Alveolar Bone Density Research Articles

Prevention of osteoradionecrosis of the jaws by low-intensity ultrasound in the dog model

The prevention of osteoradionecrosis of the jaws (ORNJ) is very important because of the current absence of effective therapies for this disease. The aim of this study was to determine whether low-intensity ultrasound has a preventive effect on ORNJ. Sixty healthy adult dogs were divided randomly into three groups: group A (radiotherapy alone), group B (radiotherapy followed by low-intensity ultrasound treatment), and a control group. The development of ORNJ was assessed and the rate of occurrence of ORNJ was compared between groups A and B. Micro-computed tomography, haematoxylin–eosin staining, and immunofluorescence were used to evaluate the microstructure of the mandible and changes in microvascular density in all groups. All animals in group A and group B (ultrasound applied for 30 days) developed ORNJ. Alveolar bone density was 609.48±53.77HU in group A and 829.65±81.46HU in group B (P=0.008). The trabecular bone volume fraction, bone surface area/bone volume ratio, trabecular thickness, and trabecular number were all lower in group A than in group B (P=0.037, P=0.022, P=0.017, and P=0.034, respectively). Haematoxylin–eosin staining showed that the Haversian canals in the osteons had expanded significantly in group A, with collagen fibres losing their circular orientation; group B tended to show typical osteons. The microvascular density in group A was decreased. In conclusion, the use of low-intensity ultrasound in the dog appears not to prevent the incidence of ORNJ, however it does somewhat improve vascularity and bone quality at the microscopic level, which contribute to ORNJ healing.

Changes in alveolar bone density around immediate functionally and nonfunctionally loaded implants

Statement of problemFew studies compare the radiographic changes in bone density associated with immediate implant loading protocols. PurposeThe purpose of this longitudinal study was to quantitatively assess radiographic changes in alveolar bone density around immediate functionally and nonfunctionally loaded implants. Material and methodsA prospective longitudinal study was conducted in which 20 participants with partially edentulous mandibles received implants that were immediately loaded either functionally (IFL) or nonfunctionally (INFL). Standardized intraoral periapical radiographs were made at baseline, 3, and 6 months. These were digitized and analyzed using the histogram tool of the GNU Image Modulation Program for changes in alveolar bone density at crestal and lateral apical levels around the implant. ResultsAn increase in the mean lateral apical pixel grayscale values of 4.68 ±0.80 at 3 months and 4.15 ±0.29 at 6 months was observed with IFL, while INFL demonstrated an increase of 5.66 ±0.53 at 3 months and 6.07 ±0.59 at 6 months. A decrease in the mean crestal pixel grayscale values of -24.40 ±7.41 with IFL and -16.86 ±5.14 with INFL was found from baseline to 3 months. ConclusionsOn the basis of this longitudinal study, it was concluded that immediate loading stimulated alveolar bone formation at 6 months after implant placement. The immediate functional loading of implants resulted in a significantly greater degree of bone demineralization at the alveolar crest from implant placement up to 3 months compared with immediate nonfunctional loading.

The Measurements of Maxillary Alveolar Bone Density at 13 - 15 Years Age by Using Spiral Computerized Tomography

Bone density is a major factor that affect mini implant primarily stability; no Iraqi studies have evaluated bone density related to mini-implant placement for orthodontic anchorage at age 13 -15 years. The present research aims to evaluate gender, side and site differences in the bone density at various orthodontic implant sites for the maxillary alveolar bone. Materials and methods: Twenty nine individuals (16 males and 13 females) had subjected to clinical examination, then 64-multislice computed tomography scan data were evaluated and bone density was measured in Hounsfield unit at 21 points (9 points for each side and 3 points between the right and left central incisors) . Results: The results obtained showed that there are no significant differences in bone density between males and females and between the left and right sides were found. There was no significant differences in bone density between the maxillary buccal cortical bone and the palatal cortical bone were generally except that at lateral incisor and canine point where the palatal side had higher bone density than buccal side. The mean bone density of the cancellous bone in the anterior part was higher than that in the posterior of the maxilla. Conclusions: When orthodontic, mini implant are indicated, no gender and side difference affect the success rate regarding bone density. Keyword: Bone density, mini-implant, computerized tomography. (J Bagh Coll Dentistry 2016; 28(2):103-107).

Methods for alveolar bone density assessment and its value for long-term prosthetic functioning

Methods for alveolar bone density assessment and its value for long-term prosthetic functioning

Clinical and radiographic evaluation of implant-supported removable partial overdenture in the lower Kennedy class IV cases

Introduction The objective of the present study was to evaluate the effect of implant-supported partial overdenture design in restoring mandibular long class IV Kennedy's classification on the supporting structure, both clinically and radiographically. Materials and methods Ten partially edentulous patients with lower six anterior teeth missing were selected. Their ages ranged from 40 to 50 years. Each patient received two dental implants placed in the lower edentulous span at the canine area bilaterally. Ball-and-socket attachment (polycarbonate housing with rubber O-ring) was used between the implant and the overlay removable partial denture for retention. Periodic evaluation was carried out for every patient before denture insertion and then after 3, 6, and 9 months. As regards the clinical evaluation, the probing depth, gingival level, and attachment level around the implants were recorded. The radiographic evaluation included the use of specially developed software for measuring the alveolar bone density in gray scales and the bone height in pixels for the implants and the residual alveolar ridges. Results All implants were highly successfully osseointegrated at the end of this study. There was a statistically nonsignificant increase in the clinical parameters (probing depth, gingival level, and attachment level) around the dental implants throughout the 9-month follow-up period after denture insertion. Radiographically, there was a nonsignificant increase in bone loss, but a significant increase in bone density around the dental implants and the alveolar ridge throughout the follow-up period. Conclusion From the previous results, it was found that the concept of immediate loaded dental implant was efficient to be used successfully in the mandibular long Kennedy class IV to retain the partial overdenture.

Bone Density Level Difference between Maxillary and Mandibular 2nd Premolar and 1st Molar in Iraqi Adults with Class I Occlusion

Background: Development of techniques that could adequately provide anchorage in moving individual tooth or groups of teeth in desired direction is one of the major concerns of orthodontic. Mini-implants provide reliable stable anchorage. The aim of this study was to compare of the bone density between two points within alveolar bone to decide which one was more reliable for insertion of mini-implant. Materials and method: Computed tomographic images were obtained for 70 patients (24 males and 46 females) with an age range 18- 30 years. Bone density of buccal cortical and cancellous bones was measured between 2nd premolar and 1st molar at two preselected level (points 3 and 6 mm) from the alveolar crest in both maxilla and mandible. Results: According to independent t-test, the bone density at point 6 mm was higher than that at point 3 mm with a statistically significant difference between them in both maxilla and mandible except in maxillary cancellous bone which shows a non-significant difference. Conclusions: It was concluded that the alveolar bone density increased from the alveolar bone crest toward the basal bone. Point 6 mm is more recommended in the upper jaw, while in the lower jaw, point 3 mm is more recommended.

Interdental alveolar bone density in bruxers, mild bruxers, and non-bruxers affected by orthodontia and impaction as influencing factors.

Aim: To assess the interdental alveolar bone density within specific regions of interest in the mandible of bruxers, mild bruxers and non-bruxers in absence or presence of influencing factors, such as orthodontia and impaction. Materials and methods: The study consisted of 104 subjects (64 bruxers and 40 controls) from the female students in the Faculty of Dentistry. Students were classified into bruxers, non-bruxers, and mild bruxers. The presence of modifying factors, such as impacted mandibular third molars and/or current or recent orthodontic treatment were identified. Panoramic radiographs were obtained, and the mean bone density values of interdental alveolar bone were measured using ImageJ software. Results: Non-bruxers had the highest mean bone density in all measured regions. The mesial aspect of the second premolar was an area of higher mean bone density in bruxers and in mild bruxers, compared to non-bruxers. In the presence of orthodontic treatment, the mean bone density in non-bruxers surpassed that of bruxers and mild bruxers. Conclusion: Bruxism, whether mild or severe decreased the interdental mean bone density in the studied regions of interest. The presence of influencing factors affected the interdental mean bone density.

Post-Treatment Radiographic and Clinical Evaluation of Matched-Taper Single-Cone versus Warm Vertical Compaction Technique: a One-Year Follow up Study

Objectives: This study evaluated the long-term post-treatment response of two root canal filling techniques. Materials and Methods: Thirty-two mandibular first molars in patients diagnosed with pulp-periapical pathosis were instrumented and filled with either: (1) Matched-taper single- cone technique using Pro Taper gutta-percha or (2) Warm vertical compaction technique with gutta-percha. AH Plus sealer was used in both groups. Periradicular alveolar bone density of the preoperative radiographs was compared to one-year postoperative recall radiographs using digital x-ray software. One-year postoperative subjective and objective pain assessments were evaluated and pain index was formulated. Results: Matched-taper single-cone technique showed a higher change in bone density (-1.67) than the warm vertical compaction technique (+0.99), a difference that was statistically non- significant. Gutta-percha warm vertical compaction exhibited less pain index than the matched- taper single-cone technique. Conclusion: Radiographically, both techniques had similar changes in periradicular bone density. Most of the recorded teeth with pain had periodontal problems or absence of permanent restorations.

Corticision: A Flapless Procedure to Accelerate Tooth Movement.

Orthodontic tooth movement results from applied forces to the teeth evoking cellular responses in the teeth and their surrounding tissues, including the periodontal ligament, alveolar bone and gingiva. It is advantageous for the orthodontist to be well informed of the detailed process of the biological events that unfold during tooth movement, since some of these details may differ from one person to another due to biological differences such as periodontal metabolism or alveolar bone density. This led us to emphasize that orthodontics is a field of endeavor where the integration of mechanics and biology is materialized, and to affirm the fact that tooth movement is conducted in individual human beings, each composed of a unique and intricate physiological system. Biological variations may be the foundation of the differences that are frequently observed in the outcomes of orthodontic treatment in particular with reference to treatment duration between patients with similar malocclusions and who were treated identically. A wide diversity of clinical trials has been carried out to control the tissue resistance to facilitate orthodontic tooth movement, which involves biomechanical, pharmaceutical, surgical, electrical regimens or tissue engineering technology. The term 'Corticision' is a neologism which indicates 'cortical bone incision'. It is a minimally invasive periodontal procedure without flap elevation, thus accelerating tooth movement with an enhanced turnover rate of the surrounding structures. This chapter introduces the technical procedure, and the biological background of how such a minor surgical procedure can receive the accelerated tooth movement with impunity and thereby shorten the duration of treatment.

Comparison of the effects of micro-osteoperforation and corticision on the rate of orthodontic tooth movement in rats.

To investigate the effects of flapless micro-osteoperforation and corticision on the rate of orthodontic tooth movement in rats. Forty-five 8-week-old male Sprague-Dawley rats were divided into the following groups: micro-osteoperforation and orthodontic force (MOP + F), corticision and orthodontic force (C + F), and orthodontic force only (F, control). The left maxillary first molars were pulled forward with a force of 50 g. Flapless surgical interventions were conducted in the MOP + F and C + F groups. The total duration of the experiment was 6 weeks. Alveolar bone density and the number of osteoclasts were evaluated using microcomputed tomography and histologic examination, respectively. The tooth movement distance was significantly higher in both experimental groups than in the control group. Bone density and bone mineral density decreased in the MOP + F and C + F groups. The number of osteoclasts in the MOP + F and C + F groups was significantly higher than in the control group F. The two minimally invasive flapless surgical interventions increased bone remodeling and osteoclast activity and induced faster orthodontic tooth movement for at least 2 weeks in rats. No differences were observed between the outcome of flapless micro-osteoperforation and corticision in the rats.

Residents' journal review

Residents' journal review

Influence of Vitamin D & Calcium Supplementation in the Management of Periodontitis.

It has long been recognized that vitamin D is a hormone and were many studies reporting that patients in periodontal maintenance programs taking vitamin D and calcium supplementation had a trend for better periodontal health compared to patients not taking supplementation. To evaluate the effect of vitamin D and calcium supplementation in reducing gingival inflammation, using clinical parameters like gingival index (GI), oral hygiene index-simplified (OHIS), probing pocket depth (PPD), clinical attachment level (CAL) and bone density (BD). Also, to assess whether calcium and vitamin D oral supplementation influences alveolar Bone Density (BD). A nonrandomised clinical trial done in Amrita School of dentistry, Kochi, India. Group A taking vitamin D (250IU/day) and calcium (500 mg/day) supplementation, and Group B were not taking oral supplementation. All subjects had at least one or more teeth with chronic moderate periodontitis. Digital Orthopantomogram images were taken to assess bone density. Data were collected at baseline and three months. OHI-S, GI, PPD, CAL, and Bone Densities (BD) were calculated per group. Karl Pearson Coefficient of correlation was used to test correlation of bone density with GI and OHI -S. Intergroup comparison of parameters were done using Independent two Sample t-test. Intragroup comparison of parameters at recall interval was done using Paired sample t-test. The results were considered statistically significant when p-value was <0.05. Both Groups showed significant change in the periodontal parameters and bone density after three months and intragroup comparison showed highly significant results for vitamin D group in relation to GI, OHI S and bone density. Calcium and vitamin D supplementation has got a positive effect on periodontal health and it can be used as an adjunct to non surgical periodontal therapy.

Dietary boron does not affect tooth strength, micro-hardness, and density, but affects tooth mineral composition and alveolar bone mineral density in rabbits fed a high-energy diet

The objective of this study was to determine whether dietary boron (B) affects the strength, density and mineral composition of teeth and mineral density of alveolar bone in rabbits with apparent obesity induced by a high-energy diet. Sixty female, 8-month-old, New Zealand rabbits were randomly assigned for 7 months into five groups as follows: (1) control 1, fed alfalfa hay only (5.91MJ/kg and 57.5mgB/kg); (2) control 2, high energy diet (11.76MJ and 3.88mgB/kg); (3) B10, high energy diet+10mgB gavage/kg body weight/96h; (4) B30, high energy diet+30mgB gavage/kg body weight/96h; (5) B50, high energy diet+50mgB gavage/kg body weight/96h. Maxillary incisor teeth of the rabbits were evaluated for compression strength, mineral composition, and micro-hardness. Enamel, dentin, cementum and pulp tissue were examined histologically. Mineral densities of the incisor teeth and surrounding alveolar bone were determined by using micro-CT. When compared to controls, the different boron treatments did not significantly affect compression strength, and micro-hardness of the teeth, although the B content of teeth increased in a dose-dependent manner. Compared to control 1, B50 teeth had decreased phosphorus (P) concentrations. Histological examination revealed that teeth structure (shape and thickness of the enamel, dentin, cementum and pulp) was similar in the B-treated and control rabbits. Micro CT evaluation revealed greater alveolar bone mineral density in B10 and B30 groups than in controls. Alveolar bone density of the B50 group was not different than the controls. Although the B treatments did not affect teeth structure, strength, mineral density and micro-hardness, increasing B intake altered the mineral composition of teeth, and, in moderate amounts, had beneficial effects on surrounding alveolar bone.

The influence of low-level laser on orthodontic relapse in rats.

This study evaluated the effect of low-level laser therapy (LLLT) on the tendency of rat molars to relapse following orthodontic tooth movement (OTM). Maxillary rat molars were moved mesially for 10 days. Animals were randomly assigned to group I (non-irradiated) or II (irradiation with LLLT). Appliances were removed, and the molars allowed to relapse for 1, 3, 5, 7, 14, or 21 days; rats in group II received LLLT according to a protocol. Bone density of periapical alveolar bone was measured using radiographs and Digora software. Dental supporting structures were examined histologically with haematoxylin and eosin and tartrate-resistant acid phosphatase. In both groups, first molar relapse was rapid 1 day after the end of active treatment; by 21 days percentage relapse was measured as 86.11 per cent in group I, and 72.22 per cent in group II. Osteoclast number was highest at the end of active OTM, and thereafter successively decreased during the relapse phase in both groups. Decrease in number, and redistribution of osteoclasts occurred more rapidly in the non-irradiated than the LLLT group. Whilst molar relapse was generally less and osteoclast numbers generally higher in group II compared to group I, the differences were not significant. There was no significant difference in bone density between the two groups. These results indicate that LLLT may reduce the relapse tendency, possibly due in part to bone formation in previous tension areas, and to redistribution of osteoclasts following removal of orthodontic force. The role of LLLT in the prevention of orthodontic relapse requires further study.

Analysis of correlation between initial alveolar bone density and apical root resorption after 12 months of orthodontic treatment without extraction.

OBJECTIVE: The aim of the present study was to investigate the correlation between initial alveolar bone density of upper central incisors (ABD-UI) and external apical root resorption (EARR) after 12 months of orthodontic movement in cases without extraction. METHODS: A total of 47 orthodontic patients 11 years old or older were submitted to periapical radiography of upper incisors prior to treatment (T1) and after 12 months of treatment (T2). ABD-UI and EARR were measured by means of densitometry. RESULTS: No statistically significant correlation was found between initial ABD-UI and EARR at T2 (r = 0.149; p = 0.157). CONCLUSION: Based on the present findings, alveolar density assessed through periapical radiography is not predictive of root resorption after 12 months of orthodontic treatment in cases without extraction.

Assessment of Mandibular Alveolar Bone Density in Osteoporotic Adults in Syria

Objectives: Many studies indicated that reduction of skeletal bone mineral density (BMD) may lead to loss of the mandibular alveolar bone mass (MABM). Since osteoporosis is characterized with low bone mineral density, it may affect both maxilla and mandible. This study aims to evaluate the correlation between mandibular alveolar bone density (MABD) and bone mineral density (BMD), and to assess the use of intra-oral periapical radiographs in osteoporosis detection. Methods: Participants were patients attending periodontal clinic, Dentistry School, Damascus University then referred to the bone density unit at Al-Mowassat teaching hospital in Damascus to receive DEXA. Dual X-ray absorptiometry (DEXA) was done on Lumbar spine vertebrae (L2-L4) and femoral neck for each participant. They were classified into three groups: osteoporotic, osteopenic and normal (control) subjects. A periapical radiograph was taken for each participant using a standardized paralleling technique with an aluminum step wedge. MABD was measured using computerized software (Digora) to calculate MABD. Results: the number of the participants was 169 individuals (age= 42± 5.3 years), they were assigned as follows (Osteopenic 57, Osteoporotic 52, control 60). A significant positive correlation between MABD and BMD was found in osteoporotic group (R = 0.527 & p < 0.01). Also there were significant differences of MABD between osteoporotic group versus both osteopenic and normal groups. Conclusions: Mandible can be affected by osteoporosis. Intra-oral periapical radiographs using aluminum step wedge is considered one of the important and useful techniques for the detection of osteoporosis

Effects of nonsurgical periodontal treatment on the alveolar bone density.

The aim of this study was to evaluate the effects of nonsurgical periodontal treatment on alveolar bone density (ABD) and bone height (BH) using direct digital radiography. Nineteen patients (mean age: 36 ± 7.3 years) with generalized chronic periodontitis were examined at baseline, 90 (90 AT) and 180 (180 AT) days after nonsurgical periodontal therapy. Radiographs were taken from two sites with specific characteristics: 39 sites with probing pocket depth (PPD) ≤ 3 mm and clinical attachment level (CAL) ≤ 1 mm (shallow sites); and 62 sites with PPD ≥ 5 mm and CAL ≥ 3 mm (deep sites). The ABD was assessed considering the bone regions of interest at the alveolar bone crest (ROI I) and at the medullar bone (ROI II). The BH was assessed considering the distance from the alveolar bone crest to the cementoenamel junction. Mann-Whitney test was used for the overall demographic data, Wilcoxon test was used to compare the baseline, 90 AT and 180 AT data as well as to compare the groups and subgroups within the same evaluation period. The significance level was set at 5%. The deep sites showed a significant increase of ABD in ROI I at 90 AT (p<0.007) and at 180 AT (p<0.005). ABD decrease was seen in ROI II at 180 AT (p<0.04) while BH reduced only in shallow sites at 90 AT. In conclusion, an increase in ABD was observed in deep sites of patients with generalized chronic periodontitis. However, no significant change in alveolar BH was observed in these sites.

Evaluation of Alveolar Bone Density at Furcation Sites Using Computer Tomography in Patients with Horizontal Bone Loss

Objectives: The aim of the current study was to evaluate quantitatively bone density in the maxillary and mandibular interradicular sites and to establish his determinants as assessed on computer tomography images. Methods: Sections of 0.5 mm thickness horizontal CT sections were selected to measure bone density of the interradicular and interdentally septum in CTs from 29 individuals (17 females, mean age 40.44 years). Results: There were statistically significant differences of mean value and of bone density at specific bone depth levels in the furcation area according to age, gender, tooth type and between the maxilla and mandible (P &lt; 0.05). The multiple linear regression analyses showed, for both mean furcation alveolar bone density value as well as particular values at different bone level as dependent variable, a strong association with gender, distance from the furcation roof to the alveolar bone septum, presence of restorative treatment of caries, presence of endodontic treatment and mean alveolar bone density of the mesial and distal alveolar septum (P &lt; 0.0001). Conclusions: Using the CT in periodontology has demonstrated to be a valid support to diagnose the changes in the alveolar bone, to monitor the treatment results with a higher precision and to point out possible error sources.

Evaluation of alveolar bone density by intraoral periapical radiography

Purpose: A method detecting change of jaw or alveolar bone density may be helpful in periodontal care, implant dentistry and evaluation of bone density of whole body. Materials and methods: In this study, bone density of intraoral periapical radiography using phantom-integrated XCP is compared with that of quantitative computed tomography (QCT). Results: Bone density of intraoral periapical radiography and the one measured by QCT showed high correlation (correlation coefficient = 0.92, P<.001) in alveolar bone, and relatively high correlation (0.73, P<.001) in cancellous bone. Conclusion: This study revealed possibility of scoring of bone density by intraoral periapical radiography. (J Korean Acad Prosthodont 2014;52:233-8)

Quantitative evaluation of alveolar cortical bone density in adults with different vertical facial types using cone-beam computed tomography

ObjectiveThe 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.MethodsCBCT 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.ResultsOn 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.ConclusionAdults 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.