OBJECTIVES: The panoramic-based indices (Mandibular Cortical Index-MCI, the height of mandibular inferior cortex-IC (mm), Panoramic Mandibular Index-PMI, Mandibular Ratio-MR) were used to evaluate their diagnostic efficacy and to determine whether they correlate with bone mineral density (BMD (g/cm(2))) of the mandible and hip, and with ultrasound parameters of the calcaneus and hand phalanges in postmenopausal, edentulous women. METHODS: Basing on MCI women were divided into three subgroups differed in the appearance of the mandibular cortex (C1 n=6, C2 n=16, C3 n=8). BMD of the hip (neck-BMD, Ward's-BMD, trochanteric BMD) and mandible (m-BMD) were measured by dual-energy X-ray absorptiometry (DXA). Calcaneus using Achilles (Speed of Sound-SOS (m/s), Broadband Ultrasound Attenuation-BUA [dB/MHz], Stiffness Index-SI [%]) and hand phalanges (amplitude dependent speed of sound-Ad-SoS (m/s)) using DBM Sonic 1200 were assessed by Quantitative Ultrasound (QUS). RESULTS: There were no significant differences between subgroups in parameters measured except for significant differences in m-BMD (P<0.01). Only m-BMD correlated significantly with DXA (r=0.43-0.45, P<0.05) and QUS (r=0.36-0.55, P<0.05) measurements excluding correlations with calcaneal SOS and trochanteric BMD. The ability of the mandibular variables to discriminate between normal and osteopenic/osteoporotic cases was assessed by calculating: specificity (ranging from 31 to 81%), sensitivity (ranging from 21 to 93%), negative and positive predictive values (ranging from 47 to 83% and 40 to 79%, respectively). CONCLUSION: MCI is a simple three-graded classification of changes in the cortex but is not able to distinguish normal and osteopenic/osteoporotic postmenopausal edentulous women. The efficacy of the panoramic-based mandibular indices in diagnosing osteopenia/osteoporosis is low to moderate.
Background The aim of the study was to establish longitudinal bone changes in obese women after laparoscopic sleeve gastrectomy (LSG). Methods Twenty-nine women at baseline mean age of 40.41 ± 9.26 years and with mean body mass index (BMI) of 43.07 ± 4.99 kg/m2 were included in a 6-month study. Skeletal status at hip [femoral neck (FN) and total hip (TH)] and spine was assessed at baseline, as well as in 3 and 6 months after surgery. Body size was measured at baseline and follow-up (weight, height, BMI, and waist). Results Baseline body weight was 117.5 ± 18.4 kg. The mean body weight and BMI decreased by 17.9 % during the first 3 months after surgery to obtain 28.4 % after 6 months. At 6 months, BMD decreased significantly for spine by 1.24 %, FN 6.99 %, and TH 5.18 %. The changes after 3 months in individual subjects showed that, in the majority of subjects, FN and TH BMD decreased significantly (in 52 % and 69 % of subjects, respectively), and in 24 % loss of BMD was found at the spine. After 6 months, the corresponding, significant decreases in individual subjects were found in 72 %, 86 %, and 38 % of woman, respectively. Those with a significant loss of FN BMD tended to lose more weight (30 ± 9.47 versus 23.25 ± 6.08 kg, p = 0.061) than others; women with a significant decrease of FN BMD lost more weight than those with no such decrease (30.43 ± 8.07 versus 15 ± 1.91 kg). Conclusion LSG proved efficient for body weight reduction, however, with a parallel decline in bone mineral density.