Influence of mastication and edentulism on mandibular bone density

The aim of this study was to demonstrate that external loading due to daily activities, including mastication, speech and involuntary open–close cycles of the jaw contributes to the internal architecture of the mandible. A bone remodelling algorithm that regulates the bone density as a function of stress and loading cycles is incorporated into finite element analysis. A three-dimensional computational model is constructed on the basis of computerised tomography (CT) images of a human mandible. Masticatory muscle activation involved during clenching is modelled by static analysis using linear optimisation. Other loading conditions are approximated by imposing mandibular flexure. The simulations predict that mandibular bone density distribution results in a tubular structure similar to what is observed in the CT images. Such bone architecture is known to provide the bone optimum strength to resist bending and torsion during mastication while reducing the bone mass. The remodelling algorithm is used to simulate the influence of edentulism on mandibular bone loss. It is shown that depending on the location and number of missing teeth, up to one-third of the mandibular bone mass can be lost due to lack of adequate mechanical stimulation.