Assessing the Reliability of Cone Beam Computed Tomography in Predicting Osteoporosis in Post-Menopausal Women – A Cross-Sectional Study

Background: The most frequent consequence of osteoporosis is osteoporotic fractures, which commonly affect older women and rise with age. The gold standard for measuring bone mineral density (BMD), Dual-Energy X-ray Absorptiometry (DEXA), is helpful in diagnosing osteoporosis. Cone beam computed tomography (CBCT), is the popular dental radiography technique that shows promise for early osteoporosis identification and referral. Objective: To assess the reliability of CBCT-based radiomorphometric indices - Cortical Index (CTCI), Mental Index (CTMI), Computed Tomography Mandibular Index (CTI (S), CTI (I), and CTI), Bone Density of Mandibular Condyle (BDMC) in predicting osteoporosis in postmenopausal women, and to correlate them with DEXA (Dual-Energy X-ray Absorptiometry) findings. Methods: A CBCT scan of 60 postmenopausal females aged over 45 years was analyzed for radiomorphometric indices. Subjects who exhibited positive osteoporosis symptoms, such as ankle pain, restricted joint movement, and vertebral fracture was assessed by Osteoporosis Risk Assessment Instrument (ORAI) and subsequently referred for DEXA scanning of spine and femur. Results: All radiomorphometric indices showed statistically significant differences across groups, except CTI (I). BDMC Showed a moderate positive correlation with DEXA T-score. Conclusion: CBCT-based radiomorphometric indices and BDMC could be used as a screening tool to predict and hence identify postmenopausal women with low BMD.