Imaging Sci Dent.  2017 Jun;47(2):87-92. 10.5624/isd.2017.47.2.87.

Is the panoramic mandibular index useful for bone quality evaluation?

• Kwon AY
• Huh KH
• Yi WJ
• Lee SS
• Choi SC
• Heo MS

• KMID: 2389888
• DOI: http://doi.org/10.5624/isd.2017.47.2.87

Abstract

PURPOSE
The aim of this study was to determine whether the panoramic mandibular index (PMI) is useful for assessing bone mineral density. We also analyzed the potential correlations between PMI parameters and patient age.
MATERIALS AND METHODS
Four observers measured the PMI of both sides of the mental foramen using a picture archiving and communication system and images in the Digital Imaging and Communications in Medicine format. They studied 300 panoramic radiographic images of patients belonging to the following age groups: 40-49 years, 50-59 years, 60-69 years, 70-79 years, and 80-89 years. The observers were allowed to zoom in or out and to adjust the contrast of the images. Further, they were instructed to record the reasons for any measurements that could not be made. Then, we conducted a reliability analysis of the measured PMI and assessed the correlations between different patient age groups and the 3 parameters used for determining the PMI from the available data.
RESULTS
Among the 600 data items collected, 23 items were considered unmeasurable by at least 1 observer for the following 4 reasons: postoperative state, lesion, unidentified mental foramen, and alveolar bone loss. The intraobserver reproducibility of the measurable data was 0.611-0.752. The mandibular cortical width (MCW) decreased significantly as patient age increased.
CONCLUSION
PMI had limited usability when the margin of the mental foramen was not clear. In contrast, MCW, a parameter used for determining the PMI, had fewer drawbacks than the PMI with respect to bone mineral density measurements and exhibited a significant correlation with patient age.

Keyword

Radiography; Panoramic; Bone density; Mandible

MeSH Terms

Alveolar Bone Loss
Bone Density
Humans
Mandible
Radiography

Figure

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  Fig. 1 A. Cropped panoramic radiograph shows the mental foramen marked with a circle and the distance measurement value. The distance between the superior margin of the mental foramen and the lower border of the mandible is 19.10 mm. B. The distance between the inferior margin of the mental foramen and the lower border of the mandible is 15.58 mm. C. The measured distance of the mandibular cortical width is 4.83 mm.

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  Fig. 2 The mental foramen is seen below the radiolucent lesion (arrow).

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  Fig. 3 A panoramic radiograph shows severe alveolar bone loss, and both sides of the mental foramen are identified near the alveolar crest level (arrow).

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