Evaluation of panoramic Radiographs as a Screening Tool of Osteoporosis in Post Menopausal Women: A Cross Sectional Study

Background: Indian women, especially those from low-income groups consume diets that are deficient of calcium, proteins and micronutrients. Hence, they are prone to suffer from osteoporotic hip fractures at a much earlier age than western women. To detect early signs of osteoporosis, it is ideal to perform Bone Mineral Density testing of all post-menopausal women who are at risk. Aim: (i) To assess and compare the relative efficacy, ease of application and measurement of the various mandibular cortical indices which were obtained on the panoramic radiographs with bone densitometry data of post-menopausal women. and (ii) To evaluate the effectiveness of these measurements in the identification of cases of osteoporosis/osteopaenia. Method: A cross sectional sample which consisted of 40 randomly selected post menopausal women who were aged 40-69 years was subjected to dental panoramic radiography. Mental index, panoramic mandibular index, gonion index, mandibular cortical index and antegonial index were measured on each radiograph. The data were expressed as mean and standard deviation. Analysis of variance with post-hoc Tukey's test was performed to determine group differences in mandibular measurements. Results: Based on the bone densitometry results, the sample was classified into normal (n=9), osteopaenic (n=15) and osteoporotic (n=16) groups. Statistically significant differences were found for mean Mental index (p=0.000), mean Panoramic Mandibular Index (p=0.007) and mean Gonial Index (p=0.000). The sensitivity (100%) and specificity (88.88%) of MCI showed good results. Conclusion: Dentists who use orthopantomographs may play a vital role in screening patients with osteoporosis, mainly among post menopausal women.