Hastar, Yilmaz, Orhan cortical width values are decreased significantly only women were in category C3. In the study by in women of the same age group. Yüzügüllü et al,8 25% and 75% of women over 60 Horner and Devlin25 have shown that the pan- years had eroded mandibular cortex according to oramic mandibular index can be used for evalua- categories C2 and C3, respectively. The difference tion of osteoporosis status. According to Benson between the two studies is attributed to different et al,15 mean panoramic mandibular index val- sample sizes. ues increase in the elderly. Recent studies about Some studies have found that low bone mineral PMI values that have been performed primarily density is related with high MCI values (C3), which on women have found PMI values between 0.31- can be extrapolated to clinical practice.11,12,22,29,34-36 0.38,15,25,35 which are higher than the mean value of In the present study, 3.2% of patients with osteo- 0.27 found in our study. Horner and Devlin25 sug- porosis had category C3, and 71.4% of patients gested that the PMI has no significant advantage with osteoporosis had Category C2. No males over the MCW, whereas Drozdzowska et al29 con- were in category C3, but 93.7% of the patients with cluded that the PMI might be used as an indicator osteoporosis were women, which may be the rea- of bone mineral changes when PMI values devi- son why C3 consisted of only women. ate markedly from the mean PMI of the popula- Some studies have evaluated the interactions tion. However, as panoramic indices were usually of radiomorphometric indices with dental sta- evaluated on women,4,25,32,35 data related to differ- tus.4,19,35 A study by Ledgerton et al35 showed a ences between genders were limited. In the pres- significant relationship between dental status and ent study, the cut-off value for the PMI was 0.30, the MCW, PMI, and MCI indices. In another study and while the mean PMI value was 0.34 on men, by Uysal et al37 MCI was found to be significantly it was 0.27 on women. It may be supposed that affected by the status of dentition. Gulsahi et al19 the reason for the differences between genders is found that one of the most important parameters that women more often have osteoporosis. There affecting MCI was dental status. Contrary to the was a significant difference between females and foregoing studies, a study by Dutra et al4 found no males for PMI values. However, while the mean significant association between dental status and panoramic mandibular index value was 0.27 on MCW. The study by Gulsahi et al19 demonstrated patients with osteoporosis, this value was 0.32 on that edentulous patients with osteoporosis may be patients without osteoporosis. identified with sufficient diagnostic efficacy by use Knezovic -Zlataric et al34 found no difference in of the MCI and MCW, but not by use of the PMI. In the distribution of women and men between MCI addition, Drozdzowska et al29 studied 30 healthy, categories C2 and C3. Knezovic -Zlataric et al34 postmenopausal, edentulous women divided into also reported that the age-related distribution of normal, osteopenic, and osteoporotic groups and MCI showed an age-related increase in the num- found no significant difference in the mean PMI. bers of individuals with C3 cortex appearance, and In our study, there was a significant difference for a significantly higher incidence of women who had MCW and PMI values according to dental status, C3 cortexes in an older age group. In the present as the MCW and PMI values of edentulous patients study, MCI values were significantly affected by were significantly lower. Dental status was also gender, as 68.5% and 2.8% of women had erod- significantly different for categories of MCI. Most ed mandibular cortex (C2 and C3), respectively, of the patients who were in categories C1, C2, and whereas only 21.8% and 0% of men had eroded C3 (55.6%, 43.2%, and 1.2%, respectively) were mandibular cortex (C2 and C3), respectively, and partially dentate. Edentulous patients appeared Table 6. Dental status on patients with and without osteoporosis. to have higher values for categories of MCI. Most patients who were in Category C3 were partially With osteoporosis Without osteoporosis dentate. These results supported the hypothesis n (%) n (%) that the lack of full occlusion causes insufficient Dentate 12 (9.5) 45 (12.5) occlusal forces to be projected to the mandible, which may affect the mandibular cortex, result- Partially dentate 70 (55.6) 252 (69.8) ing in higher MCI values.37 However, because the Edentulous 44 (34.9) 64 (17.7) mean age of the study population was 67.93 years January 2011 - Vol.5 65 European Journal of Dentistry