歯槽骨の質の評価。ヒストモルフォメトリック分析とLekholmとZarbの分類との相関性

Evaluation of Alveolar Bone Quality: Correlation Between Histomorphometric Analysis and Lekholm and Zarb Classification.

抄録

目的:

OBJECTIVES: This study evaluated the bone quality of the maxilla and mandible by using the classification proposed by Lekholm and Zarb (L & Z) and histomorphometry.

方法:

METHODS: Sixty edentulous areas were evaluated. The classification by L & Z was obtained through the evaluation of periapical and panoramic radiographs associated with the surgeon's tactile perception during milling and implant installation. Before implant installation, bone biopsies of standardized sizes were performed for histological evaluation.

結果:

上顎骨ではタイプIIIの骨質が後面（73.33％）と前面（73.33％）に多く、下顎骨ではタイプIIの骨質が後面（53.33％）と前面（60.00％）に多かった。ヒストメトリーにより、上顎の後方領域の骨組織量は、下顎の前後領域との関係で統計的な差が認められた（P≦0.043）。しかし、歯槽骨領域間の骨細胞数には差がありませんでした（P = 0.2946）。女性では、年齢とL＆Z分類との間に低い正の相関関係が認められ（rho＝0.398、P＝0.006）、男性では中程度の負の相関関係が認められた（rho＝-0.650、P＝0.016）。

RESULTS: Type III bone quality was more frequent in the posterior (73.33%) and anterior (73.33%) maxilla, whereas type II bone quality was more frequent in the posterior (53.33%) and anterior (60.00%) mandible. Through histometry, statistical difference was observed for the amount of bone tissue of the posterior region of the maxilla in relation to the anterior and posterior regions of the mandible (P ≤ 0.043). However, there was no difference in osteocyte counts between alveolar regions (P = 0.2946). In the female gender, the age showed a low positive correlation with the L & Z classification (rho = 0.398; P = 0.006) and in the male gender, a moderate negative correlation was observed (rho = -0.650, P = 0.016).

おわりに:

CONCLUSIONS: Both methods detected differences in the bone quality of the alveolar regions of the maxilla/mandible and that the classification by L & Z is a reliable method, since it was consistent with histomorphometry, considered the "gold standard" method for the evaluation of bone quality and greater bone density was observed in older men.