Three panoramic indices for identification of healthy older people at a high risk of osteoporosis

•Three panoramic indices could be used to detect the risk of osteoporosis.•Severely eroded mandibular cortex as a potent marker of osteoporosis.•Low bone density may occur in older people under 65 years. This study aimed to identify whether healthy older adults are at a high risk of osteoporosis based on the association between the T-score values of bone mineral density (BMD) and three panoramic indices. All participants (50–64 years old) underwent calcaneal quantitative ultrasound (QUS) bone densitometry. In total, 371 panoramic images were included in the analysis. The mandibular cortical width (MCW), mandibular cortical index (MCI), and panoramic mandibular index (PMI) were the three parameters assessed. The data were examined using one-way analysis of variance or Kruskal–Wallis H and post hoc tests. Spearman’s rho was used to measure correlation coefficients. T-score distributions in the normal, osteopenia, and osteoporosis categories were 80 (21.6%), 236 (63.6%), and 55 (14.8%), respectively. T-scores were significantly related to age, MCW, PMI, and MCI (p