Alveolar Bone Mineral Density Changes Around Mandibular Incisors With Aging

Objectives: Elderly females are at a higher risk of tooth loss compared to males of the same age. Bone mineral density (BMD) in the alveolar bone (AB) surrounding teeth plays a crucial role in maintaining tooth stability. Therefore, the objective of the study was to examine whether dental cone beam computed tomography (CBCT) can detect a sex-dependent increase in the risk of tooth loss with aging.
Methods: Following IRB approval, 92 CBCT images from 52 female and 40 male patients, aged between 20 and 82 years, were analyzed. Bone voxels were segmented from non-bone voxels using imaging software (ITK-SNAP). Mandibular AB regions surrounding incisors were digitally isolated within 1.2 mm of the root. The basal cortical bone (CB) regions of the same teeth were determined at 0.6 mm inside the mandibular bone borders. The mean gray value, proportional to BMD, was obtained for each bone voxel. Pearson’s correlation was performed to compare the mean gray values between males and females of the same age groups. Significance was set at p<0.05.
Results: The mean gray value for AB showed a significant negative correlation with aging in the female group (p=0.025). However, no correlation with aging was observed in CB in females or in either AB or CB in males (p>0.111). The mean gray value of AB was significantly lower in females aged 60 and older compared to males of the same age group (p=0.045).
Conclusions: The current findings suggest that a gradual decrease in AB BMD with aging leads to a significant reduction in elderly females.