Efficacy of Panoramic Mandibular Index in Diagnosing Osteoporosis in Women

Objective: In this study, the usefulness of Panoramic Mandibular Index (PMI) on panoramic radiographs in diagnosis of osteoporosis was evaluated and its correlation with bone mineral density (BMD) of the neck of femur and spine was determined. Materials and Methods: In this cross-sectional study, 140 patients (all females) were categorized as either normal, osteopenic or osteoporotic according to the WHO classification in relation to their spinal and femoral BMD determined by dual energy X-ray absorptiometry. Regarding menstruation, they were also divided into menopausal, nonmenopausal, or oophorectomized groups. Panoramic radiographs were taken from all the women in the study. PMI was calculated. The data were analyzed using Kruskal-Wallis, Mann-Whitney, and Pearson tests. Results: Specificity and sensitivity of PMI in differentiating normal and osteopenic/ osteoporotic cases were 88% and 44%, respectively. The mean PMI of nonmenopausal women was significantly different from those of menopausal and oophorectomized ones. There was a weak correlation between PMI and spinal BMD (r=0.23, P<0.05) and a moderate negative one between age and mean PMI (r=-0.45, P<0.0001). Conclusion: Dental panoramic radiographs can be used in clinical practice to assist identifying individuals with low bone mass.