Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Is the panoramic mandibular index useful for bone quality evaluation?

  • Kwon, Ah-Young (Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Huh, Kyung-Hoe (Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Yi, Won-Jin (Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Lee, Sam-Sun (Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Choi, Soon-Chul (Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Heo, Min-Suk (Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University)
  • Received : 2017.01.03
  • Accepted : 2017.04.25
  • Published : 2017.06.30
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Abstract

Purpose: The aim of this study was to determine whether the panoramic mandibular index (PMI) is useful for assessing bone mineral density. We also analyzed the potential correlations between PMI parameters and patient age. Materials and Methods: Four observers measured the PMI of both sides of the mental foramen using a picture archiving and communication system and images in the Digital Imaging and Communications in Medicine format. They studied 300 panoramic radiographic images of patients belonging to the following age groups: 40-49 years, 50-59 years, 60-69 years, 70-79 years, and 80-89 years. The observers were allowed to zoom in or out and to adjust the contrast of the images. Further, they were instructed to record the reasons for any measurements that could not be made. Then, we conducted a reliability analysis of the measured PMI and assessed the correlations between different patient age groups and the 3 parameters used for determining the PMI from the available data. Results: Among the 600 data items collected, 23 items were considered unmeasurable by at least 1 observer for the following 4 reasons: postoperative state, lesion, unidentified mental foramen, and alveolar bone loss. The intraobserver reproducibility of the measurable data was 0.611-0.752. The mandibular cortical width (MCW) decreased significantly as patient age increased. Conclusion: PMI had limited usability when the margin of the mental foramen was not clear. In contrast, MCW, a parameter used for determining the PMI, had fewer drawbacks than the PMI with respect to bone mineral density measurements and exhibited a significant correlation with patient age.

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References

  1. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1994; 843: 1-129.
  2. Kanis JA. Diagnosis of osteoporosis. Osteoporos Int 1997; 7 Suppl 3: 108-16. https://doi.org/10.1007/BF03194355
  3. Lewis MK, Blake GM, Fogelman I. Patient dose in dual X-ray absorptiometry. Osteoporos Int 1994; 4: 11-5. https://doi.org/10.1007/BF02352255
  4. Mueller D, Gandjour A. Cost-effectiveness of using clinical risk factors with and without DXA for osteoporosis screening in postmenopausal women. Value Health 2009; 12: 1106-17. https://doi.org/10.1111/j.1524-4733.2009.00577.x
  5. Devlin CV, Horner K, Devlin H. Variability in measurement of radiomorphometric indices by general dental practitioners. Dentomaxillofac Radiol 2001; 30: 120-5. https://doi.org/10.1038/sj.dmfr.4600594
  6. Benson BW, Prihoda TJ, Glass BJ. Variations in adult cortical bone mass as measured by a panoramic mandibular index. Oral Surg Oral Med Oral Pathol 1991; 71: 349-56. https://doi.org/10.1016/0030-4220(91)90314-3
  7. Klemetti E, Kolmakov S, Kroger H. Pantomography in the assessment of the osteoporosis risk group. Scand J Dent Res 1994; 102: 68-72.
  8. Klemetti E, Kolmakov S, Heiskanen P, Vainio P, Lassila V. Panoramic mandibular index and bone mineral densities in postmenopausal women. Oral Surg Oral Med Oral Pathol 1993; 75: 774-9. https://doi.org/10.1016/0030-4220(93)90438-A
  9. Ngeow WC, Dionysius DD, Ishak H, Nambiar P. Effect of ageing towards location and visibility of mental foramen on panoramic radiographs. Singapore Dent J 2010; 31: 15-9. https://doi.org/10.1016/S0377-5291(12)70004-4
  10. Yosue T, Brooks SL. The appearance of mental foramina on panoramic radiographs. I. Evaluation of patients. Oral Surg Oral Med Oral Pathol 1989; 68: 360-4. https://doi.org/10.1016/0030-4220(89)90224-7
  11. Ariji Y, Katsumata A, Kubo R, Taguchi A, Fujita H, Ariji E. Factors affecting observer agreement in morphological evaluation of mandibular cortical bone on panoramic radiographs. Oral Radiol 2017; 33: 117-23. https://doi.org/10.1007/s11282-016-0253-9
  12. Nakamoto T, Taguchi A, Ohtsuka M, Suei Y, Fujita M, Tanimoto K, et al. Dental panoramic radiograph as a tool to detect postmenopausal women with low bone mineral density: untrained general dental practitioners' diagnostic performance. Osteoporos Int 2003; 14: 659-64. https://doi.org/10.1007/s00198-003-1419-y
  13. White SC, Taguchi A, Kao D, Wu S, Service SK, Yoon D, et al. Clinical and panoramic predictors of femur bone mineral density. Osteoporos Int 2005; 16: 339-46. https://doi.org/10.1007/s00198-004-1692-4
  14. Alman AC, Johnson LR, Calverley DC, Grunwald GK, Lezotte DC, Hokanson JE. Diagnostic capabilities of fractal dimension and mandibular cortical width to identify men and women with decreased bone mineral density. Osteoporos Int 2012; 23: 1631-6. https://doi.org/10.1007/s00198-011-1678-y
  15. Sindeaux R, Figueiredo PT, de Melo NS, Guimaraes AT, Lazarte L, Pereira FB, et al. Fractal dimension and mandibular cortical width in normal and osteoporotic men and women. Maturitas 2014; 77: 142-8. https://doi.org/10.1016/j.maturitas.2013.10.011
  16. Roberts M, Yuan J, Graham J, Jacobs R, Devlin H. Changes in mandibular cortical width measurements with age in men and women. Osteoporos Int 2011; 22: 1915-25. https://doi.org/10.1007/s00198-010-1410-3
  17. 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: 60-7.
  18. Alkurt MT, Peker I, Sanal O. Assessment of repeatability and reproducibility of mental and panoramic mandibular indices on digital panoramic images. Int Dent J 2007; 57: 433-8. https://doi.org/10.1111/j.1875-595X.2007.tb00146.x
  19. Yasar F, Akgunlu F. The differences in panoramic mandibular indices and fractal dimension between patients with and without spinal osteoporosis. Dentomaxillofac Radiol 2006; 35: 1-9. https://doi.org/10.1259/dmfr/97652136
  20. Devlin H, Allen PD, Graham J, Jacobs R, Karayianni K, Lindh C, et al. Automated osteoporosis risk assessment by dentists: a new pathway to diagnosis. Bone 2007; 40: 835-42. https://doi.org/10.1016/j.bone.2006.10.024
  21. Arifin AZ, Asano A, Taguchi A, Nakamoto T, Ohtsuka M, Tsuda M, et al. Computer-aided system for measuring the mandibular cortical width on dental panoramic radiographs in identifying postmenopausal women with low bone mineral density. Osteoporos Int 2006; 17: 753-9. https://doi.org/10.1007/s00198-005-0045-2
  22. Kavitha MS, Samopa F, Asano A, Taguchi A, Sanada M. Computer-aided measurement of mandibular cortical width on dental panoramic radiographs for identifying osteoporosis. J Investig Clin Dent 2012; 3: 36-44. https://doi.org/10.1111/j.2041-1626.2011.00095.x

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