Can cone beam CT predict the hardness of interradicular cortical bone?

Head & Face Medicine

Silvia Geron³  Nir Shpack³  Raphael Pilo²  Bereznyak-Elias Yekaterina³  Tamar Brosh¹ 

[1] Department of Oral Biology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel;Department of Oral Rehabilitation, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel;Department of Orthodontics, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel

关键词: Interradicular;    Maxilla;    Mandible;    Microhardness;    Density;   

Others  :  1145579
DOI  :  10.1186/1746-160X-10-12

 received in 2013-12-26, accepted in 2014-04-10,  发布年份 2014

【 摘 要 】

Objectives

Orthodontic mini implants can be inserted at the interradicular site. The bone quality at this site may affect the stability and anchorage of the implant. Bone density is clinically evaluated by Hounsfield units (HU) obtained from cone beam CT (CBCT). The objective of this study was to determine the correlations between HU, microhardness and cortical bone thickness of interradicular site at various segments (anterior/posterior) and aspects (buccal/lingual) of both jaws in a swine model.

Materials and methods

Eight mandible and maxilla swine bones were scanned by CBCT. The HU and thickness of the above-mentioned sites were determined. Then, a Knoop microhardness test was applied and the Knoop Hardness Number was obtained (KHN).

Results

The mandible parameters spread over a wider range than the maxilla. The buccal aspect of the maxilla had higher HU and KHN values than the mandible. The lingual aspect of the mandible had higher KHN values than the maxilla. Posterior segments had higher HU and KHN values. The thickness of the alveolar cortical bone was greater in the maxilla than in the mandible. Correlations were found between HU and KHN for 3 of the 4 sites (anterior or posterior, buccal or lingual) of the mandible only. No correlations were found for the maxilla. Upon pooling the HU and KHN data for the whole jaw, correlation was found for the maxilla as well.

Conclusions

Relying on HU values as a predictor of cortical bone hardness should be considered with caution.

【 授权许可】

   
2014 Brosh et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]Papadopoulos MA, Papageorgiou SN, Zogakis IP: Clinical effectiveness of orthodontic miniscrew implants: a meta-analysis. J Dent Res 2011, 90:969-976.
• [2]Ren Y, Maltha JC, Kuijpers-Jagtman AM: Optimum force magnitude for orthodontic tooth movement: a systematic literature review. Angle Orthod 2003, 73:86-92.
• [3]Chen Y, Kyung HM, Zhao WT, Yu WJ: Critical factors for the success of orthodontic mini-implants: a systematic review. Am J Orthod Dentofac Orthop 2009, 135:284-291.
• [4]Meursinge Reynders RA, Ronchi L, Ladu L, Etten-Jamaludin F, Bipat S: Insertion torque and success of orthodontic mini-implants: a systematic review. Am J Orthod Dentofac Orthop 2012, 142:596-614.
• [5]Huja SS, Litsky AS, Beck FM, Johnson KA, Larsen PE: Pull-out strength of monocortical screws placed in the maxillae and mandibles of dogs. Am J Orthod Dentofac Orthop 2005, 127:307-313.
• [6]Park HS, Lee YJ, Jeong SH, Kwon TG: Density of the alveolar and basal bones of the maxilla and the mandible. Am J Orthod Dentofac Orthop 2008, 133:30-37.
• [7]Chun YS, Lim WH: Bone density at interradicular sites: implications for orthodontic mini-implant placement. Orthod Craniofac Res 2009, 12:25-32.
• [8]AlSamak S, Gkantidis N, Bitsanis E, Christou P: Assessment of potential orthodontic mini-implant insertion sites based on anatomical hard tissue parameters: a systematic review. Int J Oral Maxillofac Implants 2012, 27:875-887.
• [9]Lim JE, Lee SJ, Kim YJ, Lim WH, Chun YS: Comparison of cortical bone thickness and root proximity at maxillary and mandibular interradicular sites for orthodontic mini-implant placement. Orthod Craniofac Res 2009, 12:299-304.
• [10]Motoyoshi M, Yoshida T, Ono A, Shimizu N: Effect of cortical bone thickness and implant placement torque on stability of orthodontic mini-implants. Int J Oral Maxillofac Implants 2007, 22:779-784.
• [11]Cho SA, Park KT: The removal torque of titanium screw inserted in rabbit tibia treated by dual acid etching. Biomaterials 2003, 24:3611-3617.
• [12]Martinelli FL, Luiz RR, Faria M, Nojima LI: Anatomic variability in alveolar sites for skeletal anchorage. Am J Orthod Dentofac Orthop 2010, 138:252-259.
• [13]Silvestrini Biavati A, Tecco S, Migliorati M, Festa F, Marzo G, Gherlone E, Tete S: Three-dimensional tomographic mapping related to primary stability and structural miniscrew characteristics. Orthod Craniofac Res 2011, 14:88-99.
• [14]Horner KA, Behrents RG, Kim KB, Buschang PH: Cortical bone and ridge thickness of hyperdivergent and hypodivergent adults. Am J Orthod Dentofac Orthop 2012, 142:170-178.
• [15]Farnsworth D, Rossouw PE, Ceen RF, Buschang PH: Cortical bone thickness at common miniscrew implant placement sites. Am J Orthod Dentofac Orthop 2011, 139:495-503.
• [16]Motoyoshi M, Inaba M, Ono A, Ueno S, Shimizu N: The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone. Int J Oral Maxillofac Surg 2009, 38:13-18.
• [17]Hodgskinson R, Currey JD, Evans GP: Hardness, an indicator of the mechanical competence of cancellous bone. J Orthop Res 1989, 7:754-758.
• [18]Johnson WM, Rapoff AJ: Microindentation in bone: hardness variation with five independent variables. J Mater Sci Mater Med 2007, 18:591-597.
• [19]Boivin G, Bala Y, Doublier A, Farlay D, Ste-Marie LG, Meunier PJ, Delmas PD: The role of mineralization and organic matrix in the microhardness of bone tissue from controls and osteoporotic patients. Bone 2008, 43:532-538.
• [20]Lettry S, Seedhom BB, Berry E, Cuppone M: Quality assessment of the cortical bone of the human mandible. Bone 2003, 32:35-44.
• [21]Iijima M, Takano M, Yasuda Y, Muguruma T, Nakagaki S, Sakakura Y, Ochi M, Mizoguchi I: Effect of the quantity and quality of cortical bone on the failure force of a miniscrew implant. Eur J Orthod 2013, 35:583-589.
• [22]Holm L, Cunningham SJ, Petrie A, Cousley RR: An in vitro study of factors affecting the primary stability of orthodontic mini-implants. Angle Orthod 2012, 82:1022-1028.
• [23]Deguchi T, Nasu M, Murakami K, Yabuuchi T, Kamioka H, Takano-Yamamoto T: Quantitative evaluation of cortical bone thickness with computed tomographic scanning for orthodontic implants. Am J Orthod Dentofac Orthop 2006, 129:721. e7-721.e12
• [24]Lim JE, Lim WH, Chun YS: Quantitative evaluation of cortical bone thickness and root proximity at maxillary interradicular sites for orthodontic mini-implant placement. Clin Anat 2008, 21:486-491.
• [25]Lee KJ, Joo E, Kim KD, Lee JS, Park YC, Yu HS: Computed tomographic analysis of tooth-bearing alveolar bone for orthodontic miniscrew placement. Am J Orthod Dentofac Orthop 2009, 135:486-494.
• [26]Chen CH, Chang CS, Hsieh CH, Tseng YC, Shen YS, Huang IY, Yang CF, Chen CM: The use of microimplants in orthodontic anchorage. J Oral Maxillofac Surg 2006, 64:1209-1213.
• [27]Monnerat C, Restle L, Mucha JN: Tomographic mapping of mandibular interradicular spaces for placement of orthodontic mini-implants. Am J Orthod Dentofac Orthop 2009, 135:428-429.
• [28]Stoppie N, Pattijn V, Van Cleynenbreugel T, Wevers M, Vander Sloten J, Ignace N: Structural and radiological parameters for the characterization of jawbone. Clin Oral Implants Res 2006, 17:124-133.
• [29]Lee S, Gantes B, Riggs M, Crigger M: Bone density assessments of dental implant sites: 3. Bone quality evaluation during osteotomy and implant placement. Int J Oral Maxillofac Implants 2007, 22:208-212.
• [30]Tseng YC, Hsieh CH, Chen CH, Shen YS, Huang IY, Chen CM: The application of mini-implants for orthodontic anchorage. Int J Oral Maxillofac Surg 2006, 35:704-707.
• [31]Turkyilmaz I, Ozan O, Yilmaz B, Ersoy AE: Determination of bone quality of 372 implant recipient sites using Hounsfield unit from computerized tomography: a clinical study. Clin Implant Dent Relat Res 2008, 10:238-244.
• [32]Zapata U, Opperman LA, Kontogiorgos E, Elsalanty ME, Dechow PC: Biomechanical characteristics of regenerated cortical bone in the canine mandible. J Tissue Eng Regen Med 2011, 5:551-559.
• [33]Schwartz-Dabney CL, Dechow PC: Variations in cortical material properties throughout the human dentate mandible. Am J Phys Anthropol 2003, 120:252-277.
• [34]Baumgaertel S, Hans MG: Buccal cortical bone thickness for mini-implant placement. Am J Orthod Dentofac Orthop 2009, 136:230-235.