A comparative analysis of craniofacial bone density based on embryonic origin and ossification patterns

Objective: Bones develop from various embryonic origins and are formed through either endochondral or intramembranous ossification. This study aimed to explore how bone density varies across bones with different embryonic origins and ossification processes. Materials and methods: A total of 43 participants (12 males; mean age 68.3 ± 9.9 years) with a history of falls and suspected facial and wrist fractures were included. Participants were subsequently divided into three groups based on levels of osteoporosis based on the T-score of the areal bone density (aBMD) at the femoral neck. aBMD was measured using dual-energy x-ray absorptiometry (DEXA) of the total hip, femoral neck, and lumbar spine. Bone densities of the distal radius, hyoid, and craniofacial bones, including mandible, maxilla, frontal, parietal, zygomatic, and temporal bones were assessed using 3D reconstructed computed tomography images. Results: The average Hounsfield Unit of the reconstructed distal radius model varies significantly across osteoporosis levels. However, no significant differences were found in the craniofacial bones or hyoid bone models. Significant correlations were identified between bone densities of the axial and appendicular skeletons. In contrast, the craniofacial bones exhibited strong internal correlations but minimal associations with those of axial or appendicular bones, revealing distinct bone density patterns influenced by embryonic origin and ossification processes. Conclusion: Different embryonic origins and ossification processes give rise to distinct bone density patterns. These results underscore the importance of careful considerations beyond DEXA outcomes when predicting fracture risk or planning the procedures involving bone preparation, particularly in craniofacial regions.