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Relationship between Porotic Changes in Alveolar Bone and Spinal Osteoporosis

¹ Div. of Removable Prosthodontics,
² Div. of Anatomy and Cell Biology of the Hard Tissue,
³ Div. of Orthodontics, and
⁴ Div. of Reconstructive Surgery for Oral & Maxillofacial Region, Niigata University Graduate School of Medical and Dental Sciences, 5274, 2-Bancho, Gakkocho-dori, Niigata 951-8514, Japan

View larger version (115K): [in this window] [in a new window]   Figure 1. Steps involved in the analysis of alveolar trabecular bone. M1, M2, and M3 stand for the first, second, and third molars, respectively. (A) 3D image of the M2 region was reconstructed with micro-CT data. (B) The M2 was virtually removed on the image. The white outline represents the analyzed area. (C) Determining the region of interest (ROI): the sagittal plane passing through the mesial and distal M2 roots. Point I represents the highest point of the interradicular septum; points Mx and Dx represent the apex points of the mesial and distal roots of M2, respectively. The MxDx line served as the inferior border of the ROI. Mh and Dh represent the centers of the IMx and IDx, respectively. Two parallel lines, M and D, were perpendicularly drawn to MxDx through Mh and Dh, respectively. Finally, the ROI was established in the area between the M and D lines. (D) The M2 interseptal area was analyzed with 3D bone morphometry and 3D node-strut analysis. (E) The numbers of pores on the different alveolar socket walls were counted. Mesial wall, black line; lingual wall, dotted line; distal wall, white line; interseptal region, striped area. (F) Loss of alveolar crest height, defined as the distance between the top of the alveolar crest and the corresponding cementoenamel junction (CEJ) at the buccal area of the mandibular second molar (M2) region, was measured along the mesial root (mh) and distal root (dh), and then the average ({mh+dh}/2) was used as the final data in both groups. (G,H,I) Amano’s classification. Grade 0: no attrition on enamel, as shown in G. Grade 1: flat attrition on enamel. Grade 2: thread-like attrition on dentin. Grade 3: wide attrition on dentin, as seen in H. Grade 4: severe attrition without appearance of cusps and incisal edges, as shown in I. The degree of attrition of M2 was measured according to this classification.

View larger version (40K): [in this window] [in a new window]   Figure 2. Comparison between Sham and ovariectomized groups. (A) Serum estradiol concentrations at different time-points. Values are presented as means ± standard deviations (SDs) of 6 monkeys in each group. aSignificantly different from the baseline value of the same operational group (P < 0.05). bSignificantly different from the Sham value (P < 0.05). (B) Body weight at different time-points. Values are presented as means ± standard deviations (SDs) of 6 monkeys in each group. No significant differences were found between groups. (C) Changes in lumbar bone mineral density. aSignificantly different from the baseline bone mineral density of the same operational group (P < 0.05). bSignificantly different from the Sham value at the same time-point (P < 0.05). (D) % of baseline lumbar bone mineral densities which were calculated by the following equation: ({Final lumbar bone mineral density /baseline lumbar bone mineral density} X 100). The coefficient of variation of dual-energy x-ray absorptiometry measurement was less than 2%. bSignificantly different from the Sham value (P < 0.05). (E) Results of 3D morphometric analysis of the alveolar bone. Values are presented as means ± SDs of 6 monkeys in each group. No significant differences were found between groups. (F) Results of node-strut analysis of the alveolar bone. Values are presented as means ± SDs of 6 monkeys in each group. bSignificantly different from the Sham value (P < 0.05). (G) Results of trabecular architectural morphometry of the alveolar bone. Values are presented as means ± SDs of 6 monkeys in each group. bSignificantly different from the Sham value (P < 0.05). (H) Number of pores in the different walls of the alveolar socket. Significant difference was found between the Sham and the ovariectomized groups at the top of the interradicular septum. Values are presented as means ± SDs of 6 monkeys in each group. bSignificantly different from the Sham value (P < 0.05). (I) Loss of buccal alveolar crest height. Values are presented as means ± SDs of 6 monkeys in each group. No significant differences were found between groups. (J) Attrition degree according to Amano’s classification. Values are presented as means ± SDs of 6 monkeys in each group. No significant differences were found between groups.

View larger version (83K): [in this window] [in a new window]   Figure 3. Micro-CT findings of the M2 alveolar bone. The tooth was virtually removed on the images. (A) 2D sagittal view at the center of M2. The Sham group showed larger bone volume with less bone marrow space. By contrast, the ovariectomized group showed less bone volume and increased marrow space. (B) 2D frontal view at the center of M2. The Sham group displayed normal trabecular network structure; the ovariectomized group featured disconnected trabeculae. (C) 3D images of the M2 interradicular septum showing an abundance of rod-like trabeculae in the ovariectomized group, whereas those in the Sham group are principally plate-like. (D) Buccal view of the alveolar socket. The buccal wall was virtually removed on the images. Significantly more pores are visible in the alveolar socket at the top of the interradicular septum (arrow) in the ovariectomized group than in the Sham group.

View larger version (16K): [in this window] [in a new window]   Figure 4. Results of single-regression analysis. (A) Significant positive relationship between loss of buccal alveolar crest height and attrition. (B) Significant positive relationship between % of baseline bone mineral density and node number. (C) Significant negative correlation between % of baseline bone mineral density and pore count at the top of the interradicular septum. Individual data (Sham = 6, ovariectomized group = 6) and the correlation coefficient R shown in each plot.