Mandibular bone density/fractal analyses as potential diagnostic indicators for osteoporosis and periodontitis in postmenopausal women

Karaaslan R., BAĞIŞ N., FENTOĞLU Ö., BAŞ AKSU Ö., GÖKÇAY CANPOLAT A., ARAZ M., ...Daha Fazla

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2026 (SCI-Expanded, Scopus)

Özet

Objective Osteoporosis (OP) and periodontitis (P) are common chronic conditions in postmenopausal women, sharing biological pathways related to inflammation and bone metabolism. This study aimed to assess the associations among systemic bone mineral density (BMD), mandibular BMD, periodontal parameters, and mandibular fractal dimension (FD) in postmenopausal women. Study Design This cross-sectional study included 100 postmenopausal women categorized into four groups: OP+P+, OP+P−, OP−P+, and OP−P−. Systemic BMD (lumbar/femoral) and mandibular BMD (axial/sagittal) were measured using dual-energy X-ray absorptiometry. Periodontal parameters were recorded. Mandibular FD was calculated from panoramic radiographs using the box-counting method. Group comparisons, correlations, and regression analyses were performed. Results Participants with both OP and periodontitis (OP+P+) exhibited the greatest periodontal breakdown and the lowest axial mandibular BMD (P = .035). Axial mandibular BMD showed significant positive correlations with lumbar/femoral T -scores/BMD and negative correlations with bleeding on probing (BOP%). FD values in the mandibular angle were lower in osteoporotic groups (P = .010) and correlated positively with systemic BMD/ T -scores while correlating negatively with BOP%. Conclusions OP and periodontitis exert a synergistic negative effect on systemic and mandibular bone health. Mandibular BMD and FD measurements derived from dental radiographs may serve as noninvasive adjunctive indicators of low bone density in postmenopausal women.