The Relationship Between the Density of the Alveolar Processes and that of Post-cranial Bone

Abstract

Skeletal mass declines in all populations with age, and the literature suggests that changes in oral bone may be linked to the status of the post-cranial (systemic) skeleton. However, there is a lack of information defining the relationship between alveolar process bone and the post-cranial skeleton in healthy individuals. The purpose of this study was to determine: (1) if the bone densities of the maxillary and mandibular alveolar processes are related to the bone density of the spine, hip, or radius in healthy women; and (2) if the alveolar process densities decline with age. Forty-one dentate Caucasian women aged 20 to 78 years underwent assessment of post-cranial (systemic) and alveolar process bone. D-speed vertical bitewing and periapical radiographs incorporating aluminum stepwedges, controlled exposure and processing conditions, and a density correction algorithm were used to make alveolar process density assessments with regions of interest (ROIs) apical to crestal bone and intrabony defects. Anteroposterior lumbar (L1 to L4) and lateral lumbar (L2 to L4) spine, total hip (and subregions), and radius bone densities were determined by dual-energy x-ray absorptiometry (DEXA). Correlation analysis revealed significant relationships between maxillary alveolar process bone density and the density of the mandibular alveolar process (r = 0.57, p ≤ 0.001), anteroposterior lumbar spine (r = 0.53, p ≤ 0.001), lateral lumbar spine (r = 0.52, p ≤ 0.001), total hip (r = 0.39, p = 0.01), total radius (r = 0.39, p = 0.01), and age (r = -0.38, p = 0.01). A two-tailed t test comparison revealed significantly greater maxillary alveolar process bone density in women younger than 50 years of age than in those 50 and older (p ≤ 0.01). We conclude that the density of maxillary alveolar process bone is significantly related to the density of the mandibular alveolar process, lumbar spine, hip, and radius in healthy women and that maxillary alveolar process bone density declines with age.