Evaluation of Alveolar Bone Quality: Correlation Between Histomorphometric Analysis and Lekholm and Zarb Classification

Abstract

Objectives: This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry. Methods: Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation. Results: Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P 0.043). However, there was no difference in osteocyte counts between alveolar regions (P ¼ 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho ¼ 0.398; P ¼ 0.006) and in the male gender, a moderate negative correlation was observed (rho ¼ -0.650, P ¼ 0.016). Conclusions: Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the ''gold standard'' method for the evaluation of bone quality and greater bone density was observed in older men.

Bone quality effect on short implants in the edentulous mandible: a finite element study

“…In the study results, short implants in the posterior area had similar bone stress and low risk of overloaded bone as "All-On-4" in the high bone quality mandible. In practice, the bone quality of the mandible is usually acceptable [ 41 ], and the use of short implants at the posterior is an alternative. Six or more implants give more options for restoration, such as segmented prostheses.…”

“…In the study models with poorer bone quality, posterior areas showed a higher trend of bone resorption around short implants. The quality of maxillae, especially the posterior, is often unsatisfactory [ 41 ], which gives a warning for the use of short implants. Also, some clinical studies showed that short implants had a higher failure rate in the maxilla than in the mandible [ 43 , 44 ].…”

Although Anatomically Micrometers Apart: Human Periodontal Ligament Cells Are Slightly More Active in Bone Remodeling Than Alveolar Bone Derived Cells

“…In the present study, 6 pairs of samples (the extracted tooth and alveolar bone) were obtained from the lower jaw and only one sample originated from the upper jaw ( Table 2 ). It is also widely known that the bone density between the upper and lower jaw is markedly different, with the upper jaw being less dense and strong, but more vascularized than the lower jaw ( Oliveira et al, 2021 ). These aspects might be important in bone remodeling research and could be elucidated in future studies.…”

A Systematic Analysis of the Available Human Clinical Studies of Dental Implant Failure in Patients with Inflammatory Bowel Disease

“…In the study of van Steenberghe and coworkers [ 15 ], patients received standard (pretapping the bone) and Mark II (self-tapping screw shaped implants, Nobel Biocare). Before implant insertion, a minimum bone height of 7 mm was required; each patient was classified according to the jaw bone resorption and bone quality of Lekholm and Zarb [ 20 ] quantified on CT scans. The total cohort of this study consisted of 399 patients, who received 1263 implants, from which, 27 implants were lost between 1- and 6-months post-insertion.…”