Comparison of Accuracy of Prediction of Osteoporosis in Digital Panoramic Radiography with DEXA Scan in Postmenopausal Women: A Pilot Study

Abstract

Aims and objectives: To compare the accuracy of prediction of osteoporosis in digital panoramic radiography with Dual Xray absorptiometry (DEXA) scans and serum investigations such, as calcium, phosphorous, alkaline phosphatase in postmenopausal women. The objective of the study is to detect the appearance of eroded mandibular cortex (cortical shape), inferior cortical width appearance on Digital panoramic radiographs in post menopausal women, bone mineral density, with DEXA scan and serum calcium, phosphorous and alkaline phosphatase levels in postmenopausal women. The main objective of this study is to compare both tools (Digital OPG and DEXA scans) to detect similar diagnostic performances in identifying post-menopausal women with osteoporosis. Materials and methods: This is a study in the Outpatient department of Oral Medicine Diagnosis and Radiology and Bharat Scan Centre designed to compare the accuracy of prediction of osteoporosis in digital panoramic radiography with DEXA scan in postmenopausal women without estrogen use and with and without history of hysterectomy, oopherectomy and with normal values of serum calcium, phosphorous and alkaline phosphatase. The study includes 10 postmenopausal women varying in age group between 60 and 75 years who reported to the outpatient department of oral medicine diagnosis and radiology, seeking dental treatment. The BMD with digital panoramic radiography, DEXA-scan and serum calcium, phosphorous, and alkaline phosphatase levels were calculated and compared. Results: In our study, out of the10 postmenopausal women with no previous diagnosis of osteoporosis, who participated in this study, 3 women (30%) were normal, 1 woman (10%) had osteopenia and 6 women (60%) had osteoporosis on the basis of BMD. There is significant relationship in the width of the mandibular cortex for normal, osteopenic and osteoporosis patients. The cortical width was reduced and less than 4 mm in our study for patients with osteoporosis. The cortical width was normal and greater than 4 mm in our patients without osteoporosis. The mean cortical width of patients with osteoporosis was 2.7 mm, 3.9 mm for osteopenic patients, 4.18 mm for patient without osteoporosis. Conclusion: The purpose of this study is that dentists may be able to refer postmenopausal women with undetected low skeletal BMD or osteoporosis to medical professionals for further examination on the basis of incidental findings on dental panoramic radiographs.