Abstract
Dental implant surgery is a common treatment for missing teeth. Its survival rate is considerably affected by host bone quality and quantity, which is often assessed prior to surgery through dental cone-beam computed tomography (CBCT). Dental CBCT was used in this study to evaluate dental implant sites for (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness among four regions of the jawbone. In total, 315 dental implant sites (39 in the anterior mandible, 42 in the anterior maxilla, 107 in the posterior mandible, and 127 in the posterior maxilla) were identified in dental CBCT images from 128 patients. All CBCT images were loaded into Mimics 15.0 to measure cancellous bone density (unit: grayscale value (GV) and cortical bone thickness (unit: mm)). Differences among the four regions of the jawbone were evaluated using one-way analysis of variance and Scheffe’s posttest. Pearson coefficients for correlations between cancellous bone density and cortical bone thickness were also calculated for the four jawbone regions. The results revealed that the mean cancellous bone density was highest in the anterior mandible (722 ± 227 GV), followed by the anterior maxilla (542 ± 208 GV), posterior mandible (535 ± 206 GV), and posterior maxilla (388 ± 206 GV). Cortical bone thickness was highest in the posterior mandible (1.15 ± 0.42 mm), followed by the anterior mandible (1.01 ± 0.32 mm), anterior maxilla (0.89 ± 0.26 mm), and posterior maxilla (0.72 ± 0.19 mm). In the whole jawbone, a weak correlation (r = 0.133, p = 0.041) was detected between cancellous bone density and cortical bone thickness. Furthermore, except for the anterior maxilla (r = 0.306, p = 0.048), no correlation between the two bone parameters was observed (all p > 0.05). Cancellous bone density and cortical bone thickness varies by implant site in the four regions of the jawbone. The cortical and cancellous bone of a jawbone dental implant site should be evaluated individually before surgery.
Highlights
Dental implant surgery is a common treatment for missing teeth [1,2]
Parsa et al [40] compared dental cone-beam computed tomography (CT) (CBCT) with CT and micro-CT for measuring bone tissue, and the results indicated that the grayscale value (GV) obtained in dental CBCT was highly correlated with the Hounsfield units (HU) and bone volume fraction obtained in CT and micro-CT, respectively
The different dental CBCT models and scanning parameters and the inclusion of patients of a different ethnicity might have contributed to differences in cancellous bone densities between this study and preceding studies [10]. The results of this and preceding studies demonstrate that cancellous bone density at dental implant sites in jawbones descended in the following order: anterior mandible, anterior maxilla, posterior mandible, and posterior maxilla
Summary
Dental implant surgery is a common treatment for missing teeth [1,2]. Its survival rate is closely related to osseointegration ability in patients. Song et al [21] reported that cortical bone thickness measured using dental CBCT at implant sites was highly correlated with the initial stability of dental implants. Studies on cancellous bone density, cortical bone thickness, and the success rate of dental implant surgery have indicated that jawbone condition is highly correlated with the survival rate of dental implant surgery. In 2017, Ko et al [23] analyzed the cortical bone thickness of 661 dental implant sites in 173 patients by using dental CBCT and reported the following rankings (in descending order) for cortical bone thickness in different regions: posterior mandible, anterior mandible, anterior maxilla, and posterior maxilla. Dental CBCT was employed in this study to identify (1) differences in and (2) correlations between cancellous bone density and cortical bone thickness at dental implant sites in different jawbone regions
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