Objectives: 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.
Methods and materials: IRB approval was obtained for this study. Of the 125 patients (432 sites) in the study, 53% were female. 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 or 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 IAN or the most inferior point in the nasal floor (NF) in the direction of the crest of bone height (Group C, 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 gender-based disparities in jaw size, we monitored percentage changes in bone.
Results: Loss of alveolar bone width across all groups was common. When bivariate analysis was performed after Bonferroni correction (p<0.025), changes in alveolar bone width were significantly greater in females (p = 0.004). Although the loss in the basal bone was present, it was not significant between the sexes nor as great as alveolar bone resorption (p=0.880). When comparing groups using bivariate analysis, differences were not statistically significant between treatment groups and the control group (p=0.050) for basal bone and for alveolar bone (p=0.052). In the regression analysis for sex or groups, neither was statistically significant for either basal or alveolar bone (p >0.05).
Conclusion: Dental implants do not arrest post-extraction atrophy in either alveolar or basal bone. Females exhibited a statistically greater rate of alveolar bone loss. Stable long-term implant success necessitates precise placement.