Assessment of buccal bone thickness of aesthetic maxillary region: a cone-beam computed tomography study

Abstract

PurposeThe aim of this study was to analyze the anatomical dimensions of the buccal bone walls of the aesthetic maxillary region for immediate implant placement, based upon cone-beam computed tomography (CBCT) scans in a sample of adult patients.MethodsTwo calibrated examiners analyzed a sample of 50 CBCT scans, performing morphometric analyses of both incisors and canines on the left and right sides. Subsequently, in the sagittal view, a line was traced through the major axis of the selected tooth. Then, a second line (E) was traced from the buccal to the palatal wall at the level of the observed bone ridges. The heights of the buccal and palatal bone ridges were determined at the major axis of the tooth. The buccal bone thickness was measured across five lines. The first was at the level of line E. The second was at the most apical point of the tooth, and the other three lines were equidistant between the apical and the cervical lines, and parallel to them. Statistical analysis was performed with a significance level of P≤0.05 for the bone thickness means and standard deviations per tooth and patient for the five lines at varying depths.ResultsThe means of the buccal wall thicknesses in the central incisors, lateral incisors and canines were 1.14±0.65 mm, 0.95±0.67 mm and 1.15±0.68 mm, respectively. Additionally, only on the left side were significant differences in some measurements of buccal bone thickness observed according to age and gender. However, age and gender did not show significant differences in heights between the palatal and buccal plates. In a few cases, the buccal wall had a greater height than the palatal wall.ConclusionsLess than 10% of sites showed more than a 2-mm thickness of the buccal bone wall, with the exception of the central incisor region, wherein 14.4% of cases were ≥2 mm.

Buccal Bone Thickness in the Esthetic Zone of Postmenopausal Women

“…[13][14][15] Although many recent studies draw this same conclusion, these previous studies combine sexes for analysis, or do not differentiate between younger and older subjects. [16][17][18][19][20][21][22] The focus of this study is on sex-related and age-related differences, and hence uses an adequate sample size to identify differences between younger and older subjects of each sex. Using CBCT to resolve bone thicknesses less than 1 mm have shown questionable reliability, however, the clinical relevance of resolving this dimension is reportedly minimal.…”

Cone‐Beam Computed Tomography and Interdisciplinary Dentofacial Therapy: An American Academy of Periodontology Best Evidence Review Focusing on Risk Assessment of the Dentoalveolar Bone Changes Influenced by Tooth Movement

“…Cone‐beam computed tomography (CBCT) in periodontology has primarily been used for diagnostic inquiry of regional anatomy and vital structure identification in dental implant treatment 1‐6 . Historically, treatment planning decisions and risk assessment specific to alveolar bone of the natural dentition in patients requiring orthodontic tooth movement has been either intuitive and subjectively measured or determined from clinical information and two‐dimensional (2D) radiographic analyses 7,8 .…”

“…Historically, treatment planning decisions and risk assessment specific to alveolar bone of the natural dentition in patients requiring orthodontic tooth movement has been either intuitive and subjectively measured or determined from clinical information and two‐dimensional (2D) radiographic analyses 7,8 . Unequivocally, studies have confirmed that three‐dimensional (3D) imaging allows for superior measurement accuracy of alveolar ridge height and width, a known limitation of intraoral periapical or panoramic radiographs 1‐6 . It is well recognized that traditional 2D imaging diagnostics do not allow for meaningful dentoalveolar bone risk assessment, namely of the buccal plate, prior to orthodontic tooth movement 7,8 .…”

“…C one-beam computed tomography (CBCT) in periodontology has primarily been used for diagnostic inquiry of regional anatomy and vital structure identification in dental implant treatment. [1][2][3][4][5][6] Historically, treatment planning decisions and risk assessment specific to alveolar bone of the natural dentition in patients requiring orthodontic tooth movement has been either intuitive and subjectively measured or determined from clinical information and two-dimensional (2D) radiographic analyses. 7,8 Unequivocally, studies have confirmed that three-dimensional (3D) imaging allows for superior measurement accuracy of alveolar ridge height and width, a known limitation of intraoral periapical or panoramic radiographs.…”

“…7,8 Unequivocally, studies have confirmed that three-dimensional (3D) imaging allows for superior measurement accuracy of alveolar ridge height and width, a known limitation of intraoral periapical or panoramic radiographs. [1][2][3][4][5][6] It is well recognized that traditional 2D imaging diagnostics do not allow for meaningful dentoalveolar bone risk assessment, namely of the buccal plate, prior to orthodontic tooth movement. 7,8 Only recently 7,8 has 3D CBCT imaging been considered to have diagnostic merit in providing risk assessment of alveolar bone loss (ABL) produced from tooth movement and in improving the comprehensive diagnostic process of interdisciplinary dentofacial therapy (IDT) for the craniomandibular system.…”