Relationship among panoramic radiogaphy findings, biochemical markers of bone turnover and hip BMD in the diagnosis of postmenopausal osteoporosis

ABSTRACT

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. Evaluation 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. A decrease in MCW by 1mm increase 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. 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