Dental panoramic radiographs can be used to detect osteoporosis. This can help identify adult women who may benefit from bone density measurements. The authors are from Hiroshima University in Japan.
Features seen in the panoramic radiographs:
(1) mandibular cortical width at the mental foramen (relative to a female in her second decade, or age 10-19)
(2) morphology of the mandibular inferior cortex
The mandibular cortical width is measured along the inferior border of the mandible.
(1) 1 line is drawn along the inferior border of the mandible.
(2) 1 line is drawn parallel to #1 along the inner cortical table.
(3) The perpendicular distance between the 2 lines is measured at the mental foramen.
|
Mandibular Cortical Width |
Grade |
|
> 1 SD above mean for second decade |
1 |
|
1 SD above or below the mean (-1 to +1 SD) |
2 |
|
< 1 SD below mean |
3 |
|
Mandibular Cortical Morphology |
Grade |
|
endosteal margin smooth |
1 |
|
endosteal margin shows semilunar defects associated with lacunar reabsorption; endosteal cortical residues present that are 1 to 3 layers thick |
2 |
|
cortex obviously porous with dense endosteal residues |
3 |
Multiple regression analysis resulted in an equation that can predict trabecular bone density in the third lumbar vertebra of an adult woman.
|
Parameter |
Finding |
Points |
|
mandibular cortical width |
Grade 1 |
0 |
|
|
Grade 2 |
10 |
|
|
Grade 3 |
17.4 |
|
mandibular cortical morphology |
Grade 1 |
0 |
|
|
Grade 2 |
15.8 |
|
|
Grade 3 |
20.6 |
predicted density in the third lumbar vertebra in mg per cubic cm =
= 187.7 - (points for cortical width) - (points for cortical morphology) - (1.38 * (age in years))
Specialty: Surgery, orthopedic, Endocrinology, Nutrition
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