Assessment of the relationship between the mandibular cortex on panoramic radiographs and the risk of bone fracture and vascular disease in 80-year-olds

Objectives. The objective of this study was to assess cortical measurements on panoramic radiographs in 80-year-old subjects to predict bone fracture and vascular disease risks. Methods. The cortical width and shape (normal cortex, mildly to moderately eroded cortex, and severely eroded cortex) were evaluated on 659 panoramic radiographs obtained from 262 men and 397 women, all of whom were 80 years old. At baseline, a general medical examination, including heel bone density, was performed in all subjects. Fractures and vascular disease occurring within 5 years after the baseline examination were determined in 191 subjects and in 108 subjects who died within 5 years after the baseline examination. Results. There were significant correlations between heel bone density and cortical width (r = 0.435, P < .001) and shape (r = 0.231, P < .001). However, cortical measurements on panoramic radiographs were not significantly associated with the occurrence of fractures and vascular disease within 5 years after the baseline examination. Conclusions. Among the elderly, cortical measurements on panoramic radiographs may be associated with bone mineral density and physical activity, but they are not useful markers for the subsequent occurrence of fractures and vascular disease.