Role of dental panoramic radiographs in assessment of future dental conditions in patients with osteoporosis and periodontitis.

Osteoporosis affects large segments of elderly populations, especially postmenopausal women. Bone mineral density (BMD) assessment of the skeleton by means of several pieces of equipment, such as dual-energy X-ray absorptiometry, have been useful in identifying individuals with low BMD or at high risk of suffering osteoporotic fracture. Recent investigators have demonstrated a significant association between BMD of the mandible and the peripheral skeleton in postmenopausal women. Some studies also have linked low BMD of the mandible and the peripheral skeleton with alveolar bone loss of the mandible and tooth loss. Dental panoramic radiology is a useful imaging modality by which the dentist can evaluate the whole dentition as well as the jawbones. Clinicians have started to focus on some mandibular panoramic indices, such as mandibular cortical index and mandibular cortical thickness, for the identification of elderly individuals who should undergo BMD assessment. In comparison with peripheral BMD measurement equipment in the medical field, the dentist will be able to identify osteoporotic elderly individuals by means of dental panoramic radiographs taken for the diagnosis of the teeth and the jawbones without additional cost. It is likely that the clinician may estimate the future risk of tooth loss in elderly individuals with periodontitis and osteoporosis by dental panoramic radiographs.