Digital orthopantomograms in osteoporosis detection: mandibular density and mandibular radiographic indices as skeletal BMD predictors.

OBJECTIVES: To determine the correlation of skeletal bone mineral density (BMD) with mandibular density and mandibular radiographic indices estimated on digital panoramic radiographs. METHODS: Study comprised 112 female subjects older than 45 years. Digital panoramic radiographs were taken, and patients were referred to densitometric measuring (dual energy X-ray absorptiometry) of BMD in the hip bones and lumbar spine regions (L1-L4). On the radiographs, mandibular bone density was estimated and the following indices were measured by the DIGORA(®) software (Soredex, Tuusula, Finland): mental index (MI), gonial index (GI), antegonial index (AI), panoramic mandibular index (PMI) and alveolar crest resorption degree (M/M). Mandibular cortical index (MCI) was visually estimated. RESULTS: Mandibular density and visual index MCI are significant predictors of hip and spine BMD. Mandibular density was marked by a significant square trend: it decreased until the age of 54 years and remained constant until the age of 64 years when it started to increase. Significant correlations were found between MI, AI and PMI values and BMD in the hip but not in the lumbar spine region. The GI and M/M values did not show statistically significant correlations with BMD of either region. CONCLUSIONS: Mandibular bone density and mandibular radiographic indices are useful in detecting patients with decreased BMD. The applicability of orthopantomograms in diagnosing osteoporosis/osteopenia should be recognized as the potential greatest benefit of this everyday diagnostic method in dental practice.

Stabilization splint treatment on complete denture--two reported cases.

The pre-prosthetic treatments of two female patients with osteoarthritis of the temporomandibular joints were presented in this paper. In the first case report, an 83-year-old patient wore complete dentures (CDs) for 30 years. The second patient (71 years of age) wore a three-year-old upper CD and a lower removable partial denture with a two-unit fixed dental prosthesis. Pain was successfully eliminated by the stabilization splint on the upper CD. Magnetic resonance imaging was used to confirm the diagnosis and clinical follow-up of the splint treatment.

Frequency of internal derangement of the temporomandibular joint in elderly individuals.

Elderly patients suffer from various systemic diseases and are likely to neglect their problems with functional disorders in the masticatory system, which are of crucial importance for successful prosthetic treatment. The purpose of the study was to establish the frequency of symptoms, clinical signs and tissue-specific diagnoses of internal derangement of the temporomandibular joint in elderly subjects and their relation with respect to gender and type of prosthetic replacement. The study was conducted on 96 subjects, 48 complete denture wearers and 48 removable partial denture wearers, whose average age was 75.8 years. The diagnostic procedure used in this study was manual functional analysis consisting of specific techniques of dynamic compressions and translations in diagnosing internal derangement of the temporomandibular joint. Chi-square test for independent samples was used for statistical analysis of the results. The symptoms of internal derangement of the temporomandibular joint were found in 9.3% of the subjects, and tissue-specific diagnoses were established in 52.1% of the subjects. The most common diagnoses were osteoarthrosis, total disk displacement with stable reposition and partial anterolateral disk displacement. No statistically significant differences in the frequency of symptoms, clinical signs and tissue-specific diagnoses were found between genders (P>.05) and complete and removable partial denture wearers (P>.05). The frequency of subjective symptoms of internal derangement in the temporomandibular joint of elderly subjects was low in relation to the frequency of intracapsular tissue-specific diagnoses.