Panoramic radiographic index as a diagnostic indicator of osteoporosis – a double blinded population based study

Introduction: Osteoporosis is a progressive disease of the bone causing micro architecturaldeterioration of bone tissue leading to enhanced bone fragility and consequent increase in fracture risk. It is essentially a preventable disease and panoramic radiographs can prove to be a novel and easy method for early detection of this otherwise debilitating disease. Aim: The aim of the study was to evaluate the precision of panoramic mandibular index (PMI) and Body Mass Index (BMI) in detecting osteoporosis in post-menopausal women and their correlation with skeletal bone mineral density. Materials and methods: The study was conducted in a dental college in India and included 71 women in their natural menopause. The Body Mass Index (BMI) and Panoramic Mandibular Index (PMI) were calculated. The Skeletal bone mineral density (BMD) was assessed and the T-score was obtained. Based on the T-scores obtained, the patients were divided into three study groups of Normal (n=24), Osteopenic (n=30) and Osteoporotic (n=17). All the readings of T-score, Body Mass Index, PMI were tabulated for statistical analysis which was done using the ANOVA, post-hoc Tukey HSD test and Pearson correlation coefficient test with the SPSS software version 18 (IBM, Chicago) Results: A statistically significant difference in the mean scores of PMI among Normal, Osteopenic and Osteoporotic subjects was found (p<0.00). However, the difference in BMI was not significant. Also, less inter and intra investigator variability was found in our study. The PMI was significantly decreased in osteoporotic patients when compared to normal. Conclusion: As dental panoramic radiographs are relatively inexpensive and regularly taken in a large fraction of the adult population, they represent an enormous potential as a screening tool for osteoporosis.