ANALYSIS OF RADIOMORPHOMETRIC INDICES IN POSTMENOPAUSAL PATIENTS WITH OSTEOPOROSIS: CASE REPORT AND LITERATURE REVIEW

Objectives. The aim of this case report is to present a single patient case superimposed on the literature knowledge in regard to mophometric mandibular variations observed on dental panoramic radiography and used to identify patients with low bone mass density (BMD). Case presentation. A 62 years old female patient reported to the Blident Help Dental Clinic, for specific visits and treatments, 3 years apart. Based on the digital panoramic radiography and DXA measurement, an osteoporosis evaluation with radiomorphometric indices was performed. Values for maximum condylar height, maximum coronoid height, projective height of the mandibular ramus, minimum ramus breadth and antegonial angle are higher on both sides. the values decreased for gonial angle, gonial index, mandible cortical width (MCW), superior and inferior mental height and panoramic mandibular indices on both sides. Bigonial distance also dicreased and the mandibular cortical index (MCI) changed from C2 category in 2017 to C3 category in 2020. Discussions. This postmenopausal pacient had a decline in MCW values which were lower than 3 mm (threshold to differentiate normal) on panoramic radiographs of women with low BMD. Antegonial Index had a decreased value and could be used as a prediction index for osteoporosis. MCI index changed from C2 to C3 in correlation with the changes of bone mass density in lumbar spine. Conclusions. MCI, MCW, antegonial index and bone density played an important role in determining significance of effects of lower BMD at postmenopausal on the mandibular ramus region.

Alteration of mucosa cell maturation pattern after exposure to different radiographic imaging methods

Aim: Dental imaging has been widely used for diagnosis in dentistry. However, dental X-ray may induce cytotoxicity leading to apoptosis in oral mucosa cells. The present study aimed to observe the maturation pattern of buccal and gingival cells after exposure to X-ray radiation from analog/digital panoramic scanning and cone beam computed tomography (CBCT). Methods: The research samples were 40 subjects who fulfilled the inclusion and exclusion criteria. The subjects were divided into the exposed (patients who received analog/digital panoramic radiography or CBCT) and controlled (patients who had no radiography examinations) groups, with 10 subjects in each group. Exfoliative cytology smears were obtained from buccal mucosa and gingiva before exposure (or on day 0 for the control group) and 10 days later. The cells were stained with the Papanicolaou method. Then, the superficial, intermediate, and parabasal cells were counted in each glass slide. Results: No significant differences (p > 0.05) were observed among all cell types between day 0 and 10 in the control group. Meanwhile, after exposure to three kinds of radiography examinations, the frequency of intermediate cells in buccal mucosa and gingiva increased (p < 0.05), but that of superficial cells decreased (p < 0.05) significantly. No significant difference was found in the parabasal cells (p > 0.05). The frequency differences between intermediate and superficial cells showed no significant difference between the buccal mucosa and gingiva. Conclusion: Analog/digital panoramic radiography and CBCT exposure can induce cytotoxicity by altering the maturation pattern of buccal mucosa cells and gingiva, so it is strongly recommended to only perform these procedures if necessary and avoid repeated exposure to the same patient.

Digital Panoramic Radiography in Dental Age Estimation

The present study aimed to assess the validity of coronal pulp/tooth area ratio (AR) and tooth/coronal index (TCI) indices in the mandibular first molar and second premolar for age estimation.110 digital panoramic radiographs of 60 male and 50 female subjects aged between 15 to 44 years were studied. The coronal pulp/tooth area ratio (AR) and tooth/crown index (TCI) of mandibular first molar and second premolar teeth was measured using AutoCAD software. Data were analyzed based on Pearson correlation coefficient regression formula and, t-test, and ANOVA. Considering the effect of sex, differences in the morphological variable of mandibular first molar and second premolar were not statistically significant. In the mandibular first molars, the subject’s age significantly affects the AR (P-value=0.003) and TCI (P-value=0.027) indices. There was a significant and positive correlation between the two morphological variables of AR and TCI (r=0.797 for mandibular second premolar and r=0.0686 for a mandibular first molar, P-value<0.001). Linear regression analysis showed that concurrent application of the two indices in one formulation could be a reliable technique for age estimation. According to the results of this study, in the Iranian populations, the application of AR and TCI indices simultaneously in one formulation had better results for age estimation in younger adults.