Antegonial Index Research Articles

Investigation of Fractal Dimension Analysis and Radiomorphometric Indices in Children with Type 1 Diabetes Mellitus

Background: Diabetes mellitus (DM) disrupts bone metabolism, leading to slowed bone development, poor bone quality, and osteoporosis. Objectives: The aim of this study was to examine changes in the bones of adolescents with type-1 diabetes mellitus (T1DM) using fractal dimension (FD) analysis method and panoramic radiomorphometric indices. Methods: Fractal dimension values and radiomorphometric measurements of 36 children with T1DM and 36 healthy individuals were compared using panoramic radiographs. The panoramic mandibular index (PMI), mental index (MI), mandibular cortical width (MCW), amount of alveolar bone resorption (AABR), antegonial index (AI), and gonial index (GI) were measured. Mandibular cortical index (MCI) was recorded as C1, C2, and C3 classes. Results: For the angulus and corpus regions, the T1DM patient group had lower FD values, and there was a statistically significant difference between the T1DM patient group and the control group (P = 0.003, P = 0.029). Mental index, MCW, and AI values were higher in the control group than in the T1DM patient group and were statistically significant (P = 0.014, P = 0.001, P < 0.001, respectively). Conclusions: In this study examining the mandible in pediatric patients with T1DM using radiomorphometric measurements and fractal analysis method, it can be concluded that T1DM affects bone morphology and trabecular structure

Panoramic Radiographic Evaluation of the Osseous Morphological Changes in Iraqi Patients with Chronic Renal Failure

To make comparative evaluation of gonial cortical bone thickness, antegonial index, gonial angle values and mandibular canal bone resorption, pathologies like ground-glass appearance in jawbones and brown tumor i n Iraqi patients undergoing dialysis due to chronic renal failure and patients from the healthy control group on panoramic .Panoramic radiographs were taken from 40 patients divided into two groups (20 normal and 20 dialysis patients) .Gonial cortical thickness, antegonial index and gonial angle values with the mandibular canal wall resorption were assessed , pathologies such as ground-glass appearance and Brown tumor as “available” or “not available.” Mandibular canal wall resorption (Chi-square:16.52 , P<0.01) was found highly statistically significant difference between the patient and control groups ,resorption detected mainly in right side of male patients .Panoramic radiographs showed decreasing in values of the measuring parametersin patients receiving dialysis treatment due to chronic renal failure compared to the control group.

A Panoramic X-ray as a Supportive Diagnostic Tool for the Screening of Osteoporosis in Patients with Hemophilia A and B.

Hemophilia is associated with an increased risk of developing osteoporosis and osteopenia. The aim of the study was to interpret the usefulness of fractal analysis of the trabecular bone of the mandible (FD) and selected radiomorphic indices (the antegonial index (AI) and Klemetti index (KI)) to assess the risk of reduced bone mineral density (BMD) in patients with hemophilia A/B. The study group consisted of 50 patients with type A/B hemophilia. The control group consisted of 25 males without congenital bleeding disorders. The patients had a panoramic radiograph taken with the same X-ray machine (Vistapano S, Durr Dental, Bietigheim-Bissingen, Germany). The AudaXCeph software (Audax d.o.o., Ljubljana, Slovenia) was used to evaluate the AI index, and the ImageJ, software with a specially prepared script, was used to evaluate the FD. The mandibular cortex was assessed distal to the mental foramen using the Klemetti index. There were no statistically significant differences between the AI, KI and FD values between the study group and the control group. This study indicated the lack of usefulness of AI, KI and fractal analysis in identifying patients with hemophilia at risk of reduced bone mass.

Effectiveness of Orthopantomograms as a Screening Tool for Osteoporosis: A Case-Control Study.

Introduction Osteoporosis is a disease that is characterised by low bone mineral density (BMD), and loss of structural and biomechanical properties that are essential in maintaining bone homeostasis. Osteoporosis is diagnosed by clinical measurement of BMD and is the best predictor of osteoporosis. The study was conducted with the aim of assessing the effectiveness of orthopantomogram (OPG) as a screening tool for osteoporosis in postmenopausal women and chronic drug users. Objectives The primary objective of the current study was to assess the mandibular cortical width and antegonial index in postmenopausal women and chronic drug users, the secondary objective was to compare the mandibular cortical width and antegonial index of postmenopausal women and chronic drug users with that of the control group (healthy individual). Methods Three groups were taken in this study with a sample size of 300 with 100 OPG in each group. The groups categorised in the study were postmenopausal women, patients under drugs (glucocorticoids, proton pump inhibitor, anti-epileptic drugs, selective serotonin reuptake inhibitor) and the control group and the parameters assessed were antegonial index and mandibular cortical width. Results Results were tabulated and analysed using Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY). The normality tests Kolmogorov-Smirnov and Shapiro-Wilks test results reveal that the variables (both indices) follow the normal distribution. The mandibular cortical width was 3.44, 2.66 and 2.96 in the normal, postmenopausal women and women on drugs respectively. The antegonial index was 163.5, 157.2 and 158.8 in the normal, postmenopausal women and women on drugs respectively. Conclusion From the above results, it is evident that there is a statistically significant reduction in antegonial index and mandibular cortical width in postmenopausal women compared to normal individuals.Alterations of this value are suggestive that early pre-clinical changes of osteoporosis can be detected in the high-risk group using OPG.

Differences in Antegonial Index values in type II diabetes mellitus patients using panoramic radiography

Objectives: This research is aimed to analyze the value of the antegonial index in patients with type II diabetes mellitus using panoramic radiography.
 Materials and Methods: This research is using stratified random sampling study with unpaired numerical comparative formula. The research sample was patients who were visiting and diagnosed with type II diabetes mellitus for ≤ 5 years and > 5 years by doctors at the Internal Diseases Polyclinic at Ulin General Hospital, Banjarmasin. Mandibular cortical thickness can be seen in the results of panoramic radiographs using radiomorphometric measurements with mandibular cortical index measurements, which is called as antegonial index. Antegonial index measurement as a screening tool can detect either the patient is positive or negative for having bone resoption. 
 Results: The result showed average value of mandibular cortical thickness in patients with diabetes mellitus type II with a period of disease ≤ 5 years does not match the normal limit of > 3.2 mm, which is 2.57 ± 1.41 and the average value of mandibular cortical thickness in the group of patients with long period of disease > 5 years is 2.19 ± 0.76.
 Conclusion: Mandibular cortical thickness in patients with type II diabetes mellitus for ≤ 5 years and > 5 years is not within normal limits.

Bruksizmli Hastaların Radyograflarında Hounsfield Birim Değeri ve Radyomorfometrik İndekslerinin Değerlendirilmesi

Background: The aim of this retrospective study is to evaluate the effects of bruxism on the mandibular bone using radiomorphometric indices and Hounsfield unit (HU) value on digital panoramic radiography (DPR). Materials and Methods: Panoramic radiographs of 120 patients, 60 with bruxer and 60 without (control), were analyzed. Mental index (MI), panoramic mandibular index (PMI), antegonial index (AI), gonial index (GI), antegonial notch depth (AND) and mandibular cortical index (MCI) were measured bilaterally in DPR. Gray values of the cancellous bone and cortical bone at predetermined landmarks in the mandible were measured using the HU value on the DPR. Results: MI was found to be higher and statistically significant in bruxers compared to the control group (p<0.05). There was no statistically significant difference between the bruxism group and the control group in terms of AI, GI and MCI (p>0.05). While there was a significant difference in HU value in the cancellous bone in the bruxism group and the control group (p<0.05), there was no statistically significant difference in HU values between the two groups in the cortical bone (p>0.05). Conclusions: MI and AND measurements can be used in the diagnosis or follow-up of bruxism. There is no diffe-rence in mandibular cortical bone height in patients with and without bruxism according to AI, GI, and MCI. The mean PMI value measured on the left side differs between the groups. In bruxism patients, increased density in the mandibular cancellous bone, is greater and significantly different from the increase in cortical bone.

Morphological evaluation of gonial and antegonial regions in bruxers on panoramic radiographic images

BackgroundThis is the first study to report both cortical and trabecular bone evaluation of mandibles in bruxers, within the knowledge of the authors. The purpose of this study was to evaluate the effects of bruxism on both the cortical and the trabecular bone in antegonial and gonial regions of the mandible, which is the attachment of the masticatory muscles, by using panoramic radiographic images.MethodsIn this study, the data of 65 bruxer (31 female, 34 male) and 71 non-bruxer (37 female, 34 male) young adult patients (20–30 years) were evaluated. Antegonial Notch Depth (AND), Antegonial-Index (AI), Gonial-Index, Fractal Dimension (FD) and Bone Peaks (BP) were evaluated on panoramic radiographic images. The effects of the bruxism, gender and side factors were investigated according to these findings. The statistical significance level was set atP ≤ 0.05.ResultsThe mean AND of bruxers (2.03 ± 0.91) was significantly higher than non-bruxers (1.57 ± 0.71; P < 0.001). The mean AND of males was significantly higher than females on both sides (P < 0.05). The mean AI of bruxers (2.95 ± 0.50) was significantly higher than non-bruxers (2.77 ± 0.43; P = 0.019). The mean FD on each side was significantly lower in bruxers than in non-bruxers (P < 0.05). The mean FD of males (1.39 ± 0.06) was significantly higher than females (1.37 ± 0.06; P = 0.049). BP were observed in 72.5% of bruxers and 27.5% of non-bruxers. The probability of existing BP, in bruxers was approximately 3.4 times higher than in non-bruxers (P = 0.003), in males was approximately 5.5 times higher than in females (P < 0.001).ConclusionAccording to the findings of this study, the morphological differences seen in cortical and trabecular bone in the antegonial and gonial regions of the mandible in bruxers can be emphasized as deeper AND, higher AI, increased of existing BPs, and lower FD, respectively. The appearance of these morphological changes on radiographs may be useful for indication and follow-up of bruxism. Gender is an effective factor on AND, existing BP and FD.

Digital panoramic radiography and CBCT as auxiliary tools for detection of low bone mineral density in post-menopausal women: a cross-sectional study

BackgroundOsteoporosis is a chronic, multifactorial skeletal disease that occurs especially in women following a decrease in estrogen levels and decrease in bone mineral density. The aim of this study was to evaluate the relationship between qualitative and quantitative indexes in panoramic radiographs and quantitative indexes in CBCT images with femoral and vertebral BMD in postmenopausal women.MethodsThis comparative cross-sectional study was performed on postmenopausal women aging 40 to 80 years attending for obtaining either panoramic radiograph or mandibular CBCT scan. Dual energy X-ray absorptiometry (DEXA) was performed from the femur and lumbar vertebra. Quantitative parameters of mental index (MI), panoramic mandibular index (PMI), antegonial index (AI) as well as qualitative parameters of mandibular cortical index (MCI) and trabecular bone pattern (TP) were evaluated in panoramic radiographs. Quantitative parameters computed tomography mandibular index (CTMI), computed tomography index (inferior) [CTI(I)] and computed tomography index (superior) [CTI(S)] were analyzed in CBCT images. Kolmogorov-Smirnov tests and Pearson correlation coefficient were used (α = 0.05).ResultsIn individuals with panoramic radiography, statistically significant correlations were observed between MI with vertebral and femoral T-score, AI with vertebral and femoral T-score (except for the right AI with femoral T-score), and TP with vertebral and femoral T-score (p < 0.05). In the group with CBCT scans, the correlations between CTMI with vertebral and femoral T-score, CTI(I) with vertebral and femoral T-score, and CTI(S) with vertebral and femoral T-score were statistically significant (p < 0.05).Conclusionsin CBCT images, quantitative indexes of CTMI, CTI(I), and CTI(S), and in panoramic images, quantitative indexes of MI and AI and qualitative index of TP can be used to predict the possibility of osteoporosis in postmenopausal women.

Evaluation of mandibular cortical and trabecular radiomorphometry in familial Mediterranean fever patients

The objective of this retrospective study was to evaluate the mandibular cortical and trabecular morphology and microarchitecture of patients with familial Mediterranean fever (FMF) and compare them to those of healthy individuals by examining radiomorphometric indices on panoramic radiographs. We examined a group of 56 FMF patients aged 5 to 71 years and an age- and sex-matched control group of individuals with no systemic diseases. We classified the FMF and control groups according to age and sex and the FMF group according to colchicine use. We evaluated the quantitative radiomorphometic indices of gonial index, antegonial index, molar cortical thickness, mental index, panoramic mandibular index, and lacunarity, and the qualitative mandibular cortical index on all panoramic radiographs and performed between and within group analysis. Mean gonial index, antegonial index, and molar cortical thickness values of the FMF group were significantly smaller than those of the control group. Significantly fewer patients in the FMF group were classified as mandibular cortical index type 1 compared to the control group. There were no significant differences in quantitative index values according to colchicine use in the FMF group or regarding the categorical parameters of age, sex, and mandibular cortical index classification. Radiomorphometric values of the mandibular basal cortex posterior to the mental foramen differ significantly in FMF patients compared to healthy counterparts. Dentists should note mandibular morphologic changes indicative of low bone density when examining panoramic images of patients with this disease.

Mandibular Radiomorphometric Characteristics of Individuals with Bilateral or Unilateral Cleft Lip and Palate.

This study aimed to investigate and compare the mandibular radiomorphometric characteristics of patients with unilateral or bilateral cleft lip and palate (CLP) with those of individuals without CLP and to determine whether there was a difference. Retrospective cohort study. Orthodontic Department in Faculty of Dentistry. Mandibular cortical bone thickness was measured on high-quality panoramic radiographs taken from 46 patients with unilateral or bilateral CLP aged 13-15 years and 21 control patients. Three radiomorphometric indices [antegonial index (AI), mental index (MI), and panoramic mandibular index (PMI)] were measured bilaterally. AutoCAD software was used for MI, PMI, and AI measurements. Left MI values were significantly lower in individuals with unilateral cleft lip and palate (UCLP; 0.029 ± 0.04) than in individuals with bilateral cleft lip and palate (BCLP; 0.033 ± 0.07). In addition, right MI values of individuals with right UCLP (0.26 ± 0.06) were significantly lower than those of individuals with left UCLP (0.34 ± 0.06) or BCLP (0.32 ± 0.08). No difference was observed between individuals with BCLP and left UCLP. These values did not differ between groups. Antegonial index and PMI values did not differ between individuals with different types of CLP or when compared with control patients. In patients with UCLP, cortical bone thickness was found to be reduced on the cleft side compared to the intact side. Patients with UCLP with a right-sided cleft had a more substantial decrease in cortical bone thickness.

Reference values of Orthopantomographic indices for early detection of low bone mineral density in Indian population.

Orthopantomographic (OPG) indices are considered tools for early screening for low Bone Mineral Density and Osteoporosis. This tool is being used in the western population, and they have developed their reference values for all the OPG indices. The current study aimed to check the validity of the reference values for OPG indices in the Indian population. A cross-sectional study was conducted on 325 participants, and they were recruited in two sets. Dataset one of 130 aged 20-30 years and dataset two of 195 participants aged 40-60 years. OPG was performed, and indices such as Mental Index (MI), Panoramic Mandibular Index (PMI), Gonial Index (GI) and Antegonial Index (AI) were measured. Values obtained in our study were compared with the established OPG indices for the Indian and Western populations. The mean age of participants in dataset one to develop references was 23.5±2.5 years. Females had a significantly lower MI, PMI, and AI than males (p<0.05). MI was significantly higher in validation dataset one males than females (p<0.05). A good agreement was found in MI and PMI of the two references (p<0.05). The reference values derived from this study for MI, PMI, GI and AI are 3.50,0.27,1.10, 2.50, respectively. Compared with previous studies in Indian and western populations, these references were significantly lower.

Evaluation of jaw bone changes in patients with asthma using inhaled corticosteroids with mandibular radiomorphometric indices on dental panoramic radiographs.

Inhaled corticosteroids (ICSs) are an effective drug commonly used in asthma treatment. It is known that osteoporotic changes can occur secondary to steroid usage, depending on dosage and duration. The aim of this study was to compare radiomorphometric indices and fractal dimension on panoramic images of patients with asthma using ICSs and healthy controls. A total of 66 dental panoramic radiographs (DPRs) taken from 32 patients with asthma using ICSs and 34 healthy individuals were evaluated in this retrospective study. Panoramic mandibular index inferior and superior (PMI-i,PMI-s), mandibular cortical width (MCW), gonial index (GI), antegonial index (AI), mandibular cortical index (MCI), and fractal dimension analysis (FDA) were measured on DPRs. PMI-s (p=0.02), MCW (p<0.001), GI (p<0.001) and AI (p<0.001) values were significantly lower in the group of the asthma using ICSs than control group. However, the PMI-i (p ˃0.05) measurement, the MCI (p ˃0.05) and FDA values distribution were similar in both groups. The use of ICSs in asthma patients can affect bone quality. The evaluation of PMI-s, MCW, GI, and AI on DPR can help determine the effect of this drug on the jawbones in the early period and select dental and surgical treatment plans appropriately.

Panorametric study in a paediatric population in Madrid.

The aim of the study was to establish the normality ranges of the linear and angular measurements that can be carried out in orthopantomographies (OPGs) of a paediatric sample from Madrid, according to sex and dentition. OPGs performed in the Radiology Service of the Faculty of Dentistry of the Complutense University of Madrid (UCM) from caucasic children between 4-14 years old were selected. A total of 44 measurements were made in the OPGs, and the sex and type of dentition of each child were recorded. Panoramic Mandibular Index and Antegonial Index were also calculated. Statistical tests were performed with a confidence level of 95% (p < 0.05) and bilateral significance to analyse the differences between sex and type of dentition, and the correlation between the measurements of the right and left sides. A total sample of 160 OPGs (50% boys, 50% girls) were analysed. 16.25% of the sample was in primary dentition, 50% in first phase mixed dentition, 17.5% in second phase mixed dentition and 16.25% in permanent dentition. Statistically significant differences were found with respect to the sex of the subjects in 11 of the measurements; and 44 in relation to the dentition stages of the subjects. A strong correlation is found between the measurements on the right and left sides. The application of panoramic measurements as indicators of normality can help in the detection of craniofacial alterations in growth and development of the lower facial third.

Mandibular quality assessment in women aged 40-60 years using mandibular cortical index and antegonial index on panoramic radiographs

Objectives: This study aimed to describe the cortical quality of the mandible in women aged 40-60 years by analyzing the mandibular cortical index and antegonial index on panoramic radiographs.&#x0D; Materials and Methods: This study was a cross-sectional analytic descriptive study, population, and sample using secondary data on panoramic radiographs of women aged 40-60. The descriptive analysis technique used in this study was the average value (mean), standard deviation, and thickness of the mandibular cortex in radiographs of female patients aged 40-60 years.&#x0D; Results: This study observed variations in mandibular cortical bone quality on panoramic radiographs, with increasing age, bone quality tends to decrease, and there is an effect of gender involvement. Women tend to have lower bone quality, one of which is due to hormonal factors. This study observed variations in mandibular cortical bone quality on panoramic radiographs, with increasing age, bone quality tends to decrease, and there is an effect of gender involvement. Women tend to have lower bone quality, one of which is due to hormonal factors. The age group at risk of osteoporosis had the lowest mandibular cortex width value in the age group of 51-60 years.&#x0D; Conclusion: This study produced a variety of panoramic radiographs of the mandibular cortical bone quality. The value of the width of the mandibular cortex gradually decreases with age. The value of mandibular cortex width is higher in the younger generation.

Effects of conventional complete dentures and implant-supported overdentures on alveolar ridge height and mandibular bone structure: 2-year and 6-year follow-up study.

The aim of this study was to compare the changes in mandibular bone structure in edentulous patients who were rehabilitated with conventional complete dentures (CCD) and implant supported overdentures (ISO), by evaluating alveolar bone loss (ABL), panoramic mandibular index (PMI), mandibular cortical width (MCW), gonion index (GI), antegonial index (AI), and articular eminence inclination (AEI). Panoramic radiographs of 63 edentulous patients using CCD, 63 edentulous patients using ISO, and 126 patients without tooth loss were evaluated. Edentulous patients had a 2-year and 6-year follow-up panoramic radiograph image. ABL (anterior, premolar, and molar regions), MCW, PMI, AI, GI, and AEI were measured in each patient. Variation between measurements was analyzed using repeated measures ANOVA test and post hoc Tukey test. Both edentulous groups showed significantly lower mean than without tooth lost group in all measures (p < 0.000). ISO group showed significantly lower mean ABL than CCD group in anterior (p = 0.000), right premolar (p = 0.005), left premolar (p = 0.005), right molar (p < 0.000), and left premolar (p < 0.000) regions in short term. ISO group showed significantly lower mean ABL than CCD group in anterior (p = 0.021), right molar (p < 0.000), and left premolar (p < 0.000) regions in long-term. There is no statistically significant difference between the CCD and ISO groups in right premolar (p = 0.200) and left premolar (p = 0.134) regions in long term. Both edentulous groups showed significantly lower mean MCW (p < 0.000), PMI (p < 0.000), AI (p < 0.000), GI (p < 0.012), and AEI (p < 0.002) than the without tooth loss group. There is no statistically significant difference between the CCD and ISO groups in terms of changes in the mean MCW, PMI, AI, GI, and AEI measurement in short and long term (p > 0.000). In the short and long term, edentulism reduced alveolar crest height, MCW, and AEI in individuals, but had no effect on PMI, AI, or GI. The use of prosthesis did not prevent the decrease of alveolar crest height, MCW, or AEI (CCP or ISO). In the short and long term, however, ISO created less ABL in the mandibular anterior and molar regions than CCD. ABL cannot be halted in edentulous people, but by using ISO instead of CCD for rehabilitation, resorption can be reduced.

Comparison of panoramic mandibular cortical bone quality indexes in amlodipine users and healthy individuals

Hypertension and osteoporosis are believed to be linked to to each other. Previous studies have suggested that the imbalance of calcium metabolism in hypertensive condition and the use of calcium channel blockers such as amlodipine may lower the density and quality of bone. Panoramic radiography has been widely used as a reliable tool in assessing bone quality. One indicator of bone quality in panoramic radiograph is the macrostructure evaluation of mandibular cortical bone by using various indexes such as mandibular cortical index (MCI) and antegonial index (AI). This research aimed to compare the bone quality of hypertensive patients with amlodipine and healthy individuals using MCI and AI. In this study we used sixty panoramic radiographs of hypertensive patients with amlodipine and healthy individuals, thirty for each group, with various aspects of demography. The MCI analysis was done by dividing the mandibular cortical shape into three different qualitative categories and the AI analysis was done quantitatively by measuring the width of mandibular cortical bone in antegonial region using ImageJ software. There were statistically significant differences in the results between the two groups in terms of both AI (p = 0.000) and MCI (p = 0.001) in which hypertensive group had lower score. Based on this research, there were differences of mandibular bone quality of hypertensive patients with amlodipine and healthy individuals, particularly in its macrostructure.

Evaluation of mandibular bone changes in multiple myeloma patients on dental panoramic radiographs.

The aim of this study is to assess the mandibular bone structures of multiple myeloma (MM) patients on panoramic radiographs using fractal analysis (FA) and radio-morphometric indices. The study group consisted of 67 MM patients, and the control group consisted of 67 individuals without any systemic disease. The mandibular cortical index (MCI) classification, antegonial index (AGI), gonial index (GI), mandibular cortical width (MCW), panoramic mandibular index (PMI) and fractal dimensions (FD) were evaluated on panoramic radiographs. FD measurements were made by identifying 4 related areas. Shapiro-Wilk test was used to determine the normal distribution of the data. Chi-square and independent t tests were used to compare the findings between the two groups. The FD values of the study group in ROI1, ROI2, ROI3, ROI4 regions and GI values were found to be statistically significantly lower than the control group (p < 0.001). There was no statistically significant difference between the two groups in terms of AGI, MCW and PMI values (p > 0.05). While C1 was the most common type in the control group, C2 was the most common type in the study group. C2 and C3 were detected more in the study group than in the control group (p < 0.001). Our study showed a consensus with the studies advocating that fractal analysis and radio-morphometric indices are methods that can be used to determine mandibular bone density. The low bone density of MM patients is a condition that physicians should be aware of for interventional dental procedures.

Evaluation of mandibular indices and cephalometric parameters in adolescents with impacted maxillary canines

Objectives: Maxillary impacted canines have an important place in orthodontics for the reason of being a common anomaly and its treatment is time consuming and difficult. The aim of this study was to investigate the mandibular indexes and cephalometric parameters in adolescents with impacted maxillary canines. Materials and Methods: The radiographs of 4026 patients aged 12–19 years old were scanned and a total of 155 patients were included in the study. Subjects were divided into three groups according to the permanent maxillary canines: Bilateral impacted canine (BIC) (52 subjects; mean age 15.02 ± 1.74 years), unilaterally impacted canine (UIC) (51 subjects; mean age 14.89 ± 1.39 years), and the control (52 subjects; mean age 14.84 ± 1.65 years) groups. Skeletal, soft tissue and dental measurements were performed on cephalometric radiographs. Mandibular index analyzes including the panoramic mandibular index (PMI), mental index (MI), antegonial index (AI), and gonial index (GI) measurements and also angular measurements of impacted maxillary canines were performed on panoramic radiographs. Data were analyzed statistically and P &lt; 0.05 was considered significant. Results: Maxillary skeletal and dental measurements showed retrusive positioned maxillary dental arch in the sagittal direction in the impacted canine groups (P &lt; 0.05). PMI and MI values were greater in the BIC and UIC groups than in control group (P &lt; 0.05). There was no statistically significant difference in AI value among groups (P &lt; 0.05). GI value of BIC group was found statistically lower than other groups (P &lt; 0.05). Conclusion: Individuals with impacted maxillary canines have more retrusive maxillary dental arch and soft-tissue components. Furthermore, mandibular cortex was thicker in subjects with impacted maxillary canine than individuals with not and clinicians should keep in mind this when examine the panoramic radiographs in terms of early diagnosis of impacted maxillary canine teeth.

Effect of personal habits on bone mineral density among adults using orthopantomogram indices as a screening tool for osteoporosis

Background: Effect of tobacco, areca nut, and alcohol consumption (vices) on orthopantomogram (OPG) indices. Aims: To assess the relationship between vices on OPG indices in Indian adult males aged 20–60 years. Subjects and Methods: This study was conducted on 172 males with a mean age of 34.2 ± 1 years. OPG was used for measuring mandibular indices and correlated with the history of the presence of vices. Statistical Analysis Used: Data were presented as mean ± SE or frequency (%). Point biserial correlation was used to assess the correlation between OPG indices and vices. Analysis of covariance was used to analyze the differences in age-adjusted OPG indices between males who had vices against males who had no vice. Results: Overall, 21.5% of the males had at least one vice. A significant decrease in antegonial index (AI) values (P < 0.05) was found between tobacco and alcohol consumption. There was a significant decrease in the values of the gonial index (GI) and AI, having at least one vice (P < 0.05). A higher percentage of participants who had at least one adverse habit had low OPG indices score than participants who had no such habits. Conclusions: Orthopantomogram indices specifically AI were negatively affected in males who had vices.

Assessment of the efficacy of digital panoramic radiographs in analyzing changes in bone mineral density in postmenopausal women

Osteoporosis is described by the World Health Organization (WHO) as a 'progressive systemic skeletal disease characterized by low bone mass, microarchitectural deterioration of bone tissue, a consequent increase in bone fragility, and susceptibility to fracture. The maxilla and mandible are also affected by osteoporotic changes and these may be visualized using an Orthopantomogram. To determine the radiomorphometric indices in the digital orthopantomograms, to determine the bone mineral density (BMD) of the lumbar spine and femur using DXA (Dual-Energy X-ray Absorptiometry) scan, to compare the measured indices between the BMD categories and to assess the correlation of these indices with the measured BMD. The study population included 30 postmenopausal female patients. The BMD was measured at the lumbar spine and at the femur and the patients were divided into three groups of 10 subjects based on their BMD status (normal, osteopenia, and osteoporosis). The patients were then subjected to panoramic radiography and four panoramic indices were assessed (simple visual estimation, mandibular cortical index, mental index, and antegonial index). The measured indices were compared between the three BMD categories. The correlation between the indices and the BMD was also observed. The measured indices showed significant difference among the BMD categories. The quantitative indices also demonstrated a positive correlation with the measured BMD of the lumbar spine and the femur. Panoramic radiography may be used as a diagnostic tool for screening and identifying subjects who are likely to have osteoporosis.