Reliability of Orthopantomogram in Predicting Bone Mineral Density as Compared to Dual Energy X-Ray Absorptiometry in Post-menopausal Indian Females: A Radiological Original Study

Abstract

Background: Osteoporosis is commonly seen affecting the bones in post-menopausal females, especially in India. Dual energy X-ray absorptiometry (DEXA) is the gold standard for identifying osteoporosis in female patients. Digital panoramic radiography (OPG) is a common imaging modality used frequently in routine dental practice. Mandibular cortical index (MCI) on OPG can be used to diagnose osteoporosis. Therefore, this study evaluated the efficacy of MCI on OPG to help detect osteoporosis in postmenopausal Indian females. Aim: To evaluate the accuracy of OPG versus DEXA in predicting bone mineral density (BMD). Materials and Methods: The research involved forty-two women with a postmenopausal history for a minimum of a year. The BMD was measured using DEXA. OPG was taken, and analysis of the mandible on OPG was done by two observers using the MCI given by Klemetti et al. Results: OPG had an overall sensitivity and specificity of 71% in the normal group, sensitivity of 50%, specificity of 68% in the osteopenia group, and sensitivity of 36%, specificity of 89% in the osteoporotic group in predicting the BMD using MCI. A positive correlation was seen in the efficacy of OPG in predicting BMD in the normal (P = 0.031*) and osteoporotic groups (P = 0.000*). Conclusion: MCI on OPG helped diagnose normal and osteoporotic patients efficiently, but osteopenia was misdiagnosed as normal or osteoporotic. Hence, MCI alone should not be used to predict BMD.

Keywords

• dual energy x-ray absorptiometry
• mandibular cortical index
• orthopantomogram
• osteopenia
• osteoporosis