Charles F. Hildebolt, D.D.S., Ph.D.

DEPARTMENT OF Radiology
Keywords: bone loss quantitation, calcium, medical imaging, osteoporosis, vitamin D

According to the NIH and the Surgeon General’s Report on Oral Health, the majority of Americans have experienced gum disease, and the problem is most common in the elderly. Gum disease (periodontal disease) causes alveolar bone loss, and over time can result in tooth loss. In fact, 42% of Americans over the age of 65 are toothless (edentulous), and in this growing segment of the population, edentulism reduces the quality of life, impairs nutrition and requires costly treatments. Oral-bone loss and subsequent tooth loss cost an estimated $5-6 billion/year for just the surgical treatments related to oral-bone loss. Specific factors responsible for this loss and continued resorption of the residual alveolar ridge (subsequent to tooth loss) are not well understood, nor have treatments been identified to lessen or prevent this loss.

Dr. Hildebolt’s long-term goals are to provide new methods for using digital dental radiographic images to obtain oral bone mass measurements and to use these methods for osteoporotic risk assessment, treatment monitoring, and research. With methods that he and his colleagues have developed, they have found that oral bone loss is associated with femoral and vertebral bone loss and that estrogen and/or calcium and vitamin D can reduce this bone loss. He and his colleagues are currently investigating the extent to which increased intakes of calcium and vitamin D improve oral health in adults. The possibility of promoting alveolar bone gain or reducing alveolar bone loss with calcium and vitamin D supplementation could have a significant impact on quality of life by leading to a reduction in surgical treatments aimed at repairing or minimizing alveolar bone damage caused by periodontal disease, a decrease in tooth loss attributable to alveolar bone loss, a decline in the placement of implants or prosthetic devices (bridges and partial dentures) to replace lost teeth, and a reduction in the number of denture remakes and relines required because of alveolar bone resorption. Dr. Hildebolt and his colleagues are currently working on a system that will replace intraoral dental films with photostimulable phosphor plates. They are also studying disease-induced changes in the microstructure of alveolar bone (that is, the trabecular structure of cancellous bone and the osteon structure of cortical bone). Other areas for which Dr. Hildebolt has research interest include morphometric variation in skulls, brains, and teeth of contemporary humans and fossil hominids.