The Association of Osteoporosis Related to Mandibular Condyles Amongst Elderly Females: A Panoramic Radiograph Investigation using Pixel Intensity Imagery

This study aimed to evaluate the association between bone mineral density reduction and pixel intensity values measured at the centers of the mandibular condyles on digital panoramic radiographs, as well as their correlation with age and amenorrheic duration.

Fifty-five post-menopausal women with over 12 months of amenorrhea, available left femur bone mineral density data, and panoramic radiographs were studied. Based on World Health Organization criteria, 30 had normal, and 25 had BMD reduction. The pixel intensity values were measured from a 10-mm² circular region of interest at the condylar head center. Statistical analyses included the Mann–Whitney U, Spearman correlation, and receiver operating characteristic analysis.

Mean pixel intensity of the bone mineral density reduction group was significantly lower than that of the normal one (p = 0009). An area under the curve was 0.76 (95% confidence interval: 0.65–0.87). The specificity and sensitivity were 0.93 and 0.65, respectively. The elderly women showed a pronounced correlation between PI values and bone mineral density scores.

Pixel intensity at mandibular condyles associates with bone density loss, correlating with age and menopause. Overall, despite its ability to correctly identify non-disease cases, the test’s moderate AUC and limited sensitivity restrict its value as a standalone diagnostic tool.

Pixel intensity values of the condylar bone on digital panoramic radiographs showed a negative correlation with reduced bone mineral density, with more pronounced differences in elderly women.