The Radiomorphometric Indices of the Mandible as a Screening Method for Early Detection of Osteoporosis in Postmenopausal Women

Bruno Popić, Dubravka Holik, Vlatko Kopić, Kristijan Dinjar, Andrea Milostić-Srb, Danijela Nujić, Boris Dželalija


The aim of the study was to compare radiomorphometric indices measured on panoramic radiographs: mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI) with the densitometric values of skeletons in postmenopausal women, as well as and to determine the possibilities of their use in screening for early detection of osteoporosis in risky populations. Radiomorphometric indices were measured on panoramic radiographs of 146 postmenopausal patients, mean age 66.3 (±9.7) years, mean menopausal age 16.3 (±10.6) years. By dual energy X-ray absorptiometry (DXA) method were measured bone mineral density of the femur and the lumbar vertebrae (L1-L4). The Receiver Operating Characteristic (ROC) curve analysis was used to determine the changed densitometric finding, and to distinguish osteopenia and osteoporosis. The examinees with lower densitometric values had significantly lower MCW (3.60 mm) and PMI (0.36 mm) than those with regular densitometric values (p<0.001). The most frequent finding in patients with osteopenia was C2 stage of erosion (69.50%;p<0.001), while the C3 stage of erosion (57.40%;p<0.001) was in osteoporosis patients. When differing the normal from the changed finding of densitometry the results were: MCV - area under the curve (AUC) 0.862, sensitivity 92.04%, specificity 75.76%, resolution point ≤4.39 (p<0.001); for PMI-AUC 0.874, sensitivity 76.11%, specificity 84.85%, resolution point ≤ 0.41 (p<0.001) and for MCI-AUC 0.826, sensitivity 87.6%, specificity 69.7%, resolution point> 1 (p<0.001). For early detection of osteopenia and osteoporosis in postmenopausal women in everyday clinical practice, panoramic radiograph as a screen method can be of  help.


panoramic radiograph, osteoporosis, postmenopause, radiomorphometric indices

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