Aging and dental loss impact on the cortical base resorption of the mandibular bone as a confounding bias in a radio-morphometric analysis using panoramic radiographs.

Abstract

Objectives: The present study aims to assess whether changes in the cortical base of the mandibula could represent a confounding bias, caused by aging or by dental loss, for the use of radio-morphometric analyses, in order to analyse the cortical base of the mandibula. This can function as an early auxiliary diagnosis for osteoporosis.

Methods: 4,032 measurements of the cortical base of the mandibula were made using 504 panoramic radiographs of men aged between 20 and 89 years, segmented into 10-year age groups, and either dentate or edentulous. The cortical base of the mandibula measurements among age groups were compared to identify changes related to aging, and the measurements from the dentate and edentulous groups were compared to identify changes related to edentulism. All measurements were compared with previously established references of the radio-morphometric indices to verify the existence of confounding bias with factors proposed in the present study.

Results: Cortical base of mandibular thickness decreases from the mental foramen toward the mandibular ramus. It can be affirmed that this thickness decreases with age and/or dental loss (p ≤ 0.05), with edentulism being the most significant factor (p ≤ 0.05).

Conclusions: Perhaps the decreased cortical base of mandibular thickness with age and/or dental loss, does not allow the inference that aging or edentulism represents a confounding bias in the radio-morphometric indices using this thickness in auxiliary diagnosis of osteoporosis. However, edentulism impacts on osteopenia indices.

Advances in knowledge: Considering the use of the panoramic radiographic image in dental exams protocol, research efforts have been made in an attempt to establish indicators that may be detected for osteoporosis and osteopenia. It's also important to state that early diagnosis would be fundamental to reduce the social and personal impact of these diseases.