A principal components analysis: how pneumatization and edentulism contribute to maxillary atrophy

• Published in: Oral diseases Vol. 23; no. 1; pp. 55 - 61
• Main Authors: Wagner, F, Dvorak, G, Nemec, S, Pietschmann, P, Figl, M, Seemann, R
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01-01-2017
• Subjects: Aged; alveolar bone atrophy; Alveolar Bone Loss - complications; Alveolar Bone Loss - diagnostic imaging; Alveolar Bone Loss - pathology; alveolar ridge augmentation; dental implants; Dentistry; Face; Female; Humans; Male; Maxilla - diagnostic imaging; Maxilla - pathology; Maxillary Diseases - diagnostic imaging; Maxillary Diseases - pathology; Maxillary Sinus - diagnostic imaging; Maxillary Sinus - pathology; Middle Aged; morphology; Mouth, Edentulous - complications; Mouth, Edentulous - pathology; preprosthetic oral surgical procedure; Principal Component Analysis; Principal components analysis; Retrospective Studies; Tomography; Tomography, X-Ray Computed; alveolar ridge augmentation; morphology; alveolar bone atrophy; dental implants; principal components analysis; preprosthetic oral surgical procedure
• ISSN: 1354-523X; 1601-0825
• DOI: 10.1111/odi.12571

Objective
The aim of this retrospective cohort study was to investigate the role of sinus pneumatization and residual ridge resorption in maxillary bone loss in 400 computed tomography (CT) scans.
Materials and Methods
In 200 dentate and 200 edentulous patients, both sinuses were analysed using CT scans. The image analysis sequence consisted of manual placement of 24 reference points, followed by automated segmentation and final manual refinement. Finally, a principal components analysis was performed.
Results
A total of 788 sinuses were included into the analysis. The edentulous group (98 female: 67.77 ± 11.28 years, 99 male: 65.22 ± 9.87) was significantly older than the group with teeth (99 female: 46.89 ± 16.77 years, 96 male: 49.74 ± 16.2). Female and male patients did not differ regarding age. The alveolar height differed significantly between the groups (edentulous: 7.1 ± 4.3 mm, with teeth: 9.7 ± 4.1 mm), but not between gender (female: 8.3 ± 4.4 mm, male: 8.5 ± 4.4 mm). Principal components analysis was able to explain 90% of the variation in sinus morphology.
Conclusions
Prolonged edentulism in the maxillary molar region leads to centripetal and to minor degrees centrifugal ridge resorption. Minor pneumatization occurs in the sinus walls, but the sinus depth underlies the anatomical variation independent of dentition.