Trabecular bone microstructure and mineral density in human residual ridge at various intervals over a long period after tooth extraction.

BACKGROUND: Long-term changes of trabecular microstructure in human tooth extraction socket have not been investigated. PURPOSE: To examine the trabecular microstructure of human residual ridges at various intervals following tooth extraction, and to determine whether bone remodeling activity can attain points of relative stability and when such points are reached. MATERIALS AND METHODS: Forty-four bone biopsy specimens were obtained from lower molar or premolar regions of residual ridges. Postextraction times ranged from 1.6 to 360 months. Samples were analyzed using micro-computed tomography and three-dimensional bone morphometry with histological analyses. Trabecular bone parameters were plotted against postextraction times, and a stepwise piecewise linear regression analysis was performed to determine at which points of time these parameters either increased or decreased. RESULTS: Using piecewise linear regression, "inflection points" were found in most trabecular bone parameters between 7 and 12 months postextraction. Among the residual ridge samples, woven trabecular structure became mature, consisting of thick lamellar trabeculae with sufficient bone density, under dynamic bone remodeling until the 7th to 12th month post-tooth extraction. After this period, the mature network structure remained stable with low remodeling activity. CONCLUSION: Bone remodeling of trabecular structure in human residual ridge after tooth extraction had a stabilization period.

Microstructural Observation with MicroCT and Histological Analysis of Human Alveolar Bone Biopsy from a Planned Implant Site: A Case Report.

The subject was a 53-year-old male. An alveolar bone sample was obtained from the site of the lower left first molar, before dental implant placement. Although the details of the trabecular structure were not visible with conventional computed tomography, micro-computed tomography (microCT) three-dimensional images of the alveolar bone biopsy sample showed several plate-like trabeculae extending from the lingual cortical bone. Histological observations of the bone sample revealed trabeculae, cuboidal osteoblasts, osteoclasts and hematopoietic cells existing in the bone tissue at the implantation site. Bone metabolic markers and calcaneal bone density were all within normal ranges, indicating no acceleration of the patient's bone metabolism. Using microCT, and histological and histomorphometrical techniques, a great deal of valuable information about the bone tissue was obtained from a biopsy sample extracted from the patient's planned implant site.

Correlations between alveolar bone microstructure and bone turnover markers in pre- and post-menopausal women.

OBJECTIVE: Alveolar cancellous bone biopsy samples were extracted during dental implant preparation for investigating microstructural changes due to menopause and relationships between these changes and bone turnover markers. STUDY DESIGN: Subjects were 18 women receiving mandibular implants: premenopausal (n = 5), early postmenopausal (≤5 years; n = 3), and late postmenopausal (>5 years; n = 10). Bone turnover markers were measured and the samples analyzed using microscopic computerized tomography and 3-dimensional bone morphometry. RESULTS: The alveolar bone volume was significantly less in late postmenopausal women than in premenopausal ones. The trabeculae in early postmenopausal women were more separated and rod-like than in premenopausal ones (P < .05). Each alveolar bone parameter was significantly (P < .05) related to at least 1 bone turnover marker. CONCLUSIONS: Alveolar cancellous bone structure begins changing even in early postmenopausal women, and this structure varies in close relationship to bone turnover markers.