Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality

Objectives: To determine whether the bone mineral density (BMD) of the mandibular cortex is correlated with an ordinal classification of the morphology of the inferior cortex on panoramic radiographs. Methods: The cortical BMD of the mandible was measured by single-energy quantitative computed tomography at two sites: (1) buccally and distally from the mental foramen, (2) lingually and distally from the mental foramen, The morphology of the mandibular cortex was assessed on panoramic radiographs, and classified into three groups. Results: The severity of the changes in the mandibular cortex was significantly related to the BMD of the buccal cortex (ANOVA: P=0.002), Conclusions: The use of an ordinal classification of the mandibular cortex on panoramic radiographs may be helpful for general dental practitioners in the assessment of the local quality of the cortical bone.