Panoramic Radiograph as a Screening for Oral Frailty

Objectives: Slight signs of frailty in the oral and maxillofacial area may be the initial symptoms of serious systemic frailty. In 2014, the Japan Geriatrics Society defined these slight signs as “oral frailty.” The hyoid bone is located in the middle of the cervical muscles that are involved in the oral masticatory function. The position of the hyoid bone could act as a useful reference in the assessment of oral function. The position of the hyoid bone is commonly determined by lateral cephalometric analysis. The purpose of this study is to investigate the usefulness of the panoramic radiograph in the evaluation of hyoid bone position.
Methods: The study was based on 348 patients referred for a panoramic radiograph and lateral cephalograph between June 2013 and April 2016. Two observers assessed the hyoid bone position on the panoramic radiograph. The patients were divided into six groups according to how the hyoid bone appeared in the panoramic radiograph: Group 0: hyoid bone could not be observed; Group 1: part of the greater horn was observed; Group2: part of the hyoid body was observed; Group 3: half of the hyoid body was observed; Group 4: all of the hyoid body was observed; Group 5: the hyoid body was overlapped with the mandible. The gold standard for measurement of hyoid bone position is the lateral cephalograph. In each group, hyoid bone position was compared. The Kruskal-Wallis test was used for statistical analysis.
Results: Table1 shows the mean and standard deviation in hyoid bone positon from mandibular lower border of each group. Statistically significant differences were seen in each group. On panoramic radiograph, in patients whose hyoid bones were invisible, the hyoid bone was in a lower position.
Conclusions: The assessment of hyoid bone position by panoramic radiograph might be useful as a screening for oral frailty. (KAKENHI:16K11523)