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

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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.

Original languageEnglish
Article number105302
Pages (from-to)1-9
Number of pages9
JournalArchives of Oral Biology
Volume133
Early online date3 Nov 2021
DOIs
Publication statusPublished - Jan 2022

Bibliographical note

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

Keywords

  • Bone Density
  • Bone quality
  • Cortical bone
  • Mandibular residual ridge
  • Mandibular resorption
  • Trabecular bone

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