Post-Extraction Remodeling of the Adult Mandible

Abstract

Following tooth loss, the mandible shows an extensive loss of bone in some individuals. This may pose a significant problem in the prosthodontic restoration of function and esthetics. The many factors which have been proposed as being responsible for the inter-individual variation in post-extraction remodeling mean that a perfunctory analysis of the literature, in which well-controlled, relevant studies are scarce, may not provide the whole story. This article reviews the local and systemic factors which may play a role in the post-extraction remodeling of the mandible. Since severe residual ridge resorption may occur even when the bone status in the rest of the skeleton is good and vice versa, it is concluded that local functional factors are of paramount significance. It is now essential to determine how they can be modified and applied to help maintain ridge height and quality in our aging, edentulous population.

Foramina of the anterior mandible in dentate and edentulous mandibles

“…The LLF are smaller than MLF, their diameters range from 0.6 ± 0.3 mm to 0.93 ± 0.31 mm [5,28] and their bony canals run upward [10]. After tooth loss, the alveolar bone is affected by a continuous bone resorption [8,12]. As a result, we examined separately the foramina in the alveolar process.…”

“…A non-serious endosseous bleeding may also occur after the injury of the rich intraosseous vascular plexus formed from the LF canals [25]. The surgeon intervening in the anterior mandible should be particularly cautious in cases of edentulism due to the completely different osseous morphology of the mandible [12] and its arterial pattern. The horizontal bone loss and the projection of mental tubercles lead to lingual inclination of edentulous mandible and thus the drilling angulation should be adapted [8].…”

The effect of mechanical loading on osteogenesis of human dental pulp stromal cells in a novel in vitro model

“…It has been general accepted that chewing movement and the force created are very important for the maintenance of the shape and strength of the supporting alveolar bone, while loss of tooth always causes alveolar bone resorption due to lack of proper mechanical stimulation (Barros et al 2007;Kingsmill 1999;Mavropoulos et al 2007). This atrophy remodeling leads to morphology change, function loss, dental implant failure, etc (Tolstunov 2006).…”

Atrophy of the residual alveolar ridge following tooth loss in an historical population

“…Consequently, atrophy of the alveolar bone is not attributable to prosthetic factors alone (Atwood, 1979). Anatomic conditions of the jaws, systemic factors such as sex and age, hormonal balance, local inflammations and masticatory habits are supposed to act as co-factors in the development of residual ridge resorption after tooth loss (Atwood, 1971;Gruber et al, 1993;Kingsmill, 1999).…”