To demonstrate possible influences of general bone density on the mandible, histomorphometric analysis was carried out in mandibles and iliac bones and the correlation of the two bone densities was tested. Comparison of bony density in women and men over 60 years in the mandible was carried out too. Quantitative computed tomography(QCT) was taken in cross-section of mandibles at the same site where histomorphometric analysis was peformed to evaluate the reliability of QCT. The analysis included 40 cadavers with no known diseases affecting the bones. The subjects consisted of 15 females and 25 males with a mean age of 60.3 years. Spearman correlation analysis and Wilcoxon rank sum test was performed. The results were as follows. 1. There was statistically no correlation between the mandible and iliac bone in the values of corrected cortical width(CCW), cortical porosity(POR) in cortex, and total bone volume(TBV), mean trabecular plate thickness(MTPT), mean trabecular plate density(MTPD), and mean trabecular plate separation(MTPS) in trabecular bone. 2. Comparison of women and men over 60 years, men had statistically higher bone density than women except fir POR of buccal and lingual cortex, and WTPD of alveolar trabeculae in mandible. 3. There was statistically significant correlation between TBV of trabecular bone and CT No., but not between POR and CT No. in mandible. According to the results above, there was no correlation between mandible and iliac bone density and between mandibular bony density and age. Further studies are required to support the results. A more noninvasive method to be able to measure the bone density of mandible should be developed and it is necessary to accumulate data on the normal values of bone density of mandible according to age and sex. Further study should be carried out about QCT to measure mandibular bony density using QCT.
Purpose: The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme. Materials and Methods: Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used. Results: The MCI of MRONJ patients with osteoporosis(class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases(class 1: 14, class 2: 5, class 3: 0)(P=0.000). Conclusion: The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.
Objective: The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants' stability. Methods: Sixty orthodontic mini-implants (7.0 mm $\times$$\emptyset1.45$ mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning. Results: The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p < 0.05). The PTV values ranged from -3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (-0.51), bone density (-0.48), cortical bone thickness (-0.42) (p < 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (-0.66) (p < 0.01) in the mandible. Conclusions: These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.29
no.1
/
pp.21-32
/
1999
Purpose: To evaluate the effect of variable scanning protocols of computed tomography for evaluation of pre-implant site of the mandible through the comparison of the reformatted cross-sectional images of helical CT scans obtained with various imaging parameters versus those of conventional CT scans. Materials and Methods: A dry mandible was imaged using conventional nonoverlapped CT scans with 1 mm slice thickness and helical CT scans with 1 mm slice thickness and pitches of 1.0, 1.5. 2.0, 2.5 and 3.0. All helical images were reconstructed at reconstruction interval of 1 mm. DentaScan reformatted images were obtained to allow standardized visualization of cross-sectional images of the mandible. The reformatted images were reviewed and measured separately by 4 dental radiologists. The image qualities of continuity of cortical outline. trabecular bone structure and visibility of the mandibular canal were evaluated and the distance between anatomic structures were measured by 4 dental radiologists. Results: On image qualities of continuity of cortical outline. trabecular bone structure and visibility of the mandibular canal and in horizontal measurement. there was no statistically significant difference among conventional and helical scans with pitches of 1.0. 1.5 and 2.0. In vertical measurement. there was no statistically significant difference among the conventional and all imaging parameters of helical CT scans with pitches of 1.0, 1.5, 2.0, 2.5 and 3.0. Conclusion: The images of helical CT scans with 1 mm slice thickness and pitches of 1.0, 1.5 and 2.0 are as good as those of conventional CT scans with 1 mm slice thickness for evaluation of predental implant site of the mandible. Considering the radiation dose and patient comfort, helical CT scans with 1 mm slice thickness and pitch of 2.0 is recommended for evaluation of pre-implant site of the mandible.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.40
no.1
/
pp.11-16
/
2014
Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true "Hunsuck" line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was $5.55{\pm}1.07$ mm (deviated) and $5.66{\pm}1.34$ mm (contralateral) (P =0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.
Journal of Dental Rehabilitation and Applied Science
/
v.30
no.3
/
pp.215-222
/
2014
Purpose: The aim of this study was to investigate differences between the morphology of the mandibular symphysis and four facial skeletal types. Materials and Methods: 40 cone-beam computed tomographies were selected and classified in to 4 groups according to their vertical and anterior-posterior skeletal patterns. The bone volume ($mm^3$) of the symphysis, the cross sectional area corresponding to the 4 mandibular incisors' axis: the cross sectional area of total bone ($mm^2$), the area of the cancellous bone ($mm^2$) and the thickness (mm) of labial and lingual alveolar bone at 2 mm, 3 mm under the cemento-enamel junction (CEJ) were measured. General linear model (GLM), Kruskal-Wallis test and Tukey honestly significant difference (HSD) test were subsequently used for statistical analysis. Results: The lingual cortical bone thickness of the lateral incisors at 2, 3 mm under CEJ was greater in the Class I low angle group than the other 3 groups (P < 0.05). There were no statistically significant differences in the volume of the mandibular incisor bony support, cross-sectional area of total bone and cancellous bone at the mandibular incisor' axis. Conclusion: Patients in Class I, low angle group have a thicker lingual mandibular symphysis than Class I, high angle patients.
Objective: The purpose of this study was to provide clinical guidelines to indicate the best location for mini-implants as it relates to the cortical bone thickness and root proximity. Methods: CT images from 14 men and 14 women were used to evaluate the buccal interradicular cortical bone thickness and root proximity from mesial to the central incisor to the 2nd molar. Cortical bone thickness was measured at 4 different angles including $0^{\circ}$, $15^{\circ}$, $30^{\circ}$, and $45^{\circ}$. Results: There was a statistically significant difference in cortical bone thickness between the second premolar/first permanent molar site, central incisor/central incisor site, between the first/second permanent molar site and in the anterior region. A statistically significant difference in cortical bone thickness was also found when the angulation of placement was increased except for the 2 mm level from the alveolar crest. Interradicular spaces at the 1st/2nd premolar, 2nd premolar/1st permanent molar and 1st/2nd permanent molar sites are considered to be wide enough for mini-implant placement without root damage. Conclusions: Given the limits of this study, mini-implants for orthodontic anchorage may be well placed at the 4 and 6 mm level from the alveolar crest in the posterior region with a $30^{\circ}$ and $45^{\circ}$ angulation upon placement.
Surgical microscrews were introduced and used as one method to provide absolute anchorage. Some clinicians implanted microscrews or miniscrews into the basal bone below the roots of the teeth to evade damage to the roots. Because the implanted microscrews were positioned too low the applied force was insufficient to retract the anterior teeth or protract the posterior teeth, and the use of microscrews or miniscrews seemed limited in applying vertical force. However Park implanted microscrews(micro-implants (1.2mm in diameter)) into the alveolar bone between the roots of the posterior teeth to change the direction of the applied force toward increasing horizontal component of the force. Moreover, these microscrew implants were positioned in the alveolar bone between the roots without causing discernable damage to the roots. This study was performed to provide guidelines and anatomic data to assist in the determination of the safe location for micro-implants. By measuring the CT images from 21 patients, anatomical data were obtained which were then used as a guide to determine the location for the implantation of micro-implants. The thickness of the cortical bones at the alveaolar bone region increased from the anterior to the posterior teeth area. The mandibular posterior teeth area showed thicker cortical bone. A greater distance was observed in distance between the second premolar root and first molar root in the upper arch, between the first molar root and the second molar root in the lower arch. The alveolar bone of the posterior teeth area is considered the best site for the implantation of micro-implants.
Journal of Korean Academy of Oral and Maxillofacial Radiology
/
v.23
no.2
/
pp.229-250
/
1993
This study was performed to investigate the morphological and structural changes of bone tissues and the effects of irradiation on the mandibular bodies of rats which were fed low calcium diets. In order to carry out this experiment, 160 seven-week old Sprague-Dawley strain rats weighing about 150 gm were selected and equally divided into one normal diet group of 80 rats and one low calcium diet group with the remainder. These groups were then subdivided into two groups, 40 were assigned rats for each subdivided group, exposed to radiation. The Group 1 was composed of forty non-irradiated rats with normal diet, Group 2 of forty irradiated rats with normal diet, Group 3 forty non-irradiated rats with low calcium diet, and Group 4 forty irradiated rats with low calcium diet. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-50 teletherapy unit. The rats with normal and low calcium diet groups were serially terminated by ten on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandible were removed and fixed with 10% neutral formalin. The bone density of mandibular body was measured by use of bone mineral densitometer(Model DPX -alpha, Lunar Corp., U.SA). Triga Mark ill nuclear reactor in Korea Atomic Research Institute was used for neutron activation and then calcium contents of mandibular body were measured by using a 4096 multichannel analyzer (EG and G ORTEC 919 MCA, U.SA). Also the mandibular body was radiographed with a soft X-ray apparatus(Hitex Co., Ltd., Japan). Thereafter, the obtained microradiograms were observed by a light microscope and were used for the morphometric analysis using a image analyzer(Leco 2001 System, Leco Co., Canada). The morphometric analysis was performed for parameters such as the total area, the bone area, the inner and outer perimeters of the bone. The obtained results were as follows: 1. In the morphometric analysis, total area and outer perimeter of the mandibular bodies of Group 3 were a little smaller than that of Group 1. The mean bone width and bone area were much smaller than that of Group 1 and the inner perimeter of Group 3 was much longer than that of Group 1. The total area and outer perimeter of Group 2 and Group 4 showed little difference. The mean bone width and bone area of Group 4 were smaller than that of Group 2 and the inner perimeter of Group 4 was longer than that of Group 2. 2. The remarkable decreases of the number and thickness of trabeculae and also the resorption of endosteal surface of cortical bone could be seen in the microradiogram of Group 3, Group 4 since the 3rd day of experiment. On the 21st day of experiment, the above findings could be more clearly seen in Group 4 than in Group 3. 3. The bone mineral density of Group 3 was lesser than that of Group 1 and the bone mineral density of Group 4 was lesser than that of Group 2 on the 7th, 14th, 21st days. The irradiation caused the bone mineral density to be decreased regardless of diet. In the case of Groups with low calcium diet, the bone mineral density was much decreased on the 21st day than on the 3rd day of experiment. 4. The calcium content in mandible of Group 3 was smaller than that of Group 1 throughout the experiment. roup 4 showed the least amount of calcium content. The irradiation caused the calcium content to be decreased regardless of diet. In the case of Groups with low calcium diet, the calcium content was much decreased on the 21st day than on the 3rd day of experiment. In conclusion, the present study demonstrated that morphological changs and decrease of bone mass due to resorption of bone by low calcium diet, and that the resorption of bone could be found in the spongeous bone and endosteal surface of cortical bone. So the problem of resorption of bone must be considered when the old and the postmenopausal women are taken radiotherapy because the irradiation seems to be accelerated the resorption of osteoporotic bone.
Hannah Jeong;Jwa-Young Kim;Xiangguo Che;Je-Yong Choi;Insan Jang;Seong-Gon Kim
The korean journal of orthodontics
/
v.53
no.6
/
pp.393-401
/
2023
Objective: To investigate the long-term effects of 4-hexylresorcinol (4HR) on facial skeletal growth in growing male rats, with a focus on diabetic animal models. Methods: Forty male rats were used. Of them, type 1 diabetes mellitus was induced in 20 animals by administering 40 mg/kg streptozotocin (STZ), and they were assigned to either the STZ or 4HR-injected group (STZ/4HR group). The remaining 20 healthy rats were divided into control and 4HR groups. We administered 4HR subcutaneously at a weekly dose of 10 mg/kg until the rats were euthanized. At 16 weeks of age, whole blood was collected, and microcomputed tomography of the skull and femur was performed. Results: All craniofacial linear measurements were smaller in the STZ group than in the control group. The mandibular molar width was significantly smaller in the 4HR group than in the control group (P = 0.031) but larger in the STZ/4HR group than in the STZ group (P = 0.011). Among the diabetic animals, the STZ/4HR group exhibited significantly greater cortical bone thickness, bone mineral density, and bone volume than the STZ group. Serum testosterone levels were also significantly higher in the STZ/4HR group than in the STZ group. Conclusions: 4HR administration may have divergent effects on mandibular growth and bone mass in healthy and diabetic rats. In the context of diabetes, 4HR appears to have beneficial effects, potentially through the modulation of mitochondrial respiration.
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