Author(s): D Ledgerton, K Horner, H Devlin
Purpose: There have been many articles reviewing current research into the diagnosis and treatment of osteoporosis. Few are aware, however, of the large amount of research within the dental field concerning the relationship between mandibular bone mineral density and systemic osteoporosis. It has been suggested that, in the absence of a national screening programme for osteoporosis, dental practitioners may be in a position to identify those patients who appear to be at risk by evaluation of dental radiographs. In order to do this, however, radiographic indicators of osteoporosis in the mandible must be identified and the relationship between mandibular bone mineral density (BMD) and that of other skeletal areas established. The purpose of this article was to provide a review of the literature in this area. Methods: The findings of a number of the most prominent studies, using a range of methods including histomorphometric analyses, radiographic densitometry and the more sophisticated computerized absorptiometry and densitometry techniques, are described and their findings compared. Results: The results of these studies suggest that there is a moderate correlation between mandibular BMD and that of other skeletal regions. Opinion concerning the use of plain films in the identification of osteoporotic patients, however, is mixed. Conclusions: Whilst there is a relationship between mandibular and regional bone density, further, well controlled research is required in order to answer certain pragmatic questions regarding the diagnostic validity of dental radiographs in the identification of patients who would most benefit from bone densitometry assessment.