Relationship between bone alterations detected in panoramic radiographs and osteoporosis
Keywords:Osteoporosis, Panoramic radiograph, Styloid process, Bone mineral density
Objectives: Since the screening for low systemic bone mineral density (BMD) can be performed using panoramic radiography (PR), the use of other detectable signs in PR that could increase the rate of patients correctly indicated for dual bone densitometry (DXA) is still needed. Hence, this study aims to correlate low BMD with Body Mass Index (BMI) and visible changes on PR: elongated styloid process, mandibular cortical index (MCI), and number of teeth. Material and methods: PRs of 23 patients who had a DXA exam were used. Each patient was classified by three examiners with different levels of expertise (beginner, experienced, and expert) according to the MCI; the styloid process, as normal or elongated; the number of teeth; and the BMI. Results: A significant correlation was observed between the MCI and the DXA only for the expert observer (r=−0.47). For the other variables (elongated styloid process, number of teeth, and BMI) no significant correlations were observed. The inter-examiner agreement was 0.50 for the expert observer and the beginner, 0.27 for the experienced and the expert, and 0.58 for the experienced and beginner. The intra-examiner correlation was 0.77 for the expert, 0.48 for the beginner, and 0.28 for the experienced observer. Conclusion: The MCI showed a significant correlation with low bone mineral density; however, no evidence was found of a relationship between low bone mineral density and other detectable signs in RP.
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