Trabecular Alveolar Bone in the Human Mandible: a Dual-energy X-ray Absorptiometry Study

Objective: The purpose of this study was to evaluate the potential use of dual energy x-ray absorptiometry for the assessment of bone mineral content and bone mineral density before implant placement.

Materials And Methods: The material examined consisted of 63 mandibular bone specimens cut from 21 fresh cadavers (11 men; 10 women). Three specimens were cut per cadaver in the incisal, premolar, and molar regions. Three regions of interest (G, R1, and R2) were delineated. The global bone specimen (G) consisted of the whole specimen (ie, both cortical and trabecular bone). R1 and R2 were delineated in the trabecular bone of the alveolar process.

Results: In all subjects, the combined bone mineral content of the whole mandible specimens (global bone mineral content) was significantly correlated with age. The difference between the mean bone mineral densities of the male and female mandibles was found to be significant for G (P = .009). The mean bone mineral densities of dentate and edentulous specimens were also found to be significantly different for G and R1, respectively (P = .001 and P = .02), but not for R2. A positive correlation could be detected among the mean bone mineral density of G and R1, G and R2, and R1 and R2 of (1) male and female specimens, (2) dentate and edentulous specimens, and (3) incisal, premolar, and molar specimens.

Conclusions: The intra-alveolar trabecular bone of these 21 mandibles is affected by the same local and systemic influences as cortical bone, whereas the infra-alveolar trabecular bone is mostly sensitive to dental status. The cortical and trabecular bone of the 10 mandibles from women is more sensitive to systemic influences, whereas that from men is more sensitive to local influences. This is somewhat in agreement with some studies that found an association between osteoporosis and oral bone loss, which is a metric measure.