Dental and Medical Problems
2019, vol. 56, nr 1, January-March, p. 21–25
Publication type: original article
Investigation of the determinants of the mandibular cortical morphology
Badanie determinant morfologii warstwy korowej żuchwy
1 Department of Dento-Maxillofacial Radiology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
Background. The mandibular cortical index (MCI) is a measurement based on the visual assessment of changes in the morphology of the mandibular cortex on panoramic radiographs.
Objectives. The present study aimed to investigate age, gender, dental status (DS), occlusal function, and presence of torus mandibularis (TM) as variables that might have a possible effect on MCI.
Material and Methods. A total of 381 patients (155 men and 226 women) aged 21–84 years (mean age: 43.8 ±14.5 years) were included in this study. Age, gender and DS were recorded for each patient. The occlusal function was evaluated using the Eichner index (EI). The presence of tori was assessed by visual inspection and digital palpation. The MCI assessments were done based on Klemetti’s classification (C1–C3). Statistical comparisons were performed using the χ2 test, independent samples t-test and multiple logistic regression analysis (p < 0.05).
Results. Significant differences were observed between the MCI categories regarding age, gender, DS, EI, and TM. The likelihood of the MCI categories C2 and C3 was increased in males (odds ratio (OR) 9.33; p < 0.001), when TM was absent (OR 2.73; p < 0.001), in EI Class B (OR 2.68; p = 0.027), and in the age group 50–70 years (OR 2.5; p = 0.018).
Conclusion. Morphological changes of the mandibular cortical bone are related to gender, presence of TM, occlusal function expressed as EI, and age.
panoramic radiography, mandibular cortical morphology, bone hyperplasia
radiografia panoramiczna, morfologia warstwy korowej żuchwy, hiperplazja kości
- Raisz LG. Physiology and pathophysiology of bone remodeling. Clin Chem. 1999;45(8 Pt 2):1353–1358.
- Consensus development conference: Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993;94(6):646–650.
- von Wowern N. General and oral aspects of osteoporosis: A review. Clin Oral Investig. 2001;5(2):71–82.
- Klemetti E, Vainio P, Lassila V, Alhava E. Cortical bone mineral density in the mandible and osteoporosis status in postmenopausal women. Scand J Dent Res. 1993;101(4):219–223.
- Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res. 1994;102(1):68–72.
- White SC. Oral radiographic predictors of osteoporosis. Dentomaxillofac Radiol. 2002;31(2):84–92.
- Savic Pavicin I, Dumancic J, Jukic T, Badel T, Badanjak A. Digital orthopantomograms in osteoporosis detection: Mandibular density and mandibular radiographic indices as skeletal BMD predictors. Dentomaxillofac Radiol. 2014;43(7):20130366.
- Leite AF, Figueiredo PT, Guia CM, Melo NS, de Paula AP. Correlations between seven panoramic radiomorphometric indices and bone mineral density in postmenopausal women. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(3):449–456.
- Hrdlička A. Mandibular and maxillary hyperostoses. Am J Phys Anthropol. 1940;27(1):1–67.
- Hosoi T, Yoda T, Yamaguchi M, Amano H, Orimo H. Elderly women with oral exostoses had higher bone mineral density. J Bone Miner Metab. 2003;21(2):120–122.
- Hjertstedt J, Burns EA, Fleming R, et al. Mandibular and palatal tori, bone mineral density, and salivary cortisol in communitydwelling elderly men and women. J Gerontol A Biol Sci Med Sci. 2001;56(11):M731–735.
- Ledgerton D, Horner K, Devlin H, Worthington H. Radiomorphometric indices of the mandible in a British female population. Dentomaxillofac Radiol. 1999;28(3):173–181.
- Gulsahi A, Yüzügüllü B, Imirzalioglu P, Genç Y. Assessment of panoramic radiomorphometric indices in Turkish patients of different age groups, gender and dental status. Dentomaxillofac Radiol. 2008;37(5):288–292.
- Bozdag G, Sener S. The evaluation of MCI, MI, PMI and GT on both genders with different age and dental status. Dentomaxillofac Radiol. 2015;44(9):20140435.
- Yoshinaka M, Ikebe K, Furuya-Yoshinaka M, Maeda Y. Prevalence of torus mandibularis among a group of elderly Japanese and its relationship with occlusal force. Gerodontology. 2014;31(2):117–122.
- Taguchi A, Tanimoto K, Suei Y, Wada T. Tooth loss and mandibular osteopenia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(1):127–132.
- Kribbs PJ. Comparison of mandibular bone in normal and osteoporotic women. J Prosthet Dent. 1990;63(2):218–222.
- Roberts M, Yuan J, Graham J, Jacobs R, Devlin H. Changes in mandibular cortical width measurements with age in men and women. Osteoporos Int. 2011;22(6):1915–1925.
- Klemetti E, Kolmakow S. Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofac Radiol. 1997;26(1):22–25.
- Horner K, Devlin H. The relationships between two indices of mandibular bone quality and bone mineral density measured by dual energy X-ray absorptiometry. Dentomaxillofac Radiol. 1998;27(1):17–21.
- Knezović Zlatarić D, Celebić A, Lazić B, et al. Influence of age and gender on radiomorphometric indices of the mandible in removable denture wearers. Coll Antropol. 2002;26(1):259–266.
- Uysal S, Çağırankaya BL, Hatipoğlu MG. Do gender and torus mandibularis affect mandibular cortical index? A cross-sectional study. Head Face Med. 2007;3:37.
- Ikebe K, Hazeyama T, Iwase K, et al. Association of symptomless TMJ sounds with occlusal force and masticatory performance in older adults. J Oral Rehabil. 2008;35(5):317–323.
- Eggen S, Natvig B. Relationship between torus mandibularis and number of present teeth. Scand J Dent Res. 1986;94(3):233–240.
- Kerdpon D, Sirirungrojying S. A clinical study of oral tori in southern Thailand: Prevalence and the relation to parafunctional activity. Eur J Oral Sci. 1999;107(1):9–13.
- Eggen S. Torus mandibularis: An estimation of the degree of genetic determination. Acta Odontol Scand. 1989;47(6):409–415.
- De Luca Canto G, Torres de Freitas S, Schuldt Filho G, de Sousa Vieira R. Association between mandibular torus and parafunctional activity. J Stomat Occ Med. 2012;6(2):43–49.
- Cortes AR, Jin Z, Morrison MD, Arita ES, Song J, Tamimi F. Mandibular tori are associated with mechanical stress and mandibular shape. J Oral Maxillofac Surg. 2014;72(11):2115–2125.
- Al-Dwairi ZN, Al-Daqaq ANF, Kielbassa AM, Lynch E. Association between oral tori, occlusal force, and mandibular cortical index. Quintessence Int. 2017;48(10):841–849.
- Çağırankaya B, Hatipoğlu M, Kansu Ö. Is there an association between torus mandibularis and bite force? J Hacettepe Univ Fac Dent. 2005;29(4):15–17.