Penilaian kualitas kortikal mandibula pasien diabetes mellitus tipe 2 dengan analisis radiomorfometrik pada radiograf panoramik

Abstract

Objectives: This research aims to evaluate radiological finding on bone of patients with T2DM (type 2 Diabetes Mellitus) by evaluating mandibular cortical quality using radiomorphometric assessment specifically MCI (Mandibular Cortical Index) and AI (Antegonial Index). 
 Material and Methods: This research is a descriptive analytic cross-sectional study, populations and samples using secondary data radiographs of T2DM patients that have been proven by medical statement from a doctor and normal sample were selected according to specified criterias. 
 Results: It showed between group consisting of patients with T2DM and another one with normal patients, both have dominant result of MCI assessment type C2. While the result of Antegonial Index assessment there were a difference of cortical thickness between two groups. The average AI value from normal patients were 4,179 with standard deviation of 0.420, while another group with T2DM were 3,641 with standard deviation of 0.477. 
 Conclusion: Based on the results of the study, it was found that there has been a significance difference of cortical bone qualities between two groups of samples which can be seen from the result of Antegonial Index, a T2DM patients has average values lower than normal patients, while for the results of MCI assessment between two groups have similar types. 

Differences in Antegonial Index values in type II diabetes mellitus patients using panoramic radiography

“…7 The condition of hyperglycemia can increase the formation of advanced glycation end-products (AGEs), leading to various chronic complications, both macrovascular and microvascular, and resulting in decreased bone thickness. 8 This statement is supported by a study conducted by Putri et al (2020), which stated that patients with type II diabetes mellitus experience a decrease in bone thickness. 1 Type II diabetes mellitus is one of the disorders that can affect bone mineral density (BMD).…”

“…8 This statement is supported by a study conducted by Putri et al (2020), which stated that patients with type II diabetes mellitus experience a decrease in bone thickness. 1 Type II diabetes mellitus is one of the disorders that can affect bone mineral density (BMD). 9 Epsilawati et al (2018) stated that low insulin levels in the blood can disrupt the physiological process of bone remodeling.…”

“…Diabetes mellitus (DM) is a common medical condition that affects a significant number of people worldwide. 1 According to the International Diabetes Federation (IDF) in 2019, it was projected that the prevalence of diabetes mellitus worldwide would increase from 463 million people in 2019 to approximately 578 million people in 2030. Indonesia ranks seventh globally in terms of the number of people affected by diabetes mellitus, with a total of 10.7 million individuals.…”

“…5 The condition of hyperglycemia leads to a decrease in the body's calcium levels, resulting in a decline in the quality of bone tissue. 1 Poor glucose control in patients with type II diabetes mellitus can lead to the occurrence of hyperglycemia. 6 Poor glycemic control is more commonly observed in patients with type II diabetes mellitus who have been suffering for less than 5 years compared to those who have been suffering for more than 5 years.…”

“…Radiomorphometric measurements can be utilized to evaluate radiographic changes in the mandibular bone. 1,14,15 Mandibular cortical measurements, including mandibular cortical index (MCI), panoramic mandibular index (PMI), mental index (MI), gonial index (GI), and antegonial index (AI). 10,14 -16 One of the measurements using panoramic radiography that has been widely used and has been proven to have a strong correlation in assessing mandibular cortical thickness and observing signs of bone resorption is by using the measurement of the antegonial index angle.…”