# Evaluation of Mandibular Bone Alterations by Panoramic Radiography: A Potential Tool in the Identification of Signs of Osteopenia and Osteoporosis

**Authors:** Esdras Gabriel Alves-Silva, Betania Fachetti Ribeiro, Camila Fontes Silva, Rita de Kássia-Alves, Rodrigo Arruda-Vasconcelos, Lidiane Mendes Louzada, Rebecca F. Almeida-Gomes, João Miguel Marques Santos, Brenda P. F. A. Gomes

PMC · DOI: 10.3390/bioengineering12070746 · 2025-07-09

## TL;DR

This study explores whether panoramic dental X-rays can help detect signs of weak bones like osteopenia and osteoporosis in the jaw.

## Contribution

The study introduces panoramic radiography as a potential diagnostic tool for identifying mandibular bone alterations linked to osteopenia and osteoporosis.

## Key findings

- 52% of cases showed semilunar defects in the mandibular cortex, suggesting osteopenia.
- 5% of cases exhibited a porous and thin cortex, indicating osteoporosis.
- Risk factors like smoking and comorbidities were associated with bone changes observed in radiographs.

## Abstract

This study aimed to evaluate the validity of panoramic radiography as an auxiliary method for identifying mandibular bone features consistent with a diagnosis of osteopenia or osteoporosis. Ninety panoramic radiographs were analyzed to assess the quality of the mandibular cortical layer below the mental foramen on both sides of the mandible. Scores C1 (normal), C2 (osteopenia), and C3 (osteoporosis) were attributed according to the cortical morphology. The sample consisted of 78 (86%) women aged 45 years or older and 12 (14%) men older than 60 years old. In 39 (43%) cases, the C1 score was evidenced as the lower mandibular cortical layer was normal on the image. The C2 score was identified in 47 (52%) cases, in which the cortical layer showed semilunar defects. Four (5%) cases presented a C3 score, with the cortical layer showing a clearly porous, thinner bone cortex. The presence of risk behaviors (e.g., smoking and alcoholism) as well as some comorbidities (e.g., systemic arterial hypertension, diabetes mellitus and thyroid disorders) was also observed. Mandibular bone changes were observed in association with a set of risk factors using panoramic radiography.

## Linked entities

- **Diseases:** osteoporosis (MONDO:0005298), diabetes mellitus (MONDO:0005015)

## Full-text entities

- **Diseases:** thyroid disorders (MESH:D013959), diabetes mellitus (MESH:D003920), hypertension (MESH:D006973), alcoholism (MESH:D000437), Osteopenia (MESH:D001851), Osteoporosis (MESH:D010024)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12292467/full.md

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Source: https://tomesphere.com/paper/PMC12292467