Analysis of bone mineral loss by dental panoramic radiography in men over 40 years old in the state of Roraima / Análise da perda mineral óssea por radiografia panorâmica dentária em homens com mais de 40 anos de idade no estado de Roraima

Mario Maciel de Lima Junior, Fernando Coutinho Marques Filho, Magna Feitosa Barbosa, Barbara Marques Suppi


Background: The present study was conducted to understand the possible application of panoramic radiography as an alternative diagnostic measure for the detection of osteopenia and osteoporosis. Moreover, we surveyed to understand the oral hygiene of the participants.Materials and Methods: A questionnaire-based survey for self-assessment was done, followed by a detailed radiographic evaluation and Cortical Mandibular Index (ICM) and Mentonian Index (IM) recording. Later, statistical analyses were done for descriptive analysis and possible important factors responsible for the obtained ICM and IM values. Results: The obtained results suggested that for the present study population of 112 participants, and considered 25 parameters, age was a major factor (P 0.00456) along with the use of a personal toothbrush (P 0.01265), and exchange of a new toothbrush (P 0.0293). These factors were significantly influential on the ICM outcomes (P 0.06645) whereas the influence of the considered parameters was not significantly influential on IM results. Conclusion: The descriptive results suggested that osteopenia and osteoporosis were dominant among the patients as confirmed by the radiographic analysis. Hence, panoramic radiography can be an effective alternative in the diagnosis of osteoporosis. However, confirmation should be obtained from further large-scale studies on diverse populations with more contributing factors.


osteoporosis, osteopenia, cortical mandibular index, mentonian index, bone mineral density, dental radiography.

Full Text:



Golchin MM, Heidari L, Ghaderian SM, Akhavan-Niaki H. Osteoporosis: a silent disease with complex genetic contribution. J Genet Genomics 2016;43(2):49-61.

Lin JT, Lane JM. Osteoporosis: a review. Clin Orthop Relat Res 2004;425:126-34.

Lydick E, Martin A, Yawn B. Impact of fears on quality of life in patients with a silent disease: osteoporosis. Clin Ther 1996;18(6):1307-15.

Sweet MG, Sweet JM, JereMiah MP, Galazka SS. Diagnosis and treatment of osteoporosis. Am Fam Physician 2009;79(3):193-200.

Bartl R, Frisch B. Osteoporosis: diagnosis, prevention, therapy. Springer Science & Business Media 2009.

Kim J, Kim SW, Lee SY, Kim TH, Jung JH. Bone mineral density in osteoporotic patients with pyogenic vertebral osteomyelitis: effect of early versus late treatment for osteoporosis. Osteoporos Int 2018;29(12):2761-70.

Liu TT, Li XD, Wang WZ, Zhang JG, Yang DZ. Efficacy of weight adjusted bone mineral content in osteoporosis diagnosis in Chinese female population. Chin Med J 2019;132(7):772.

Bould N. Negligent administration of steroids without bone protection resulting in glaucoma, cataracts, visual loss and osteoporosis. Clin Risk 2015;21(6):121-3.

Davies A, Horne M. Negligent failure to prescribe prophylaxis against steroid-induced osteoporosis: Shirley Maureen Edmunds v Cardiff and Vale NHS Trust. Clin Risk 2007;13(2):79-80.

Kim Y, Kim HY, Kim JH. Associations between reported dietary sodium intake and osteoporosis in Korean postmenopausal women: The 2008-2011 Korea national health and nutrition examination survey. Asia Pac J Public Health 2017;29(5):430-9.

Gardiner A, Miedany YE, Toth M. Osteoporosis: not only in women, but in men too. Br J Nurs 2007;16(12):731-5.

Mahl CR, Licks R, Fontanella VR. Comparison of morphometric indices obtained from dental panoramic radiography for identifying individuals with osteoporosis/osteopenia. Radiol Bras 2008;41(3):183-7.

Moura-Leite FR, Ramos-Jorge ML, Bonanato K, Paiva SM, Vale MP, Pordeus IA. Prevalence, intensity and impact of dental pain in 5-year-old preschool children. Oral Health Prev Dent 2008;6(4).

Vlasiadis KZ, Damilakis J, Velegrakis GA, Skouteris CA, Fragouli I, Goumenou A, et al. Relationship between BMD, dental panoramic radiographic findings and biochemical markers of bone turnover in diagnosis of osteoporosis. Maturitas 2008;59(3):226-33.

Marinho BC, Guerra LP, Drummond JB, Silva BC, Soares MM. The burden of osteoporosis in Brazil. Arq Bras Endocrinol Metabol 2014;58(5):434-43.

Baccaro LF, Conde DM, Costa-Paiva L, Pinto-Neto AM. The epidemiology and management of postmenopausal osteoporosis: a viewpoint from Brazil. Clin Interv Aging 2015;10:583.

Ballane G, Cauley JA, Luckey MM, Fuleihan GE. Worldwide prevalence and incidence of osteoporotic vertebral fractures. Osteoporos Int 2017;28(5):1531-42.

Zeng Q, Li N, Wang Q, Feng J, Sun D, Zhang Q, et al. The prevalence of osteoporosis in China, a nationwide, multicenter DXA survey. J Bone Miner Res 2019;34(10):1789-97.

Wang XR, Kwok TC, Griffith JF, Yu BW, Leung JC, Wáng YX. Prevalence of cervical spine degenerative changes in elderly population and its weak association with aging, neck pain, and osteoporosis. Ann Transl Med 2019;7(18).

Thambiah SC, Yeap SS. Osteoporosis in South-East Asian Countries. Clin Biochem Rev 2020;41(1):29.

Li H, Wallin M, Barregard L, Sallsten G, Lundh T, Ohlsson C, et al. Smoking‐induced risk of osteoporosis is partly mediated by cadmium from tobacco smoke: The MrOS Sweden Study. J Bone Miner Res 2020;35(8):1424-9.

Raza L, Ahmed A, Kumar V, Hasnain A. Study on awareness of osteoporosis and its associated risk factors among housewives and working women in Karachi. J Pak Med Assoc 2017;67(12):1879-83.

Higgs J, Derbyshire E, Styles K. Nutrition and osteoporosis prevention for the orthopaedic surgeon: a wholefoods approach. EFORT Open Rev 2017;2(6):300-8.

Lin KM, Lu CL, Hung KC, Wu PC, Pan CF, Wu CJ, et al. The paradoxical role of uric acid in osteoporosis. Nutrients 2019;11(9):2111.

Mohsin S, Baniyas MM, AlDarmaki RS, Tekes K, Kalász H, Adeghate EA. An update on therapies for the treatment of diabetes-induced osteoporosis. Expert Opin Biol Ther 2019;19(9):937-48.

Matzkin EG, DeMaio M, Charles JF, Franklin CC. Diagnosis and treatment of osteoporosis: what orthopaedic surgeons need to know. J Am Acad Orthop Surg 2019;27(20):e902-12.

Kapoor N, Cherian KE, Pramanik BK, Govind S, Winford ME, Shetty S, et al. Association between dental health and osteoporosis: A study in South Indian postmenopausal women. J Mid-life Health 2017;8(4):159.

Ghapanchi J, Zahed M, Haghnegahdar A, Niakan N, Sadeghzadeh A. Osteoporosis and jaw abnormalities in panoramic radiography of chronic liver failure patients. BioMed Res Int 2018;2018.

De Medeiros FC, Kudo GA, Leme BG, Saraiva PP, Verri FR, Honório HM, et al. Dental implants in patients with osteoporosis: a systematic review with meta-analysis. Int J Oral Maxillofac Surg 2018;47(4):480-91.

Menon A, Sengottaiyan V, Ganapathy D. Osteoporosis and its dental impact. Drug Invent Today 2019;11(2).

AL-Yasiry AM. Dental health of osteopenia diabetes mellitus male patients. Med J Babylon 2018;15(2):118.

Ledgerton D, Horner K, Devlin H, Worthington H. Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol 1999;28(3):173-81.

Yasar F, Akgunlu F. The differences in panoramic mandibular indices and fractal dimension between patients with and without spinal osteoporosis. Dentomaxillofac Radiol 2006;35(1):1-9.

Calciolari E, Donos N, Park JC, Petrie A, Mardas N. Panoramic measures for oral bone mass in detecting osteoporosis: a systematic review and meta-analysis. J Dent Res 2015;94(3_suppl):17S-27S.

Hastar E, Yilmaz HH, Orhan H. Evaluation of mental index, mandibular cortical index and panoramic mandibular index on dental panoramic radiographs in the elderly. Eur J Dent 2011;5(1):60.

Sghaireen MG, Alam MK, Patil SR, Rahman SA, Alhabib S, Lynch CD, Al-Omiri M. Morphometric analysis of panoramic mandibular index, mental index, and antegonial index. J Int Med Res 2020;48(3):0300060520912138.

Savic Pavicin I, Dumancic J, Jukic T, Badel T, Badanjak A. Digital orthopantomograms in osteoporosis detection: mandibular density and mandibular radiographic indices as skeletal BMD predictors. Dentomaxillofac Radiol 2014;43(7):20130366.