Evaluation of mandibular bone abnormalities in patients with chronic kidney disease using cone beam computed tomography: A retrospective study

ACTA ODONTOLOGICA SCANDINAVICA

Heelim Lee(a,†), Jae Suk Jung(a,†), Jiwoo Lee(a), Seung Il Song(b), Jeong Keun Lee(b), Ji Min Kim(c), Bumhee Park(c), Inwhee Park(d) and Suk Ji(a,* )

a Department of Periodontology, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea

b Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea

c Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Medical Center, Suwon, Republic of Korea

d Department of Nephrology, Ajou University School of Medicine, Suwon, Korea

† Contributed equally to this work.

* Correspondence

Objective: This study evaluated mandibular cortical thickness and morphological changes in chronic kidney disease (CKD) patients using cone beam computed tomography (CBCT) and their correlation with bone metabolism markers.

Methods: CKD patients were divided into CKD-I (eGFR (estimated glomerular filtration rate) < 30) and CKD-II (eGFR ≥ 30) groups, with healthy controls for comparison. Mental index (MI), antegonial index (AI), and panoramic mandibular index (PMI) were compared using Kruskal-Wallis test. Mandibular cortical index (MCI) classifications, lamina dura loss, and soft tissue calcifications were assessed using Fisher’s test. Relationships between serum bone metabolism markers and radiomorphometric indices were analyzed by linear regression.

Results: The study included 94 CKD patients (56 CKD-I, 38 CKD-II) and 88 controls. MI and AI were significantly lower in CKD-I versus controls (p < 0.05). MCI class I was less prevalent in CKD-I (5.4%) than controls (35.2%) (p < 0.001). Lamina dura loss (p = 0.006) and soft tissue calcifications (p = 0.009) occurred more frequently in CKD groups. Elevated alkaline phosphatase was associated with reduced cortical thickness (p < 0.01).

Conclusions: Although findings should be interpreted considering the retrospective design’s limitations, CBCT revealed significant bone abnormalities in CKD patients, with compromised bone quality and reduced mandibular cortical thickness, especially in advanced renal impairment, suggesting its value for pre-implant bone quality assessment in CKD patients.

Renal insufficiency; chronic; bone diseases; metabolic; cone-beam computed tomography; dental implantation

https://doi.org/10.2340/aos.v84.44619