Goals/Purpose:
Facial bone aging is a dynamic process composed primarily of morphologic change and volume loss. The current literature strongly supports that the bone density of the axial skeleton decreases with age with resulting osteoporosis. In this study, we will evaluate how facial bone density changes with age and compare these changes to those found in the bone density of the axial skeleton.
Methods/Technique:
DEXA scans of the facial bones and lumbar spine were obtained from 30 female and 30 male Caucasian subjects. There were ten male and ten female subjects in each of three age categories (20-40, 41-60 and 60+). The following measurements were obtained: maxillary bone density (average bone density of the left and right maxilla), mandibular ramus bone density (average bone density of the left and right mandibular ramus), and lumbar spine bone density (average bone density of L1-L4 vertabrae). Patients with a known diagnosis of osteoporosis were excluded.
Results/Complications:
Lumbar spine bone density significantly decreased with age for both genders between the middle and old age groups. Both the maxillary and mandibular ramus bone density decreased significantly with age for both genders between the young and middle age groups. Female subjects within each age group had decreased bone density of the lumbar spine and maxilla compared to male subjects.
Average Age Within Each Age Group for Both Genders
| Young Age | Middle Age | Old Age |
Male (yrs) | 29.9 | 54.5 | 76 |
Female (yrs) | 27 | 51 | 70 |
Average Lumbar, Maxillary and Mandibular Bone Density
| Young Age | Middle Age | Old Age |
Lumbar Spine Density Male (gm/cm2) | 1.29 | 1.29 | 1.15 |
Lumbar Spine Density Female (gm/cm2) | 1.23 | 1.24 | 1.08 |
Maxillary Density Male (gm/cm2) | 1.9 | 1.58 | 1.56 |
Maxillary Density Female (gm/cm2) | 1.75 | 1.55 | 1.5 |
Mandibular Density Male (gm/cm2) | 1.52 | 1.33 | 1.35 |
Mandibular Density Female (gm/cm2) | 1.52 | 1.32 | 1.18 |
Conclusion:
These results suggest that the bony density of the face changes dramatically with age. This loss of bony density may contribute to the decreased facial bone volume and projection seen with aging. Our results suggest that the axial and facial skeleton undergo similar decreases in bone density with age, and that facial bone aging may be linked to the same metabolic factors that cause osteoporosis in the axial skeleton. A better understanding of facial bone strength and support will further our understanding of facial aging and future possibilities for facial rejuvenation.
