Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women

Clinical Research 8 min 80

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Created On: 14/01/2020

Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women

The National Institute of Health (NIH) defines osteoporosis as a skeletal disorder characterized by decreased bone strength, influencing a person to an increased risk of fracture.

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Key take away

Mandibular Cortical Index can be used as a screening tool for detecting osteoporosis. At phalanx III the quantitative ultrasound found to be an efficient method to assess the bone status.

Background

The National Institute of Health (NIH) defines osteoporosis as a skeletal disorder characterized by decreased bone strength, influencing a person to an increased risk of fracture. There are a number of methods available to determine the bone mineral density (BMD) such as the gold standard method, a dual-energy X-ray absorptiometry (DXA). The latest method which involves no radiation exposure is the quantitative ultrasound (QUS). This method is efficient and cost-effective in estimating BMD through skeletal sites with the predominance of cortical bone, such as calcaneus and recently - proximal phalanges. But, no studies describe the correlation between panoramic radiographs and QUS of the phalanx or radius.

The Dental panoramic radiograph is the most popularly used diagnostics tool before dental treatment. Cost-effectiveness is one of the advantages of panoramic radio-graphs. Over the last decades, panoramic radio-graphs become the attention of the researchers. Thus, dentists can be very helpful in predicting the risk of bone fractures. The dental radiographic panoramic images were used to predict low bone mineral density in patients. Dental panoramic radiographs can be implemented by clinicians to estimate the risk of fractures and osteoporosis.

Rationale behind research

As there were no methods prior available to found out the correlation between the QUS of the phalanx or radius and the panoramic radiographic results, thus this study was conducted.

Objective

To estimate the efficacy of panoramic radiography using morphometric analysis in diagnosis and detection of osteopenia and osteoporosis among postmenopausal women.

Method

Study outcomes:

Mandibular morphometric analysis including measurements of distance between upper and lower mandibular borders just behind the mental foramen (H), distance: mental foramen - inferior mandibular cortex (IM), the mandibular cortical width of the mental region (MCW)
Bone mineral status was assessed by QUS at the radius and proximal phalanx III finger

Time period: NA

Result

Outcomes

Baseline: There were no significant differences observed at baseline

Study Outcomes:

The mandibular height lies between 13.42–34.42 mm
The recorded mean mandibular cortical width was 3.31 mm
The mean value of PMI was found to be 0.33 and MR was 2.57
Assessment of skeletal status depicts that higher mean value of Ad SoS was found in the radius than in the III finger and phalanx T-score values were lower than those of the radius
Incidence of ostopenia was indicated by T-score of the radius was < − 1.0 in 22 patients and phalanx T-score in 39 patients
In 48 postmenopausal women, the mandibular cortical cortex of category C1 was reported, C2 was reported in 37 and C3 in 12 women. In older women, the higher score of Mandibular Cortical Index (MCI) was reported
MCI found to be correlated with the skeletal status as well as H, MCW and MR with p value = 0.01. Phalanx T-score was not found to be correlated to PMI, MR or MCW

Conclusion

Panoramic radiography is usually performed in older patients to assess dental status before dental treatment moreover it has been used for the assessment of the status of bones. Numerous studies suggest that the findings of these radiographs could help identify patients with low BMD. The present study presents the outcomes of the comparison of the results from panoramic radiographic images and QUS of the phalanx and radius.

The results of the present study showed no correlation between MCW and phalanx as well as between Ad-SoS and phalanx T-score. In addition, both PMI and MR were worthless in the screening of osteoporosis in women. The results from the present study found to be consistent with the previous studies which indicated the poor utility of PMI and MR, but it emphasized on the effectiveness of MCI and MCW as screening tools for osteoporosis.

An association between mandibular cortical shape and bone status was found in this study. This is clear from this study that the MCI can be efficiently assessed with the help of panoramic radiographs, and these can be used for the diagnosis of osteoporosis. Also, it can be used to evaluate the BMD. After assessment of the results of the dental panoramic radiography at dental clinics, the patients can be screened for the osteoporosis.

Limitations

Clinical take-away

The present article suggested a very simple and potential method to diagnose the patients with osteoporosis. The patients can be referred for the osteoporosis screening after the assessment of the dental panoramic radiography in the dental clinics.