Regional differences in microarchitecture and mineralization of the atrophic edentulous mandible: A microcomputed tomography study

Hannah Dekker; Engelbert A J M Schulten; Christiaan M Ten Bruggenkate; Elisabeth Bloemena; Leo J van Ruijven; Nathalie Bravenboer

doi:10.1016/j.archoralbio.2021.105302

Regional differences in microarchitecture and mineralization of the atrophic edentulous mandible: A microcomputed tomography study

Arch Oral Biol. 2022 Jan:133:105302. doi: 10.1016/j.archoralbio.2021.105302. Epub 2021 Nov 3.

Authors

Hannah Dekker¹, Engelbert A J M Schulten², Christiaan M Ten Bruggenkate³, Elisabeth Bloemena², Leo J van Ruijven⁴, Nathalie Bravenboer⁵

Affiliations

¹ Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: ha.dekker@amsterdamumc.nl.
² Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
³ Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Alrijne Hospital, Leiderdorp, The Netherlands.
⁴ Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
⁵ Department of Clinical Chemistry, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

PMID: 34773733
DOI: 10.1016/j.archoralbio.2021.105302

Abstract

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.

Keywords: Bone Density; Bone quality; Cortical bone; Mandibular residual ridge; Mandibular resorption; Trabecular bone.

MeSH terms

Bicuspid / diagnostic imaging
Bone Density*
Female
Humans
Male
Mandible* / diagnostic imaging
Molar / diagnostic imaging
X-Ray Microtomography