Characteristic features of trabecular bone in edentulous maxillae

Abstract

Following tooth loss, the maxillary alveolar ridge is affected by extensive resorption and its cancellous bone substance undergoes intense remodeling processes. This is particularly important for endosseous implant surgery as the primary stability and thus the prognosis of endosseous implants depends on the cancellous bone density and structure of the alveolar ridge. To analyze the structure of alveolar trabecular bone, 156 sections were obtained from 52 edentulous maxillae (29 female, 23 male; mean age: 72.5 years) from the lateral incisor, first premolar, and first molar regions. The structural histomorphometric analysis was performed on cancellous bone of the section surfaces using semiautomatic image analysis. The following parameters were measured: trabecular bone volume, trabecular number, trabecular thickness, trabecular plate separation and trabecular interconnection. All examined parameters showed an extreme range of variation. A difference of more than 45% between the highest (= 51.93%) and the lowest (= 6.73%) trabecular bone volumes was found. Furthermore, the measurements showed that trabecular bone volume, thickness and number were distinctly lower in the molar region than in the incisal and premolar regions. Significant sex-specific differences were found in all investigated regions, female maxillae showing a smaller amount and a lower connectivity of cancellous bone than male maxillae.

MicroCT-based evaluation of the trabecular bone quality of different implant anchorage sites for masticatory rehabilitation of the maxilla

“…Only the region of the first molar assessed by Ulm et al (1999) presented a higher bone volume fraction compared with our 'posterior' results, which is presumably due to the inclusion of the maxillary tuberosity in the VOI in this study. Both, histology and microCT, represent standard techniques for bone quality evaluation.…”

“…Comparison of the results on maxillary trabecular bone quality with previous histological data ( Ulm et al, 1999) confirmed a decreasing quality from anterior to posterior regions, but the values of the present study were in general slightly higher (i.e., minor differences for bone volume fraction and more distinct differences for trabecular thickness, separation, and number). Only the region of the first molar assessed by Ulm et al (1999) presented a higher bone volume fraction compared with our 'posterior' results, which is presumably due to the inclusion of the maxillary tuberosity in the VOI in this study.…”

“…Any effect of sex on trabecular bone quality e as often shown in other studies (Ulm et al, 1999(Ulm et al, , 2009Nkenke et al, 2003;Bertl et al, 2014) e was not detected in any of the assessed regions. In general, a slightly higher quality among males was detected, but differences in mean values were insignificant.…”

“…Compared with previous studies on edentulous specimens (micro-CT (Kato et al, 2005) and histomorphometric (Nkenke et al, 2003) analyses), a slightly higher bone volume fraction associated with a higher trabecular thickness was detected for the zygomatic bone. Nkenke et al (2003) evaluated the trabecular bone quality of the zygomatic bone as poor when compared with the maxilla (Ulm et al, 1999) due to reduced trabecular connectivity. They assumed primary implant stability to be achieved mainly via multi-cortex stabilization (up to 4 times compared with 1 or 2 times for standard dental implants) (Nkenke et al, 2003).…”

Evaluation of changes in trabecular alveolar bone during growth using conventional panoramic radiographs

“…The alveolar bone is a skeletal part that is dependent on the presence of teeth and masticatory function, since, in the absence of teeth [2] or lack of mechanical stimulation transmitted by implant supported overdenture, it undergoes disuse atrophy [3]. Independently of the age, there is a great inter-individual variation in trabecular volume and interconnections, leading to variable trabecular bone patterns [4]. Variation in the trabecular bone microstructure is also sitedependent within individuals [5,6].…”