Abstract
Objective
The use of mandibular anatomic indicators on panoramic radiographs, i.e. the number
of lost teeth, mandibular cortical width at the mental region (MCW), panoramic mandibular
index (PMI), alveolar crest resorption degree (M/M ratio) and morphologic classification
of the mandibular inferior cortex (MIC grade) can be useful in the evaluation of bone
resorption in different age groups of women to determine the presence of osteoporosis.
The purpose of this study was to assess the validity of mandibular radiomorphometric
measurements and to determine the frequency of tooth loss in postmenopausal women.
Subjects and methods
An assessment of the number of lost teeth, MCW, PMI, M/M ratio and MIC grade was performed
on dental panoramic radiographs in a group of 133 postmenopausal women 38–80 years-of-age.
BMD at the lumbar spine was measured by dual energy X-ray absorptiometry. BMD values
were categorized as normal (T-score greater than 1.0), and as indicative of osteopenia
(T-score −1.0 to −2.5) or osteoporosis (T-score less than −2.5) according to the World
Health Organization classification.
Results
In our study when the T-score at the lumbar spine is decreased, the age of menopause
is increased, and the MCW is decreased to a point of statistical significance. A decrease
in MCW by 1 mm increases the likelihood of osteopenia or osteoporosis to 43%, having taken into
consideration the effect of the years elapsed since menopause. It was also shown that
age, years since menopause, MCW value, and the number of teeth lost have a statistically
important effect on the incidence of moderate or severe cortical erosion. Moreover,
when the MCI is C2 or C3 (mild or severe erosions) the age is increased, the years
since menopause are increased and the MCW is decreased to a point of statistical significance.
As far as tooth loss is concerned, an increase by 1 unit in the number of teeth lost, increase the likelihood of moderate or severe erosion
to 6%, having taken into account the years elapsed since menopause. Our study also
demonstrated that postmenopausal women tend to lose their teeth at an age older than
50 years. They usually lose the 1st and 2nd mandibular molars and the 1st and 2nd
maxillary premolars. Loss of front teeth and canines occurs at an age older than 60
years (except for the lateral maxillary incisors). At a younger age they tend to lose
the 2nd maxillary premolars more frequently than their mandibular counterparts.
Conclusions
In conclusion, panoramic radiographs constitute an integral part of almost every routine
dental evaluation and can be useful for the early diagnosis of osteoporosis in postmenopausal
women. Dentists have sufficient clinical and radiographic information that enables
them to play a significant role in patient screening for osteoporosis.
Keywords
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Article info
Publication history
Published online: September 24, 2007
Accepted:
August 21,
2007
Received in revised form:
July 30,
2007
Received:
December 26,
2006
Identification
Copyright
© 2007 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
