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Radiograph plays the major role of diagnosis, treatment and surgery in the Dental field. There are many types of Intra and extra oral radiographs in which Dental Panoramic Radiograph helps in visualising the full view of the oral cavity. Pulpitis is the dental diseases caused due to the inflammation of the dental pulp from untreated caries, trauma or multiple restorations which leads to Apical Periodontitis. To predict the severity of pulp vitality pulp inflammation has to be evaluated. Radiographs helps the dentist in diagnosing the extent of tooth decay and inflammation. An automatic diagnostic model is proposed using robust algorithms to diagnose pulpits. Dental Panoramic Radiograph is used in the proposed research to diagnose the pulpitis and to classify the normal teeth from the pulpitis. The collected images are pre-processed using Histogram Equalization and filtered using Gaussian and Median filters. Modified K-Means algorithm is applied to segment the bony and teeth area from the oral cavity area. Integral Histogram of Gradients with Discrete Wavelet Transform feature extraction techniques and Multi-Layer Neural Network Classifier is proposed to achieve the accuracy of 91.09% which can be used as an assistive tool by the dentist to diagnose pulpitis.

Osteoporosis is one type of disease that is not easily detected. This disease can cause fractures for the sufferer. Early detection of osteoporosis is crucial to prevent fractures. This study aims to detect osteoporosis through features extracted from cortical bone and trabeculae in dental panoramic images. The results of the selected feature extraction are trained using an artificial neural network. Based on the study results, the dominant features for osteoporosis detection are radio morphometric index and morphological features. The accuracy, sensitivity, and specificity of the J48 and Learning Vector Quantization (LVQ) are 83.88 %, 78.57 %, and 100 %, respectively.

Amaç: Bu çalışmanın amacı yapay zeka (Artificial Intelligence) (AI) sistemleri kullanılarak dental panoramik radyografik görüntülerden alveoler kemik kaybını tespit etmektir.Gereç ve Yöntem: Bu çalışmada toplam 2276 panoramik radyografik görüntü kullanıldı. Bunların 1137'si kemik yıkımı olan vakalara aitken, 1139'u periodontal olarak sağlıklıydı. Veri kümesi eğitim (n = 1856), doğrulama (n = 210) ve test seti (n = 210) olarak üç bölüme ayrıldı. Veri setindeki tüm görüntüler eğitimden önce 1472x718 piksel olarak yeniden boyutlandırıldı. Açık kaynaklı python programlama dili ve OpenCV, NumPy, Pandas ve Matplotlib kütüphaneleri etkili bir şekilde kullanılarak rastgele bir dizi oluşturuldu. Ön işleme için önceden eğitilmiş bir Google Net Inception v3 CNN ağı kullanılmış ve veri setleri aktarım öğrenimi kullanılarak eğitildi. Tanısal performans, duyarlılık, özgüllük, kesinlik, doğruluk ve F1 skoru kullanılarak konfüzyon matrisi ile değerlendirildi.Bulgular: Kemik kaybı olan 105 olgunun 99'u AI sistemi ile tespit edildi. Duyarlılık 0.94, özgüllük 0.88, hassasiyet 0.89, doğruluk 0.91 ve F1 skoru 0.91 idi.Sonuç: Konvolüsyon nöral ağ modeli periodontal kemik kayıplarını belirlemede başarılıdır. Gelecekte tanı ve tedavi planlamasında hekimlerin çalışmasını kolaylaştıran bir sistem olarak kullanılabilir., Objectives: The aim of this study was to detect alveolar bone loss from dental panoramic radiographic images using artificial intelligence systems.Material and Methods: A total of 2276 panoramic radiographic images were used in this study. While 1137 of them belong to cases with bone destruction, 1139 were periodontally healthy. The dataset is divided into three parts as training (n=1856) , validation (n=210) and testing set (n= 210). All images in the data set were resized to 1472x718 pixels before training. A random sequence was created using the open-source python programming language and OpenCV, NumPy, Pandas, and Matplotlib libraries effectively. A pre-trained Google Net Inception v3 CNN network was used for preprocessing and data sets were trained using transfer learning. Diagnostic performance was evaluated with the confusion matrix using sensivitiy, specificity, precision, accuracy and F1 score.Results: Of the 105 cases with bone loss, 99 were detected by the AI system. Sensitivity was 0.94, specificity 0.88, precision 0.89, accuracy 0.91 and F1 score 0.91. Conclusion: The convolutional neural network model is successful in determining periodontal bone losses. It can be used as a system to facilitate the work of physicians in diagnosis and treatment planning in the future.

Calcification regions are sometimes observed on dental panoramic radiographs and it is known that these regions are a sign of vascular disease. It has been pointed out that the detection of calcification regions in dental panoramic radiographs can encourage patients to undergo medical checkups by a physician. Medical checkups can prevent the sudden onset of vascular disease. For this purpose, a method of automatically detecting calcification regions using an object detector based on deep learning has been proposed. Although this method significantly reduces the number of false positives compared with conventional methods based on image features, its detection accuracy is still insufficient. In this paper, we propose a method of detecting calcification regions in dental panoramic radiographs using a novel object detector based on deep learning. On the basis of PraNet, which has been increasingly applied to medical image processing in recent years, we introduce the Double U-Net structure and enhance the prediction accuracy for the initial guidance region. The proposed method can improve the detection accuracy for calcification regions. The experimental results show that the proposed method improves the detection performance compared with other methods.

The use of radiographic indices is noticeably diminished due to the lack of simplicity and standardisation among the existing ones. The aim of this study was to introduce a radiographic index to aid clinicians in determining the extent and severity of interproximal alveolar bone loss (iABL), in relation to individual root lengths, among patients suffering from periodontitis. A retrospective analysis of 50 anonymised dental panoramic tomograms (DPTs) of patients with periodontitis was conducted. Visual interpretation of iABL was recorded by a single investigator and by 20 volunteering clinicians for the ‘worst site’ in each quintet. Results were compared to a gold standard quantification method. Intra-examiner and inter-examiner agreement were measured using the Kappa coefficient and the intra-class correlation coefficient, respectively. Validity was assessed using Cramér’s V test. The mean intra-examiner agreement on the severity and pattern of iABL was 0.808 (K) and 0.802 (K), respectively. A stronger overall inter-examiner agreement was noted when the severity in contrast to the pattern of iABL and presence/absence of furcation involvement were analysed. The statistically significant total mean agreement values from this correlation coefficient were 0.892 and 0.739, respectively. A very strong association between all the visual interpretations carried out by all participants and the gold standard measurements was evident. Within the limitations of this study, the proposed radiographic index may serve as a simple, yet valid and reliable, adjunctive screening tool to further assist clinicians in determining the extent and severity of iABL in patients with periodontitis.

Maxillary and mandibular incisors have increased risk for severe orthodontically induced inflammatory root resorption. A patient-related risk factor is aberrant root morphology. This study aimed to assess the frequency of detection of different root morphologies in anterior teeth using dental panoramic tomography (DPT) and long cone periapical radiographs (LCPAs). A retrospective cross-sectional design was used to assess a sample of 50 consecutive pre-treatment radiographic records of patients from a specialist orthodontic practice in Adelaide, Australia. A reference guide was developed that included three previously unreported morphologies: pipette and bent, bent and pointed, bent and blunt. Two trained and calibrated assessors examined each record against the inclusion criteria, then independently assessed each anterior tooth from DPTs and LCPAs to detect the type of root morphology present. Data were analysed using the chi-square statistical test. Radiographic records for 48 patients (48 DPTs and 161 LCPAs) were eligible, with 355 and 426 teeth on DPTs and LCPAs, respectively, included for assessment. Normal root morphology (119 teeth) was commonly observed in DPTs, while bent (154 teeth) was frequently observed using LCPAs. Mandibular incisors often had normal morphology in DPTs but bent in LCPAs. Bent was the most common morphology in maxillary lateral incisors using DPT and LCPAs, although maxillary centrals were mostly normal in DPTs but pointed in LCPAs. Differences using the two image acquisition methods were highly significant (p < 0.01). Aberrant root morphologies are more easily detected in anterior teeth using LCPAs compared to DPTs.

Aim: To review and search studies that evaluated the radiation doses and risks from dental panoramic radiography (DPR). This review may answer the following question “does panoramic dental radiation expose patients to health risks? Materiels and Methods: The search strategy was performed using the databases including GoogleScholar, PubMed, Science Direct and Nature from 2010 until september 2020. The search was limited to articles published in English. The 1031 titles that appeared, 15 fulfilled the criteria and were included in the review. Results: in 10 studies, the effective dose from DPRs was in the range of 5-49µSv, depending on the panoramic equipment used. The salivary glands received the highest absorbed doses (359-3044,3 μGy) and the thyroid gland absorbed doses were (40-250µGy). In terms of health risk, according to 5 studies, DPRs can induce genotoxic effects in oral epithelial cells and even induce cytotoxic effects leading to cell death. In 2 studies, women are at higher risk than men. The overall risk of cancer from radiation in children was more than adult. Conclusion: DPR can expose patient to health risks. It should only be applied when necessary, using radiation protection criteria.

Dental panoramic radiography (DPR) images have recently attracted increasing attention in osteoporosis analysis because of their inner correlation. Many approaches leverage machine learning techniques (e.g., deep convolutional neural networks (CNNs)) to study DPR images of a patient to provide initial analysis of osteoporosis, which demonstrates promising results and significantly reduces financial cost. However, these methods heavily rely on the trabecula landmarks of DPR images that requires a large amount of manual annotations by dentist, and thus are limited in practical application. Addressing this issue, we propose to automatically detect trabecular landmarks in DPR images. In specific, we first apply CNNs-based detector for trabecular landmark detection and analyze its limitations. Using CNNs-based detection as a baseline, we then introduce a statistic shape model (SSM) for trabecular landmark detection by taking advantage of spatial distribution prior of trabecular landmarks in DPR images and their structural relations. In experiment on 108 images, our solution outperforms CNNs-based detector. Moreover, compared to CNN-based detectors, our method avoids the needs of vast training samples, which is more practical in application.

Objectives Among common head and neck cancers (HNCs), oropharyngeal cancer (OPC) patients have been identified as having a better dentition than many other tumour subsites. OPC consists of human papillomavirus (HPV)-positive and negative groups with different prognosis. The purpose of this study is to explore the presenting dental status of OPC patients based on HPV status at the pre-radiotherapy phase.Materials and methods The study reviewed the dental panoramic radiographs of OPC patients seen at a dedicated pre-radiotherapy dental assessment clinic from 2011-2017. Only patients planned for intensity-modulated radiotherapy treatment were included within this study. Relevant dental and oncological data were collected.Results A total of 316 patients with known HPV status (215 positive; 101 negative) were included for analysis. HPV-positive patients had significantly more teeth on attendance than HPV-negative patients (22.3 vs 19.0, p = 0.0000) and horizontal bone loss was less severe compared to HPV-negative patients (p = 0.0000). HPV-positive males and patients in the 55-64 decade presented with the best and most complex dentition.Conclusion The rise of OPC with the prospect of long survival, particularly in HPV-positive patients, requires a dentition with adequate function and subsequent maintenance. The current study demonstrated that these patients have a complex dentition presenting new challenges to the dentist. This may explain in part the elevated osteoradionecrosis rate seen in this tumour group.

Summary Objectives To analyse prevalence, pattern, and severity of taurodontism in individuals with Van der Woude syndrome (VWS) exhibiting cleft palate and compare with aged-matched non-syndromic cleft palate (NSCP) and non-cleft controls. Materials and methods One hundred and seventy-eight dental panoramic tomographs (DPTs) (105 girls and 73 boys) consisting of 42 VWS patients (x¯=8.55±1.02 years), 42 NSCP patients (x¯=8.59±1.02 years), and 94 normative non-cleft children (x¯=8.79±1.16 years) were assessed and their first permanent molars evaluated. Measurement 3 of the taurodontism index developed by Shifman and Chanannel with the Tulensalo modification was used. Prevalence, pattern, and severity were compared between groups. Statistical differences were determined by one-way analysis of variance and Fisher test. Repeatability was calculated by Cohens Kappa test. Results The prevalence of taurodontic molars was 59.5% in VWS, 45.2% in NSCP, and 26.6% in non-cleft controls. The prevalence and severity of taurodontism in VWS and NSCP were significantly higher than in non-cleft children in all first permanent molars. There was no significant difference in prevalence and severity between VWS and NSCP. The odds for having taurodontism in the VWS group was approximately double compared to the NSCP group. Most of the taurodontic molars showed hypotaurodontism and taurodontism occurred bilaterally more frequently than unilaterally. Conclusion This study shows a higher prevalence of taurodontism in VWS and NSCP. Most taurodontic molars are hypotaurodontic and most occur bilaterally.

Objective To evaluate the effects of functional appliance treatment on mandibular trabecular structure using fractal dimension (FD) analysis of dental panoramic radiographs. Materials and Methods This study was conducted using digital panoramic radiographs of 45 patients with Class II malocclusion treated with functional appliances (treatment group, mean age: 11.39 ± 0.97 years; 23 girls, 22 boys) acquired before (T0) and after (T1) treatment and the panoramic radiographs of 45 control subjects who had undergone no orthodontic treatment (control group, mean age: 11.31 ± 0.87 years; 23 girls, 22 boys). FD values in the condylar process, mandibular corpus, and mandibular angle were analyzed from the panoramic radiographs of both groups. Results Analysis of changes in FD between T0 and T1 revealed significant increases in the FD values of the right and left condylar processes and right mandibular corpus in the treatment group (P < .001) and in the right condylar process in the control group (P < .05). Between-group comparisons demonstrated that the treatment group showed greater changes in the condylar process (right, P < .001; left, P < .05) and right mandibular corpus (P < .05) compared to controls. Correlation analysis between the cephalometric and FD changes in the treatment group showed the right condylar process changes were negatively correlated with GoGn/SN angle (P < .05) and positively correlated with Co-Go (P < .05), although these correlations were weak. Conclusions FD analysis demonstrated significant changes in trabeculation of the condyle and mandibular corpus in the treatment group compared to the control group. Functional appliance treatment may lead to skeletal correction by altering skeletal form and trabeculation of the mandibular bone.

La radiografía panorámica, ortopantomografía o tomografía panorámica dental es una técnica radiográfica muy utilizada en odontología. Y dentro de las patologías cervicofaciales encontradas en estas radiografías de rutina están las placas ateromatosas calcificadas, originadas por el depósito excesivo de lípidos y células inflamatorias, ocasionando el posible cierre de una arteria en su pared íntima. Esta patología se cronifica por la presencia de factores de riesgo que ocasionan un daño endotelial, tales como: hipertensión arterial, diabetes mellitus, obesidad entre otros. El diagnóstico de esta patología es de relevancia ya que ayudara en la prevención de enfermedades como el accidente cerebro vascular e infarto cerebral. Este artículo presenta el caso de una paciente femenina de 42 años, quien acude al centro de especialidades odontológicas de la Universidad Católica De Cuenca sede Azogues, para un control de su salud bucal, se le realizó una ortopantomografía diagnostica de rutina, en la cual presento radiopacidades a nivel cervical, los cuales fueron diagnosticados como placas ateromatosas en carótida. El objetivo de este artículo es enfatizar la importancia del diagnóstico a nivel cervicofacial en ortopantomografías de rutina en la práctica odontológica

Background Known as the most common bone pathosis, osteoporosis affects millions of people every year. Clinical diagnostic methods for osteoporosis are expensive and, therefore, have limited availability in population prescreening. Recently, studies have shown that dental panoramic radiography (DPR) can provide information of bone density changes and have potential to be used in trabecular bone structure analysis. Objective The aim of this study was to investigate the potential of using deep neural networks on DPR images for osteoporosis prescreening. Materials and Methods We collected 108 DPR images from 108 patients (52 patients with osteoporosis and 56 normal individuals). We designed a deep learning algorithm for osteoporosis prescreening. The algorithm uses a multitask scheme to transfer the network pretrained on ImageNet to our data set and improves accuracy in osteoporosis prescreening. Results The leave-one-out cross-validation showed that the highest overall accuracy of osteoporosis prescreening to be 92%, demonstrating its significant advantage over previous methods. Discussion The study findings showed that using deep neural networks can significantly improve the accuracy of prescreening for osteoporosis, based on 108 DPR images.

Mandibular cortical erosion detected on dental panoramic radiographs is associated with increased risk of osteoporosis in older adults. Additionally, many reports have demonstrated an association between decreased number of teeth present and osteoporosis. However, whether mandibular cortical erosion is associated with a decreased number of teeth remains unclear. The purpose of this study, therefore, was to clarify the association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older. Among patients who visited our university hospital and underwent dental panoramic radiography for the diagnosis of dental diseases, 839 patients (293 men and 546 women) aged 40–89 years (mean [SD], 63.7 [10.6] years) participated in this study. Multiple regression analysis revealed that mildly to moderately eroded cortex (p = 0.007) and severe eroded cortex (p

Dental Panoramic radiography (DPR) image provides a potentially inexpensive source to evaluate bone density change through visual clue analysis on trabecular bone structure. However, dense overlapping of bone structures in DPR image and scarcity of labeled samples make learning of accurate mapping from DPR patches to osteoporosis condition challenging. In this paper, we propose a deep Octuplet Siamese Network (OSN) to learn and fuse discriminative features for osteoporosis condition prediction using multiple DRP patches. By exploring common features, OSN uses patches of eight locations together to train the shared feature extractor. Feature fusion for different location adopts both accumulation and concatenation with fully considering of patches’ spatial symmetry. In our dedicated two-stage fine-tuning scheme, an augmented texture analysis dataset is employed to prevent overfitting in transferring weights learned on ImageNet to DPR dataset when using merely 108 samples. Leave-one-out test shows that our proposed OSN outperforms all other state of the art methods in osteoporosis category classification task.

Studies reported that the mandibular cortical width (MCW) measured on dental panoramic radiographs (DPRs) was significantly correlated with bone mineral density. However, MCW is not a perfect index by itself, and studies suggest the added utility of mandibular cortical index (MCI). In this study, we propose a method for computerized estimation of mandibular cortical degree (MCD), a new continuous measure of MCI, for osteoporotic risk assessment. The mandibular contour was automatically segmented using an active contour model. The regions of interest near mental foramen were extracted for MCW and MCD determination. The MCW was measured on the basis of residue-line detection results and pixel profiles. Image features including texture features based on gray-level co-occurrence matrices were determined. The MCD were estimated using support vector regression (SVR). The SVR was trained using previously collected 99 DPRs, including 26 osteoporotic cases, by a computed radiography system. The proposed scheme was tested using 99 DPRs obtained by a photon-counting system with data of bone mineral density at distal forearm. The number of osteoporotic, osteopenic, and control cases were 12, 18, and 69 cases, respectively. The subjective MCD by a dental radiologist was employed for training and evaluation. The correlation coefficients with the subjective MCD were −0.549 for MCW alone, 0.609 for the MCD by the features without MCW, and 0.617 for the MCD by the features and MCW. The correlation coefficients with the BMD were 0.619, −0.608, and −0.670, respectively. The areas under the receiver operating characteristic curves for detecting osteoporotic cases were 0.830, 0.884, and 0.901, respectively, whereas those for detecting high-risk cases were 0.835, 0.833, and 0.880, respectively. In conclusion, our scheme may have a potential to identify asymptomatic osteoporotic and osteopenic patients through dental examinations.

The aim of this study was to assess the determinants of oral health including the number of decayed, missing, and filled teeth (DMFT) and periodontal indices in postmenopausal women with osteoporosis, osteoporosis treated with bisphosphonate therapy, and control group and to examine the correlation between dental panoramic indices (Mental Index—MI, Mandibular Cortical Index—MCI) and bone mineral density in these three groups of patients. The presented non-interventional study involved 120 postmenopausal women: women with osteoporosis (O) (n = 45), women with osteoporosis treated with bisphosphonates (OBP) (n = 45), and control group (C) (n = 30). DMFT, plaque, gingival and papilla bleeding index, pocket depth, clinical attachment loss, and the presence of periodontitis were evaluated for each patient. MI and MCI of all participants were measured on a dental panoramic radiograph. Group OBP showed significantly higher gingival, bleeding index and deeper pocket depth than C and/or O group. No significant differences were found in MI (p = .303) or MCI (p = .06) in all the examined groups. Also, there were no significant differences between the three groups in the presence of periodontitis as well as in the DMFT index. BP therapy could have a negative influence on periodontal health. Further, MI and MCI are not precise diagnostic tools for diagnosing low BMD in postmenopausal women. BP therapy could have a negative influence on the determinants of oral health in postmenopausal women with osteoporosis.

This bibliometric study evaluated the scientific impact of papers dealing with osteoporosis detected by dental panoramic radiographs by performing citation analysis and cited reference analysis. Retrospective data was extracted from the Web of Science Core Collection database and imported into VOSviewer, CRExplorer, and CitNetExplorer for analyzing semantic contents, cited references, and temporal citation network. The 280 relevant papers identified were cited 4874 times, having an h-index of 38 and 17.4 citations per paper. The top five major contributing countries were Japan (n = 54, 19.3%), USA (n = 43, 15.4%), Brazil (n = 38, 13.6%), Turkey (n = 38, 13.6%), and the UK (n = 32, 11.4%). Citation per paper correlated with publication count among the authors and institutions. Mandibular cortical width was the most frequently used and most cited measurement index. References published during the 1970s and 1980s have built the foundation for the development of research that investigates the potential associations between osteoporosis and radiographic measurements on panoramic radiographs. Osteoporosis detection by dental panoramic radiographs is a perennially investigated research topic with global contributions. Panoramic radiographs are considered early detection and screening tools for osteoporosis by worldwide research.

Mandibular bone is among the bones which mineral density is reduced due to osteoporosis. Hence, dental panoramic gradiographs have become an alternative solution to identify osteoporosis. Previous study has shown that the number of branching differs between normal people and patients with osteoporosis. Another study has proposed an algorithm called COSFIRE which is able to detect branches in retinal vessel images. However, branch structures in trabecular bone differ from that in retinal vessel images. For that reason, the COSFIRE method alone is considered unable to detect such structures. In this study, we propose multiscale mechanism to detect different size of trabecular branches. Morphological structures in the trabecular bone is first enhanced using the line operator method. Then the branches are detected using COSFIRE. Experiment of the branching detection conducted to 20 images yields an accuracy of 95.25% whereas the experiment of the classification step gives the sensitivity, specificity, and accuracy of 0.95122, 0.26315, and 0.55102, respectively.

Objective To determine whether individual measurements or a combination of textural features and mandibular cortical width (MCW) derived from digital dental panoramic radiographs (DPRs) are more useful in assessment of osteoporosis. Study Design Textural features were obtained by using fractal dimension (FD) and gray-level co-occurrence matrix (GLCM). Digital DPRs and bone mineral densities (BMDs) of the lumbar spine and the femoral neck were obtained from 141 female patients. A naive Bayes classifier, a k -nearest neighbor ( k -NN) algorithm, and a support vector machine were assessed for classifying osteoporosis. Results The combinations of FD plus MCW (95.3%, 92.1%, 96.8%) and GLCM plus MCW (93.7%, 89.5%, 94.2%) for femoral neck BMD showed the highest diagnostic accuracy with the use of the naive Bayes, k -NN, and support vector machine classifiers, respectively. Conclusions The combination of textural features and MCW contributed a better assessment of osteoporosis compared with the use of only individual measurements.

We hypothesized that mandibular cortical width (MCW) is smaller in children with osteogenesis imperfecta (OI) than in healthy children and that pamidronate can improve the cortical mandibular thickness. The aim of this study was to assess changes in the MCW on dental panoramic radiographs (DPRs) of children with normal bone mineral density (BMD) and with OI. We also compared the MCW of children with different types of OI regarding the number of pamidronate cycles and age at the beginning of treatment. MCW measurements were retrospectively obtained from 197 DPRs of 66 children with OI types I, III, and IV who were in treatment with a comparable dosage of cyclical intravenous pamidronate between 2007 and 2013. The control group had 92 DPRs from normal BMD children. Factorial analysis of variance was used to compare MCW measurements among different age groups and between sexes and also to compare MCW measurements of children with different types of OI among different pamidronate cycles and age at the beginning of treatment. No significant differences in results were found between male and female subjects in both OI and healthy children, so they were evaluated altogether (P > 0.05). There was an increase of MCW values related to aging in all normal BMD and OI children but on a smaller scale in children with OI types I and III. Children with OI presented lower mean MCW values than did children with normal BMD at the beginning of treatment (P < 0.05). A linear model estimated the number of pamidronate cycles necessary to achieve mean MCW values equivalent to those of healthy children. The thinning of the mandibular cortex depended on the number of pamidronate cycles, the type of OI, and the age at the beginning of treatment. DPRs could thus provide a way to identify cyclic pamidronate treatment outcomes in patients with OI.

Background Osteoporosis is defined as a skeletal disorder characterized by low-bone mass predisposing to an increased risk of fracture. At present, the evaluation of bone mineral density (BMD) is the main diagnostic tool in osteoporosis, and it is the most effective and accurate measurement for identifying and monitoring the disease. However, several studies have been conducted with the object of detecting whether these skeletal changes in the mandible are specific to the osteoporotic stage. Objectives The purpose of this study was to determine whether the madibular indices on panoramic radiographs are useful for identifying women with osteoporosis or osteopenia (low BMD). Methods Tunisian women aged from 30 to 60 years,who consulted the Rheumatology department of Fattouma Bourguiba university hospital in2017.The measure the BMD using the dual-energy X-ray absorptiometry (DEXA), were recruited to participate in this case-control study.Among the 60 women selected, 30 were diagnosed with osteoporosis or osteopenia (T-score -1; controls). The mandibular cortical index (MCI), the mental index (MI), the panoramic mandibular index (PMI) and the alveolar crest resorption degree (M/M ratio)were measured from digital panoramic radiographs in the right and left mandibles and the mean was calculated for each subject.The MI, PMI and M/M ratio values were evaluated using the Z test, and MCI values were analysed using the Chi2 test. Results The mean age of patients with osteoporosis/osteopenia was 58.61±8.11and 56.07±9.72 in the control group.The mean bone miniral density (BMD)in vertebral site was 0.856±0.090g/cm2 and 1.216±0.185g/cm2 in control group.In femoral site,it was 0.877±0.221g/cm2 and 1.061±0.142g/cm2 respectively.The mean T-score in vertebral site was -2.38±0.81DS in osteoporosis/ osteopenia group and 0.64±1.58DS in control group.In femoral site,it was -1.57±0.97DS and 0.21±1.16 respectively. The analysis of the panoramic radiography showed that in the osteoporosis/osteopenia group: the mean value of MI was 3.56±0.89, the mean PMI was 0.25±0.06 and the mean M/Mratio was 0.71±0.14; concerning the MCI: 46.7% were classified C2 stage and 53.3% were classified C3 stage. In the control group, the mean MI was 4.42±0.98, the mean PMI was 0.30±0.07 and the mean M/Mratio was 0.77±0.11; 30.1% were classified C1 stage, 53.3% were classified C2 stage and only 16.6% were classified C1 stage. This study showed that the MI and the PMI were significantly smaller in the group with osteoporosis/osteopenia. However, the M/M ratio was not significantly different.Therefore, the MCI was significantly more affected in the osteoporosis/osteopenia group. Conclusions In our study, we proved that the MI, PMI and MCI values were affected in women with osteoporosis/osteopenia, compared with normal patients. Therefore, these indices could be used as an ancillary method in the diagnosis of osteoporosis in women. References C S Valerio et al, Dentomaxillofacial Radiology (2013) 42, 20120059. Andre Ferreira Leite, et al, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:648–656. Vlasiadis Z. Konstantinos, et al, Maturitas 58 (2007) 226–235. Disclosure of Interest None declared

A panoramic radiography image provides not only details of teeth but also rich information about trabecular bone. Recent studies have addressed the correlation between trabecular bone structure and osteoporosis. In this paper, we collect a dataset containing 40 images from 40 different subjects, and construct a new methodology based on a two-stage classification framework that combines multiple trabecular bone regions of interest (ROIs) for osteoporosis prescreening. In the first stage, different support vector machines (SVMs) are adopted to describe different information of different ROIs. In the second stage, the output probabilities of the first stage are effectively combined by using an additional linear SVM model to make a final prediction. Based on our two stage model, we test the performance of different image features by using leave-one-out cross-valuation and analysis of variance rules. The results suggest that the proposed method with the HOG (histogram of oriented gradients) feature achieves the best overall accuracy.

The association of sella turcica bridging and various dental anomalies has been an area of interest for researchers. Based on the evidence of a common embryologic origin between sella turcica and the teeth, the objectives of this study were to measure the dimensions of sella turcica and to test whether an association exists between sella bridging and impacted canines.Orthodontic records comprising standard-quality lateral cephalograms and dental panoramic radiographs were selected. Thirty-one patients with palatally impacted canines (20 female, 11 male; mean age, 18.4 ± 8.9 years) and 70 controls with erupted canines (35 male, 35 female; mean age, 17.1 ± 7.5 years) were included in the study. Comparison of sella dimensions between the patients and the controls was carried out by independent sample t tests, whereas the association of sella bridging with impacted canines was analyzed using the chi-square test.The frequencies of complete and partial calcification of sella in the patients were 8 (25.8%) and 17 (54.8%), respectively, whereas those in the controls were 0 and 36 (51.4%), respectively. The frequency of sella bridging was significantly higher in subjects with canine impaction than in the controls (P 0.001). The sagittal interclinoidal distance was found to be significantly reduced in the patients (P = 0.028). According to the statistical analysis, age and sex do not influence the dimensions and calcification of sella turcica.Sella bridging is frequently found in patients with impacted canines. Hence, sella bridging can complement other diagnostic parameters in confirming the status of canine impaction.

© 2014 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Objectives: The aim of this retrospective study was to quantify the level of dental developmental delay in a group of patients with Aperts syndrome when compared to matched controls. Methods: Twenty-six Dental Panoramic Tomographic (DPT) radiographs of patients with Apert syndrome attending Great Ormond Street Hospital were compared to controls (n = 29) from the Eastman Dental Hospital, UK. Dental development was assessed using the staging systems of Demirjian and Haavikko, and dental age (DA) was estimated using the weighted averages method. Results: Dental age, as estimated using the 12 stages of Haavikko and eight stages of Demirjian, suggested no statistical evidence of developmental delay between the Aperts and control group. Conclusions: The hypothesis 'that there is no difference in the dental development of subjects with Apert syndrome, when compared to a group of matched controls', was accepted.

Objectives: Some calcifications of the head and neck region may be seen on dental panoramic images due to the superimpositions and proximity of structures. The aim of the present study was to evaluate the prevalence of soft tissue calcifications observed on digital panoramic images and the relationship of the calcifications with age and gender. Materials and Methods: Four thousand two hundred and sixty-three digital dental panoramic radiographs of the individuals aged between 6 and 89 who had visited the faculty of dentistry for different oral and dental complaints were evaluated retrospectively and detected calcifications were recorded with the age and gender information. Data were analyzed by means of descriptive statistics, Pearson Chi-squared, and independent samples t-test. Results: Two hundred and seventy calcifications (6.4%) were detected in the whole study population. Observed calcification types were tonsillolith (2.5%), carotid artery calcification (2.3%), sialolith (1%), and calcified lymph node (0.6%). The prevalence of calcifications for all types increased with age (P < 0.001). Conclusions: The prevalence of calcifications seen on the dental panoramic images is relatively rare, but the detection during routine dental examinations is important in terms of the need for more detailed evaluation of the patients.

Osteoporosis is a systemic disease that is considered a public health problem since it presents socioeconomic impacts. The disease results in micro architectural deterioration of bone tissue and decrease of bone mineral density (BMD) with consequent increase of bone fragility and susceptibility to fractures. Dual energy X-ray absorptiometry (DXA) is considered the gold standard for BMD evaluation, but investigations about several panoramic radiography indices have been done in order to seek a predictor of low BMD so that the dentist can play an important role in screening patients with low BMD and referring them properly for bone densitometry for osteoporosis investigation. The aim of this paper is to present a review of mandibular radio morphometric indices evaluated in dental panoramic radiographies and used to recognize patients with low BMD.

This article describes how dentists can recognize osteoporosis before fractures develop, and discusses whether osteoporosis affects tooth loss or inhibits implant osseointegration. Some success in diagnosing osteoporosis has been obtained using clinical questionnaires that attempt to identify those who have strong risk factors for the disease, and analysis of the sparse trabeculation and thinning of the mandibular cortex often seen in dental panoramic radiographs. The role of osteoporosis in periodontal disease is unclear as there are many conflicting reports, but the evidence suggests that tooth loss may be more prevalent in patients with osteoporosis.

Active contours, or snakes, are computer-generated curves that move within images to find object boundaries. They are often used in computer vision and image analysis to detect and locate objects, and to describe their shape. Thus active contour can be used for object segmentation, especially the lesion in medical images. This paper presents the application of active contour models (Snakes) for the segmentation of lesions in dental panoramic image. The aim is to assist the clinical expert in locating potentially cyst or tumor cases for further analysis (e.g. classification of cyst or tumor lesion). In order to apply the snake formulation, color images were converted into gray images. Then, with correct parameters, we can create a snake that is attracted to edges or termination. Initializing contour, choosing parameter value and number of iteration affect the behaviour of the snake in a particular way. Using Receiver Pperating Characteristic (ROC), an average accuracy rate of 99.67 % is obtained. Examples of Snake segmentation results of lesions are presented.

Objectives: The aims of this study were to evaluate the influence of gender and dental status on the mental index, mandibular cortical index and panoramic mandibular index from dental panoramic radiographs in elderly who had osteoporosis or did not have osteoporosis. Methods: Panoramic radiographs of 487 elderly dental patients (age range 60-88 years) were evaluated. It were recorded osteoporotic status according to the patients' medical anamnesis and values of the mandibular cortical index (MCI), panoramic mandibular index (PMI), mandibular cortical width (MCW) Results: Dental status was statistically significantly associated with the mandibular cortical width, panoramic mandibular index and the categories of MCI (P

Objectives: To determine the extent to which clinical and radiographic features of bisphosphonate-associated osteonecrosis of the jaw (BONJ) are correlated. Design: Retrospective case review. Methods: The records of 39 patients diagnosed with BONJ and examined by panoramic radiography were retrospectively evaluated. The arches were divided into sextants (n = 234) and evaluated for the following signs: sclerosis, surface irregularity, sockets, fragmentation and lysis. Main outcome measures: The McNemar, Kruskall–Wallis and equivalency tests were performed to analyze the association between clinical and radiographic signs and BONJ severity. Results: Sixty-two out of 234 sextants were abnormal by clinical criteria and 61 out of 234 sextants demonstrated at least one radiographic abnormality. There was agreement between clinical and radiographic detection in 41 sextants. The data showed equivalency between BONJ diagnosis and both sclerosis and surface irregularity. The correlation between number of clinical sites and any radiographic finding was significant in the maxilla (P

Mandibular cortical erosion detected on dental panoramic radiographs (DPRs) may be useful for identifying women with osteoporosis, but little is known about the variation in diagnostic efficacy of observers worldwide. The purpose of this study was to measure the accuracy in identifying women at risk for osteoporosis in a worldwide group of observers using DPRs. We constructed a website that included background information about osteoporosis screening and instructions regarding the interpretation of mandibular cortical erosion. DPRs of 100 Japanese postmenopausal women aged 50 years or older who had completed skeletal bone mineral measurements by dual energy X-ray absorptiometry were digitized at 300 dpi. These were displayed on the website and used for the evaluation of diagnostic efficacy. Sixty observers aged 25 to 66 years recruited from 16 countries participated in this study. These observers classified cortical erosion into one of three groups (none, mild to moderate, and severe) on the website via the Internet, twice with an approximately 2-week interval. The diagnostic efficacy of the Osteoporosis Self-Assessment Tool (OST), a simple clinical decision rule based on age and weight, was also calculated and compared with that of cortical erosion. The overall mean sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 60 observers in identifying women with osteoporosis by cortical erosion on DPRs were 82.5, 46.2, 46.7, and 84.0%, respectively. Those same values by the OST index were 82.9, 43.1, 43.9, and 82.4%, respectively. The intra-observer agreement in classifying cortical erosion on DPRs was sufficient (weighted kappa values > 0.6) in 36 (60%) observers. This was significantly increased in observers who specialized in oral radiology (P < 0.05). In the 36 observers with sufficient intra-observer agreement, the overall mean sensitivity, specificity, PPV, and NPV in identifying women with osteoporosis by any cortical erosion were 83.5, 48.7, 48.3, and 85.7%, respectively. The mean PPV and NPV were significantly higher in the 36 observers with sufficient intra-observer agreement than in the 24 observers with insufficient intra-observer agreement. Our results reconfirm the efficacy of cortical erosion findings in identifying postmenopausal women at risk for osteoporosis, among observers with sufficient intra-observer agreement. Information gathered from radiographic examination is at least as useful as that gathered from the OST index.

A thin or eroded cortex of the mandible detected on dental panoramic radiographs is independently associated with low skeletal bone mineral density (BMD) or osteoporosis in postmenopausal women. The purposes of this study were to develop new computer-aided diagnosis system that combines these two panoramic measures by using fuzzy neural networks (FNN) for identifying postmenopausal women with osteoporosis. Dental panoramic radiographs of 100 postmenopausal women who visited our clinic and had BMD assessments at the lumbar spine and the femoral neck were used in this study. Mandibular cortical width and shape were measured by computer-aided systems and used as the inputs. This system partitioned the input space into a set of subspaces using a novel fuzzy thresholding and constructed the fuzzy inference system incorporated with multi layer perceptron neural network. Our results show that the combination of cortical width and shape by using FNN can be used for the identification of postmenopausal women with osteoporosis in dental clinic. Dentists may identify postmenopausal women accurately by using the new FNN based system and refer them to medical professional for BMD testing.

Measurement of cortical thickness and subjective assessment of cortical porosity on panoramic radiographs are methods previously reported for diagnosing osteoporosis. The aims of this study were to determine the relative efficacy of the mandibular cortical index and cortical width in detecting osteoporosis, both alone and in combination, and to determine the optimal cortical width threshold for referral for additional osteoporosis investigation.Six hundred seventy-one postmenopausal women 45 to 70 years of age were recruited for this study. They received dual energy x-ray absorptiometry (DXA) scans of the left hip and lumbar spine (L1 to L4), and dental panoramic radiographic examinations of the teeth and jaws. Three observers separately assessed the mandibular cortical width and porosity in the mental foramen region of the mandible. Cortical width was corrected for magnification errors. Chi-squared automatic interaction detection analysis (CHAID) software was used (SPSS AnswerTree, version 3.1, SPSS Inc., Chicago, IL).Chi-squared automatic interaction detection analysis showed that the cortical porosity was a poorer predictor of osteoporosis than mandibular cortical width. For the 3 observers, a mandibular cortical width of3 mm provided diagnostic odds ratios of 6.51, 6.09, and 8.04. The test is therefore only recommended in triage screening of individuals by using radiographs made for purposes other than osteoporosis.When evaluating panoramic radiographs, only those patients with the thinnest mandibular cortices (i.e.,3 mm) should be referred for further osteoporosis investigation.

This paper proposes an improvement of an automatic detection method for carotid artery calcification in dental panoramic radiographs based on local intensity distribution. To improve detection rates, K-Means method with constraints is used for enhancement of an estimated shape of the calcification. For the reduction of detection error rates, “surrounding region occupancy rate” which is a new statistics is defined. The proposed method can achieve higher detection rates and lower detection error rates. The experimental result shows that the improvement of the detection performance is obtained.

Findings on dental panoramic radiographs (DPRs) have shown that mandibular cortical index (MCI) based on the morphology of mandibular inferior cortex was significantly correlated with osteoporosis. MCI on DPRs can be categorized into one of three groups and has the high potential for identifying patients with osteoporosis. However, most DPRs are used only for diagnosing dental conditions by dentists in their routine clinical work. Moreover, MCI is not generally quantified but assessed subjectively. In this study, we investigated a computer-aided diagnosis (CAD) system that automatically classifies mandibular cortical bone for detection of osteoporotic patients at early stage. First, an inferior border of mandibular bone was detected by use of an active contour method. Second, regions of interest including the cortical bone are extracted and analyzed for its thickness and roughness. Finally, support vector machine (SVM) differentiate cases into three MCI categories by features including the thickness and roughness. Ninety eight DPRs were used to evaluate our proposed scheme. The number of cases classified to Class I, II, and III by a dental radiologist are 56, 25 and 17 cases, respectively. Experimental result based on the leave-one-out cross-validation evaluation showed that the sensitivities for the classes I, II, and III were 94.6%, 57.7% and 94.1%, respectively. Distribution of the groups in the feature space indicates a possibility of MCI quantification by the proposed method. Therefore, our scheme has a potential in identifying osteoporotic patients at an early stage.

Aim: Carotid artery calcification can results in important vascular obstruction. It is reported that the combination of risk factors such as periodontitis, pulp stones contribute to carotid artery calcification. However in the literature, no study has yet investigated carotid artery calcification with respect to tonsillolith. The objective of this study was to investigate whether carotid artery calcification correlate with tonsillolith using dental panoramic radiography. Material and method: Panoramic radiographs were examined to detect carotid artery calcification and tonsillolith. Results: There was no correlation between the carotid artery calcification and tonsillolith. Conclusion: It can be stated that there is no relationship between carotid artery calcification and tonsillolith.

Objective. The objective of this study was to assess the accuracy of dental panoramic tomograph (DPT) in the presurgical assessment of mandibular third molar teeth by correlating the radiologic interpretation with surgical findings. Study design. DPTs of 300 mandibular third molar teeth were assessed by 9 staff oral surgeons for root morphology and proximity to the inferior alveolar neurovascular bundle. Detailed records were made at surgery. Results. The sensitivity and specificity for observation of root curvatures (±15%) were 29% and 94%, respectively. The sensitivity and specificity of determining an intimate relationship between the root and the neurovascular bundle were 66% and 74%, respectively. Kappa analysis demonstrated poor levels of agreement between radiologic interpretation and surgical findings when the number of roots was determined (0.191) and also when the roots were fused or separate (0.466). Conclusion. Using DPTs to assess mandibular third molar teeth before surgery gives poor diagnostic accuracy of anatomic form and structures. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:119-25)

BACKGROUND: We have previously described a weighted index for determining the diagnostic significance of dento-osseous changes observed on dental panoramic radiographs (DPRs) in individuals at 50% risk of inheriting Familial Adenomatous Polyposis (FAP). A diagnostic test based on this index (Dental Panoramic Radiograph Score, DPRS) was shown to have a sensitivity of 69% and specificity of 100%. OBJECTIVES: To evaluate the validity of the diagnostic test in an independent sample of individuals at 50% risk of inheriting FAP. DESIGN: A retrospective assessment of DPRs in individuals at 50% risk of inheriting FAP. SUBJECTS AND METHODS: A final year dental student assessed blindly and independently, DPRs from an independent sample (n = 119) of affected (n = 26), unaffected (n = 78) and clinically low risk individuals (n = 15). This revealed a sensitivity and specificity of 62 and 97% respectively which is in close agreement with results of the previous study. The dental student's training in assessing DPRs was previously tested using radiographs from 81 individuals from our original study. Weighted Kappa statistics were used to test for agreement. A kappa score of 0.82 (95% confidence interval 0.70-0.93) indicated almost perfect agreement. MAIN OUTCOME: The DPRS is a reproducible and valid index for assessing the diagnostic significance of dentoosseous changes, in individuals at 50% risk of FAP, even in relatively inexperienced hands.

This article provides an overview of the technique of dental panoramic tomography (DPT), including examples of common radiographic errors. Basic radiographic anatomy and current dental nomenclature and notation are also outlined. Dental disease, namely caries, periapical disease and periodontitis, and the appearance of the alveolar and basal bone structures are illustrated.

Background: Many researchers have reported relationships between the calcification stages of individual teeth and skeletal maturity. A few studies are available in the literature about Indian populations. In view of this fact, this study was conducted to investigate the relationship between the dental calcification stages and skeletal maturity stages among North-Indian individuals. The objective of this study was to determine whether dental calcification can be used as a first-level diagnostic tool for assessment of skeletal maturity. Materials and Methods: The study participants included (60 males, 60 females) ranging from 7 to 13 years. A total of 120 dental panoramic radiographs and hand-wrist radiographs were obtained and analyzed. Calcification stages of the mandibular dentition (canines, first premolars, second premolars, and second molars) were rated according to the system of Demirjian et al. Skeletal maturity indicators stages were determined using the Fishman method. Results and Conclusion: Bivarate correlation ranged from 0.58 to 0.75 for males and 0.73 to 0.84 for females. Canine showed the highest correlation in males and second molar showed the highest correlation in females. Canine calcification Stage H represent prepeak of the pubertal growth spurt in male patients. Calcification Stage G for second molar represents the prepeak and Stage H represents the peak of pubertal growth spurt in females.

Introduction Hereditary nonpolyposis colorectal cancer is a colorectal cancer syndrome characterized by the development of colorectal cancer and extracolonic tumors, and this syndrome has an autosomal dominant mode of inheritance. To our knowledge, our study was the first to find dento-osseous anomalies and the second to observe Fordyce granules in a family with individuals with hereditary nonpolyposis colorectal cancer. Case presentations Twenty members of one Brazilian family with individuals with hereditary nonpolyposis colorectal cancer were analyzed according to the presence of colorectal cancer and the occurrence of Fordyce granules and dento-osseous anomalies. Their average age was 29.6 (range 7 to 53 years) years. Medical examinations of this family with hereditary nonpolyposis colorectal cancer were performed at the Coloproctology Division of our hospital. Then, all individuals were referred to our Oral Care Center for Inherited Diseases for intraoral examinations to verify the presence of Fordyce granules. Dental panoramic radiographs were done in order to describe dento-osseous anomalies on applying the Dental Panoramic Radiograph System. Of the 20 family members, four were diagnosed with hereditary nonpolyposis colorectal cancer and all four presented Fordyce granules in their upper lip, but only one of these four patients (Case 2) had a significant dento-osseous anomaly. Conclusions Our familial study verified the presence of Fordyce granules in all individuals diagnosed with hereditary nonpolyposis colorectal cancer, and the presence of significant dento-osseous anomalies in one of these cases. However, the relationship between oral manifestations and hereditary nonpolyposis colorectal cancer should be further investigated.

In this paper, we propose an improvement of an automatic detection method for carotid artery calcification in dental panoramic radiographs based on local features. To reduce misdetections for the candidate region of the calcification, the proposed method is focused on the estimated shape of the calcification. Machine learning is also applied to distinguish the misdetections. A new removal method for the mandibular bone and the area below mandible is also proposed. The proposed method can reduce the misdetection of the carotid artery calcification. The experimental result shows that the improvement of the detection performance is obtained.

Bone Mineral Density (BMD) is used to identify the osteoporosis that is normally, quantitatively measured using Dual Energy X-ray Absorptiometry (DXA). Though since the total number of DXA in Indonesia is still very limited, there is urgent need to find alternative method for early detection of osteoporosis[1]. Dental panoramic radiograph, allegedy, has the potential to detect early sign of osteoporosis, and the purpose of this research is to prove that allegation[2]. Four samples of rib from cow used to substitute the jaw that clinically would be the object of evaluation. The images from microCT scan are used as `gold standard' of bone density, then panoramic images are processed using filtering and segmentation process so the images can be analysed to measure the bone density. The bone density results from both microCT and radiography panoramic images are compared to determine the potential of dental panoramic radiograph. The result of this research is dental panoramic radiograph has the potential to detect early sign of osteoporosis, though to be used for clinical purpose further research is still needed.

A case of an incidental finding of an intranasal foreign body on a dental panoramic radiograph is reported. The foreign body, a calculus-encrusted plastic pearl, had been asymptomatic despite being present for over 20 years. The diagnosis of a nasal foreign body in a patient is of significance if an oral surgical procedure is being planned with the patient under general anesthesia because the foreign body may be dislodged into the airway during nasal intubation. Similar reports of incidentally discovered intranasal foreign bodies on dental radiographs are reviewed. The epidemiology, diagnosis, management, and complications of nasal foreign bodies are discussed.

Vertical asymmetry of the mandibular ramus and condylar heights was measured with a new method from dental panoramic radiographs. The study groups consisted of 45 psoriatic arthritis (PA) and 45 control (CO) matched pairs. Vertical asymmetry was calculated with the formula (R - L)/(R + L) x 100. Females showed no statistical significant difference in vertical asymmetry between the PA and CO pairs. In males however, vertical asymmetry showed a statistically significant difference between the PA and CO groups among those aged 35-55 years (P = 0.008). This group included four men with arthritis mutilans, a severe form of psoriatic arthritis.

Objective The purpose of this study was to test a new method of dental panoramic tomogram (DPT) analysis to show the differences of mandibular bone volume and relative bone density (RBD) in order to detect osteoporosis. Materials and methods A case–control study compared 62 women with osteoporosis (O) and 24 women with osteopenia (o) to a control group of 33 women with normal bone mineral density (N). DPTs were analyzed using an original method resulting in anatomic and RBD indexes as well as using previously described methods: panoramic mandibular index (PMI) and mandibular cortical width (MCW). Results One anatomic and four RBD indexes differed statistically significantly between the group O and N and three RBD indexes differed statistically significantly between o and N. PMI did not show statistically significant differences between the groups. The MCW differed significantly at two measured sites between O and N. Conclusions Average values of RBD indexes were statistically significantly different between O and N and also between o and N. Important differences regarding RBD were confirmed using a new and original method of common DPT analysis. This method could serve as a screening tool for osteoporosis.