Long-term CBCT evaluation of bone volume stability post dental implant placement: 1. Exploring sex as a risk factor

This retrospective study assesses the long-term effects of implants on alveolar and basal bone to determine if a patient's sex affects dimensional changes in the jaw and evaluate whether dental implants halt the atrophy of bone when compared to no post-extraction intervention.

Institutional Review Board approval was obtained for this study. Of the 125 patients (432 sites) in the study, 53% were women. All had two CBCTs taken, an average of 4.7 years apart. The scans were divided into three groups. In the control group, the extraction site (first CBCT, T1) was not replaced when the second scan was taken (T2). Group 2 had no implant at T1 and an implant at T2. Group 3 had an implant at T1 and T2. Measurements were made from landmarks at predetermined levels (superior cortex of the inferior alveolar nerve or the most inferior point in the nasal floor in the direction of the crest of bone height (control group and groups 2 and 3). To avoid osseous changes due to placement, measurements were made from the inferior alveolar nerve for mandibular implants or the nasal floor for maxillary implants. Recognizing sex-based disparities in jaw size, percentage changes in bone were monitored.

Loss of alveolar bone width across all groups was common. When bivariate analysis was performed after Bonferroni correction (P .025), changes in alveolar bone width were significantly greater in women (P = .004). Although the loss in the basal bone was present, it was not significant between the sexes nor as great as alveolar bone resorption (P = .880). When comparing groups using bivariate analysis, differences were not statistically significant between treatment groups and the control group (P = .050) for basal bone and for alveolar bone (P = .052). In the regression analysis for sex or group, neither was statistically significant for either basal or alveolar bone (P > .05).

Dental implants do not arrest post-extraction atrophy in either alveolar or basal bone. Women exhibited a statistically greater rate of alveolar bone loss. Stable long-term implant success necessitates precise placement.