Noninvasive evaluation of the correlation between thickness of the buccal bone and attached gingiva of maxillary premolars

Abstract

Objective To noninvasively determine the relationship between the thickness of the buccal bone and attached gingiva of the maxillary premolars. Material and Methods 128 maxillary premolars in 32 patients were assessed for measurement of buccal bone thickness and corresponding attached gingival thickness at 3 mm apical to cemento‐enamel junction. Buccal bone thickness was measured on cone‐beam computed tomography scans and attached gingival thickness by ultrasound unit. Pearson's correlation coefficient was calculated to assess the correlation between buccal bone and attached gingival thickness at each tooth type. Results The mean buccal bone thickness at the maxillary premolars was 1.07 mm. The 1st premolars had a buccal bone thickness < 1 mm at 68% of all sites, and the 2nd premolars had a buccal bone thickness of 1.0‐2.0 mm at 32% of all sites. The 1st premolars had a gingival thickness > 1.2 mm at 55% of all sites, and the 2nd premolars had a gingival thickness of 1.1‐1.3 mm at 45% of all sites. The correlation between buccal bone and attached gingival thickness was moderately positive (r = 0.406; P < .001). Conclusions The relationship between buccal bone thickness and gingival thickness is independent of each other in the maxillary right first premolar, whereas a moderate correlation with a dependent relation exists in the maxillary right second premolar, maxillary left first premolar, and maxillary left second premolar. Clinical Significance Soft tissue and hard tissue associated with volumetric changes in maxillary premolar region can be unfavorable for both aesthetic and implant placement. In fact this study highlighted the relationship between the thickness of attached gingiva and corresponding buccal bone in maxillary premolar region so to enable for proper planning of implant therapy following extraction.

In Vivo Evaluation of Periodontal Phenotypes Using Cone-Beam Computed Tomography, Intraoral Scanning by Computer-Aided Design, and Prosthetic-Driven Implant Planning Technology

“…However, Fu et al made soft tissue measurements 2 mm more apically than the bone margin [ 50 ], and Younes et al made them 3 mm below the edge of the gum with an ultrasonic probe 4 mm in diameter [ 19 ]. A clear positive correlation between the buccal bone thickness and attached gingival thickness was also shown by Ganji et al in the upper premolar area in the Saudi population [ 22 ].…”

“…La Rocca et al verified GT at 1 mm from the gingival margin [ 35 ], Claffey et al measured it at 2 mm from the gingival margin [ 34 ], and Zucchelli et al used 1.5 mm from the gingival margin [ 36 ]. Using a periodontal probe, Shah et al measured GT in the middle of the keratinized gingiva [ 20 ], and Ganji et al measured it 3 mm from the CEJ [ 22 ]. Some researchers take GT measurements at 2 or more sites [ 14 , 35 , 37 – 39 ].…”

“…While assessing the TLPAC, Stein et al conducted a radiovisiography examination using the parallel profile radiographs technique [ 14 ]. This examination, however, can only be conducted in the anterior section of the dentition, while CBCT can be conducted in any section of the dentition [ 22 ]. Many authors assessed the thickness of the labial plate of the bone and the locations of the measurement points were diverse depending on the adopted reference point, namely, CEJ or the edge of the alveolar crest [ 19 , 21 , 24 , 25 , 35 , 46 – 49 ].…”

“…Scientists have begun to use 3D visualization for assessment of the periodontal phenotype using the CBCT method. The authors emphasize that it is an examination with high validity and accuracy [ 22 , 23 , 25 , 26 ]. It allows assessment of the dimensions of the TLPAC; however, determining the parameters of soft tissues was often impossible due to their adhesion to the lips, cheeks, and tongue [ 27 , 28 ].…”

Facial Alveolar Bone Thickness and Modifying Factors of Anterior Maxillary Teeth: A Systematic Review and Meta-Analysis of Cone-Beam Computed Tomography Studies

“…According to the geographical setting of the study sample, 15 studies were made in populations from Asia, ve from America, six from Europe and three from Africa. Sixteen studies [12-17, 19, 23, 24, 38-44] analyzed FAB thickness considering FBC as the anatomical reference point, while 13 studies [20,22,25,[45][46][47][48][49][50][51][52][53][54] used CEJ. Fifteen studies analyzed the CEJ-FBC distance; ten studies evaluated the prevalence of FAB thickness < 1 mm, and only 7 analyzed the presence of dehiscence or fenestration.…”