Pre-implant assessment of alveolar bone density using dental radiographs and DEXA: a scoping review

Farina Pramanik, Rafiqah Rezky Amelia Jamaluddin, Rifarana Inayah, Daisy Wulansari, Jamas Ari Anggraini, Cortino Sukotjo

Abstract


ABSTRAK

Introduction: Implant stability is strongly influenced by alveolar bone density, as higher density enhances primary stability and supports long-term osseointegration, making its evaluation a crucial component in presurgical planning. Radiological assessment offers a readily available, non-invasive approach for evaluating bone quality prior to implant placement. Commonly used imaging modalities include periapical, panoramic, and cone-beam computed tomography (CBCT), while dual-energy X-ray absorptiometry (DEXA) remains the gold standard for measuring bone mineral density. This review aims to assess alveolar bone density before dental implant placement using periapical, panoramic, CBCT, and DEXA. Methods: A scoping review was conducted across Science Direct, PubMed, PMC, Semantic Scholar, and Google Scholar using the search terms “Alveolar bone, density, presurgical, dental implant, radiograph”. Inclusion and exclusion criteria were applied to 408 retrieved records, yielding 17 relevant articles for analysis. Results: Multiple radiographic methods and measurement protocols were identified. Of the 17 included studies, 7 utilized CBCT, 2 panoramic, 2 periapical, 3 DEXA, and 3 combined modalities. Findings indicated that the mandibular bone, particularly in the anterior region, generally exhibits higher density than the maxillary sites. Substantial variability was noted in measurement techniques, reference points, and units, including HU, g/cm³, mmAleq, and GV. Conclusion: Radiographic evaluation of alveolar bone density is essential for implant treatment planning. CBCT emerged as the most widely used and informative modality. Studies show that the anterior mandibular region has the highest bone density among other regions, thereby affecting implant stability.

KATA KUNCI: alveolar bone density, CBCT, DEXA, panoramic, periapical, radiograph

Penilaian densitas tulang alveolar sebelum perawatan implant menggunakan radiografi dental dan DEXA: a scoping review

ABSTRACT 

Pendahuluan: Stabilitas implan sangat dipengaruhi oleh densitas tulang alveolar, dimana densitas tulang yang tinggi akan meningkatkan stabilitas primer implan dan mendukung osseointegrasi, sehingga evaluasi densitas tulang merupakan tahap yang penting sebelum dilakukan pembedahan. Pemeriksaan radiografi untuk evaluasi kualitas tulang merupakan prosedur yang penting dalam perencanaan sebelum pembedahan implan, oleh karena mudah didapatkan dan tidak bersifat invasif. Radiografi periapikal, panoramik dan CBCT merupakan teknik yang paling sering digunakan untuk mengevaluasi kualitas tulang pada perawatan implant. Sedangkan, DEXA merupakan metode gold standard untuk mengukur densitas mineral tulang. Jurnal ini bertujuan untuk menilai densitas tulang sebelum pemasangan implan, menggunakan radiografi periapikal, panoramik, CBCT dan DEXA. Metode: Scoping review ini menggunakan database seperti Science Direct, PubMed, PMC, Semantic Scholar, dan Google Scholar, menggunakan kata kunci: “Alveolar bone, density, presurgical, dental implant, and radiograph”. Pencarian mendapatkan 408 artikel, dan total 17 artikel yang digunakan pada jurnal ini. Hasil: Berbagai pemeriksaan radiografi dapat digunakan untuk mengevaluasi densitas tulang. Dari total 17 artikel, 7 artikel menggunakan CBCT, 2 panoramik, 3 DEXA, dan 3 menggabungkan 2 modalitas. Hasil penelitian menemukan bahwa mandibula, terutama pada anterior, memiliki densitas tulang yang lebih tinggi dibandingkan maksila. Dari berbagai artikel ini juga didapatkan beberapa perbedaan dalam teknik pengukuran, titik referensi, dan satuan (HU, g/cm³, mmAleq, GV). Simpulan: Pemeriksaan radiografi untuk mengukur densitas tulang alveolar merupakan teknik yang penting dalam menentukan rencana perawatan implant, dengan CBCT menjadi modalitas yang paling sering digunakan dan memberikan informasi yang paling banyak. Penelitian menunjukkan regio anterior mandibula memiliki densitas tulang yang paling tinggi di antara regio lainnya, sehingga mempengaruhi stabilitas implan

KEYWORDS: densitas tulang alveolar, CBCT, DEXA, panoramik, periapikal, radiografi


Keywords


Alveolar bone density, CBCT, DEXA, panoramic, periapical, radiograph

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References


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DOI: https://doi.org/10.24198/pjdrs.v9i3.65953

DOI (PDF): https://doi.org/10.24198/pjdrs.v9i3.65953.g26772

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