Relationship Among Panoramic Radiography Findings, Biochemical Markers of Bone Turnover and Hip BMD in the Diagnosis of Postmenopausal Osteoporosis

Background/Objective: Recent investigations have shown that panoramic radiography might be a useful tool in the early diagnosis of osteoporosis. In addition, bone turnover biochemical markers might be valuable in predicting osteoporosis and fracture risks in the elderly, especially in post-menopausal women. The aim of the present study was to evaluate the relationship among the radiomorphometric indices of the mandible, biochemical markers of the bone turnover and hip BMD in a group of post-menopausal women. Patients and Methods: Evaluations of mandibular cortical width (MCW), mandibular cortical index (CI), panoramic index (PMI) and alveolar crest resorption ratio (M/M ratio) were carried out on panoramic radiographs of 140 post-menopausal women with an age range of 44-82 years. Hip BMD was measured by DEXA method. BMD values were divided into three groups of normal (T score>-1.0), osteopenic (T score, -2.5 to -1.0) and osteoporotic (T score<-2.5). Serum alkaline phosphatase and 25(OH) D3 were measured. Results: A decrease in MCW by 1 mm increases the likelihood of osteopenia or osteoporosis up to 40%, having taken into consideration the effect of menopause duration. A 1 mm decrease in MCW increased the likelihood of moderate or severe erosion of the lower cortex of the mandible up to 28% by taking age into consideration. The results did not demonstrate a statistically significant relationship between bone turnover markers and mandibular radiomorphometric indices. Conclusion: Panoramic radiography gives sufficient information to make an early diagnosis regarding osteoporosis in post-menopausal women. Panoramic radiographs may be valuable in the prevention of osteoporotic fractures in elderly women.