Ultrasound measurement of mandibular arterial blood supply: techniques for defining ischemia in the pathogenesis of alveolar ridge atrophy and tooth loss in the elderly?

PURPOSE

To adapt ultrasound methods used to measure blood flow in the extremities to quantify mandible blood flow in order to determine the role of ischemia in the pathogenesis of mandible atrophy and tooth loss in the elderly.

PATIENTS AND METHODS

Doppler and duplex ultrasound techniques as used in measurement of arterial pulse in the extremities were adapted for recording the intraoral pulse profile at 7 sites in 57 patients of varying ages.

RESULTS

After omitting the large number (26 patients) with signals of indeterminate strength, the mental artery pulse was strong in 11 of 12 (92%) in those younger than 65 versus 9 of 19 (47% in those older than 65 years; P = .02). The equivalent figures for the sublingual artery were 15 of 15 strong for those younger than 65 and 11 of 17 (65%) for those older than 65 years ( P = .02). The varying depth of soft tissue overlying the inferior alveolar artery made its signal difficult to evaluate, but there was no statistically significant age-related difference in the inferior alveolar artery signals. In 4 elderly patients (2 with established carotid artery disease), Doppler and duplex scanning showed reversal of mental artery flow, indicating collateral flow to the mandible.

CONCLUSIONS

Ultrasound Doppler techniques used for measuring peripheral arterial flow can be adapted to quantify mandible alveolar ridge perfusion. This provides means to evaluate the role of arterial obstruction in mandible alveolar ridge atrophy and tooth loss in the elderly. The mental artery is the best site for this purpose. Preliminary data suggest an age-related reduction in mental artery flow.