Bone microarchitecture at oral implant sites in ectodermal dysplasia (ED): a comparison between males and females
Corresponding Author
Patcharawan Silthampitag
Professorial Unit, Faculty of Dentistry, The University of Sydney, Westmead Centre for Oral Health, Westmead, NSW, Australia
Corresponding author:
Patcharawan Silthampitag
Professorial Unit (Level 3)
Faculty of Dentistry
The University of Sydney
Westmead Centre for Oral Health
Westmead, NSW 2145
Australia
Tel.: (+61) 4 1164 9182, (+61) 2 98457192
Fax: (+61) 2 9633 2893
e-mail: [email protected]
Search for more papers by this authorIven Klineberg
Professorial Unit, Faculty of Dentistry, The University of Sydney, Westmead Centre for Oral Health, Westmead, NSW, Australia
Search for more papers by this authorBruce Austin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Sydney, Westmead Centre for Oral Health, Westmead, NSW, Australia
Search for more papers by this authorAllan S. Jones
Australian Centre for Microscopy & Microanalysis, The University of Sydney, NSW, Australia
Search for more papers by this authorCorresponding Author
Patcharawan Silthampitag
Professorial Unit, Faculty of Dentistry, The University of Sydney, Westmead Centre for Oral Health, Westmead, NSW, Australia
Corresponding author:
Patcharawan Silthampitag
Professorial Unit (Level 3)
Faculty of Dentistry
The University of Sydney
Westmead Centre for Oral Health
Westmead, NSW 2145
Australia
Tel.: (+61) 4 1164 9182, (+61) 2 98457192
Fax: (+61) 2 9633 2893
e-mail: [email protected]
Search for more papers by this authorIven Klineberg
Professorial Unit, Faculty of Dentistry, The University of Sydney, Westmead Centre for Oral Health, Westmead, NSW, Australia
Search for more papers by this authorBruce Austin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Sydney, Westmead Centre for Oral Health, Westmead, NSW, Australia
Search for more papers by this authorAllan S. Jones
Australian Centre for Microscopy & Microanalysis, The University of Sydney, NSW, Australia
Search for more papers by this authorAbstract
Objective
The aim of this study was to analyse the microarchitecture of bone in association with implant placement in young ectodermal dysplasia (ED) patients. The general hypothesis was that the structural and morphological features of bone microarchitecture are different between males and females, which may influence clinical outcomes.
Materials and Methods
The bone harvesting is not additionally invasive, as the procedure was made at the time and site of implant placement. Twenty one samples (8 female, 13 male) were harvested from nine ED participants whose age ranged between 14 and 21 years and specified by the site of harvesting. Micro-CT analysis at 5 µm resolution was conducted on each sample. Specialized CT analysis of the three-dimensional (3-D) bone microstructure was made to compare structural parameters. In addition, two bone samples (one male, one female) were sent to the University of Michigan and analysed at 9 µm resolution.
Results
No significant difference was found between male and female samples. Bone analysis of particular sites revealed that bone-specific surface (BS/BV) was found to be significantly higher in male than in female samples, whilst the mean values of 10 parameters, the grey scale value histograms and 3-D visualization showed that female samples had higher compact density than male samples.
Conclusion
Microstructural analyses indicated that female ED bone was more compact and with greater trabecular connectedness than male bone. These features may enhance resistance to external force transfer of mastication compared with male bone. Further bone samples from other jaw bone areas will provide information on whether there are regional differences in jawbone quality and quantity, which may influence implant treatment outcomes, as well as follow-up analyses of treatment outcomes.
References
- Adell, R., Eriksson, B., Lekholm, U., Branemark, P.I. & Jemt, T. (1990) Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. The International Journal of Oral & Maxillofacial Implants 5: 347–359.
- Albrektsson, T., Dahl, E., Enbom, L., Engevall, S., Engquist, B., Eriksson, A.R., Feldmann, G., Freiberg, N., Glantz, P.O., Kjellman, O., Kristersson, L., Kvint, S., Kondell, P.A., Palmquist, J., Werndahl, L. & Astrand, P. (1988) Osseointegrated oral implants. A swedish multicenter study of 8139 consecutively inserted nobelpharma implants. Journal of Periodontology 59: 287–296.
- Aranyarachkul, P., Caruso, J., Gantes, B., Schulz, E., Riggs, M., Dus, I., Yamada, J.M. & Crigger, M. (2005) Bone density assessments of dental implant sites: 2. Quantitative cone-beam computerized tomography. The International Journal of Oral & Maxillofacial Implants 20: 416–424.
- Becker, W. & Becker, B.E. (1995) Replacement of maxillary and mandibular molars with single endosseous implant restorations: a retrospective study. Journal of Prosthetic Dentistry 74: 51–55.
- Bergendal, T., Eckerdal, O., Hallonsten, A.L., Koch, G., Kurol, J. & Kvint, S. (1991) Osseointegrated implants in the oral habilitation of a boy with ectodermal dysplasia: a case report. International Dental Journal 41: 149–156.
- Branemark, P.I., Adell, R., Breine, U., Hansson, B.O., Lindstrom, J. & Ohlsson, A. (1969) Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scandinavian Journal of Plastic & Reconstructive Surgery 3: 81–100.
- Brocard, D., Barthet, P., Baysse, E., Duffort, J.F., Eller, P., Justumus, P., Marin, P., Oscaby, F., Simonet, T., Benqué, E. & Brunel, G. (2000) A multicenter report on 1,022 consecutively placed iti implants: a 7-year longitudinal study. The International Journal of Oral & Maxillofacial Implants 15: 691–700.
- Carballido-Gamio, J., Majumdar, S., Carballido-Gamio, J. & Majumdar, S. (2006) Clinical utility of microarchitecture measurements of trabecular bone. Current Osteoporosis Reports 4: 64–70.
- Cattaneo, P.M., Bloch, C.B., Calmar, D., Hjortshoj, M., Melsen, B., Cattaneo, P.M., Bloch, C.B., Calmar, D., Hjortshoj, M. & Melsen, B. (2008) Comparison between conventional and cone-beam computed tomography-generated cephalograms. American Journal of Orthodontics & Dentofacial Orthopedics 134: 798–802.
- Clarke, A. (1987) Hypohidrotic ectodermal dysplasia. Journal of Medical Genetics 24: 659–663.
- Clarke, A., Phillips, D.I., Brown, R. & Harper, P.S. (1987) Clinical aspects of x-linked hypohidrotic ectodermal dysplasia. Archives of Disease in Childhood 62: 989–996.
- Dalle Carbonare, L. & Giannini, S. (2004) Bone microarchitecture as an important determinant of bone strength. Journal of Endocrinological Investigation 27: 99–105.
- Dalle Carbonare, L., Valenti, M.T., Bertoldo, F., Zanatta, M., Zenari, S., Realdi, G., Lo Cascio, V. & Giannini, S. (2005) Bone microarchitecture evaluated by histomorphometry. Micron 36: 609–616.
- Davies, J.E. & Davies, J.E. (2003) Understanding peri-implant endosseous healing. Journal of Dental Education 67: 932–949.
- Dellavia, C., Catti, F., Sforza, C., Tommasi, D.G. & Ferrario, V.F. (2010) Craniofacial growth in ectodermal dysplasia an 8 year longitudinal evaluation of italian subjects. Angle Orthodontist 80: 733–739.
- Denissen, H.W., Kalk, W., Veldhuis, H.A. & van Waas, M.A. (1993) Anatomic consideration for preventive implantation. The International Journal of Oral & Maxillofacial Implants 8: 191–196.
- Ding, M. & Hvid, I. (2000) Quantification of age-related changes in the structure model type and trabecular thickness of human tibial cancellous bone. Bone 26: 291–295.
- Ekelund, J.A., Lindquist, L.W., Carlsson, G.E., Jemt, T., Ekelund, J.-A., Lindquist, L.W., Carlsson, G.E. & Jemt, T. (2003) Implant treatment in the edentulous mandible: a prospective study on branemark system implants over more than 20 years. International Journal of Prosthodontics 16: 602–608.
- Ekstrand, K. & Thomsson, M. (1988) Ectodermal dysplasia with partial anodontia: prosthetic treatment with implant fixed prosthesis. Journal of Dentistry for Children 55: 282–284.
- Engquist, B., Bergendal, T., Kallus, T. & Linden, U. (1988) A retrospective multicenter evaluation of osseointegrated implants supporting overdentures. The International Journal of Oral & Maxillofacial Implants 3: 129–134.
- Friberg, B., Jemt, T. & Lekholm, U. (1991) Early failures in 4,641 consecutively placed branemark dental implants: a study from stage 1 surgery to the connection of completed prostheses. The International Journal of Oral & Maxillofacial Implants 6: 142–146.
- Fugazzotto, P.A., Wheeler, S.L. & Lindsay, J.A. (1993) Success and failure rates of cylinder implants in type iv bone. Journal of Periodontology 64: 1085–1087.
- Genant, H.K., Engelke, K. & Prevrhal, S. (2008) Advanced ct bone imaging in osteoporosis. Rheumatology 47(Suppl. 4): iv9–iv16.
- Genant, H.K., Jiang, Y., Genant, H.K. & Jiang, Y. (2006) Advanced imaging assessment of bone quality. Annals of the New York Academy of Sciences 1068: 410–428.
- Gilgenkrantz, S., Blanchet-Bardon, C., Nazzaro, V., Formiga, L., Mujica, P. & Alembik, Y. (1989) Hypohidrotic ectodermal dysplasia. Clinical study of a family of 30 over three generations. Human Genetics 81: 120–122.
- Guckes, A.D., Brahim, J.S., McCarthy, G.R., Rudy, S.F. & Cooper, L.F. (1991) Using endosseous dental implants for patients with ectodermal dysplasia. Journal of the American Dental Association 122: 59–62.
- Hahn, M., Vogel, M., Pompesius-Kempa, M. & Delling, G. (1992) Trabecular bone pattern factor–a new parameter for simple quantification of bone microarchitecture. Bone 13: 327–330.
- Harris, D.A., Jones, A.S. & Darendeliler, M.A. (2006) Physical properties of root cementum: Part 8. Volumetric analysis of root resorption craters after application of controlled intrusive light and heavy orthodontic forces: a microcomputed tomography scan study. American Journal of Orthodontics and Dentofacial Orthopedics 130: 639–647.
- Higuchi, K.W., Folmer, T. & Kultje, C. (1995) Implant survival rates in partially edentulous patients: a 3-year prospective multicenter study. Journal of Oral & Maxillofacial Surgery 53: 264–268.
- Hildebrand, T. & Regsegger, P. (1997) Quantification of bone microarchitecture with the structure model index. Computer Methods in Biomechanics and Biomedical Engineering 1: 15–23.
- Högler, W., Blimkie, C.J., Cowell, C.T., Inglis, D., Rauch, F., Kemp, A.F., Wiebe, P., Duncan, C.S., Farpour-Lambert, N., Woodhead, H.J. & Blimkie, C.J.R. (2008) Sex-specific developmental changes in muscle size and bone geometry at the femoral shaft. Bone 42: 982–989.
- Jaffin, R.A. & Berman, C.L. (1991) The excessive loss of branemark fixtures in type iv bone: a 5-year analysis. Journal of Periodontology 62: 2–4.
- Johnson, E.L., Roberts, M.W., Guckes, A.D., Bailey, L.J., Phillips, C.L. & Wright, J.T. (2002) Analysis of craniofacial development in children with hypohidrotic ectodermal dysplasia. American Journal of Medical Genetics 112: 327–334.
- Jones, A.S., Reztsov, A. & Loo, C.E. (2007) Application of invariant grey scale features for analysis of porous minerals. Micron 38: 40–48.
- Kalk, W., Denissen, H.W. & Kayser, A.F. (1993) Preventive goals in oral implantology. International Dental Journal 43: 483–491.
- Khosla, S., Riggs, B.L., Atkinson, E.J., Oberg, A.L., McDaniel, L.J., Holets, M., Peterson, J.M. & Melton, L.J.III, Khosla, S., Riggs, B.L., Atkinson, E.J., Oberg, A.L., McDaniel, L.J., Holets, M., Peterson, J.M. & Melton, L.J.III. (2006) Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. Journal of Bone & Mineral Research 21: 124–131.
- Kuhn, J.L., Goldstein, S.A., Feldkamp, L.A., Goulet, R.W. & Jesion, G. (1990) Evaluation of a microcomputed tomography system to study trabecular bone structure. Journal of Orthopaedic Research 8: 833–842.
- Lindquist, L.W., Carlsson, G.E. & Jemt, T. (1996) A prospective 15-year follow-up study of mandibular fixed prostheses supported by osseointegrated implants. Clinical results and marginal bone loss.[erratum appears in clin oral implants res 1997 aug;8(4):342]. Clinical Oral Implants Research 7: 329–336.
- Macdonald, H.M., Nishiyama, K.K., Kang, J., Hanley, D.A., Boyd, S.K., Macdonald, H.M., Nishiyama, K.K., Kang, J., Hanley, D.A. & Boyd, S.K. (2011) Age-related patterns of trabecular and cortical bone loss differ between sexes and skeletal sites: a population-based hr-pqct study. Journal of Bone & Mineral Research 26: 50–62.
- Moon, H.S., Won, Y.Y., Kim, K.D., Ruprecht, A., Kim, H.J., Kook, H.K. & Chung, M.K. (2004) The three-dimensional microstructure of the trabecular bone in the mandible. Surgical and Radiologic Anatomy 26: 466–473.
- Murphy, W.M. (1995) Clinical and experimental bone changes after intraosseous implantation. Journal of Prosthetic Dentistry 73: 31–35.
- Nakata, M., Koshiba, H., Eto, K. & Nance, W.E. (1980) A genetic study of anodontia in x-linked hypohidrotic ectodermal dysplasia. American Journal of Human Genetics 32: 908–919.
- Pigno, M.A., Blackman, R.B., Cronin, R.J., Jr. & Cavazos, E. (1996) Prosthodontic management of ectodermal dysplasia: a review of the literature. Journal of Prosthetic Dentistry 76: 541–545.
- Prager, T.M., Finke, C., Miethke, R.R., Prager, T.M., Finke, C. & Miethke, R.-R. (2006) Dental findings in patients with ectodermal dysplasia. Journal of Orofacial Orthopedics 67: 347–355.
- Schouten, C., Meijer, G.J., van den Beucken, J.J., Spauwen, P.H., Jansen, J.A., Schouten, C., Meijer, G.J., van den Beucken, J.J.J.P., Spauwen, P.H.M. & Jansen, J.A. (2009) The quantitative assessment of peri-implant bone responses using histomorphometry and micro-computed tomography. Biomaterials 30: 4539–4549.
- Schwartz-Arad, D., Kidron, N., Dolev, E., Schwartz-Arad, D., Kidron, N. & Dolev, E. (2005) A long-term study of implants supporting overdentures as a model for implant success. Journal of Periodontology 76: 1431–1435.
10.1902/jop.2005.76.9.1431 Google Scholar
- Silthampitag, P., Klineberg, I., Jones, A.S., Austin, B., Zee, K.Y., Wallace, C., Scholz, S., Naim, A. & Zoud, K. (2011) Ultramicroscopy of bone at oral implant sites: a comparison of ed and regular patients. Part 1 defining the protocol. The International Journal of Prosthodontics 24: 147–154.
- van Steenberghe, D., Lekholm, U., Bolender, C., Folmer, T., Henry, P., Herrmann, I., Higuchi, K., Laney, W., Linden, U. & Astrand, P. (1990) Applicability of osseointegrated oral implants in the rehabilitation of partial edentulism: a prospective multicenter study on 558 fixtures. The International Journal of Oral & Maxillofacial Implants 5: 272–281.
- Tape, M.W. & Tye, E. (1995) Ectodermal dysplasia: literature review and a case report. Compendium of Continuing Education in Dentistry 16: 524–528.
- Truhlar, R.S., Morris, H.F. & Ochi, S. (2000) Implant surface coating and bone quality-related survival outcomes through 36 months post-placement of root-form endosseous dental implants. Annals of Periodontology 5: 109–108.
- Truhlar, R.S., Orenstein, I.H., Morris, H.F. & Ochi, S. (1997) Distribution of bone quality in patients receiving endosseous dental implants. Journal of Oral & Maxillofacial Surgery 55: 38–45.
- Uchiyama, T., Tanizawa, T., Muramatsu, H., Endo, N., Takahashi, H.E. & Hara, T. (1999) Three-dimensional microstructural analysis of human trabecular bone in relation to its mechanical properties. Bone 25: 487–491.
- Ulm, C., Tepper, G., Blahout, R., Rausch-Fan, X., Hienz, S. & Matejka, M. (2009) Characteristic features of trabecular bone in edentulous mandibles. Clinical Oral Implants Research 20: 594–600.
- Weber, H.P. & Fiorellini, J.P. (1992) The biology and morphology of the implant-tissue interface. Alpha Omegan 85: 61–64.
- von Wowern, N., Harder, F., Hjorting-Hansen, E. & Gotfredsen, K. (1990) Iti implants with overdentures: a prevention of bone loss in edentulous mandibles? The International Journal of Oral & Maxillofacial Implants 5: 135–139.
Citing Literature
