Skeletal and Alveolar Bone Loss Related to Differences in Trabecular Bone Coarseness

Objectives: To investigate the mandibular alveolar bone height in women without periodontal problems as a function of changes in skeletal bone mineral density (BMD) and varying mandibular bone trabeculation at two occasions five years apart.

Methods: Methods: BMD was measured with dual X-ray absorptiometry in 128 women (22-75yrs old) in 1996 and in 2001. The trabecular bone was assessed as dense, mixed, or sparse. Mandibular alveolar bone height, the distance between the cemento-enamel junction and the alveolar bone crest, was measured with Schei ruler and related to BMD group (osteoporotic, osteopenic or normal) and trabeculation group.

Results: The dense trabeculation group had the highest BMD and the sparse group the lowest. In the dense group, 47% lost more than 5% from 1996 to 2001 versus 19% in the less dense group. The changes in BMD (both in relative and in absolute numbers) and alveolar bone height followed the same pattern: larger changes in osteoporotic women than non-osteoporotic but also larger changes in women with dense trabecular bone than in women with less dense bone. In women with a very dense trabecular network, the alveolar bone height and skeletal bone density decreased even more after five years than it did in osteoporotic women. The premolars had both the largest initial and the largest change in bone height, thereafter the canine and the first molar.
Conclusions: Fast bone losers are common in women with dense trabeculation. Dense trabeculation implies the largest trabecular, endosteal bone surface, consequently the largest number of bone cells, and maybe these cells have larger cell activity than cells in less dense bone? Negative events may lead to the most negative response in dense trabecular bone but maybe to the best result after appropriate treatment?