Association between Bone Mineral Density, Panoramic Radiographic Indices of the Mandible, and Tooth Loss in Dental Patients at a Tertiary Hospital

Chulamanee Sookprome

Authors

Chulamanee Sookprome Rajavithi Hospital

Keywords:

Bone mineral density, Panoramic radiographic indices, Tooth loss

Abstract

Background: Previous studies have shown the association between decreased bone mineral density and changes in mandibular bone structure. This has led to increased interest in investigating the relationship between osteoporosis, panoramic radiographic imaging and tooth loss. Panoramic radiographs which commonly used in dentistry are considered a useful and cost-effective screening tool for identifying patients at risk for osteoporosis. Objective: To examine the association between bone mineral density (BMD), tooth loss and three panoramic radiographic indices of mandible (panoramic mandibular index-PMI, mental index-MI, and mandibular cortical index-MCI) in dental patients. Methods: This cross-sectional study included 125 patients who had an oral examination and were treated at Rajavithi Hospital during the period from January 2024 to August 2025. Inclusion criteria were the patients with no history of fractures and no prior use of osteoporosis. All participants had undergone bone mineral density (BMD) assessment and digital panoramic radiographic imaging. BMD T-score and parameters such as PMI, MI, MCI, and tooth loss were measured. The independent t-test, One-Way ANOVA and Pearson correlation were analyzed. Results: A total 125 dental patients in this research were 13 males (10.4%) and 112 female (89.6%), age from 50 to 89 years. This study found a significant association between BMD T-score and panoramic radiographic indices of mandible (MI, MCI) and
tooth loss (p-value < .05). However, BMD T-score was not significantly associated with PMI. Conclusions: These findings of this study suggest that in patients’ panoramic radiographic indices (MI, MCI indices) and tooth loss may be a useful index for screening osteoporosis. Bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DEXA) remains the method for screening osteoporosis.

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