Alveolar Cortical Bone Density among Different Facial Types: A CBCT Study

Aim: To evaluate and compare the cortical bone density amongst skeletally Class I individuals with different facial forms using Cone Beam Computer Tomography (CBCT). Materials and Methods: Cross-sectional study was conducted using pre-treatment CBCT records of 45 patients, 15 each of hyperdivergent, normodivergent and hypodivergent facial pattern categories selected from the institutional archives. Median bone density was assessed in anterior and posterior sites of maxilla and mandible, followed by comparison of data between hypodivergent, normodiveregent and hyperdivergent subjects. The inter-group statistical comparison of continuous variables was done using Kruskal-Wallis H test. Intra-group statistical comparison of continuous variables was done using Mann-Whitney U test. Results: Median anterior bone density in maxilla and mandible were relatively similar across the 03 facial patterns (P>0.05). However, buccal cortical bone density was increased in normodivergent and hypodivergent subjects compared to hyperdivergent subjects, which was statistically significant (P<0.05). It was also noticed in this study that the density of left buccal region was higher when compared to right which was statistically significant (P<0.05), across 3 facial patterns. Conclusion: This study concludes that hyperdivergent subjects have relatively less dense bones in both maxilla and mandible as compared to other facial patterns. Clinically, it is advised to place wider diameter and increased length TADs in these subjects for better initial and long term stability. However, long term prospective studies with a larger sample size are required to validate the findings of these studies.