Diagnostic efficacy of alveolar bone loss of the mandible for identifying postmenopausal women with femoral osteoporosis

Objectives: Mandibular cortical width (MCW) detected on panoramic radiographs may be useful for identifying postmenopausal women with osteoporosis. There is little known regarding whether alveolar bone loss (ABL) of the mandible detected on panoramic radiographs is a potentially accurate screening tool for osteoporosis in comparison with MCW. The purpose of this study was to evaluate whether ABL of the mandible on panoramic radiographs is useful for identifying femoral osteoporosis in postmenopausal women in comparison with MCW. Methods: Three hundred and fifty-four Japanese postmenopausal women (mean age +/- SD, 56.8 +/- 7.7 years) were recruited for this study. Femoral BMD was measured by dual energy X-ray absorptiometry. Panoramic radiographs were obtained to estimate ABL of the mandible and MCW. Results: A multiple regression analysis revealed that femoral BMD was significantly associated with MCW (P < 0.001), weight (P < 0.001), age (P < 0.001) and ABL of the mandible (P = 0.029; adjusted r(2) = 0.380). The area under the ROC curve (AUC) for identifying femoral osteoporosis was 0.609 [95% confidence interval (0), 0.523-0.696] for ABL of the mandible and 0.779 (95% CI, 0.713-0.844) for MCW, respectively. AUC for ABL of the mandible indicated less accuracy. Conclusions: Our results suggest that ABL of the mandible on panoramic radiographs may not be useful for identifying postmenopausal women with femoral osteoporosis in comparison with MCW.