Analysis of Bone Quality on Panoramic Radiograph in Osteoporosis Research by Fractal Dimension

Objective: To Assess the correlation between different quality analysis parameters of trabecular pattern in digital panoramic radiographies and relations with forearm bone mass density (BMD) performed by DXA. Methods: The study was developed using panoramic and peripheral bone densitometry dual energy X-ray absorptiometry (DXA) of 68 patients, 9 males and 59 females (19 - 73 years old). In the panoramic radiographs, evaluation of the trabecular bone morphology through assessment of fractal dimension (FD), connectivity (C) and total number of “bright” pixels (ET) was performed. In DXA, the exam determines the bone mineral density of the forearm to identify who has a high risk of osteoporosis. Statistics analyzed the relationship of these exams and the contribution of dental radiographs in detecting patients at risk for osteoporosis. Results: The average age of subjects was 43.85. In the analysis of trabecular pattern, a significant correlation between the FD, ET and C factors in level of 5% (Pearson correlation test) was found. Correlation tests showed no significant correlation between DF and BMD. Conclusions: The analysis showed correlations with each other, detecting alterations in the trabecular pattern. It cannot be related to BMD with FD but should be taken into account that examining the bone or trabecular alveolar process, when, for example, diagnostic analysis of pre-implant bone quality, is required.

Use of Panoramic Radiographs to Detect Signs of Osteoporosis in Edentulous

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.