TY - JOUR
T1 - Regional differences in microarchitecture and mineralization of the atrophic edentulous mandible
T2 - A microcomputed tomography study
AU - Dekker, Hannah
AU - Schulten, Engelbert A.J.M.
AU - ten Bruggenkate, Christiaan M.
AU - Bloemena, Elisabeth
AU - van Ruijven, Leo J.
AU - Bravenboer, Nathalie
N1 - Funding Information: The authors thank Inez Lichters and the Department of Anatomy, Embryology and Physiology from the Amsterdam University Medical Centers, location AMC, for providing and preparing the anatomical specimens. Furthermore, the authors thank Jorieke Grooten for her valuable contribution to the study execution and Birgit Lissenberg-Witte for her input in the statistical analyses. Publisher Copyright: © 2021 The Authors
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Objective: The aim of the present study was to assess mineralization and trabecular microarchitecture in atrophic edentulous mandibles and to identify regional differences and relations with the extent of resorption. Methods: Cortical and trabecular bone volumes in anterior, premolar and molar regions of 10 edentulous cadaveric mandibles (5 males and 5 females; mean age ± SD: 85.4 ± 8.3 years) were assessed by microcomputed tomography. Mandibular height and Cawood & Howell classes were recorded. Concerning trabecular volumes, bone mineral density (BMD), bone volume fraction, trabecular tissue volume fraction, connectivity density, trabecular number, trabecular thickness, trabecular separation, degree of anisotropy, and structural model index were measured; concerning cortical volumes porosity, BMD and cortical thickness were measured. Results: In molar regions, the bone volume fraction and trabecular number were lower, whereas trabecular separation, degree of anisotropy and cortical BMD were higher compared to anterior regions. In premolar regions, mandibular height correlated negatively with trabecular number (Spearman's correlation r = 0.73, p = 0.017) and connectivity density (Spearman's correlation r = 0.82, p = 0.004), and correlated positively with trabecular separation (Spearman's correlation r = − 0.65, p = 0.04). Cortical BMD was higher at bucco-inferior cortex of molar and inferior border of premolar region and lower at anterior cranial buccal and lingual surface. Conclusions: In the premolar region, increased resorption coincides with local impairment of trabecular bone quality. Cortical bone BMD is higher in areas with highest strains and lower in areas with most mandibular resorption. Trabecular bone volume and quality is superior in the anterior region of the edentulous mandible, which might explain improved primary stability of dental implants in this region.
AB - Objective: The aim of the present study was to assess mineralization and trabecular microarchitecture in atrophic edentulous mandibles and to identify regional differences and relations with the extent of resorption. Methods: Cortical and trabecular bone volumes in anterior, premolar and molar regions of 10 edentulous cadaveric mandibles (5 males and 5 females; mean age ± SD: 85.4 ± 8.3 years) were assessed by microcomputed tomography. Mandibular height and Cawood & Howell classes were recorded. Concerning trabecular volumes, bone mineral density (BMD), bone volume fraction, trabecular tissue volume fraction, connectivity density, trabecular number, trabecular thickness, trabecular separation, degree of anisotropy, and structural model index were measured; concerning cortical volumes porosity, BMD and cortical thickness were measured. Results: In molar regions, the bone volume fraction and trabecular number were lower, whereas trabecular separation, degree of anisotropy and cortical BMD were higher compared to anterior regions. In premolar regions, mandibular height correlated negatively with trabecular number (Spearman's correlation r = 0.73, p = 0.017) and connectivity density (Spearman's correlation r = 0.82, p = 0.004), and correlated positively with trabecular separation (Spearman's correlation r = − 0.65, p = 0.04). Cortical BMD was higher at bucco-inferior cortex of molar and inferior border of premolar region and lower at anterior cranial buccal and lingual surface. Conclusions: In the premolar region, increased resorption coincides with local impairment of trabecular bone quality. Cortical bone BMD is higher in areas with highest strains and lower in areas with most mandibular resorption. Trabecular bone volume and quality is superior in the anterior region of the edentulous mandible, which might explain improved primary stability of dental implants in this region.
KW - Bone Density
KW - Bone quality
KW - Cortical bone
KW - Mandibular residual ridge
KW - Mandibular resorption
KW - Trabecular bone
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U2 - https://doi.org/10.1016/j.archoralbio.2021.105302
DO - https://doi.org/10.1016/j.archoralbio.2021.105302
M3 - Article
C2 - 34773733
SN - 0003-9969
VL - 133
SP - 1
EP - 9
JO - Archives of Oral Biology
JF - Archives of Oral Biology
M1 - 105302
ER -