Research Article
BibTex RIS Cite

Relationship Between the Mandibular Cortical Index and Periodontitis Stage/Grade: A Retrospective Radiographic Study

Year 2025, Volume: 12 Issue: 1, 88 - 92, 21.04.2025

Ömer Faruk Okumuş , Şükran Acıpınar

https://doi.org/10.15311/selcukdentj.1518035

Abstract

Background: In the literature, the relationship of the mandibular cortical index (MCI) with the stage and grade of periodontitis has not yet been investigated. This study aimed to examine the relationship between the stage and grade of periodontitis and MCI according to the current classification of periodontal disease.
Methods: A total of 199 patients (119 females, 80 males) were included in this study. The study population consisted of patients with periodontitis and controls without periodontitis. The stage and grade of the patients with periodontitis were determined according to the criteria of the “2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions”. For this classification, patient records, including periodontal data and panoramic radiographs were used. The MCI values of the patients were also recorded by evaluating the same panoramic radiograph. The Pearson chi-square test was used to compare categorical data according to groups, and multiple comparisons were undertaken with the Bonferroni-corrected Z test.
Results: The non-periodontitis (NP) group had the highest C1 type bone rate (p<0.001). The C3 rate of the stage Ⅲ/Ⅳ group was significantly higher compared to all the remaining groups (stage Ⅰ, stage Ⅱ, and NP) (p<0.001). The C3 rate was significantly higher in the grade C group than in the grade B and NP groups (p<0.001).
Conclusions: The data obtained from this study suggest that there is a positive relationship between the stage and grade of periodontitis and MCI.
Keywords: Bone Density, Mandibular Cortical İndex, Osteoporosis, Periodontitis

Keywords

Bone Density Mandibular Cortical İndex Osteoporosis Periodontitis

References

  • 1- Slots J. Periodontitis: facts, fallacies and the future. Periodontol 2000. 2017 Oct;75(1):7-23.
  • 2- Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol 2018;89 Suppl 1:S159–72. https://doi.org/10.1002/JPER.18-0006.
  • 3- Barbato L, Francioni E, Bianchi M, Mascitelli E, Marco LB, Tonelli DP. Periodontitis and bone metabolism. Clin Cases Miner Bone Metab. 2015;12(2):174-7.
  • 4- Klemetti E, Collin HL, Forss H, Markkanen H, Lassila V. Mineral status of skeleton and advanced periodontal disease. J Clin Periodontol 1994;21:184–8. https://doi.org/10.1111/j.1600-051x.1994.tb00301.x.
  • 5- von Wowern N, Westergaard J, Kollerup G. Bone mineral content and bone metabolism in young adults with severe periodontitis. J Clin Periodontol 2001;28:583–8. https://doi.org/10.1034/j.1600-051x.2001.028006583.x.
  • 6- Sindel D, Gula G. Assessment of Bone Mineral Density in Osteoporosis. Turk Osteoporoz Derg 2015;21. https://doi.org/10.4274/tod.41275.
  • 7- Valerio CS, Trindade AM, Mazzieiro ET, Amaral TP, Manzi FR. Use of digital panoramic radiography as an auxiliary means of low bone mineral density detection in post-menopausal women. Dento Maxillo Facial Radiol 2013;42:20120059. https://doi.org/10.1259/dmfr.20120059.
  • 8- Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res 1994;102:68–72. https://doi.org/10.1111/j.1600-0722.1994.tb01156.x.
  • 9- Moeintaghavi A, Hosseinizarch H, Tabassi SM. The comparison of mandibular radiomorphometric indices in panoramic radiography between patients with chronic periodontitis and healthy individuals. J Contemp Dent Pract 2014;15:461–5. https://doi.org/10.5005/jp-journals-10024-1563.
  • 10- M. M. SW, Savitri Y, K. AM. Identification of Mandibular Cortical Index (MCI) in chronic periodontitis patients. EurAsian J Biosci 2020;14:3201–5.
  • 11- Öztürkmen Z, Özbek M, Özcan Bulut S, Akçiçek Türk G. Evaluation of the mandibular cortical index on digital panoramic images of the chronic periodontitis patients. Clin Dent Res 2019; 43:41–9.
  • 12- Cakur B, Dagistan S, Sahin A, Harorli A, Yilmaz A. Reliability of mandibular cortical index and mandibular bone mineral density in the detection of osteoporotic women. Dentomaxillofac Radiol. 2009 Jul;38(5):255-61.
  • 13- Hastar E, Yilmaz HH, Orhan H. Evaluation of mental index, mandibular cortical index and panoramic mandibular index on dental panoramic radiographs in the elderly. Eur J Dent. 2011 Jan;5(1):60-7.
  • 14- Kolte RA, Kolte AP, Potey AM. Risk assessment of osteoporosis in pre- and postmenopausal periodontally healthy and chronic periodontitis women with digital panoramic radiographs. J Indian Soc Periodontol 2017;21:461–5. https://doi.org/10.4103/jisp.jisp_238_17.
  • 15- Mudda JA, Bajaj M, Patil VA. A Radiographic comparison of mandibular bone quality in pre- and post-menopausal women in Indian population. J Indian Soc Periodontol 2010;14:121–5. https://doi.org/10.4103/0972-124X.70833.
  • 16- Yasa Y, Buyuk SK, Genc E. Comparison of mandibular cortical bone among obese, overweight, and normal weight adolescents using panoramic mandibular index and mental index. Clin Oral Investig. 2020 Aug;24(8):2919-24.
  • 17- Jagelaviciene E, Kubilius R, Krasauskiene A. The relationship between panoramic radiomorphometric indices of the mandible and calcaneus bone mineral density. Med Kaunas Lith 2010;46:95–103.
  • 18- Seki K, Nagasaki M, Yoshino T, Yano M, Kawamoto A, Shimizu O. Radiographical Diagnostic Evaluation of Mandibular Cortical Index Classification and Mandibular Cortical Width in Female Patients Prescribed Antiosteoporosis Medication: A Retrospective Cohort Study. Diagnostics (Basel). 2024 May 13;14(10):1009.
  • 19- Horner K, Devlin H. The relationships between two indices of mandibular bone quality and bone mineral density measured by dual energy X-ray absorptiometry. Dentomaxillofacial Radiol 1998;27:17–21. https://doi.org/10.1038/sj.dmfr.4600307.
  • 20- Taguchi A, Suei Y, Sanada M, Ohtsuka M, Nakamoto T, Sumida H, et al. Validation of dental panoramic radiography measures for identifying postmenopausal women with spinal osteoporosis. AJR Am J Roentgenol 2004;183:1755–60. https://doi.org/10.2214/ajr.183.6.01831755.
  • 21- Drozdzowska B, Pluskiewicz W, Tarnawska B. Panoramic-based mandibular indices in relation to mandibular bone mineral density and skeletal status assessed by dual energy X-ray absorptiometry and quantitative ultrasound. Dentomaxillofacial Radiol 2002;31:361–7. https://doi.org/10.1038/sj.dmfr.4600729.
  • 22- Tonguc M, Buyukkaplan U, Fentoglu O, Gumus B, Cerci S, Kirzioglu F. Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis. Dentomaxillofacial Radiol 2012;41. https://doi.org/10.1259/dmfr/21900076.
  • 23- Takaishi Y, Okamoto Y, Ikeo T, Morii H, Takeda M, Hide K, et al. Correlations between periodontitis and loss of mandibular bone in relation to systemic bone changes in postmenopausal Japanese women. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 2005;16:1875–82. https://doi.org/10.1007/s00198-005-1955-8.
  • 24- Nackaerts O, Gijbels F, Sanna A-M, Jacobs R. Is there a relation between local bone quality as assessed on panoramic radiographs and alveolar bone level? Clin Oral Investig 2008;12:31–5. https://doi.org/10.1007/s00784-007-0139-7.
  • 25- Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Periodontol 2018;89:S183–203.
  • 26- Hajishengallis G. Immunomicrobial pathogenesis of periodontitis: keystones, pathobionts, and host response. Trends Immunol 2014;35:3–11. https://doi.org/10.1016/j.it.2013.09.001.
  • 27- Beiler TFCSB, de Mello Neto JM, Alves JC, Hamlet S, Ipe D, da Silva Figueredo CM. Impact of non-surgical periodontal treatment on salivary expression of cytokines related to bone metabolism. Odontology. 2020 Oct;108(4):646-52.
  • 28- 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. https://doi.org/10.1186/1746-160X-3-37.
  • 29- Moghadam MA, Reyhani Z, Shokrollahi M, Zadeh SF. Evaluation of mandibular cortical indexes in digital panoramic radiography. EurAsian J Biosci 2020;14.
  • 30- Kamber-Ćesir A, Dardagan Đonlagić A, Ajanović M, Strujić Porović S, Gavranović A, Kazazić L, et al. The Influence of Gender on the Cortical Width of the Lower Border of the Mandible and the Mandibular Cortical Index. Acta Med Acad. 2018 Nov;47(2):149-54.

Mandibular Kortikal İndeks ile Periodontitis Evre/Derecesi Arasındaki İlişki: Retrospektif Radyografik Çalışma

Year 2025, Volume: 12 Issue: 1, 88 - 92, 21.04.2025

Ömer Faruk Okumuş , Şükran Acıpınar

https://doi.org/10.15311/selcukdentj.1518035

Abstract

Amaç: Mandibular kortikal indeks (MKİ), mandibular kemik mineral yoğunluğunu değerlendirmek için kullanılan radyomorfometrik indekslerden biridir. Mandibular kortikal indeksinin (MKİ) periodontitisin evresi ve derecesi ile ilişkisi literatürde henüz araştırılmamıştır. Bu retrospektif çalışmada, periodontal hastalığın mevcut sınıflandırmasına göre periodontitisin evresi ve derecesi ile MKİ arasındaki ilişkinin incelenmesi amaçlanmıştır.
Gereç ve Yöntemler: Bu çalışmaya 119’u kadın, 80’i erkek olmak üzere toplam 199 hasta dahil edilmiştir. Çalışma popülasyonu periodontitisli hastalar ve periodontitisi olmayan kontrol hastalarından oluşmuştur. Periodontitisli hastaların evresi ve derecesi “2017 Dünya Periodontal ve Peri-İmplant Hastalıkların ve Durumlarının Sınıflandırılması Çalıştayı” kriterlerine göre belirlenmiştir. Bu sınıflandırma için klinik periodontal verileri ve panoramik radyografileri içeren hasta kayıtları kullanılmıştır. Aynı panoramik radyografi değerlendirilerek hastaların MKİ değerleri de kaydedilmiştir. İstatistiksel analizde kategorik verilerin gruplara göre karşılaştırılmasında Pearson ki-kare testi kullanılırken, çoklu karşılaştırmalar ise Bonferroni düzeltmeli Z testi ile yapılmıştır.
Bulgular: Periodontitis olmayan (NP) grup en yüksek C1 tipi kemik oranına sahip olarak belirlenmiştir (p<0,001). Evre Ⅲ/Ⅳ grubunun C3 oranı diğer tüm gruplara (evre Ⅰ, evre 2 ve NP) göre anlamlı derecede yüksek bulunmuştur (p<0,001). C3 oranı C derece grubunda B ve NP gruplarına göre anlamlı derecede yüksektir (p<0,001).
Sonuçlar: Bu çalışmadan elde edilen veriler periodontitisin evresi ve derecesi ile MKİ arasında pozitif bir ilişki olduğunu göstermektedir.
Anahtar Kelimeler: Kemik Yoğunluğu, Mandibular Kortikal İndeks, Osteoporoz, Periodontitis

Keywords

Kemik Yoğunluğu Mandibular Kortikal İndeks Osteoporoz Periodontitis

References

  • 1- Slots J. Periodontitis: facts, fallacies and the future. Periodontol 2000. 2017 Oct;75(1):7-23.
  • 2- Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol 2018;89 Suppl 1:S159–72. https://doi.org/10.1002/JPER.18-0006.
  • 3- Barbato L, Francioni E, Bianchi M, Mascitelli E, Marco LB, Tonelli DP. Periodontitis and bone metabolism. Clin Cases Miner Bone Metab. 2015;12(2):174-7.
  • 4- Klemetti E, Collin HL, Forss H, Markkanen H, Lassila V. Mineral status of skeleton and advanced periodontal disease. J Clin Periodontol 1994;21:184–8. https://doi.org/10.1111/j.1600-051x.1994.tb00301.x.
  • 5- von Wowern N, Westergaard J, Kollerup G. Bone mineral content and bone metabolism in young adults with severe periodontitis. J Clin Periodontol 2001;28:583–8. https://doi.org/10.1034/j.1600-051x.2001.028006583.x.
  • 6- Sindel D, Gula G. Assessment of Bone Mineral Density in Osteoporosis. Turk Osteoporoz Derg 2015;21. https://doi.org/10.4274/tod.41275.
  • 7- Valerio CS, Trindade AM, Mazzieiro ET, Amaral TP, Manzi FR. Use of digital panoramic radiography as an auxiliary means of low bone mineral density detection in post-menopausal women. Dento Maxillo Facial Radiol 2013;42:20120059. https://doi.org/10.1259/dmfr.20120059.
  • 8- Klemetti E, Kolmakov S, Kröger H. Pantomography in assessment of the osteoporosis risk group. Scand J Dent Res 1994;102:68–72. https://doi.org/10.1111/j.1600-0722.1994.tb01156.x.
  • 9- Moeintaghavi A, Hosseinizarch H, Tabassi SM. The comparison of mandibular radiomorphometric indices in panoramic radiography between patients with chronic periodontitis and healthy individuals. J Contemp Dent Pract 2014;15:461–5. https://doi.org/10.5005/jp-journals-10024-1563.
  • 10- M. M. SW, Savitri Y, K. AM. Identification of Mandibular Cortical Index (MCI) in chronic periodontitis patients. EurAsian J Biosci 2020;14:3201–5.
  • 11- Öztürkmen Z, Özbek M, Özcan Bulut S, Akçiçek Türk G. Evaluation of the mandibular cortical index on digital panoramic images of the chronic periodontitis patients. Clin Dent Res 2019; 43:41–9.
  • 12- Cakur B, Dagistan S, Sahin A, Harorli A, Yilmaz A. Reliability of mandibular cortical index and mandibular bone mineral density in the detection of osteoporotic women. Dentomaxillofac Radiol. 2009 Jul;38(5):255-61.
  • 13- Hastar E, Yilmaz HH, Orhan H. Evaluation of mental index, mandibular cortical index and panoramic mandibular index on dental panoramic radiographs in the elderly. Eur J Dent. 2011 Jan;5(1):60-7.
  • 14- Kolte RA, Kolte AP, Potey AM. Risk assessment of osteoporosis in pre- and postmenopausal periodontally healthy and chronic periodontitis women with digital panoramic radiographs. J Indian Soc Periodontol 2017;21:461–5. https://doi.org/10.4103/jisp.jisp_238_17.
  • 15- Mudda JA, Bajaj M, Patil VA. A Radiographic comparison of mandibular bone quality in pre- and post-menopausal women in Indian population. J Indian Soc Periodontol 2010;14:121–5. https://doi.org/10.4103/0972-124X.70833.
  • 16- Yasa Y, Buyuk SK, Genc E. Comparison of mandibular cortical bone among obese, overweight, and normal weight adolescents using panoramic mandibular index and mental index. Clin Oral Investig. 2020 Aug;24(8):2919-24.
  • 17- Jagelaviciene E, Kubilius R, Krasauskiene A. The relationship between panoramic radiomorphometric indices of the mandible and calcaneus bone mineral density. Med Kaunas Lith 2010;46:95–103.
  • 18- Seki K, Nagasaki M, Yoshino T, Yano M, Kawamoto A, Shimizu O. Radiographical Diagnostic Evaluation of Mandibular Cortical Index Classification and Mandibular Cortical Width in Female Patients Prescribed Antiosteoporosis Medication: A Retrospective Cohort Study. Diagnostics (Basel). 2024 May 13;14(10):1009.
  • 19- Horner K, Devlin H. The relationships between two indices of mandibular bone quality and bone mineral density measured by dual energy X-ray absorptiometry. Dentomaxillofacial Radiol 1998;27:17–21. https://doi.org/10.1038/sj.dmfr.4600307.
  • 20- Taguchi A, Suei Y, Sanada M, Ohtsuka M, Nakamoto T, Sumida H, et al. Validation of dental panoramic radiography measures for identifying postmenopausal women with spinal osteoporosis. AJR Am J Roentgenol 2004;183:1755–60. https://doi.org/10.2214/ajr.183.6.01831755.
  • 21- Drozdzowska B, Pluskiewicz W, Tarnawska B. Panoramic-based mandibular indices in relation to mandibular bone mineral density and skeletal status assessed by dual energy X-ray absorptiometry and quantitative ultrasound. Dentomaxillofacial Radiol 2002;31:361–7. https://doi.org/10.1038/sj.dmfr.4600729.
  • 22- Tonguc M, Buyukkaplan U, Fentoglu O, Gumus B, Cerci S, Kirzioglu F. Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis. Dentomaxillofacial Radiol 2012;41. https://doi.org/10.1259/dmfr/21900076.
  • 23- Takaishi Y, Okamoto Y, Ikeo T, Morii H, Takeda M, Hide K, et al. Correlations between periodontitis and loss of mandibular bone in relation to systemic bone changes in postmenopausal Japanese women. Osteoporos Int J Establ Result Coop Eur Found Osteoporos Natl Osteoporos Found USA 2005;16:1875–82. https://doi.org/10.1007/s00198-005-1955-8.
  • 24- Nackaerts O, Gijbels F, Sanna A-M, Jacobs R. Is there a relation between local bone quality as assessed on panoramic radiographs and alveolar bone level? Clin Oral Investig 2008;12:31–5. https://doi.org/10.1007/s00784-007-0139-7.
  • 25- Albandar JM, Susin C, Hughes FJ. Manifestations of systemic diseases and conditions that affect the periodontal attachment apparatus: Case definitions and diagnostic considerations. J Periodontol 2018;89:S183–203.
  • 26- Hajishengallis G. Immunomicrobial pathogenesis of periodontitis: keystones, pathobionts, and host response. Trends Immunol 2014;35:3–11. https://doi.org/10.1016/j.it.2013.09.001.
  • 27- Beiler TFCSB, de Mello Neto JM, Alves JC, Hamlet S, Ipe D, da Silva Figueredo CM. Impact of non-surgical periodontal treatment on salivary expression of cytokines related to bone metabolism. Odontology. 2020 Oct;108(4):646-52.
  • 28- 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. https://doi.org/10.1186/1746-160X-3-37.
  • 29- Moghadam MA, Reyhani Z, Shokrollahi M, Zadeh SF. Evaluation of mandibular cortical indexes in digital panoramic radiography. EurAsian J Biosci 2020;14.
  • 30- Kamber-Ćesir A, Dardagan Đonlagić A, Ajanović M, Strujić Porović S, Gavranović A, Kazazić L, et al. The Influence of Gender on the Cortical Width of the Lower Border of the Mandible and the Mandibular Cortical Index. Acta Med Acad. 2018 Nov;47(2):149-54.
There are 30 citations in total.

Details

Primary Language English
Subjects Periodontics
Journal Section Research
Authors

Ömer Faruk Okumuş

Şükran Acıpınar 0000-0003-1711-2183

Publication Date April 21, 2025
Submission Date July 18, 2024
Acceptance Date November 5, 2024
Published in Issue Year 2025 Volume: 12 Issue: 1

Cite

Vancouver Okumuş ÖF, Acıpınar Ş. Relationship Between the Mandibular Cortical Index and Periodontitis Stage/Grade: A Retrospective Radiographic Study. Selcuk Dent J. 2025;12(1):88-92.
 Download Cover Image

Selcuk Dental Journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY NC).