Comparative Analysis of Mandibular Cortical Index in Orthopantomogram and Bone Mineral Density in Dual Energy X-Ray Absorptiometry in Postmenopausal Females –A Radiological Study in North Indian Population

The Purpose of current study is that Osteoporosis is a systemic disorder characterized by low bone mass leading to fractures reported commonly in females after menopause. The investigations for osteoporosis most commonly used DEXA are very costly and not easily available. Few studies have proposed the use of orthopantomogram as a diagnostic marker for osteoporosis as it is simple, quick, easy, inexpensive, non-invasive and widely used. Thus the present study has undertaken to assess the relation between mandibular cortical index (MCI) of panoramic radiograph and bone mineral density of body measured by dual energy x-ray absorptiometry (DEXA).The study comprised of fifty post-menopausal females. All the females were subjected to panoramic radiographs and DEXA. The visual analysis was done based on the radiographic appearance of the lower border of the mandible on the left side by two observers who were blinded about DEXA results. Intra/Inter-observer variability was ruled out by visual analysis at two occasions which was followed by comparison of different grades of MCI and BMD statistically.There was significant difference in the three groups of mandibular cortical index of panoramic radiograph as interpreted by the two observers (p value < 0.05).The intra-observer reproducibility of this index had moderate agreement (Kappa value of 0.34& 0.31) and the interobserver agreement of this index followed fair reproducibility (kappa value of 0.37&0.32). This study concluded that there is a significant correlation between mandibular cortical index (MCI) and bone mineral density (BMD) of the lumbar vertebrae as determined by the dual energy x-ray absortiometry(DEXA). So, visual examination of the panoramic radiographs can be used as a screening procedure for diagnosis and referral of patients for further evaluation of osteoporosis.