Osteoporosis is often detected late and becomes severe because of a lack of subjective symptoms. Digital panoramic radiography (DPR) has been reported to be useful for osteoporosis screening based on the morphological classification of the mandibular inferior cortex. The purpose of this study was to evaluate the sensitivity and specificity of the mandibular cortical index (MCI) in the diagnosis of osteoporosis in a group of patients who were and were not using antiosteoporosis medication (AOM). Three hundred and fifty female patients aged 40 years or older who had DPR imaging performed during a 6-year period from December 2015 to February 2022 met the selection criteria. Two examiners recorded mandibular cortical width and MCI from the images. These results were statistically examined together with the patients\' demographic data. Forty-nine patients were using AOM (13 nonbisphosphonate/denosumab and 36 bisphosphonate/denosumab). MCI type 3 was the most common in the AOM group. In the MCI classification, DPR imaging among the AOM group was more sensitive (0.95) than that of the control group. This method of estimating osteoporosis based on MCI classification using DPR images has high sensitivity, especially in patients using AOM, suggesting that this method is useful as a screening test.

UNASSIGNED: Recently, an artificial intelligence-based computer-assisted diagnosis (AI-CAD) for panoramic radiography was developed to scan the inferior margin of the mandible and automatically evaluate mandibular cortical morphology. The aim of this study was to analyze quantitatively the mandibular cortical morphology using the AI-CAD, especially focusing on underlying diseases and dental status in women over 20 years of age.
UNASSIGNED: 419 patients in women over 20 years of age who underwent panoramic radiography were included in this study. The mandibular cortical morphology was analyzed with an AI-CAD that evaluated the degree of deformation of the mandibular inferior cortex (MIC) and mandibular cortical index (MCI) automatically. Those were analyzed in relation to underlying diseases, such as diabetes, hypertension, dyslipidemia, rheumatism and osteoporosis, and dental status, such as the number of teeth present in the maxilla and mandible.
UNASSIGNED: The degree of deformation of MIC in women under 51 years of age (21-50 years; n = 229, 16.0 ± 12.7) was significantly lower than those of over 50 years of age (51-90 years; n = 190, 45.1 ± 23.0), and the MCI was a significant difference for the different age group. Regarding the degree of deformation of MIC and MCI in women over 50 years of age, osteoporosis and number of total teeth present in the maxilla and mandible were significant differences.
UNASSIGNED: The results of this study indicated that the mandibular cortical morphology using the AI-CAD is significantly related to osteoporosis and dental status in women over 50 years of age.

Long-term use of L-Thyroxine (LT4), the synthetic thyroxine hormone used for thyroid hormone replacement therapy, is an important risk factor for osteoporosis. The aim of this study was to investigate the differences between mandibular cortical index (MCI) and trabecular bone fractal dimension (FD) values on panoramic radiographs of patients using LT4 and control subjects.
A total of 142 female patients, 71 cases and 71 controls, were analyzed in the study. Ages were matched in case and control groups and the mean age was 36.6 ± 8.2 (18 to 50) years. MCI consisting of C1 (Normal Mandibular Cortex), C2 (Moderately Resorbed Mandibular Cortex) and, C3 (Severely Resorbed Cortex) scores was determined for case and control groups. Fractal analysis was performed using ImageJ on selected regions of interest from the gonial and interdental regions. The box-count method was used to calculate FD values. Wilcoxon signed-rank test, Mann-Whitney U test, and Spearman correlation analysis were applied to compare the measurements. Statistical significance of differences was established at P < 0.05 level.
FD values did not show statistically significant differences between case and control groups (p > 0.05). The mean FD in the right gonial region was 1.38 ± 0.07 in the case group and 1.38 ± 0.08 in the control group (p = 0.715). The mean FD in the right interdental region was 1.37 ± 0.06 in the cases and 1.36 ± 0.06 in the control group (p = 0.373). The mean FD in the left gonial region was 1.39 ± 0.07 in the cases and 1.39 ± 0.07 in the control group (p = 0.865). The mean FD in the left interdental region is 1.37 ± 0.06 in the cases and 1.38 ± 0.05 in the control group (p = 0.369). The most common MCI score was C1, with 62% in the cases and 83.1% in the control group. MCI scores showed a statistically significant difference between cases and controls (p = 0.016, p < 0.05). While the C2 score was higher in the cases, the C1 score was higher in the controls.
LT4 use was not associated with the FD of mandibular trabecular bone, but was associated with MCI values of cortical bone. Further studies on larger samples with different imaging modalities and image processing methods are needed.

UNASSIGNED: This study aimed to assess fractal dimension (FD) and the radiomorphometric indexes on the digital panoramic radiography (DPR) of patient with primary hypothyroidism receiving levothyroxine sodium replacement therapy.
UNASSIGNED: A total of 115 subjects were included in this cross sectional retrospective study. According to the results of the thyroid function tests, the subjects were divided into two groups as primary hypothyroidism (levothyroxine sodium replacement therapy given), (n = 57) and the healthy control group (n = 58). The fractal dimension (FD), panoramic mandibular index (PMI), mandibular cortical width (MCW), gonial index (GI) and mandibular cortical index (MCI) values of all patients were calculated on DPRs. The statistical analysis of all data was performed with SPSS version 22.
UNASSIGNED: The distributions of age and gender in the primary hypothroidism group were similar to control group (p = 0.19 and p = 0.62, respectively). The two groups did not differ statistically significantly in terms of FD, PMI, MCW, GI, and MCI.
UNASSIGNED: We determined that mandibular cortical and trabecular bone structure did not significantly differ between healthy individuals and patients receiving drug replacement theraphy due to hypothyroidism, but our results should be further supported with the investigation of clinical parameters.

OBJECTIVE: To analyze factors predicting mandibular cortical width (MCW) and mandibular cortical index (MCI) in adult females and males.
METHODS: Data on 427 females and 335 males aged 40-84 from The Tromsø study: Tromsø7 were used. T-score, age, menopausal status (for females), remaining teeth, and periodontal status were analyzed in linear and logistic regression analyses as predictors of MCW and MCI, respectively.
RESULTS: T-score, age, and the number of remaining teeth significantly predicted MCW in females but not males. Standardized β coefficients were 0.286, -0.231, and 0.131, respectively. The linear regression model explained 24% of MCW variation in females. MCI in females was significantly predicted by T-score, age, and remaining teeth with the Wald values of 9.65, 6.17, and 5.83, respectively. The logistic regression model explained 16.3-23% of the variation in MCI in females. In males, T-score was the only significant predictor of the eroded cortex, and the logistic model explained only 4.3-5.8% of the variation in MCI.
CONCLUSIONS: The T-score demonstrated a stronger relationship with MCW and MCI than other factors in females, which supports the usefulness of those indices for osteoporosis screening. Conversely, the T-score exhibited no association with MCW and remained the only significant predictor of MCI in males, yet to a lesser extent than in females.
CONCLUSIONS: Understanding factors affecting mandibular cortical morphology is essential for further investigations of MCW and MCI usefulness for osteoporosis screening in females and males.

This study aims to evaluate whether there is a relationship between the appositional classification in the mandible angle region and the mandibular cortical index (MCI) seen in bruxist individuals and to differentiate between the bruxist group without mandibular apposition and the non-bruxist group on panoramic radiographs.
The mandible angle region of 209 individuals, 170 bruxists and 39 non-bruxists, were included in the study. Each mandible angle apposition was classified as G0 (No directional change, no bone apposition)-G1 (Directional change on the basal cortex. No bone apposition)-G2 (Directional change plus generalized bone apposition with inhomogeneous surface)-G3 (Directional change plus localized bone apposition at one or more sites). The MCI of each individual was recorded according to their classified apposition.
No statistically significant difference was found in the relationship between MCI and apposition severity in mandible angle grades in bruxist individuals (p = 0.063). A statistically significant difference was found between MCI and the bruxist G0/non-bruxist G0 groups (p < 0.001). While the MCI-C1 was higher in non-bruxist G0 individuals, the MCI-C2 was higher in bruxist G0 individuals. A statistically significant correlation was found between gender and severity of grades (p < 0.001).
Although it is known that appositional changes are seen in the mandible angle region in bruxism, MCI can be used as a valuable radiologic diagnostic criterion during the evaluation of bruxist and healthy individuals in the G0 grade who have not yet radiologically demonstrated bone apposition in the mandible angle.

UNASSIGNED: This prospective study was designed to evaluate the effects of bruxism on mandibular cortical bone using radiomorphometric indices on digital panoramic radiographs.
UNASSIGNED: The mandibular cortical index (MCI), mental index (MI), and panoramic mandibular index (PMI) were measured on digital panoramic radiographs and evaluated for 128 bruxers (66 female, 60 male) and 128 control subjects. The data were analyzed statistically using intraclass correlation coefficients (ICC), Kappa statistics, Chi-square test, Kolmogorov-Smirnov test, independent t-test, and Pearson\'s correlation analysis.
UNASSIGNED: There was no difference between the groups in terms of MCI type (P > 0.05). While mean MI values were significantly higher in bruxers than the control group (P = 0.007), the difference between groups in mean PMI values was nonsignificant (P > 0.05). In both groups, the C1 type was more prevalent in females than in males (P = 0.001). Females showed significantly lower mean MI values than males in both groups (P ≤ 0.040). However, the difference between genders in mean PMI values was not significant (P > 0.05).
UNASSIGNED: MI measurements may be useful when radiomorphometric indices are to be used for the diagnosis or follow-up of bruxism in the mandible. Among radiomorphometric indices, MI and MCI values are affected by gender differences.

UNASSIGNED: The number of women with osteoporosis i.e. with reduced bone mass and disruption of bone architecture, is increasing in India due to severe deficiency of Vitamin D. It has been reported throughout the country in urban and rural post-menopausal women. Vitamin D synthesis is affected by geographical location, atmospheric pollution, clothing, melanin pigmentation and sunlight exposure. Moreover, ageing is also associated with decreased vitamin D synthesis. Vitamin D deficiency is the most underdiagnosed medical condition in postmenopausal woman.
UNASSIGNED: Therefore, this study was planned to estimate and to evaluate alveolar bone mass using radio morphometric indices in postmenopausal women and its correlation with serum vitamin D3.
UNASSIGNED: We conducted a study comprising of a study group of 60 post-menopausal women, divided into 2 sub-groups, each group comprising of 30 individuals, depending on their occupation and domicile. Blood samples were taken to evaluate serum vitamin D3 level. Also, panoramic radiographs of all the study subjects were recorded for evaluation of 3 radio morphometric indices viz. mandibular cortical index (MCI), mental index (MI), and panoramic mandibular index (PMI).
UNASSIGNED: Statistical analysis revealed higher significant values in rural than in urban postmenopausal woman.
UNASSIGNED: A high overall prevalence (90%) of vitamin D deficiency was also observed in the study subjects.

OBJECTIVE: To evaluate the influence of gender on the mental index (MI) and the mandibular cortical index (MCI).
METHODS: In this study, there were 120 subjects (43 male and 77 female subjects), who had undergone a dental panoramic radiograph examination for the needs of diagnosis and future treatment planning. MI and MCI were determined by orthopantomograph.
RESULTS: There was a statistically significant difference in MI dependent on gender. Male patients demonstrated significantly higher values for MI than female patients (right: t=4.127; P=0.0001, left: t=3.110; P=0.002). No statistically significant difference was observed for MCI dependent on gender (right: χ²=2.36 P=0.308, left: χ²=3.85 P=0.146).
CONCLUSIONS: MI is affected by gender, but MCI is not.

BACKGROUND: Torus mandibularis (TM) is one of the most common oral exostoses. The presence of TMs has been correlated with high skeletal bone mineral density. This study aimed to evaluate the relationship between TM and mandibular bone quality based on the measurement of mandibular cortical index (MCI).
METHODS: A case-control study was designed for patients who attended the Department of Dentomaxillofacial Radiology at the University of Hacettepe for routine dental examination. Patients with TMs were defined as cases, and those without TMs were defined as controls. The presence of tori was assessed by visual inspection and digital palpation. MCI assessments were done based on Klemetti\'s classification. The associations between the presence of TMs, MCI, and the parafunctional activity were assessed.
RESULTS: The sample consisted of 80 subjects with TMs and 80 control subjects. The presence of TMs was strongly associated with the parafunctional activity (p = 0.036) and a non-eroded mandibular cortex (MCI C1, p = 0.001).
CONCLUSIONS: Parafunctional activity may be a factor related to the formation or existence of TMs. The association between TMs and mandibular morphology may suggest that subjects with TMs may have a higher mandibular bone quality compared to those without TMs.