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PubMed2006

[Bidirectional and unidirectional distraction of defects of the alveolar process comparative clinical study].

AIM: The purpose of the retrospective study was to compare bidirectional distraction osteogenesis with the currently used unidirectional method of alveolar ridge distraction with regard to bone height attained and complications. PATIENTS AND METHODS: Overall 21 patients were treated by distraction osteogenesis for localized defects of the alveolar ridge. Vertical augmentation of the mandible and maxilla was performed using 10 unidirectional (group A) and 12 bidirectional (group B) devices. The effect of therapy was evaluated by height of bone gain and observed complications. RESULTS: The average gain of vertical bone height was approximately 6 mm. No statistically significant differences occurred between the two treatment groups (p=0.09). For the entire study two complications were observed: beside breakage of a distractor device (unidirectional distraction) an infection during the retention time (bidirectional distraction) developed. CONCLUSIONS: It could be shown that osteodistraction is a potentially valuable therapy for the correction of alveolar defects. We observed complications in both groups. No statistical differences were noted in regard to gained bone height and complications between the two groups.

Adult↗
PubMed2005

Changes in the radiographic characteristics of the mandibular alveolar process in dentate women with varying bone mineral density: a 5-year prospective study.

The association between skeletal bone mineral density (BMD) and mandibular alveolar bone mass has been reported to be rather weak, probably due to local functional factors. Many new investigations are therefore focused on assessing the mandibular bone structure. No long-term structural alterations have been reported in human mandibular bone with the exception of alveolar crest changes related to periodontal disease. The aim of this prospective study was to investigate dentate women to see if possible alterations in the radiographic characteristics of the mandibular alveolar bone are related to changes in BMD. The BMD of 131 women (initial age 22-75 years) was determined in the distal forearm with dual energy X-ray absorptiometry on two occasions separated by an interval of 5 years. Mandibular alveolar bone mass (MABM) was assessed both by the optical density and by the grey-level value on digitized, calibrated, periapical radiographs. The radiographic alveolar bone structure was evaluated with a visual index [Lindh C, Petersson A, Rohlin M. Assessment of the trabecular pattern before endosseous implant treatment: diagnostic outcome of periapical radiography in the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:335-43. ] and digitally by the alveolar bone texture. MABM decreased significantly during the 5-year period. Changes in MABM, evaluated by the mean grey-level value of a bone segment between the premolars, were correlated to changes in skeletal BMD (r = 0.33, P < 0.001). Changes in MABM, evaluated by the optical density, did not correlate to changes in skeletal BMD. The overall trabecular pattern did not change during the study period, but small changes in the bone texture were measured. The changes in the bone texture were correlated with BMD change (r = 0.39, P < 0.001). We conclude that changes in the mandibular alveolar bone do reflect changes in the skeletal BMD, and these may be estimated on periapical radiographs by changes in their grey-level value and their texture.

Absorptiometry, Photon↗