Purpose: To evaluate the effect of the systemic osteoporosis on radiographic density of alveolar bone and cortical thickness of mandible. Materials and Methods: The bone mineral density values of lumbar and femur were measured by dual-energy X-ray absorptiometry and T scores of lumbar, femur were obtained respectively. Radiographic densities of alveolar bones and panorama mandibular index (PMI, represents as cortical thickness) were analysed statistically according to age and T score variables. Results: The radiographic density of alveolar bone of maxillary molar showed significant difference by age and femur T group. That of mandibular molar showed significant difference between femur T group. Panorama mandibular index showed significant difference between age groups. Conclusion: The radiographic density of alvealar bones was more dependent on age and femur T than lumbar T. Cortical thickness of mandible was correlated with increasing age.
Purpose: The purpose of this study was to analyze the quantity and quality of the mandibular anterior alveolar bone in terms of alveolar width, density, and total alveolar height (TAH) based on dental status, gender, and age. Additionally, this study aimed to quantitatively evaluate the available alveolar height for graft harvesting (AHGH) and examine its variability based on the aforementioned factors. Materials and Methods: This retrospective cone-beam computed tomographic study included a total of 100 subjects. On the basis of gender, dental status, and age, the scans were divided into 3 primary groups and 8 subgroups. The mandibular alveolar width and density were measured 5 mm mesial to the mental foramen bilaterally and at the midline. The TAH was measured at the midline, and the AHGH was measured as the midline distance between 5 mm apical to the root of the canines and 5 mm superior to the lower border. Results: The mandibular alveolar width was statistically similar between dentulous and edentulous patients (P>0.05). A significantly greater density was observed at the midline in edentulous patients (P<0.05). The TAH was significantly greater in edentulous male patients than in edentulous female patients (P<0.05). Dentulous and male patients had significantly greater AHGH than edentulous and female patients, respectively (P<0.05). Conclusion: Based on the data evaluated in this study, it can be concluded that the mandibular symphyseal area has adequate bone quality and quantity for bone graft harvesting for dental implant therapy.
Objective: The purpose of this study was to quantitatively evaluate the cortical bone densities of the maxillary and mandibular alveolar processes in adults with different vertical facial types using cone-beam computed tomography (CBCT) images. Methods: CBCT images (n = 142) of adult patients (20-45 years) were classified into hypodivergent, normodivergent, and hyperdivergent groups on the basis of linear and angular S-N/Go-Me measurements. The cortical bone densities (in Hounsfield units) at maxillary and mandibular interdental sites from the distal aspect of the canine to the mesial aspect of the second molar were measured on the images. Results: On the maxillary buccal side, female subjects in the hyperdivergent group showed significantly decreased bone density, while in the posterior region, male subjects in the hyperdivergent group displayed significantly decreased bone density when compared with corresponding subjects in the other groups (p<0.001). Furthermore, the subjects in the hyperdivergent group had significantly lower bone densities on the mandibular buccal side than hypodivergent subjects. The maxillary palatal bone density did not differ significantly among groups, but female subjects showed significantly denser palatal cortical bone. No significant difference in bone density was found between the palatal and buccal sides in the maxillary premolar region. Overall, the palatal cortical bone was denser anteriorly and buccal cortical bone was denser posteriorly. Conclusion: Adults with the hyperdivergent facial type tend to have less-dense buccal cortical bone in the maxillary and mandibular alveolar processes. Clinicians should be aware of the variability of cortical bone densities at mini-implant placement sites.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제37권6호
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pp.496-504
/
2011
Introduction: This study compared the alveolar bone density of the mandible according to gender, age and position using Cone-beam computed tomography (CT). Materials and Methods: The maxillofacial CT scan data was obtained from 60 Korean patients. In addition, the alveloar bone density of 5 males and 5 females with normal occlusion aged from 10 to 70 years was measured at the buccal cortical bone, cancellous bone and lingual cortical bone, as well as at the position of the incisors, canines, premolars and molars. Results: The age-specific mean bone density was highest in patients in their third decade. The buccal cortical bone of the molars showed the highest bone density. Males in their fifties and sixties had a higher bone density in the cancellous bone in the region of the premolars and the buccal cortical bone of the molars, respectively, than females but there was no significant difference between males and females in the other parts. The cancellous bone density was highest in those in their twenties and thirties, and tended to decline up to their seventh decade. Conclusion: These results revealed a significantly different bone density according to gender, age and position in the Korean population. In addition, it is possible to predict the bone density based on these results.
In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.
Purpose: To assess the possibility of using panoramic indices as an indicator of jaw osteoporosis. Methods: Mandibular cortical width (MCW), degree of mandibular alveolar bone resorption (ABR) and morphology of mandibular inferior cortex (MIC) on panoramic radiograph were used as panoramic indices. These panoramic indices were compared with bone mineral density (BMD) of lumbar (L1-L4) and femoral neck measured by dual energy X-ray absorptiometry. We also compared MCW and ABR of young men with those of postmenopausal women. Results : There was a significant correlation between ABR and BMD of lumbar and femoral neck. And also significant correlation between MIC and BMD of lumbar and femoral neck. ANOVA test of BMD of lumbar and femoral neck showed significant differences according to morphologic classification of inferior cortex. There was significant difference in MCW and ABR between young men and postmenopausal women. Conclusion: Our results suggested that ABR and MIC on panoramic radiograph could be reliable in screening of osteoporosis.
Objective: The aim of this retrospective study was to evaluate the pre- and postsurgical bone densities at alveolar and extra-alveolar sites following two-jaw orthognathic surgery. Methods: The sample consisted of 10 patients (mean age, 23.2 years; range, 18.0-27.8 years; 8 males, 2 females) who underwent two-jaw orthognathic surgery. A three-dimensional imaging program (Invivo 5) was used with multidetector computed tomography images taken pre- and postoperatively (obtained 32.3 ± 6.0 days before surgery and 5.8 ± 2.6 days after surgery, respectively) for the measurement of bone densities at the following sites: (1) alveolar bone in the maxilla and mandible, (2) extra-alveolar sites, such as the top of the head, menton (Me), condyle, and the fourth cervical vertebrae (C4). Results: When pre- and postsurgical bone densities were compared, an overall tendency of decrease in bone density was noted. Statistically significant reductions were observed in the densities of cancellous bone at several areas of the maxillary alveolar bone; cortical and cancellous bone in most areas of the mandibular alveolar bone; cortical bone in Me; and cancellous bone in C4. There was no statistically significant difference in bone density in relation to the depth of the alveolar bone. In a comparison of the bone densities between groups with and without genioplasty, there was almost no statistically significant difference. Conclusions: Accelerated tooth movement following orthognathic surgery may be confirmed with reduced bone density. In addition, this study could offer insights into bone metabolism changes following orthognathic surgery, providing direction for further investigations in this field.
To demonstrate possible influences of general bone density on the mandible, histomorphometric analysis was carried out in mandibles and iliac bones and the correlation of the two bone densities was tested. Comparison of bony density in women and men over 60 years in the mandible was carried out too. Quantitative computed tomography(QCT) was taken in cross-section of mandibles at the same site where histomorphometric analysis was peformed to evaluate the reliability of QCT. The analysis included 40 cadavers with no known diseases affecting the bones. The subjects consisted of 15 females and 25 males with a mean age of 60.3 years. Spearman correlation analysis and Wilcoxon rank sum test was performed. The results were as follows. 1. There was statistically no correlation between the mandible and iliac bone in the values of corrected cortical width(CCW), cortical porosity(POR) in cortex, and total bone volume(TBV), mean trabecular plate thickness(MTPT), mean trabecular plate density(MTPD), and mean trabecular plate separation(MTPS) in trabecular bone. 2. Comparison of women and men over 60 years, men had statistically higher bone density than women except fir POR of buccal and lingual cortex, and WTPD of alveolar trabeculae in mandible. 3. There was statistically significant correlation between TBV of trabecular bone and CT No., but not between POR and CT No. in mandible. According to the results above, there was no correlation between mandible and iliac bone density and between mandibular bony density and age. Further studies are required to support the results. A more noninvasive method to be able to measure the bone density of mandible should be developed and it is necessary to accumulate data on the normal values of bone density of mandible according to age and sex. Further study should be carried out about QCT to measure mandibular bony density using QCT.
Objectives : To compare jaw bone density of young adults (control group) and post-menopausal women(experimental group) in periapical and panoramic film. Materials and Methods : The bone mineral density values of lumbar and femur were measured by dual-energy X-ray absorptiometry(DEXA) and T scores of lumbar were obtained. T scores were classified into 3 group (T<-2.5, $-2.5{\leqq}T<-1$, $-1{\leqq}T$). Radiographic densities of alveolar bones were measured from interdental bones of premolar, molar areas in the maxilla and mandible and expressed into copper step wedge thickness by Scion $Image^{(R)}$ program. We considered these values of step wedge thickness as bone density of alveolar bone. Panorama mandibular index(PMI) was calculated by the method that the height of the inferior cortex of the mandible was divided by the height from the lower border of the mandible to the superior edge of the mental foramen. Bone density of alveolar bone and PMI were analysed statistically. Results : There were significant differences in bone mineral density of lumbar and femoral neck between control and experimental groups. There were also significant differences in bone density of premolar and molar area of jaw between control and experimental groups by MANOVA test. When considered lumbar T variables, there was only difference in interdental bone density of maxillary molar area between control and experimental group, but there was interaction. Interdental bone density of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. There was significant difference in PMI between control and experimental groups, but there was also inter action, thus, PMI of experimental group was appeared higher in $-1{\leqq}T$ group and lower in T<-2.5 group than control group. Conclusion : There were significant differences of alveolar density and cortical bone thickness between young men and post-menopausal women in periapical and panoramic film. These differences were dependent on lumbar T.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제28권2호
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pp.95-102
/
2002
DM is a systemic disease with many complications. One of them, diabetic osteopenia is important sequelae and many authors reported reduced bone mass in diabetic rats. However, in mandible, study has been rare because of its anatomical limits. So the objective of this study was to investigate bony change in mandible of diabetic rats. Thirty-two adult rats were used in this study. Half of them were male and female respectively. In sixteen rats, streptozotocin was injected intraperitoneally to induce DM and the serum glucose concentration was checked to ensure the induction of DM prior to the time of sacrifice. At 1, 2, 3, 4, 6, 8, 12, 16weeks, control group and diabetic group rats were sacrificed respectively. And then bone mineral density of mandibles and femurs of the rats was measured using dual energy X-ray absorptiometry(DEXA). In addition serum osteocalcin and urine deoxypyridinoline were measured as markers of bone formation and resoption respectively. Mandibular and femoral bone density in streptozotocin induced rats was decreased with significance statistically after 4 weeks from injection. In mandible, comparing with femur, bone density was moderately decreased. The alveolar bone in mandible was more decreased bone density than the whole body in the mandible From these results, bone mineral density decreased in uncontrolled diabetic group with time, and especially alveolar bone was more destructive in the mandible. So authors think that consideration of reduced bone mineral density is necessary in dental procedure.
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