complications, because this organ is involved in various metabolic activities. Hepatic osteodystrophy is one of the major health issues encountered by this group of patients. The current study evaluated osteoporosis and bone changes in oral panoramic radiographies of cirrhotic patients.

MATERIALS AND METHODS

In this study, 138 panoramic views of CLF patients, candidates for liver transplant (65 females, 73 males, aged 19-68 years) referred to Shiraz University Dental Clinic (Shiraz, Iran) for pretransplant oral examination, were evaluated. Also 138 healthy individuals (69 females, 69 males, aged 18-70 years) referred to the same clinic were examined. Abnormalities such as osteoporosis, pathologic radiolucencies, pathologic calcifications, tonsilloliths, condylar degeneration, and other findings in the alveolar bones were recorded.

RESULTS

Osteoporosis was a common finding in CLF patients (p<0.001), and the probability of detecting low bone density in the panoramic view was 20.37 times higher among patients than healthy subjects. The probability of detecting pathologic jaw radiolucencies was 8.92 times higher in the case group than in the controls (p<0.001). Other bone abnormalities such as condylar degeneration and idiopathic osteosclerosis were also more prevalent in CLF patients compared to healthy subjects (p<0.001).

CONCLUSION

Cirrhotic patients are prone to osteoporosis of the alveolar bones. Also, pathologic jaw radiolucencies as a result of oral infections are more prevalent in this group of patients. Routine oral panoramic views are acceptable and cost-effective radiographies for use in detecting such abnormalities in the alveolar bones as well as overall dental health. These findings also support the importance of dental health examinations prior to liver transplantation to reduce the risk of organ rejection.

Use of cone beam computed tomography in identifying postmenopausal women with osteoporosis

The aim of this study is to correlate radiometric indices from cone beam computed tomography (CBCT) images and bone mineral density (BMD) in postmenopausal women. Quantitative CBCT indices can be used to screen for women with low BMD.

PURPOSE

Osteoporosis is a disease characterized by the deterioration of bone tissue and the consequent decrease in BMD and increase in bone fragility. Several studies have been performed to assess radiometric indices in panoramic images as low-BMD predictors. The aim of this study is to correlate radiometric indices from CBCT images and BMD in postmenopausal women.

METHODS

Sixty postmenopausal women with indications for dental implants and CBCT evaluation were selected. Dual-energy X-ray absorptiometry (DXA) was performed, and the patients were divided into normal, osteopenia, and osteoporosis groups, according to the World Health Organization (WHO) criteria. Cross-sectional images were used to evaluate the computed tomography mandibular index (CTMI), the computed tomography index (inferior) (CTI (I)) and computed tomography index (superior) (CTI (S)). Student's t test was used to compare the differences between the indices of the groups' intraclass correlation coefficient (ICC).

RESULTS

Statistical analysis showed a high degree of interobserver and intraobserver agreement for all measurements (ICC > 0.80). The mean values of CTMI, CTI (S), and CTI (I) were lower in the osteoporosis group than in osteopenia and normal patients (p < 0.05). In comparing normal patients and women with osteopenia, there was no statistically significant difference in the mean value of CTI (I) (p = 0.075).

CONCLUSIONS

Quantitative CBCT indices may help dentists to screen for women with low spinal and femoral bone mineral density so that they can refer postmenopausal women for bone densitometry.

Assessment of osteoporotic alterations in type 2 diabetes: a retrospective study

OBJECTIVES

To analyze the influence of Type 2 diabetes on bone mineral density (BMD) and panoramic radiomorphometry in postmenopausal females, comparing with results from non-diabetic postmenopausal females.

METHODS

A total of 228 postmenopausal females (mean age: 59.51 ± 11.08 years) were included in this study. Demographics, T scores and Z scores from peripheral dual X-ray absorptiometry (DXA) and mandibular cortical index (MCI) from panoramic radiographs were assessed. Mean comparison between results for diabetics and non-diabetics was carried out with the Student's t-test. In addition, non-parametric correlations between MCI and DXA results were carried out with Spearman's test, at a level of significance of 5%.

RESULTS

Mean Z score values were significantly higher in diabetics than in non-diabetics (p = 0.001). T and Z score values were also significantly correlated with MCI (r = 0.428, p = 0.001, and r = 0.356, p = 0.022, respectively).

CONCLUSIONS

Within the limitations of this study, the present results suggest that Type 2 diabetes might increase BMD in postmenopausal females.

Efficacy of Panoramic Radiography in the Detection of Osteoporosis in Post-Menopausal Women When Compared to Dual Energy X-Ray Absorptiometry

OBJECTIVE

It is a well-known fact that osteoporosis affects the people with old age and remains unnoticeable until the patient presents with fracture. Various studies in the literature reveal that panoramic radiographs may prove to be beneficial in the detection of Osteoporosis in patients. Henceforth this present study was aimed to validate the use of Klemetti Index (KI) on panoramic radiographs so as to detect osteoporosis in the patients at an early stage.

METHODS

60 postmenopausal women were selected. A panoramic radiograph was taken to grade their mandibular cortex on the basis of Klemetti Index. All the panoramic radiographs were evaluated by 5 different Oral Medicine and Radiology specialists. Later all the patients were subjected to dual energy X-ray absorptimetry (DEXA) scan for bone mineral density evaluation. The results were evaluated statistically.

RESULTS

The average accuracy of the five observers to demonstrate normal bone, osteopenia and osteoporosis when compared to DEXA scan was 58.08%, 63.3% and 64.74% respectively. The observations of the 5 observers on the basis of KI were not statistically different from the BMD evaluation done with the help of DEXA Scan.

CONCLUSION

Panoramic radiographs can be used as a screening tool for the evaluation as well as early detection of osteoporosis with the usage of Klemetti Index.

Risk of osteoporosis in elderly individuals attending a dental clinic

OBJECTIVE

Osteoporosis has become a critical public health problem with the rapidly aging population in Japan. It is necessary for dentists to know their patients' status because it influences dental treatment. The purpose of this study was to predict the risk of osteoporosis in elderly patients visiting a dental clinic by assessing mandibular cortical morphology on panoramic radiographs.

METHOD

Three-hundred and thirty patients were divided into three classes based on the morphology of their mandibular cortex on panoramic radiographs. Mandibular cortical bone width at the mental foramen was also measured. Bone mineral density (BMD) was determined at the calcaneus using a quantitative ultrasound device.

RESULTS

The mandibular cortical width decreased significantly from Class 1 (normal cortex), to Class 2 (moderately eroded cortex) and to Class 3 (severely eroded cortex). BMD was negatively correlated with age in both female and male patients. Most (108/186) female patients had a class 3 cortex with a low BMD. Among women, mandibular cortical width was significantly correlated with BMD. Thirty-three percent of the female had received a previous diagnosis of osteoporosis. In contrast, only 13.9% (20/144) of the male had a Class 3 cortex. In men, mandibular cortical width did not significantly correlate with BMD. Only a few of the men had received a previous diagnosis of osteoporosis. The number of remaining teeth did not correlate with low BMD in either sex.

CONCLUSION

Our findings reveal that most elderly female patients visiting the dental clinic had a high risk of osteoporosis and a low BMD.

IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices

Purpose

The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening.

Materials and Methods

A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS.

Results

The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%).

Conclusion

IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.

The influence of bone mineral density and bisphosphonate therapy on the determinants of oral health and changes on dental panoramic radiographs in postmenopausal women

OBJECTIVES

The aim of this study was to assess the determinants of oral health including the number of decayed, missing, and filled teeth (DMFT) and periodontal indices in postmenopausal women with osteoporosis, osteoporosis treated with bisphosphonate therapy, and control group and to examine the correlation between dental panoramic indices (Mental Index-MI, Mandibular Cortical Index-MCI) and bone mineral density in these three groups of patients.

MATERIALS AND METHODS

The presented non-interventional study involved 120 postmenopausal women: women with osteoporosis (O) (n = 45), women with osteoporosis treated with bisphosphonates (OBP) (n = 45), and control group (C) (n = 30). DMFT, plaque, gingival and papilla bleeding index, pocket depth, clinical attachment loss, and the presence of periodontitis were evaluated for each patient. MI and MCI of all participants were measured on a dental panoramic radiograph.

RESULTS

Group OBP showed significantly higher gingival, bleeding index and deeper pocket depth than C and/or O group. No significant differences were found in MI (p = .303) or MCI (p = .06) in all the examined groups. Also, there were no significant differences between the three groups in the presence of periodontitis as well as in the DMFT index.

CONCLUSION

BP therapy could have a negative influence on periodontal health. Further, MI and MCI are not precise diagnostic tools for diagnosing low BMD in postmenopausal women.

CLINICAL RELEVANCE

BP therapy could have a negative influence on the determinants of oral health in postmenopausal women with osteoporosis.