A review of residual ridge resorption and bone density

Residual ridge resorption is a common and often incapacitating problem, particularly for persons with edentulous mandibles. Several studies suggest a correlation between ridge resorption and osteoporosis. Recent radiologic studies indicate that the mineral density of the cortex and the bone mass in the mandible are correlated with skeletal bone density. Most resorption occurs in the alveolar process, whereas the basal portion remains relatively intact. On the other hand, radiologic measurements of bone density primarily yield information after the basal portion, where the bone mass of the mandible is greatest and functional stresses of mastication may affect bone density. Ironically, radiologic measurements may not accurately indicate the effect of osteoporosis on alveolar resorption. Apparently, excessive occlusal force can also produce extensive atrophy without systemic impact. Not until muscular function decreases does real osteoporosis develop in edentulous jaws. Not only does the volume of the ridge decrease, but also the density of the basal portion decreases as a result of diminished function. This article reviews the literature on residual ridge resorption and components that may affect the rate of resorption.