Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 12 2 2025 09 23 106 114 Mansour Khorasani Department of Oral & Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Homayon Sheikholeslami Department of Internal Medicine, Medical Faculty, Qazvin University of Medical Sciences, Qazvin, Iran. Samaneh Rastegari Dental Faculty, Qazvin University of Medical Sciences, Qazvin, Iran. Amir Javadi Department of Biostatistics, Qazvin University of Medical Sciences, Qazvin, Iran. Taniya Poorsoleiman Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran. Maryam Tofangchiha Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. 2025 08 20 Introduction: Osteoporosis is the most common metabolic bone disease and is characterized by an increased risk of bone fractures. Early detection of osteoporosis is necessary to prevent hip fractures later in life. We evaluated changes in mandibular radiomorphometric indices in postmenopausal women using Dual Energy X-Ray Absorptiometry (DXA) to assess their association with Osteoporosis.  Materials and Methods: Nine radiomorphometric indices and the number of mandibular teeth on dental panoramic radiographs were evaluated in 85 post-menopausal women at age 45-74. DXA measured bone mineral density (BMD) at the lumbar spine. BMD values were categorized as normal (T-score greater than -1.0), indicative of osteopenia (-1.0 T-score<-2.5), or osteoporosis (T-score<-2.5) according to the World Health Organization classification.  Results: The AA, AI and MI were significantly smaller in individuals with low bone mass (p<0.05). The AD was significantly larger in osteoporotic individuals (p<0.05) and the comparison of MCI among the three subgroups of MBD showed significant differences. There was no significant difference between the three categories of skeletal bone status for PMI, M/M Ratio, GA and the number of mandibular teeth.   Conclusion: Osteoporotic individuals are more likely to have altered inferior cortex and antegonial region morphology and thickness than non-osteoporotic individuals. The smaller AI and larger AD were strongly associated with lower bone mass. Clinical relevance: In this study, we provided a model to assess the risk of osteopenia or osteoporosis in dental panoramic radiography.  Keywords: Osteoporosis; Panoramic radiography; Mandible; Bone mineral density. https://jcr.tums.ac.ir/index.php/jcr/article/view/558 https://jcr.tums.ac.ir/index.php/jcr/article/download/558/449