The aim of this study was to identify and evaluate the changes of oral health and panoramic radiograph indexes in cancer patients that have been administered antiresorptive drugs.

Subjects who had a diagnosis of cancer with bone metastasis that were about to start antiresorptive therapy with denosumab or zoledronic acid were included. A preliminary dental clinical assessment, together with a panoramic radiograph, was performed at T0 to prevent the onset of Medication related osteonecrosis of the jaw (MRONJ) and T1 (1 year follow up). In order to calculate at both T0 and T1 the mandibular cortical width (MCW), the panoramic mandibular index (PMI), and the mandibular cortical index (MCI), panoramic radiographs were analyzed by a single operator.

Thirty-three subjects with a mean age of 59.9 years were included in the study. A significant reduction in the PMI value from T0 to T1 (p = 0.00236) and a significant variation from T0 to T1 for MCI (p < 0.05) were observed.

Radiomorphometric indices could represent a promising field of research that can take advantage from the easy detectability in dental panoramic radiographs. Further research is needed to explore the possible role of PMI and MCI in bone cancer patients.