This study aimed to assess the accuracy of radiomorphometric indices based on digital panoramic and CBCT images by comparing them to gold standard measurements on dry mandibles and to assess the effectiveness of these indices as osteoporosis predictors in healthy and osteoporotic women.
Method:
The in-vitro part of this study comprised ten mandibles each was scanned by Digital panorama and CBCT. Six radiomorphometric indices (MI, PMI, M/M Ratio, AI, Gonial angle and GI) were measured on the digital panoramic image, while three indices (MI, PMI and M/M Ratio) were measured on selected CBCT images by 3 observers and the average of each was calculated and compared to the real measurement obtained directly on the mandibles. For the clinical part, twenty selected female volunteers were scanned by Digital panoramic, DEXA and CBCT scans. According to the DEXA results, they were categorized into either normal or osteopenic/osteoporotic group. The same measurements were performed on digital panoramic, and CBCT images by 3 observers and the average of each was calculated.
Result:
The in-vitro study demonstrated that there was a statistically significant positive direct correlation between real, panoramic and CBCT measurements. The clinical study demonstrated that there was no significant correlation between the DEXA results with either panoramic or CBCT indices in the normal, osteopenic and osteoporotic groups.
Conclusion:
Panoramic measurements; especially the Gonial angle, MI & PMI, are accurate and effective. All CBCT measurements specially the vertical measurements performed on cross sectional cuts were highly representative of the real measurements. Within the limitation of the current study regarding the limited sample size in the clinical sector, the bone of the mandible does not appear to reflect the characteristics of the skeleton as a whole. PMI and MI, with a larger sample size, may serve as prognostic osteoporosis indices.