Date of Completion


Embargo Period



Dr. Pamela Taxel Dr. Regina Landesberg

Field of Study

Dental Science


Master of Dental Science

Open Access

Campus Access


Introduction: Osteoporosis is characterized by reduced bone mass and diminished architectural strength that results in an increased risk of fracture. Literature suggests a possible association between osteoporosis and mandibular bone loss. Oral or intravenously administered bisphosphonates have been shown to decrease bone turnover, prevent bone loss in patients with osteoporosis and reducing the fracture risk. However, the studies done to find the efficacy of the bisphosphonates in increasing trabecular bone density or morphologic characteristics for the mandible have been very limited.

Objectives: Identify if there is a difference between mandibular trabecular bone in control women versus women on long term use of bisphosphonates.

Methods: Sample was divided into five groups. Women never on bisphosphonates: normal postmenopausal women (C1), osteopenic women (C2), osteoporotic women (C3), women on bisphosphonates for less than two years (G1) and women on bisphosphonates for more than 2 years (G2). Fractal analysis tools using Box counting was employed on digital panoramic images of C1, C2, C3, G1 and G2 groups. The gold standard was dual energy x-ray absorptiometry of hip (HIPNT) and lumbar spine (L1L4T) represented as T-Score values.

Results: Analysis of Variance for both the HIPNT and L1L4T data showed P-value

Discussion and Conclusions: The results indicate that osteoporotic/osteopenic individuals on bisphosphonates have shown improvements in bone density scores. However there were no changes detected in mandibular trabecular bone with box counting method on panoramic images.

Major Advisor

Dr. Alan Lurie