PURPOSE: The purpose of this study was to investigate whether panoramic radiographs were useful in predicting osteoporosis. MATERIALS AND METHODS: 50 postmenoposal women between the age of 41.8 and 78.5 were classified as normal and osteoporosis groups according to the bone mineral density of lumbar vertebrae. Panoramic radiographs were taken. Age, body mass index, remaining mandibular teeth, mandibular cortical thickness and morphology, and fractal dimensions at periapical areas of mandibular first molars were evaluated to differentiate the two groups. RESULTS: The age of osteoporotic group was statistically significantly higher than that of normal group (p<0.05), but not the body mass index or number of remaining mandibular teeth. The mean fractal dimension of osteoporotic group was 1.391+/-0.085, and was significantly lower than that of the normal group, which was 1.523+/-0.725 (p<0.01). Thick mandibular cortical thickness was common in normal group, whereas thin or very thin mandibular cortical thickness was common in osteoporotic group and the difference was significant (p<0.05). C2 pattern was common in normal group followed by C1, whereas C2 was common in osteoporotic group followed by C3. The difference was statistically significant (p<0.01). CONCLUSION: Age, mandibular cortical thickness and shape, fractal dimension on panoramic radiographs were useful in predicting osteoporosis.