Retrospective clinical artificial intelligence-assisted study of loaded peri-implant versus edentulous bone

Abstract

Abstract This study aims to clarify the relationship between mechanical stimulation by masticatory loading, bone mineralization distribution (BMD) and osteocyte lacunar shape complexity features (SCFs), through the retrospective clinical analysis of peri-implant bone compared to edentulous bone in human jaws. The multivariate analysis was conducted in two dental contexts: in peri-implant bone, subjected to mechanical forces during chewing, and in edentulous bone, not subjected to masticatory load. The study was conducted by synchrotron radiation high-resolution phase-contrast tomography combined with artificial intelligence (AI)-based image segmentation techniques. Histomorphometry was performed to verify and complement results with additional information on soft tissues. Osteocyte lacunar volume was shown to be significantly larger in the peri-implant group than in the edentulous group. Wide distributions of Aspect Ratio and Sphericity were found in edentulous specimens; this variation was not observed among peri-implant bone samples, suggesting that loading affects peri-implant lacunar SCFs, making them more uniform in shape and size. Lacunar SCFs were found highly correlated with BMD parameters only in the peri-implant (loaded) tissues and not in the edentulous bone. Overall, our results confirm that mechanical loading positively influences osteocyte activity, which suggests that immediate loading of dental implants has a biologic rationale.