Assessment of the correlation between mandibular radiomorphometric patterns and dual-energy X-ray absorptiometry measurements for screening bone mineral density.

The objective of this study was to investigate the correlation between scores for femoral and lumbar spine bone mineral density (dual-energy X-ray absorptiometry [DXA]) and visual, qualitative mandibular bone pattern assess¬ments (mandibular cortical index, trabecular bone pattern, and visual mandibular cortical width) as well as age and body mass index. Three trained observers evaluated 200 panoramic radiographs and 200 femoral and lumbar spine DXA measurements from 100 male and 100 female participants. The κ test showed an acceptable agreement among observers (0.73; P = 0.003). The Shapiro-Wilk test revealed that the variables were not normally distributed, so the Spearman correlation test was used. The mean age of the sample was 60.7 (13.9) years, and 86.0% of the patients were White. There were inverse correlations between the mandibular cortical index and the spine T-score in men, women, and the total sample as well as between the spine Z-score in the total sample. An inverse correlation was observed between the trabecular bone pattern and the spine T- and Z-scores in women and the total sample. The results also showed inverse correlations between the visual mandibular cortical width and all parameters analyzed in men, women, and the total sample except for the femur T-score and spine T- and Z-scores in men. Body mass index was correlated with all DXA parameters. Age was inversely correlated with femur T-scores in men and women but not with spine DXA values in men. The results suggest that qualitative assessments of radiomorphometric patterns on panoramic radiographs correlate with DXA values and therefore are suitable for screening patients at risk of developing low bone mineral density.