Bone mineral density of cancellous bone in edentulous areas: quantitative CT measurement

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21 36 20171228 Chinese Journal of Tissue Engineering Research December 28, 2017 Vol.21, No.36 CT ( 646000 646000). CT [J].201721(36):5775-5780. DOI:10.3969/j.issn.2095-4344.2017.36.007 ORCID: 0000-0003-3392-435X() CT CT CT 1990 CT CBCT CT X CT CT CT CT CT mg/cm CT 646000 :R318 :A :2095-4344 (2017)36-05775-06 2017-09-16 CT CT CT CT 90 CT ()(mg/cm ) (P < 0.001) (P < 0.05)> >>(P < 0.05) CT CT CT (2017JY0111)(16PJ174) Bone mineral density of cancellous bone in edentulous areas: quantitative CT measurement Huang Ying, Zhang Hui, Cai Yue, Zeng Fan-gang, Guo Ling ( Department of Prosthodontics, Department of Radiology, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou 646000, Sichuan Province, China) Abstract BACKGROUND: The bone mineral density (BMD) in unit volume can be accurately measured with the theory of quantitative CT. After tooth loss, bone resorption certainly exists in the alveolar bone healing. Therefore, it is important to accurately evaluate the BMD of cancellous bone in the plantation area before implantation. OBJECTIVE: To evaluate the changes in BMD of alveolar cancellous bone after the loss of tooth, and explore whether the BMD shows the differences in different genders, ages and dental sites. Huang Ying, Studying for master s degree, Physician, Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou 646000, Sichuan Province, China Corresponding author: Guo Ling, M.D., Associate professor, Department of Prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou 646000, Sichuan Province, China ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 5775

. CT METHODS: Corrected voxel values were obtained from the cone-beam CT with the theory of quantitative CT. Ninety patients underwent cone-beam CT, and their BMD (mg/cm ) in dentulous areas and control areas (homonymous region of the same jaw) was obtained. RESULTS AND CONCLUSION: The BMD of alveolar cancellous bone reduced after the loss of tooth (P < 0.001). The BMD reduction of the edentulous cancellous bone, normal cancellous bone and the cancellous bone after tooth loss had no correlation with gender. The BMD reduction of the edentulous cancellous bone and the cance llous bone after tooth loss was not associated with age (P > 0.05), while the BMD of the control area decreased with increasing age (P < 0.05). The order of the BMD of cancellous bone was as follows: mandibular posterior region > mandibular anterior region > maxillary anterior region > maxillary posterior region. To conclude, quantitative CT is a available method for detecting the changes in the BMD of alveolar cancellous bone after tooth loss. Subject headings: Tissue Engineering; Bone Density; Mandible; Maxilla Funding: a grant from the Science and Technology Department of Sichuan Province, No. 2017JY0111; the Project of Sichuan Provincial Health and Family Planning Commission, No. 16PJ174 Cite this article: Huang Y, Zhang H, Cai Y, Zeng FG, Guo L. Bone mineral density of cancellous bone in edentulous areas: quantitative CT measurement. Zhongguo Zuzhi Gongcheng Yanjiu. 2017;21(36):5775-5780. 0 Introduction CT(cone-beam computed tomography CBCT) CT [1] CT CT [2-3] CT [3] CT(quantitative computed tomographyqct) XCT CT (region of interestroi) CT [4] CT(bone mineral densitybmd) X(dual-energy X-ray absorptiometry DXA) [5] CTCT 1Subjects and methods 1.1 1.2 20144201610 1.3 20144201610 CT 9041491977 5776 (45±13) 18/ 3 6 () 1.4 (K 2 HP 4 ) ()Naitoh [5] 050150250350450550650 750850 mg/cm 3 K 2 HP 4 15 ml 1.5 1.5.1 CT K 2 HP 4 CT(pax-uni3D CT89 kvp 8.0 ma360 8.0 cm 8.0 cm) DicomEz3D plus 1 mm2 mm 10 CT(1)10CT CT 1.5.2 CT DicomEz3D plus 4 1 CT(2) P.O. Box 10002, Shenyang 110180

. CT CT (3) CT CTCT1 2 CT 1.6 CT CT 1.7 SPSS 17.0 K 2 HP 4 CT CT (mg/cm 3 )x±s t () t () t () α=0.05 2Results 2.1 90 2.2 1 2.3 CTr =0.947 P < 0.05CT R =0.897 F =69.708P < 0.05 CTt t=1.953p < 0.05CT y=91.233+1.953x(4) CT(HU) (mg/cm 3 ) t r =0.889 P < 0.001 t P < 0.001 2.4 t ()(P > 0.05) ()(2) 2.5 () 3 () () (P > 0.05)3 () (P < 0.053) t (P < 0.05) 404160> 60 2.6 () 4 ()(P > 0.05) (P < 0.0014) t (P < 0.05) >>> 3Discussion [7] CT CT CT [8] CTX [9-10] CT [11-12] CT CT CT [13-14] CT X CTCTX [314] ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 5777

. CT A B 1 K HP CT Figure 1 The cone-beam CT values of the K HP body models CT 2 CT Figure 2 Cone-beam CT values of the proximal cancellous bone in the edentulous area A B CT A B 2 000 CBCT (HU) 1 500 1 000 500 3 CT Figure 3 Cone-beam CT values of the proximal cancellous bone in the control area A B CT 0 500 0 200 400 600 800 1 000 (mg/cm³) 4 CT(CBCT) Figure 4 Linear regression fitting of the liquid concentration and cone-beam CT values 1 Table 1 Basic information of the participants n 49 41 90 (x±s) 42±14 49±12 45±13 (x±smg/cm ) (x±smg/cm ) 352.89±86.11 296.26±92.75 320.64±80.62 385.49±77.24 363.81±76.56 379.52±73.27 2 ( ) (x ±smg/cm ) Table 2 Comparison of cancellous bone mineral density between the edentulous area and control area and their difference value of different sexes n () 49 352.89±86.11 385.49±77.24 73.61±15.43 41 296.26±92.75 363.81±76.56 46.34±16.75 (P > 0.05) 3 ( ) (x±smg/cm ) Table 3 Comparison of cancellous bone mineral density between the edentulous area and control area and their difference value at different ages () n () 40 29 307.60±75.86 406.77±64.98 69.87±19.48 4160 47 343.25±84.01 383.20±58.52 56.77±24.98 > 60 14 309.73±46.52 354.96±80.32 63.20±28.52 (P < 0.05) 4 ( ) (x±smg/cm ) Table 4 Comparison of cancellus bone mineral density between the edentulous area and control area and their difference value at different dental sites n () 15 295.24±50.04 348.58±77.45 73.61±35.43 28 280.55±63.15 328.17±72.68 46.34±29.75 13 250.97±74.11 366.87±97.00 55.87±32.23 34 379.56±73.73 450.83±89.83 71.26±52.68 (P < 0.05) 5778 P.O. Box 10002, Shenyang 110180

. CT X X [15-16] CT CTX CTCTCT(HU) (mg/cm 3 )CT CT [17-18] CT (Ca 5 OH(PO 4 )) (K 2 HP 4 ) [19] CT CT 3 70%80% [20-21] 1.2 mm4.4 mm [22] [23] [24-25] [26] 40 4060>60 3040 65 [27-28] 30%50% 2%3%30% 6580 50% () 60 CT >>> [29-30] Norton [31] 32139 Fanuscu [32] CT51529 HU 186389 HU CTCT Turkyilmaz [33] ( ) CT CNKI 3 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 5779

. CT () 3.0 4 References [1] Zhang DZ, Xiao WL, Zhou R, et al. Evaluation of bone height and bone mineral density using cone beam computed tomography after secondary bone graft in alveolar cleft. J Craniofac Surg. 2015;26(5):1463-1466. [2] Jeroen VD, Laura FPN, Yan H, et al. Accuracy and reliability of different cone beam computed tomography (CBCT) devices for structural analysis of alveolar bone in comparison with multislice CT and micro-ct. Eur J Oral Implantol. 2017; 10(1):95-105. [3],,.[J].,2013,14(1):47-50. [4] Andruch K, Płachta A. Evaluating maxilla bone quality through clinical investigation of voxel grey scale values from cone- -beam computed tomography for dental use. Adv Clin Exp Med. 2015;24(6):1071-1077. [5],,,.CT[J].,2004,8(18):3594-3595. [6] Naitoh M, Hirukawa A, Katsumata A, et al. Evaluation of voxel values in mandibular cancellous bone: relationship between cone-beam computed tomography and multislice helical computed tomography. Clin Oral Implants Res. 2009;20(5): 503-506. [7] Hao Y, Zhao W, Wang Y, et al. Assessments of jaw bone density at implant sitesusing 3D cone-beam computed tomography. Eur Rev Med Pharmacol Sci. 2014;18: 1398-1403. [8] Hohlweg-Majert B, Metzgerb MC, Kummerc T. Morphometric analysis-cone beam computed tomography to predict bone quality and quantity. J Craniomaxillofac Surg. 2011;39: 330-334. [9] Marquezan M, Souza MMG, Araújo MTS, et al. Is miniscrew primary stability influenced by bone density? Braz Oral Res. 2011;25(5):427-432. [10] Cha JY, Kil JK, Yoon TM, et al. Miniscrew stability evaluated with computerized tomography scanning. Am J Orthod Dentofacial Orthop. 2010;137(1):73-79. [11] Varshowsaz M, Goorang S, Ehsani S, et al. Comparison of tissue density in hounsfield units in computed tomography and cone beam computed tomography. J Dent. 2016;13(2): 108-115. [12] Chindasombatjaroen J, Kakimoto N, Shimamoto H, et al. Correlation between pixel values in a cone-beam computed tomographic scanner and the computed tomographic values in a multidetector row computed tomographic scanner. J Comput Assist Tomogr. 2011;35(5):662-665. [13] Pauwels R, Jacobs R, Singer SR, et al. CBCT-based bone quality assessment: are Hounsfield units applicable? Dentomaxillofac Radiol. 2014;44(1):46-51. [14] Nackaerts O, Maes F, Yan H, et al. Analysis of intensity variability in multislice and cone beam computed tomography. Clin Oral Implants Res. 2011;22:873-879. [15],,,.X(DXA) CT(QCT)[J].,2007, 26(5):504-507. [16],,,.QCTCADBMD [J].,2009,20(3):178-183. [17],. [J]., 2009,36(3):370-373. [18],,,.CT [J].,2012,33(4):234-239. [19] Mueller DK, Kutscherenko A, Bartel H, et al. Phantom-less QCT BMD system as screening tool for osteoporosis without additional radiation. Eur J Ratiol. 2011;79(3):375-381. [20] Lekovic V, kenney EB, Weinlaendar M, et al. A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases. J Periodontol. 1997;68(6):563-570. [21] Wheel SL, Vogel RE, Casellini R. Tissue preservation and maintenance of optimium aesthetics: a clinical report. Int J Oral MaxillofaImplant. 2000;15(2):265-271. [22].[J].,2012,39(2):211-213. [23]. [D].:,2010. [24],.[J]., 2011,21(1):55-58. [25] van Daatselaar AN, Dunn SM, Spoelder HJ, et al. Feasibility of local CT of dental tissues. Dentomaxillofac Radiol. 2003; 32:173-180. [26] Bhola M, Neely AL, kdhatkar S. Immediate implant placement : clinical decisions, advantages, and disadvantages. J Prosthodant. 2008;17(7):576-581. [27].[J].,2007,42(3):129-131. [28].CT[D].:,2010. [29] Azeredo F, DE Menezes LM, Enciso R, et al. Computed gray levels in multisliceand cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2013;14(4):147-155. [30],,,. [J].,2013,18(10):1-6. [31] Norton RM, Gamble C. Bone classification: an objective scale of bone density usig the computerized tomography scan. Clin Oral Implants Res. 2001;12(2):79-84. [32] Fanuscu MI, Chang TI. Three dimensional morphometric analysis of human cadaver bone: microstructural data from maxilla and mandible. Clin Oral Implants Res. 2004;15(2): 213-218. [33] Turkyilmaz I, Tumer C. Bone density assessments of oral implant sites using computerized tomography. Oral Rehabil. 2007;34:267-272. 5780 P.O. Box 10002, Shenyang 110180