ANALYSIS OF RADIOMORPHOMETRIC INDICES IN POSTMENOPAUSAL PATIENTS WITH OSTEOPOROSIS: CASE REPORT AND LITERATURE REVIEW

Ioana Mădălina Lescai,Department Of Obstetrics & Gynaecology, Emergency University Hospital, Bucharest, Romania ,Laurența Lelia Mihai,Monica Mihaela Cîrstoiu, ,“Carol Davila“ University Of Medicine And Pharmacy, Bucharest, Romania

doi:10.37897/rjs.2021.2.6

Ioana Mădălina Lescai, Department Of Obstetrics & Gynaecology, Emergency University Hospital, Bucharest, Romania + Show 4 more

Open Access

https://doi.org/10.37897/rjs.2021.2.6

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Journal: Romanian Journal of Stomatology	Publication Date: Jun 30, 2021
License type: cc-by

Abstract

Objectives. The aim of this case report is to present a single patient case superimposed on the literature knowledge in regard to mophometric mandibular variations observed on dental panoramic radiography and used to identify patients with low bone mass density (BMD). Case presentation. A 62 years old female patient reported to the Blident Help Dental Clinic, for specific visits and treatments, 3 years apart. Based on the digital panoramic radiography and DXA measurement, an osteoporosis evaluation with radiomorphometric indices was performed. Values for maximum condylar height, maximum coronoid height, projective height of the mandibular ramus, minimum ramus breadth and antegonial angle are higher on both sides. the values decreased for gonial angle, gonial index, mandible cortical width (MCW), superior and inferior mental height and panoramic mandibular indices on both sides. Bigonial distance also dicreased and the mandibular cortical index (MCI) changed from C2 category in 2017 to C3 category in 2020. Discussions. This postmenopausal pacient had a decline in MCW values which were lower than 3 mm (threshold to differentiate normal) on panoramic radiographs of women with low BMD. Antegonial Index had a decreased value and could be used as a prediction index for osteoporosis. MCI index changed from C2 to C3 in correlation with the changes of bone mass density in lumbar spine. Conclusions. MCI, MCW, antegonial index and bone density played an important role in determining significance of effects of lower BMD at postmenopausal on the mandibular ramus region.

Highlights

Osteoporosis is a systemic disease that is considered a public health problem due to its social impact
There is a wealth of research in the field of dentistry investigating whether panoramic radiography can be applied to identify patients at risk for reduced bone mass and osteoporosis
To forensic medicine, the mandible is considered a good indicator for distinguishing changes in tooth or bone morphology and sexuality by gender and age of bones affected with osteoporosis

Summary

INTRODUCTION

Osteoporosis is a systemic disease that is considered a public health problem due to its social impact. There is a wealth of research in the field of dentistry investigating whether panoramic radiography can be applied to identify patients at risk for reduced bone mass and osteoporosis. This would allow dentists to make aware patients of the possible underlying treatment and to present this risk before the pacient suffers any fracture. To forensic medicine, the mandible is considered a good indicator for distinguishing changes in tooth or bone morphology and sexuality by gender and age (gonial angle, mandibular index, panoramic index) of bones affected with osteoporosis (especially postmenopausal women). Antegonial angle (AA) is formed by two lines drawn parallel to the opposite area which intersected the deepest point of the antegonial notch [9]

AIM

CONCLUSIONS