Osteoporosis Diagnostics in Dental Radiology (Panoramic Radiograph): The Mini Osteoporosis Pre-Screening (MOPS).

Background/

Objectives

Osteoporosis is highly relevant to dentistry, oral surgery, and implantology. Because panoramic radiographs are routinely acquired in dental practice, they may enable opportunistic pre-screening. This pilot study evaluated established radiomorphometric indices on orthopantomograms (OPGs) and introduced a new qualitative index, the Mini Osteoporosis Pre-Screening (MOPS) index, based on the appearance of the cervical vertebral bodies visible on panoramic radiographs.

Methods

This retrospective study analyzed 40 pseudonymized patient datasets, each including both OPG and dual-energy X-ray absorptiometry (DXA) examinations. DXA findings served as the reference standard in the study group. In addition 80 OPG scans from a control group of young adults without clinical or anamnestic evidence of osteoporosis were assessed. Two independent examiners with backgrounds in radiology and dentistry evaluated four indices: mandibular cortical width (MCW), panoramic mandibular index (PMI), mandibular cortical index (MCI), and MOPS.

Results

Relative to the reference standard, MOPS demonstrated diagnostic accuracy ranging from 83% to 100% across selected groups. In women, accuracy ranged from 90% to 100%, with a sensitivity of 1.0 and specificity of 0.9. MCI and MOPS were more robust than MCW, whereas PMI showed limited applicability in routine clinical images.

Conclusions

Panoramic radiographs can show osteoporosis-related changes in the mandible and cervical spine. MOPS offers a rapid, cost-neutral pre-screening method and may help dentists identify patients who warrant DXA referral. Larger prospective studies are needed to confirm its clinical utility.