Bone mass and trabecular pattern in the mandible as an indicator of skeletal osteopenia: a 10-year follow-up study

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Aug;108(2):284-91. doi: 10.1016/j.tripleo.2009.01.014. Epub 2009 Apr 22.


Objectives: The aim of this investigation was to evaluate mandibular trabecular pattern as an indicator of osteopenia and bone mineral density (BMD) changes in relation to mandibular bone changes.

Study design: Forty females (49 to 80 years old) underwent intraoral radiography and BMD examinations 10 years apart. The trabecular pattern was assessed visually (Lindh's index), bone texture digitally, and bone mass by its grey-level values.

Results: With the exception of one subject, all individuals with sparse trabeculation were found to be osteopenic. All mandibular variables were tested for correlations with forearm and hip BMDs. They predicted forearm BMD, but adjusted for body mass index not hip BMD. Age, body mass index, and mandibular variables explained 29% to 64% of BMD variance. BMD changes correlated with body mass index change, bone texture change, and trabeculation change.

Conclusions: Mandibular variables identify individuals with low BMD, but they are not discriminating enough for osteoporosis diagnostics. Mandibular bone changes correlated with forearm BMD changes.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Aged, 80 and over
  • Alveolar Process / anatomy & histology*
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / pathology
  • Bone Density
  • Bone Diseases, Metabolic / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Forearm / diagnostic imaging
  • Humans
  • Mandible / anatomy & histology*
  • Mandible / diagnostic imaging
  • Mandible / pathology
  • Middle Aged
  • Osteoporosis / diagnostic imaging*
  • Reference Values
  • Statistics, Nonparametric