PURPOSE: This study was conducted to compare the radiomorphometric indices of the mandible on panoramic radiographs among three groups of normal, osteopenia and osteoporosis and to determine whether panoramic indices have validity in predicting osteoporotic risk. MATERIALS AND METHODS: Ninty-four postmenupausal women aged 42-72 years (mean 62+/-7.5) were examined using dual energy X-ray absorptionmetry (DEXA) of the lumbar and classified into three groups by WHO classification. Panoramic mandibular index (PMI), mandibular cortical thickness (Mental index (MI), Antegonial index (AI), Gonial index (GI) ) and the mandibular cortical index (MCI) were measured bilaterally on panoramic radiographs and analyzed. RESULTS: There were signigicant differences among normal, osteopenic and osteoporoti groups in PMI (I), PMI (S), MI, AI, GI and MCI. The sensitivities of the MCI (93%) and the combination index of MCI and MI (90%) in diagnosing osteopenic/osteoporotic cases were high. CONCLUSION: The widths and shapes of the mandibular cortical bone on panoramic radiography may highly reflect the systemic osteopenic/osteoporotic conditions of the patients.