Can mandibular bone resorption predict hip fracture in elderly women? A systematic review of diagnostic test accuracy

Gerodontology 2013; doi:10.1111/ger.12077 


The aim of this systematic review was to determine the diagnostic accuracy of the mandibular cortical width measurements and porosity in detecting hip osteoporosis.


All of the included studies used measurements on panoramic radiographs.

Materials and methods

Studies were included if they compared the radiographic measurements (or index tests) with central dual energy X-ray absorptiometry (DXA) of the hip as the reference standard. A measure of diagnostic accuracy such as sensitivity and specificity or area under the receiver operating characteristic curve was also required for inclusion.


Seven studies were identified. Meta-analysis was not possible because of the heterogeneity of the studies. The studies all demonstrated moderate diagnostic accuracy.


If a patient with a thin or porous mandibular cortex is identified by a chance radiographic finding, additional clinical risk factors need to be considered and the patient referred for further investigation with DXA where necessary.


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