Alveolar bone heterogeneity during aging: a cone-beam CT based assessment of alveolar bone in tooth loss patients

This retrospective study aimed to evaluate differences in cortical and trabecular alveolar bone between normal dentition and edentulous sites across different age and sex groups. A total of 191 partially edentulous patients who underwent preoperative cone-beam CT (CBCT) were retrospectively analyzed. Cortical bone thickness, cortical bone density, and trabecular bone density were measured at both normal dentition and edentulous sites across six anatomical regions in the maxilla and mandible. Comparisons were made across age groups and sexes, and between paired edentulous and normal sites. Implant outcomes were recorded, and success rates were calculated. At normal dentition sites, cortical bone thickness and density significantly declined with age, particularly in the posterior regions. Young females showed higher cortical bone mass than males, though this difference diminished with age. In contrast, trabecular bone density tended to increase with age. Edentulous sites showed significantly reduced cortical thickness, cortical density, and trabecular density compared to normal sites. Among 180 patients with implant placement, the success rate was 98.88%, with failures limited to three male patients. This study revealed heterogeneous alterations in alveolar bone associated with aging, with cortical bone exhibiting more pronounced atrophy than trabecular bone. Despite these variations in bone quantity and quality, implant restoration achieved a high success rate, regardless of the underlying alveolar bone condition.