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Assessment of residual alveolar bone volume in hemodialysis patients using CBCT
Dan Zhao1, Xiaolei Chen, Li Yue
1State Key Laboratory of Oral Diseases, Department of Oral Implantology, National Clinical Key Specialty, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Insights
This study found that chronic kidney disease patients on hemodialysis have sufficient residual alveolar bone for dental implants. However, bone height in upper jaw areas and width in specific locations were reduced, requiring careful implant planning.
Area of Science:
- Oral and Maxillofacial Surgery
- Nephrology
- Radiology
Background:
- Chronic kidney disease (CKD) and hemodialysis (HD) can impact bone health.
- Assessing residual alveolar bone volume is crucial for dental implant success in CKD patients.
Purpose of the Study:
- To evaluate residual alveolar bone volume in Chinese patients undergoing hemodialysis (HD) using cone-beam computed tomography (CBCT).
- To compare bone dimensions between HD patients and healthy controls for dental implant considerations.
Main Methods:
- CBCT scans were performed on 208 HD patients and healthy controls.
- Residual alveolar bone height and width were measured at specific landmarks.
- Statistical analysis compared bone volume between the two groups.
Main Results:
- No significant demographic or tooth loss differences were found between groups.
- HD patients showed significantly lower residual bone height at upper premolars and first molars compared to controls.
- Alveolar bone width differences were observed at specific upper and lower jaw locations in HD patients.
Conclusions:
- Residual alveolar bone volume is generally sufficient for dental implant placement in HD patients.
- Reduced bone height and varied bone width in specific areas of HD patients necessitate cautious implant treatment planning.
- Implant planning for patients undergoing HD requires special consideration due to altered alveolar bone dimensions.
Background:
The study aims to assess the residual alveolar bone volume in Chinese chronic kidney disease (CKD) patients undergoing hemodialysis (HD) using cone-beam computed tomography (CBCT).
Materials And Methods:
Two hundred and eight HD patients and healthy controls were enrolled to undergo CBCT examination. To evaluate residual alveolar bone volume, bone height was measured from the alveolar crest (AC) to the maxillary sinus floor or the mandibular nerve canal, whereas bone width was measured at a depth of 1.0, 3.0, and 6.0 mm apical to the AC.
Results:
There was no significant difference in demographics and the extent of tooth loss between HD patients and control group. Both groups showed abundant residual bone volume. However, the heights of residual alveolar bone at the upper premolars and first molar in HD patients were significantly lower than those of the control group (p < 0.05). No significant difference was observed for alveolar bone at the lower premolars and molars. The bone width showed statistical differences for HD patients' upper second molars, lower first premolars, and second molars (p < 0.05).
Conclusions:
While the residual bone was sufficient for implant placement, HD patients exhibited with significantly lower residual bone height at the sites of the upper premolars and first molar and varied residual bone width depending on the location.
Clinical Relevance:
Owing to these changes, special cautions need to be taken for patients undergoing HD or with chronically impaired renal functions during implant treatment planning.
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