Quantitative assessment of mandibular cortical erosion on dental panoramic radiographs for screening osteoporosis

  • Chisako MuramatsuEmail author
  • Kazuki Horiba
  • Tatsuro Hayashi
  • Tatsumasa Fukui
  • Takeshi Hara
  • Akitoshi Katsumata
  • Hiroshi Fujita
Original Article



Studies reported that the mandibular cortical width (MCW) measured on dental panoramic radiographs (DPRs) was significantly correlated with bone mineral density. However, MCW is not a perfect index by itself, and studies suggest the added utility of mandibular cortical index (MCI). In this study, we propose a method for computerized estimation of mandibular cortical degree (MCD), a new continuous measure of MCI, for osteoporotic risk assessment.


The mandibular contour was automatically segmented using an active contour model. The regions of interest near mental foramen were extracted for MCW and MCD determination. The MCW was measured on the basis of residue-line detection results and pixel profiles. Image features including texture features based on gray-level co-occurrence matrices were determined. The MCD were estimated using support vector regression (SVR). The SVR was trained using previously collected 99 DPRs, including 26 osteoporotic cases, by a computed radiography system. The proposed scheme was tested using 99 DPRs obtained by a photon-counting system with data of bone mineral density at distal forearm. The number of osteoporotic, osteopenic, and control cases were 12, 18, and 69 cases, respectively. The subjective MCD by a dental radiologist was employed for training and evaluation.


The correlation coefficients with the subjective MCD were −0.549 for MCW alone, 0.609 for the MCD by the features without MCW, and 0.617 for the MCD by the features and MCW. The correlation coefficients with the BMD were 0.619, −0.608, and −0.670, respectively. The areas under the receiver operating characteristic curves for detecting osteoporotic cases were 0.830, 0.884, and 0.901, respectively, whereas those for detecting high-risk cases were 0.835, 0.833, and 0.880, respectively.


In conclusion, our scheme may have a potential to identify asymptomatic osteoporotic and osteopenic patients through dental examinations.


Dental panoramic radiographs Mandibular cortex erosion Mandibular cortical width Osteoporosis Textural features 



Authors appreciate the members of the Fujita Laboratory at Gifu University and dental CAD research group at Asahi University School of Dentistry, Aichi Gakuin University and Media, Co., Ltd. for their valuable discussion.

Compliance with ethical standards


This study was supported in part by Grant-in-Aid for Scientific Research (b) JSPS KAKENHI Grant Number 26293402 and Grant-in-Aid for Scientific Research on Innovative Areas (Multidisciplinary Computational Anatomy), MEXT, Japan, Grant Number 26108005.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© CARS 2016

Authors and Affiliations

  • Chisako Muramatsu
    • 1
    Email author
  • Kazuki Horiba
    • 1
  • Tatsuro Hayashi
    • 2
  • Tatsumasa Fukui
    • 3
  • Takeshi Hara
    • 1
  • Akitoshi Katsumata
    • 3
  • Hiroshi Fujita
    • 1
  1. 1.Department of Intelligent Image Information, Graduate School of MedicineGifu UniversityGifuJapan
  2. 2.Media Co., LtdTokyoJapan
  3. 3.Department of Oral RadiologyAsahi University School of DentistryMizuhoJapan

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