Use of Panoramic Radiographs to Detect Signs of Osteoporosis in Edentulous

DOI: 10.4236/health.2015.712181   PDF   HTML   XML   2,917 Downloads   3,610 Views   Citations


Objective: The objective is to analyze the importance of panoramic and carpal radiographs for evaluation of edentulous individuals in different ages, demonstrating the contribution of different dental radiographic techniques in detecting patients with signs of osteoporosis. Methods: The study was developed using panoramic and carpal digital radiographs of 30 edentulous women (age ranged 50 - 90 years). The panoramic radiographs were performed to measure the thickness of the mental index—MI and gonial index—GI, and evaluation of the morphology of the mandibular cortical shape (Klemetti classification). The carpal radiographs were performed to measure the cortical thickness of the 2nd, 3rd and 4th metacarpals (metacarpal index). Statistics analyzed the relationship of these indices with the patient’s age and the contribution of dental radiographs in detecting patients at risk for osteoporosis. Results: The average age of subjects was 68.43 years. In the analysis of cortical thickness of the panoramic radiographs, the mean values of mental index (MI) and gonial index (GI) for the age group 50 to 59 years were considered normal values (≥3.1 mm and ≥1.2 mm , respectively). To analyze the morphology of the cortex, the C3 group corresponded to the majority of cases (43.33%). The higher the age range, more morphological changes were observed (sum of the characteristics of groups C2 and C3). For the hand-wrist radiographs, the highest values of the metacarpal index (BMI) were found in the youngest age group (50 - 59 years). Conclusions: There was positive correlation between age and indices of quantitative assessment (IM, IG, BMI) and qualitative (analysis Klemetti) on panoramic and carpal radiographs. Age is a risk factor for the onset of osteoporosis.

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Ramalli, L. , Camargo, A. , Monteiro, S. and Watanabe, P. (2015) Use of Panoramic Radiographs to Detect Signs of Osteoporosis in Edentulous. Health, 7, 1671-1677. doi: 10.4236/health.2015.712181.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bassi, F., Rizzatti, A., Schierano, G. and Preti, G. (2001) Evaluation of the Utility of Cephalometric Parameters in Constructing Complete Denture. Part II: Placement of Anterior Teeth. Journal of Oral Rehabilitation, 28, 349-353.
[2] Amorin, V.C.P., Laganá, D.C., Eduardo, J.V.P. and Zanetti, A.L. (2003) Analysis of the Condyle/Fossa Relationships before and after Prosthetic Rehabilitation with Maxillary Complete Denture and Mandibular Removable Partial Denture. Journal of Prosthetic Dentistry, 89, 508-514.
[3] Campostrini, E.P., Ferreira, E.F. and Rocha, F.L. (2007) Conditions of the Oral Health of the Brazilian Elderly. Arquivos em Odontologia, 43, 48-56.
[4] Costa, C.B. (2009) Evaluation of the Golden Ratio in Lateral Cephalometric Radiographs of Edentulous Individuals before and after Treatment by Complete Dentures. Master Dissertation, Sao José dos Campos Dental School, Sao José dos Campos.
[5] Bras, J., van Ooij, C.P., Abraham-Inpijn, L., Kusen, G.J. and Wilmink, J.M. (1982) Radiographic Interpretation of the Mandibular Angular Cortex: A Diagnostic Tool in Metabolic Bone Loss. Part I. Normal state. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 53, 541-545.
[6] Devlin, H. and Horner, K. (2002) Mandibular Radiomorphometric Indices in the Diagnosis of Reduced Skeletal Bone Mineral Density. Osteoporosis International, 13, 373-378.
[7] Ciftci, Y., Kocadereli, I., Canay, S. and Senyilmaz, P. (2005) Cephalometric Evaluation of Maxillomandibular Relationships in Patients Wearing Complete Dentures. The Angle Orthodontist, 75, 821-825.
[8] Dias, A.T., Soares, R.O., Lima, W.M. and Sá, M.V. (2006) Vertical Dimension of Occlusion in Complete Denture. Odontologia Clin Cientif, 5, 41-47.
[9] Klemetti, E., Kolmakov, S. and Kroger, H. (1994) Pantomography in Assessment of the Osteoporosis Risk Group. Scandinavian Journal of Dental Research, 102, 68-72.
[10] Brzoza, D., Barrera, N., Contasti, G. and Hernández, A. (2005) Predicting Vertical Dimension with Cephalograms, for Edentulous Patients. Gerodontology, 22, 98-103.
[11] Evans, R.A., McDonnell, G.D. and Schieb, M. (1978) Metacarpal Cortical Area as an Index of Bone Mass. The British Journal of Radiology, 51, 428-431.
[12] Balcikonyte, E., Balciuniene, I. and Alekna, V. (2004) Panoramic Radiographs in Assessment of the Bone Mineral Density. Stomatologija, 6, 17-9.
[13] Mahl, C.R.W., Licks, R. and Fontanella, V.R.C. (2008) Comparison of Orphometric Indices Obtained from Dental Panoramic Radiography for Identifying Individuals with Osteoporosis/Osteopenia. Radiologia Brasileira, 41, 183-187.
[14] Alonso, M.B.C.C., Cortes, A.R.G., Camargo, A.J., Arita, E.S., Haiter-Neto, F. and Watanabe, P.C.A. (2011) Assessment of Panoramic Radiomorphometric Indices of the Mandible in a Brazilian Population. ISRN Rheumatology, 2011, Article ID: 854287.
[15] Nielsen, S.P. (2001) The Metacarpal Index Revisited: A Brief Overview. Journal of Clinical Densitometry, 4, 199-207.
[16] Vehmas, T., Solovieva, S., Riihimaki, H., Luoma, K. and Leino-Arjas, P. (2005) Hand Workload and the Metacarpal Cortical Index. A Study of Middle-Aged Teachers and Dentists. Osteoporosis International, 16, 672-680.
[17] Coimbra, A.M.V., Janovistz, D.Y. and Marques Neto, J.F. (1994) The Value of Radiological Assessment in Post-Menopausal Osteoporosis. Revista Brasileira de Reumatologia, 34, 161-166.
[18] Haara, M., Heliovaara, M., Impivaara, O., Arokoski, J. P., Manninen, P., Knekt, P. and Kroger, H. (2006) Low Metacarpal Index Predicts Hip Fracture: A Prospective Population Study of 3561 Subjects with 15 Years of Follow-Up. Acta Orthopaedica, 77, 9-14.
[19] Ariton, S.G., Pauna, M. and Mihai, G.I. (2008) Cephalometric Evaluation of the Maxillomandibular Relationships of a Patient Wearing Complete Dentures. TMJ, 58, 87-90.
[20] Camargo, A.J., Arita, E.S., Fenandez, M.C.C. and Watanabe, P.C.A. (2015) Comparison of Two Radiological Methods for Evaluation of Bone Density in Postmenopausal Women. International Journal of Morphology, 33, 732-736.

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