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

doi:10.3969/j.issn.2095-4344.2017.36.007

Abstract

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.
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/cm3) 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.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Tissue Engineering, Bone Density, Mandible, Maxilla

CLC Number:

R318

Huang Ying1, Zhang Hui1, Cai Yue1, Zeng Fan-gang2, Guo Ling1. Bone mineral density of cancellous bone in edentulous areas: quantitative CT measurement[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(36): 5775-5780.

Figures/Tables 1

2.1 受试者数量分析纳入对象90例均进入结果分析。 2.2 受试者基线分析见表1。 2.3 缺牙区与对照区骨密度比较对各样本溶液浓度和对应的锥形束CT值进行直线相关分析，相关系数r =0.947，P < 0.05，认为样本溶液浓度与锥形束CT值之间存在线性相关关系。行回归分析直线模型拟合，决定系数R =0.897，表明拟合模型的意义较大。进一步对模型进行方差分析显示，F =69.708，P < 0.05，表明此模型有意义，即液体浓度对锥形束CT值是有影响的。回归系数t 检验结果： t=1.953，P < 0.05，即液体浓度与锥形束CT值之间存在直线关系，直线回归方程为y=91.233+1.953x(图4)，将患者缺牙区与对照区锥形束CT值(HU)代入以上直线回归方程，分别得到其对应的骨密度(mg/cm3)。将缺牙区与对照区骨密度进行配对样本t 检验，相关系数r =0.889，相关系数假设检验的P < 0.001，故缺牙区与对照区骨密度相关性有显著性意义。配对t 检验结果：P < 0.001，差异有显著性意义，可认为缺牙区与对照区松质骨骨密度有差异，即缺牙后缺牙区松质骨骨密度降低。 2.4 不同性别松质骨密度比较采用两独立样本t 检验分析法比较男女性缺牙区、对照区松质骨密度及骨密度差值(缺牙区-对照区)的差异，结果显示差异无显著性意义(P > 0.05)，提示不同性别间缺牙区、对照区松质骨密度及骨密度差值(缺牙区-对照区)无显著差异(表2)。 2.5 不同年龄段松质骨密度比较由于男女不同性别间缺牙区、对照区松质骨密度及骨密度差值(缺牙区-对照区)无显著性意义，故进行年龄分段时未对性别进行分组。将患者分为3个年龄阶段，并运用方差分析比较不同年龄段间缺牙区、对照区松质骨密度及骨密度差值(缺牙区-对照区)的差异。其中缺牙区骨密度和骨密度差值(缺牙区-对照区)差异无显著性意义(P > 0.05)，提示3个年龄段间缺牙区骨密度和骨密度差值(缺牙区-对照区)均无差异。而不同年龄段间对照区骨密度差异(P < 0.05；表3)。再将不同年龄组分别进行两样本t 检验显示差异有显著性意义(P < 0.05)，提示≤40岁组对照区骨密度最大，41-60岁组其次，> 60岁组对照区松质骨密度最小。 2.6 上下颌不同区域松质骨密度比较上下颌不同区域缺牙区、对照区松质骨密度及骨密度差值(缺牙区-对照区)的比较，将缺失牙位分为4个区域，分别是上颌前牙区、上颌后牙区、下颌前牙区及下颌后牙区，运用方差分析比较各区域之间的差异，其中缺牙区松质骨骨密度和骨密度差值(缺牙区-对照区)差异无显著性意义(P > 0.05)，提示上下颌骨不同区域缺牙区松质骨密度相差不大，上下颌骨不同区域缺牙区与对照区骨密度差值的差异也不明显。而颌骨不同区域对照区骨密度差异有显著性意义(P < 0.001，表4)，再分别进行t 检验两两比较差异均有显著性意义(P < 0.05)，可以认为对照区松质骨密度在颌骨不同区域存在显著差异，且下颌后牙区>下颌前牙区>上颌前牙区>上颌后牙区。"

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