EC Dental Science

Research Article Volume 22 Issue 12 - 2023

Assessment of Jaw Bone Density Using Cone Beam Computed Tomography for Dental Implant Treatment Planning

SK Khairur Rahman1, AKM Habibullah2*, Mahmudul Hasan3, Tamanna Khandker Tonny4, Wahidujjaman3, Salma Aktar5, Tamanna Sultana Ami6 and Md Rassell7

1Dental Surgeon, OSD, Directorate General of Health Services (DGHS), Dhaka, Bangladesh
2Medical Officer, Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
3Assistant Professor, Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
4Medical Officer, Department of Paediatic Dentistry, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
5Assistant Professor and Head, Department of Orthodontics, Holy Family Red Crescent Medical College, Dental Unit, Dhaka, Bangladesh
6Dental Surgeon, Private Practitioner, Dhaka, Bangladesh
7Associate Professor, Department of Surgical Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

*Corresponding Author: AKM Habibullah, Medical Officer, Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Email: dr.mithu.bsmmu@gmail.com
Received: November 08, 2023; Published: November 21, 2023



Background: Dental implants have become an important option in the treatment plan in dentistry. Implant success is related to bone quality as well as bone density. Bone quality and quantity are typically estimated from radiographs before implant site preparation. A good preoperative assessment of bone density can guide the clinician regarding the implant type and the surgical technique to be used. Cone beam computed tomography (CBCT) can provide an accurate three dimensional high resolution images as well as a direct measurement of bone density expressed in Hounsfield units (HU), a value that offers crucial information about the bone quality, which is a major concern for implant success.

Aim of the Study: To assess the bone density in terms of Hounsfield units of different region of upper and lower jaw by Cone beam computed tomography for dental implant treatment planning.

Materials and Methods: This Cross Sectional Study was conducted with 20 patients having one or more missing tooth, who were selected from the outdoor clinic of Department of Prosthodontics or Department of Oral and Maxillofacial Surgery, BSMMU, Dhaka, Bangladesh and planned for dental implant treatment. After the clinical examination, CBCT images of the maxilla and mandible was obtained by the same operator according to the standardized procedure. Bone density in terms of Hounsfield unit (HU) was measured from anterior and posterior region of both jaws. All the information was recorded in a specifically designed data entry sheet. Data were processed and analyzed by SPSS version 22 (Armonk, NY, USA). Descriptive statistics, independent sample t-test and ANOVA with Post Hoc Tukey were used to analyze and compare the data. P-value less than 0.05 (p < 0.05) was considered statistically significant. The summarized data was presented as mean, standard deviation, percentages and ratio on table and diagram.

Results: In this present study, differences in the bone densities of the four regions in the mouth were significant, with the anterior mandible yielding a higher mean bone density value (1615.65 ± 203.64), followed by posterior mandible (1434.15 ± 222.65), anterior maxilla (1421.00 ± 202.85), and the posterior maxilla (1265.05 ± 120.80). However, when considering all four regions in male and female participants, the mean bone density in female was (1494.84 ± 230.12 HU), which was higher than male (1393.37 ± 215.56 HU). The results of this study also indicated a strong correlation between the four regions of the jaw and the bone density. The mean bone density value from anterior and posterior regions of both jaws were higher than previously reported studies. In this present study, only D1 and D2 types of bone were found in the four different areas of jaws.

Conclusion: The study conclude that, the anterior mandible has the highest jaw bone density followed by posterior mandible, anterior maxilla, and the lowest jaw bone density in the posterior maxilla. It is suggested that a CBCT investigation can provide valuable information of bone density to the clinicians prior to installation of the dental implants.

 Keywords: Dental Implant; Maxilla; Mandible; Cone Beam Computed Tomography; Hounsfield Units; Bone Density; Bone Quality

  1. Alattar AN and Bede SYH. “Does mixed conventional/piezosurgery implant site preparation afect implant stability?” Journal of Craniofacial Surgery5 (5): e472-e475.
  2. Hsu YY., et al. “Insertion speed afects the initial stability of dental implants”. Journal of Medical and Biological Engineering4 (2022): 516-552.
  3. Dioguardi M., et al. “Guided dental implant surgery: systematic review”. Journal of Clinical Medicine4 (2023): 1490.
  4. Hartshorne J. “Essential guidelines for using cone beamcomputed tomography (CBCT) in implantdentistry”. Part 2: Clinical Considerations, International Dentistry – African Edition4 (2018): 40-68.
  5. Suprijanto J. “Image analysis for dental bone quality assessmentusing CBCT imaging”. Journal of Physics: Conference Series (2016): 1-6.
  6. Córdova-Limaylla NE., et al. “Evaluation of Buccal Bone Wall Thickness of Anterosuperior Teeth and Nasopalatine Duct Morphology in Cone Beam Computed Tomography of Patients Living at Different Altitudes: A Two-Year Retrospective Study”. Journal of International Society of Preventive and Community Dentistry6 (2021): 652.
  7. Al-Attas MA., et al. “Radiographic Evaluation of Bone Density in Dentulous and Edentulous Patients in Riyadh, KSA”. Nigerian Journal of Clinical Practice2 (2020): 258.
  8. Aranyarachkul P., et al. “Bone Density Assessments of Dental Implant Sites: 2. Quantitative Cone-Beam Computerized Tomography”. The International Journal of Oral and Maxillofacial Implants 20 (2005): 416-424.
  9. Radi IAW., et al. “Prognosis of Dental Implants in Patients with Low Bone Density: A Systematic Review and Meta-Analysis”. Journal of Prosthetic Dentistry 120 (2018): 668-677.
  10. Pauwels R. “Cone Beam CT for Dental and Maxillofacial Imaging: Dose Matters”. Radiation Protection Dosimetry 165 (2015): 156-161.
  11. Felicori SM., et al. “Assessment of Maxillary Bone Density by the Tomodensitometric Scale in Cone-Beam Computed Tomography (CBCT)”. International Journal of Health Sciences 33 (2015): 319-322.
  12. Parsa A., et al. “Influence of cone beam CT scanning parameters on grey value measurements at an implant site”. Dentomaxillofacial Radiology3 (2013): 79884780.
  13. Hao Y., et al. “Assessments of jaw bone density at implant sites using 3D cone-beam computed tomography”. European Review for Medical and Pharmacological Sciences9 (2014): 1398-403.
  14. Gulsahi A. “Bone quality assessment for dental implants”. In: I. Turkyilmaz (edition.) Implant Dentistry – The Most Promising Discipline of Dentistry, In Tech, Rijeka, Ch. 20 (2011): 437-452.
  15. Norton MR and Gamble C. “Bone classification: an objective scale of bone density using the computerized tomography scan”. Clinical Oral Implants Research1 (2001): 79-84.
  16. Kobayashi F., et al. “A study of volumetric visualization and quantitative evaluation of bone trabeculae in helical CT: Quantitative evaluation of bone trabeculae”. Dentomaxillofacial Radiology 32 (2003): 181-185.
  17. Park HS., et al. “Density of the alveolar and basal bones of the maxilla and the mandible”. American Journal of Orthodontics and Dentofacial Orthopedics 133 (2008): 30-37.
  18. Shapurian T., et al. “Quantitative evaluation of bone density using the Hounsfield index”. The International Journal of Oral and Maxillofacial Implants2 (2006): 290-297.
  19. Turkyilmaz I., et al. “Bone density assessments of oral implant sites using computerized tomography”. Journal of Oral Rehabilitation4 (2007): 267-272.
  20. Naitoh M., et al. “Evaluation of voxel values in mandibular cancellous bone: relationship between cone-beam computed tomography and multislice helical computed tomography”. Clinical Oral Implants Research 20 (2009): 503-506.
  21. Manivasagam VK and Popat KC. “Hydrothermally treated titanium surfaces for enhanced osteogenic differentiation of adipose derived stem cells”. Materials Science and Engineering C 128 (2021): 112315.
  22. Heinemann F., et al. “Bone stability around dental implants: Treatment related factors”. Details - Anatomischer Anzeiger 199 (2015): 3-8.
  23. Sayed ME., et al. “Role of Stem Cells in Augmenting Dental Implant Osseointegration: A Systematic Review”. Coatings 11 (2021): 1035.
  24. Lekholm U and Zarb Ga. “Patient selection and preparation in: Brånemark PI, Zarb GA, AlbrektssonTs. Tissue integrated prostheses: osseointegration in clinical dentistry”. Chicago: Quintessence Publishing Co (1985): 199-209.
  25. Jaffin RA and Berman CL. “The excessive loss of Branemark fixtures in type IV bone: a 5-year analysis”. Journal of Periodontology1 (1991): 2-4.
  26. Nackaerts O., et al. “Analysis of intensity variability in multislice and cone beam computed tomography”. Clinical Oral Implants Research8 (2011): 873-879.
  27. Wada M., et al. “The relationship between the bone characters obtained by CBCT and primary stability of the implants”. The International Journal of Implant Dentistry1 (2015): 1-5.
  28. Misch CE. “Contemporary Implant Dentistry, Third Edition, Mosby Inc., St. Louis. Morar, L.; B ˘aciut, G.; B ˘aciut,,M.; Bran, S.; Colosi, H (2008).
  29. Al-Nakib LH. “Computed tomography bone density in Hounsfield units at dental implant receiving sites in different regions of the jaw bone”. Journal of Baghdad College of Dentistry1 (2014): 92-97.
  30. Dahiya K., et al. “Qualitative Assessment of Reliability of Cone-beam Computed Tomography in evaluating Bone Density at Posterior Mandibular Implant Site”. The Journal of Contemporary Dental Practice4 (2018): 426-430.
  31. Ahmed M., et al. “Assessment of jaw bone density in terms of hounsfield units using cone beam computed tomography for dental implant treatment planning”. Pakistan Armed Forces Medical Journal1 (2021): 221-227.
  32. Hassan NA and Al-Radha ASD. “CBCT Evaluation of Quality and Quantity of Bones for Immediate Implant Treatment Planning in Central Incisor Area in relation to Arch Form”. Scientific World Journal (2023): 8863318.
  33. Jalal Ranj., et al. “Evaluating Maxillary Bone Density by (CBCT) as a Tool in Implant Prognosis in Kurdish Population”. Azerbaijan Medical Association Journal 63 (2023): 8705-8715.
  34. Rios HF., et al. “The use of cone‐beam computed tomography in management of patients requiring dental implants: An American Academy of Periodontology best evidence review”. Journal of Periodontology10 (2017): 946-959.
  35. Fuh LJ., et al. “Variations in bone density at dental implant sites in different regions of the jawbone”. Journal of Oral Rehabilitation5 (2010): 346-351.
  36. Kyi YMS., et al. “A study on evaluation of trabecular bone density in partially edentulous maxilla”. Clinical Implant Dentistry and Related Research1 (2020): 11-18.
  37. Reitan K. “Effects of Force Magnitude and Direction of Tooth Movement on Different Alveolar Bone Types”. The Angle Orthodontist4 (1964): 244-255.
  38. Almasoud NN., et al. “Alveolar bone density and its clinical implication in the placement of dental implants and orthodontic mini-implants”. Saudi Medical Journal6 (2016): 684-689.

AKM Habibullah., et al. “Assessment of Jaw Bone Density Using Cone Beam Computed Tomography for Dental Implant Treatment Planning”.”. EC Dental Science 22.12 (2023): 01-12.

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