Korean J Orthod.  2020 Mar;50(2):108-119. 10.4041/kjod.2020.50.2.108.

Sex-, growth pattern-, and growth status-related variability in maxillary and mandibular buccal cortical thickness and density

• Schneider
• Gandhi V
• Upadhyay M
• Allareddy
• Tadinada A
• Yadav S

• KMID: 2471871
• DOI: http://doi.org/10.4041/kjod.2020.50.2.108

Abstract

OBJECTIVE
The primary objective of this study was to quantitatively analyze the bone parameters (thickness and density) at four different interdental areas from the distal region of the canine to the mesial region of the second molar in the maxilla and the mandible. The secondary aim was to compare and contrast the bone parameters at these specific locations in terms of sex, growth status, and facial type.
METHODS
This retrospective cone-beam computed tomography (CBCT) study reviewed 290 CBCT images of patients seeking orthodontic treatment. Cortical bone thickness in millimeters (mm) and density in pixel intensity value were measured for the regions (1) between the canine and first premolar, (2) between the first and second premolars, (3) between the second premolar and first molar, and (4) between the first and second molars. At each location, the bone thickness and density were measured at distances of 2, 6, and 10 mm from the alveolar crest.
RESULTS
The sex comparison (male vs. female) in cortical bone thickness showed no significant difference (p > 0.001). The bone density in growing subjects was significantly (p < 0.001) lower than that in non-growing subjects for most locations. There was no significant difference (p > 0.001) in bone parameters in relation to facial pattern in the maxilla and mandible for most sites.
CONCLUSIONS
There was no significant sex-related difference in cortical bone thickness. The buccal cortical bone density was higher in females than in males. Bone parameters were similar for subjects with hyperdivergent, hypodivergent, and normodivergent facial patterns.

Keyword

Mini-implants; Facial pattern; Cortical bone density; Cortical bone thickness

MeSH Terms

Bicuspid
Bone Density
Cone-Beam Computed Tomography
Female
Humans
Male
Mandible
Maxilla
Molar
Retrospective Studies

Figure

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  Figure 1 Flowchart showing the groups based on the three variables.CBCT, Cone beam computed tomography.

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  Figure 2 Schematic diagram representing the sites used in this study to measure the buccal cortical bone thickness and density. Vertical white lines represent the interdental location, while horizontal lines represent the distance from the alveolar crest: red, 2 mm; yellow, 6 mm; and green, 10 mm.

• 

  Figure 3 Mean thickness (mm) and density (Hounsfield unit, in boxes) of buccal cortical bone in male (A) and female (B) subjects for interdental locations 2 mm, 6 mm, and 10 mm from the crestal bone. For the maxilla - bottom to top and for the mandible - top to bottom. Red color represents the lowest value for a particular location, while yellow and green colors represent the intermediate and highest values, respectively.

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  Figure 4 Intergroup comparisons of male and female subjects for cortical bone thickness at the respective interdental locations.Independent sample t-test; *statistically significant at p < 0.001.

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  Figure 5 Mean thickness (mm) and density (Hounsfield unit, in boxes) of buccal cortical bone in hyperdivergent (A), hypodivergent (B), and normodivergent (C) subjects at interdental locations 2 mm, 6 mm, and 10 mm from the crestal bone. For the maxilla - bottom to top and for the mandible - top to bottom. Red color represents the lowest value for a particular location, while yellow and green represent the intermediate and highest values, respectively.

• 

  Figure 6 Intergroup comparisons of hyperdivergent, hypodivergent, and normodivergent subjects for cortical bone thickness at the respective interdental locations.A, Hyperdivergent; B, hypodivergent; C, normodivergent.Analysis of variance and Tukey's multiple comparisons; Signs for statistically significant difference (p < 0.001): *A vs. B, †B vs. C, ‡C vs. A.

• 

  Figure 7 Mean thickness (mm) and density (Hounsfield unit, in boxes) of buccal cortical bone in growing (A) and non-growing (B) subjects for the interdental locations 2 mm, 6 mm, and 10 mm from the crestal bone: For the maxilla - bottom to top, and for the mandible - top to bottom. Red color represents the lowest value for a particular location, while yellow and green represent the intermediate and highest values, respectively.

• 

  Figure 8 Intergroup comparisons of growing and non-growing subjects for cortical bone thickness at the respective interdental locations.Independent sample t-test; *statistically significant at p < 0.001.

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  Figure 9 Intergroup comparisons of male and female subjects for the cortical bone density at the respective interdental locations.HU, Hounsfield unit.Independent sample t-test; *statistically significant at p < 0.001.

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  Figure 10 Intergroup comparisons of hyperdivergent, hypodivergent, and normodivergent subjects for cortical bone density at the respective interdental locations.HU, Hounsfield unit; A, hyperdivergent; B, hypodivergent; C, normodivergent.Analysis of variance and Tukey's multiple comparisons; Signs for statistically significant difference (p < 0.001): *A vs. B, †B vs. C, ‡C vs. A.

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  Figure 11 Intergroup comparisons of growing and non-growing subjects for cortical bone density at the respective interdental locations.HU, Hounsfield unit.Independent sample t-test; *statistically significant at p < 0.001.

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