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AB0848 Dental panoramic radiography as a tool for identification of osteoporosis: among tunisian women
  1. M Brahem1,
  2. M Jguirim1,
  3. M Khemiss2,
  4. I Chaabani2,
  5. E Chebil3,
  6. M Younes4,
  7. T Ben Alaya2,
  8. M Ben Khelifa2,
  9. I Bejia1,
  10. M Touzi1,
  11. S Zrour1,
  12. N Bergaoui1
  1. 1Rheumatology
  2. 2Stomatology, Fattouma Bourguiba Hospital Monastir, Monastir
  3. 3Maxilla-Facial
  4. 4Rheumatology, Taher Sfar Mahdia, mahdia, Tunisia


Background Osteoporosis is defined as a skeletal disorder characterized by low-bone mass predisposing to an increased risk of fracture. At present, the evaluation of bone mineral density (BMD) is the main diagnostic tool in osteoporosis, and it is the most effective and accurate measurement for identifying and monitoring the disease. However, several studies have been conducted with the object of detecting whether these skeletal changes in the mandible are specific to the osteoporotic stage.

Objectives The purpose of this study was to determine whether the madibular indices on panoramic radiographs are useful for identifying women with osteoporosis or osteopenia (low BMD).

Methods Tunisian women aged from 30 to 60 years,who consulted the Rheumatology department of Fattouma Bourguiba university hospital in2017.The measure the BMD using the dual-energy X-ray absorptiometry (DEXA), were recruited to participate in this case-control study.Among the 60 women selected, 30 were diagnosed with osteoporosis or osteopenia (T-score <-1; cases) and 30 with normal T-score (T-score >-1; controls). The mandibular cortical index (MCI), the mental index (MI), the panoramic mandibular index (PMI) and the alveolar crest resorption degree (M/M ratio)were measured from digital panoramic radiographs in the right and left mandibles and the mean was calculated for each subject.The MI, PMI and M/M ratio values were evaluated using the Z test, and MCI values were analysed using the Chi2 test.

Results The mean age of patients with osteoporosis/osteopenia was 58.61±8.11and 56.07±9.72 in the control group.The mean bone miniral density (BMD)in vertebral site was 0.856±0.090g/cm2 and 1.216±0.185g/cm2 in control group.In femoral site,it was 0.877±0.221g/cm2 and 1.061±0.142g/cm2 respectively.The mean T-score in vertebral site was -2.38±0.81DS in osteoporosis/ osteopenia group and 0.64±1.58DS in control group.In femoral site,it was -1.57±0.97DS and 0.21±1.16 respectively.

The analysis of the panoramic radiography showed that in the osteoporosis/osteopenia group: the mean value of MI was 3.56±0.89, the mean PMI was 0.25±0.06 and the mean M/Mratio was 0.71±0.14; concerning the MCI: 46.7% were classified C2 stage and 53.3% were classified C3 stage.

In the control group, the mean MI was 4.42±0.98, the mean PMI was 0.30±0.07 and the mean M/Mratio was 0.77±0.11; 30.1% were classified C1 stage, 53.3% were classified C2 stage and only 16.6% were classified C1 stage.

This study showed that the MI and the PMI were significantly smaller in the group with osteoporosis/osteopenia. However, the M/M ratio was not significantly different.Therefore, the MCI was significantly more affected in the osteoporosis/osteopenia group.

Conclusions In our study, we proved that the MI, PMI and MCI values were affected in women with osteoporosis/osteopenia, compared with normal patients. Therefore, these indices could be used as an ancillary method in the diagnosis of osteoporosis in women.


  1. C S Valerio et al, Dentomaxillofacial Radiology (2013) 42, 20120059.

  2. André Ferreira Leite, et al, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:648–656.

  3. Vlasiadis Z. Konstantinos, et al, Maturitas 58 (2007) 226–235.


Disclosure of Interest None declared

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