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Villa-Campos O, Reis INRD, César-Neto JB, Romito GA. Management of an extensive soft tissue deficiency prior to immediate implant in the aesthetic zone: a 4-year follow-up. BMJ Case Rep 2024; 17:e259271. [PMID: 38925675 DOI: 10.1136/bcr-2023-259271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Soft tissue deficiency in a tooth extraction site in the aesthetic area is a common and challenging clinical situation. This case report demonstrates the successful treatment of extensive gingival recession and buccal bone dehiscence associated with a hopeless tooth. Initially, a connective tissue graft was used to cover the root and thicken the soft tissue. After 2 months, the tooth was extracted, an implant was immediately placed, and a temporary restoration was installed. After 3 months, the soft tissue exhibited a natural and harmonious architecture. A custom zirconia abutment and crown were then fabricated and placed. At the 4-year follow-up, the peri-implant tissue displayed satisfactory aesthetics, with a well-structured buccal bone plate and healthy peri-implant indicators. This two-stage approach, addressing gingival recession first and proceeding with immediate implant placement after soft tissue healing, proved to be a safe and effective method with stable long-term results.
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Zhang Y, Wen G, Dong W. Clinical outcomes of narrow- and regular-diameter implants with bone augmentation in the anterior maxilla: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:196. [PMID: 38443497 DOI: 10.1007/s00784-024-05588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES To evaluate the clinical outcomes of narrow-diameter implants (NDIs) and regular-diameter implants (RDIs) with bone augmentation in the anterior maxilla, with implant survival rate (ISR) as the primary outcome. Additionally, secondary outcomes such as peri-implant marginal bone loss (MBL), pocket probing depth (PPD), mechanical complications, and biological complications were also considered. MATERIALS AND METHODS A thorough literature search was performed to identify randomized controlled trials and cohort studies comparing outcomes of NDIs and RDIs with bone augmentation in the anterior maxilla published up to February 2024. Only studies with a minimum follow-up period of 12 months were selected for analysis. Meta-analysis was performed if at least two articles with similar characteristics were available. RESULTS Of the 288 articles initially considered, 5 were included in the analysis, involving 282 NDIs and 100 RDIs. At the 36-month follow-up, no statistically significant differences in ISR, which ranged 93.8-100% for NDIs and were 100% for RDIs, were observed between the two groups (relative risk, 0.989; 95% confidence interval, 0.839-1.165; p = 0.896). Similarly, MBL and PPD did not differ significantly between the two groups. Soft tissue dehiscence was the most common complication found in RDIs. CONCLUSION The results indicate that NDIs yield clinical outcomes similar to those of RDIs with bone augmentation in the anterior maxilla over a 36-month follow-up period. CLINICAL RELEVANCE Considering the similar clinical outcomes, the shortened treatment duration and more rapid esthetic improvement associated with NDIs may render them preferrable to RDIs with bone augmentation, particularly in this esthetic zone.
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Affiliation(s)
- Yan Zhang
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China
| | - Guochen Wen
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China
| | - Wei Dong
- School of Stomatology, North China University of Science and Technology, Tangshan, Hebei, 063210, China.
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Pan W, Yu L, Chen S, Zhou J, Chi J, Voliere G, Du W, Gong Y, Lin H, Hu R. Morphometric evaluation of alveolar bone after orthodontic treatment of multiple impacted teeth in the unilateral maxillary anterior region. Am J Orthod Dentofacial Orthop 2023; 164:783-792. [PMID: 37498252 DOI: 10.1016/j.ajodo.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION This study aimed to investigate the height and thickness of alveolar bone by cone-beam computed tomography imaging after orthodontic treatment in the unilateral maxillary anterior region and speculate on reasons for the difference in alveolar bone morphology. METHODS This study selected 11 patients (3 males and 8 females; mean age, 9.42 ± 1.45 years). Cone-beam computed tomography was performed for these 11 patients before and after treatment using Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). Labial and palatal alveolar bone thickness (BT) at root apices and different levels along the roots and loss of alveolar bone height was measured for each impacted tooth and its contralateral homonymous tooth. RESULTS After orthodontic therapy, all 3 impacted anterior teeth had different degrees of loss of labial alveolar bone height compared with the normal side (central incisor: -1.5 mm, P <0.005; lateral incisor: -1.06 mm, P <0.01; canine: -0.59 mm, P < 0.01). The lateral incisors also showed palatal alveolar bone height loss compared with the unaffected side (-0.8 mm, P <0.005). Alveolar BT at root apices of impacted canines was 1.14 mm thicker than the normal side (P <0.005). Central and lateral incisors were similar to the normal side. The thickness of the alveolar bone at 8, 10, and 12 mm of the impacted canine position was still larger than that on the healthy side, whereas the difference in average thickness between the healthy and affected side had been significantly reduced compared with pretreatment measurements. CONCLUSIONS There is satisfactory retention of alveolar bone height in canines after orthodontic treatment; however, alveolar bone loss is slightly worse at central and lateral incisors. Retention of alveolar BT was normal for impacted anterior teeth, whereas excess apical alveolar BT at the canines, although still present, was substantially less significant than had been observed before treatment.
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Affiliation(s)
- Wenhao Pan
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Liyun Yu
- Third Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Siyun Chen
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jianan Zhou
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jun Chi
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Gerald Voliere
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wulong Du
- Department of Stomatology, Lishui Central Hospital/The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, China
| | - Yixuan Gong
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China
| | - Haisheng Lin
- Department of Stomatology, Taizhou Hospital, Wenzhou Medical University, Taizhou, Zhejiang, China.
| | - Rongdang Hu
- Department of Orthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Huang Z, Shi J, Gao G, Shi M, Gong Z, Liu H, Zeng P, Chen S, Gan X, Ding J, Wang Y, Chen Z. Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment: A retrospective cross-sectional study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101634. [PMID: 37709143 DOI: 10.1016/j.jormas.2023.101634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/26/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Apical palatal bone is important in immediate implant evaluation. Current consensus gives qualitative suggestions regarding it, limiting its clinical decision-making value. OBJECTIVES To quantify the apical palatal bone dimension in maxillary incisors and reveal its quantitative correlation with other implant-related hard tissue indices to give practical advice for pre-immediate implant evaluation and design. MATERIAL AND METHODS A retrospective analysis of immediate implant-related hard tissue indices in maxillary incisors obtained by cone beam computed tomography (CBCT) was conducted. Palatal bone thickness at the apex level (Apical-P) on the sagittal section was selected as a parameter reflecting the apical palatal bone. Its quantitative correlation with other immediate implant-related hard tissue indices was revealed. Clinical advice of pre-immediate implant assessment was given based on the quantitative classification of Apical-P and its other correlated immediate implant-related hard tissue indices. RESULTS Apical-P positively correlated with cervical palatal bone, whole cervical buccal-palatal bone, sagittal root angle, and basal bone width indices. while negatively correlated with apical buccal bone, cervical buccal bone, and basal bone length indices. Six quantitative categories of Apical-P are proposed. Cases with Apical-P below 4 mm had an insufficient apical bone thickness to accommodate the implant placement, while Apical-P beyond 12 mm should be cautious about the severe implant inclination. Cases with Apical-P of 4-12 mm can generally achieve satisfying immediate implant outcomes via regulating the implant inclination. CONCLUSIONS Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment can be achieved, providing a quantitative guide for immediate implant placement in the maxillary incisor zone.
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Affiliation(s)
- Zhuwei Huang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Jiamin Shi
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Guangqi Gao
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Mengru Shi
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Zhuohong Gong
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Haiwen Liu
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Peisheng Zeng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Shijie Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Xuejing Gan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Jianfeng Ding
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China
| | - Yan Wang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China.
| | - Zetao Chen
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China.
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Aljabr AA, Almas K, Aljofi FE, Aljabr AA, Alzaben B, Alqanas S. A CBCT Study of Labial Alveolar Bone Thickness in the Maxillary Anterior Region in a Teaching Hospital Population in the Eastern Province of Saudi Arabia. Biomedicines 2023; 11:1571. [PMID: 37371666 DOI: 10.3390/biomedicines11061571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/19/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Labial alveolar bone thickness in the maxillary anterior region is the key factor in the placement of implants. Differences in the thickness of the bone are reported among different ethnic groups. Thus, the present study was aimed at assessing labial alveolar bone thickness in the maxillary anterior region in the population of the eastern province of Saudi Arabia. MATERIALS AND METHODS The six anterior teeth in each of the 186 CBCT sagittal images were analyzed at three points: Point A from the facial plate at the level of the bone crest to the coronal root third, Point B to the mid-root surface, and Point C to the apical third. Crest height (Point D) was measured as the distance from the CEJ to the alveolar bone crest. The analysis was done using SPSS version 20. A p-value of <0.05 was considered statistically significant. RESULTS The bone thickness at any given point (Point A, Point B, or Point C) was less than the preferred bone thickness of 2 mm in all six teeth. The thickness was minimum at Point B, maximum at Point C, and intermediate at Point A. This difference was found to be statistically significant (p-value < 0.05). The crestal height (Point D) was less than 3 mm, and it was not statistically significant. Comparison of bone thickness on the right and left sides for any given point was not statistically significant except at Point A in the central incisor, where it was statistically significant (p-value = 0.035). Gender comparison of bone thickness showed no difference at Point A; however, at Points B and C, it showed statistical significance (p-value < 0.05). CONCLUSIONS The alveolar bone thickness being <2 mm in the labial anterior region warns of the importance of the proper assessment of bone during implant placement to have a predictable outcome.
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Affiliation(s)
- Abdulmajeed A Aljabr
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Faisal E Aljofi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Abdullah A Aljabr
- Department of Medical Education, College of Dentistry, Majmaah University, P.O. Box 1712, Al Majma'ah 15341, Saudi Arabia
| | - Bader Alzaben
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sarah Alqanas
- College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Zhang T, Zhang L, Li M, Yi F, Li C, Lu Y. Morphological changes in alveolar bone thickness and height after orthodontic proclination or labial movement combined with autogenous soft tissue grafting: a CBCT evaluation. BMC Oral Health 2023; 23:218. [PMID: 37061689 PMCID: PMC10105956 DOI: 10.1186/s12903-023-02944-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Autogenous soft tissue grafting is indicated in thin gingival biotypes before orthodontic proclination or labial movements to increase the keratinized gingiva and prevent gingival recession. However, its effect on local alveolar bone remodeling is unclear. The aim of this study was to investigate the effects of autogenous soft tissue grafting on local alveolar bone after orthodontic proclination or labial movements. METHODS Sixteen patients with a thin scalloped gingival biotype, narrow keratinized gingiva, or thin cortical bone requiring orthodontic proclination or labial movement of teeth were included. Cone-beam computed tomography (CBCT) images were obtained before grafting and at least 6 months after surgery. Sixty mandibular teeth were included, and the vertical bone level and horizontal labial bone thickness were measured. The results were compared using paired t-tests or Wilcoxon signed-rank test. RESULTS The horizontal labial bone thickness increased, especially at 6 mm below the cementoenamel junction (CEJ) in the mandibular central and lateral incisors (P < 0.05). The total alveolar bone area of the canines, first premolars, and second premolars increased at 3, 6, and 9 mm below the CEJ, respectively, and the differences were statistically significant (P < 0.05). Additionally, vertical bone height increased minimally on the labial side, but the differences were not statistically significant (P > 0.05). CONCLUSIONS New bone regeneration was observed on the labial (pressure) side after autogenous soft tissue grafting, which may represent a mechanism to effectively prevent gingival recession and maintain periodontal health. IRB APPROVAL All the experimental procedures involving humans in this study were approved by the Medical Ethics Committee of Xiangya Stomatological Hospital, Central South University ( No. 20190048).
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Affiliation(s)
- Tianyu Zhang
- Department of Orthodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Lingling Zhang
- Department of Orthodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Min Li
- Department of Periodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Fang Yi
- Department of Orthodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Chengri Li
- Department of Orthodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China
| | - Yanqin Lu
- Department of Orthodontics, Hunan Key Laboratory of Oral Health Research & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China.
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Vyas R, Khurana S, Khurana D, Singer SR, Creanga AG. Cone Beam Computed Tomography (CBCT) Evaluation of Alveolar Bone Thickness and Root Angulation in Anterior Maxilla for Planning Immediate Implant Placement. Cureus 2023; 15:e37875. [PMID: 37213997 PMCID: PMC10199654 DOI: 10.7759/cureus.37875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE This retrospective study aimed to measure the labial, palatal, mesial, and distal bone thickness around maxillary central and lateral incisors and canines and height from crest to apex, using cone beam computed tomography (CBCT) images and compare the results based on gender. The second objective of the study was to measure root angulation on CBCT images and its relation with the labial cortical thicknesses. Material and Methods: After the Institutional Review Board (IRB) approval, a total of 140 CBCT volumes were included in this study according to the set criteria. On each scan, right-side maxillary central, lateral incisors, and canine were selected for the measurements. All the measurements were done at three levels at the alveolar crest (L1), mid-root (L2), and apical region (L3) for each tooth. Results: The Student's t-test was performed to compare the result of buccal, palatal, mesial, and distal bone thickness, angulation, and height of all subjects. Buccal alveolar bone thickness was minimum at the mid-root region, and the palatal bone thickness was minimum at the crestal region. The mesial bone thickness was minimum at the mid-root level, and distal bone thickness was minimum at the crest level. The available bone height was maximum at the lateral incisor and equal for the central incisor and canine. The canine was the most angulated tooth. CONCLUSION Cone beam computed tomography is a reliable imaging modality to evaluate pre-surgical immediate implant sites and measure alveolar bone thickness. The canine was the most angulated tooth with more buccal alveolar bone thickness.
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Affiliation(s)
- Rutvi Vyas
- Oral and Maxillofacial Radiology, University of Florida Health, Gainesville, USA
| | - Sonam Khurana
- Oral Pathology, Radiology, and Medicine, New York University (NYU) College of Dentistry, New York, USA
| | - Dhruv Khurana
- Addiction Psychiatry, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Steven Rrrrr Singer
- Diagnsotic Sciences, Rutgers, Newark, USA
- Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, USA
| | - Adriana G Creanga
- Oral and Maxillofacial Radiology, Rutgers School of Dental Medicine, Newark, USA
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AlAli F, Atieh MA, Hannawi H, Jamal M, Harbi NA, Alsabeeha NHM, Shah M. Anterior Maxillary Labial Bone Thickness on Cone Beam Computed Tomography. Int Dent J 2023; 73:219-227. [PMID: 35527034 PMCID: PMC10023538 DOI: 10.1016/j.identj.2022.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/26/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
AIM The objective of this research was to measure the labial bone thickness (LBT) in relation to the 6 anterior maxillary teeth at different levels along the long axis and the distance between cementoenamel junction and bone crest (CEJ-BC) based on cone beam computed tomography (CBCT) scans retrieved from patients of Arab ethnicity and identify any association with patients' characteristics. MATERIALS AND METHODS A total of 100 CBCT scans were evaluated by one calibrated examiner. The thickness of the labial bone was measured perpendicular to the long axis of the tooth at 1, 3, and 5 mm from the alveolar crest (LBT-1, LBT-3, and LBT-5, respectively) and CEJ-BC using a medical imaging viewer. RESULTS CBCT scans of 58 female patients and 42 male patients with a mean age of 39.7 ± 9.5 years were included. A high variation of CEJ-BC was observed (range, 0.55-3.90 mm). Statistically significant higher CEJ-BC values were associated with men and increased age (>50 years). The overall means of LBT-1 were 0.76 ± 0.26, 0.79 ± 0.26, and 0.83 ± 0.37 mm; LBT-3: 0.92 ± 0.36, 1.05 ± 0.46, and 1.03 ± 0.48 mm; LBT-5: 1.17 ± 0.52, 0.80 ± 0.45, and 0.81 ± 0.40 mm for central incisors, lateral incisors, and canines, respectively. The LBT was <1 mm in 74.2% of all maxillary anterior teeth, with central incisors showing the highest predilection (85% with LBT <1 mm). No significant association between LBT and patient characteristics was observed. CONCLUSIONS The CEJ-BC distance is greater in men and increases with age, particularly in those aged 50 years and older. The LBT in the 6 maxillary anterior teeth is predominantly thin (<1 mm) and has no correlation to age or sex. An increased LBT was observed at a 3-mm level when compared with LBT-1 and LBT-5. Such variability should be taken into consideration when planning for implant placement.
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Affiliation(s)
- Fawaghi AlAli
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Momen A Atieh
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates; Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Haifa Hannawi
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates; Emirates Health Services, Dubai, United Arab Emirates
| | - Mohamad Jamal
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | | | | | - Maanas Shah
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates.
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Tissue Expander Followed by Autogenous Bone Graft Versus Autogenous Bone Graft Alone for Mandibular Reconstruction: Quantitative Assessment. J Craniofac Surg 2023; 34:e52-e57. [PMID: 36036490 DOI: 10.1097/scs.0000000000008979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/30/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The use of a tissue expander in maxillofacial intraoral tissue reconstruction is a developing approach, which provide adequate tissue coverage and aesthetics. OBJECTIVES The purpose of this study was to quantitatively compare the use of a soft tissue expander in conjunction with autogenous bone graft with bone graft alone for the repair of the mandible's anterior region. METHODS The study comprised 24 patients with bone defects in the anterior mandibular region. Patients were divided into 2 groups at random. In group I, expander with bone graft was used, whereas in group II, bone graft was used alone. Volumetric measures of the grafted area was performed using CBCT, and cephalometric evaluations of the anteroposterior and vertical skeletal relationship, as well as the soft tissue profile were recoded. A comparison was made between the 2 groups 6 and 24 months after surgery with P ≤ 0.05 considered significant. RESULTS The mean difference in grafted bone volume between the 2 groups was 1.95 cm 3 , indicating a significant difference between the 2 groups ( P = 0.05) with superior group I results. The soft tissue profile of group I demonstrated a considerable improvement and stability of the lower lip, the labiomental sulcus, and the thickness of the soft tissue Pogonion compared with group II. CONCLUSION The use of a tissue expander in conjunction with a bone graft resulted in a better soft tissue profile, making it a favored approach in maxillofacial reconstruction.
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Montanha-Andrade K, Crusoé-Rebello IM, Barreto M, Neves FS, Santos JND, Cury PR. Assessment of the relationship between tooth inclination and gingival and alveolar bone dimensions using computed tomography of the maxillary anterior teeth: a cross-sectional study. Dental Press J Orthod 2022; 27:e222136. [PMID: 36169497 PMCID: PMC9507018 DOI: 10.1590/2177-6709.27.4.e222136.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The present study aimed to investigate the relationship between tooth inclination and gingival and bone dimensions in maxillary anterior teeth. METHODS This cross-sectional study included cone-beam computed tomography (CBCT) images of 160 maxillary anterior teeth (30 individuals). Tooth inclination, gingival and bone thickness, and distances from cementoenamel junction to alveolar bone crest and gingival margin were measured in the labial surface. The correlations were analyzed using Pearson and partial correlation tests (p≤0.05). RESULTS In the central incisors, tooth inclination was positively and significantly related to apical bone thickness (R = 0.34, p= 0.001). In the canines, tooth inclination was negatively and significantly related to cervical bone thickness (R = - 0.34, p= 0.01) and positively associated to apical bone thickness (R = 0.36, p= 0.01) and to gingival margin-cementoenamel junction distance (R = 0.31, p= 0.03). In the lateral incisors, tooth inclination was not associated with gingival or bone dimensions. CONCLUSIONS In the central incisors, the greater the labial tooth inclination, the greater is the apical bone thickness. In the canines, the greater the labial tooth inclination, the smallest is the cervical bone thickness, the greater is the apical bone thickness, and the greater is the gingival margin. Gingival and bone dimensions should be assessed when planning orthodontic treatment involving buccal movement of central incisors and canines.
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Affiliation(s)
| | - Ieda Margarida Crusoé-Rebello
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Radiologia Dentomaxilofacial (Salvador/BA, Brazil)
| | - Mauricio Barreto
- Escola Bahiana de Medicina e Saúde Pública, Departamento de Implantologia (Salvador/BA, Brazil)
| | - Frederico Sampaio Neves
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Radiologia Dentomaxilofacial (Salvador/BA, Brazil)
| | - Jean Nunes Dos Santos
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Patologia Oral (Salvador/BA, Brazil)
| | - Patricia Ramos Cury
- Universidade Federal da Bahia, Faculdade de Odontologia, Departamento de Periodontia (Salvador/BA, Brazil)
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Thickness of the Buccal and Alveolar Bones Overlying Central Incisors: A Radiographic Iraqi Study. ScientificWorldJournal 2022; 2022:7226998. [PMID: 35185395 PMCID: PMC8849938 DOI: 10.1155/2022/7226998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Initial bone thickness has a substantial impact on the success of dental implant treatments. The objective of the current study was to analyze the thickness of the buccal and alveolar bone at the central incisors using CBCT in relation to gender and side to determine the anatomical features and choose the best implant treatment option for minimizing the surgical complications. Methods. One hundred CBCT images were investigated (50 females and 50 males, aged 20 to 50 years old). The buccal bone thickness and alveolar bone thickness were evaluated for right and left sides of each subject at three sites; C: crest (3 mm); M: middle (6 mm); A: apical (9 mm) from the cementoenamel junction. Results. The mean thickness of buccal bone was less than 2 mm on the incisors according to side and gender. Buccal bone thickness revealed a statistically significant difference between right and left sides at the apical point in both females and males with
values of (
) and (0.001), respectively. The buccal bone thickness displayed statistically significant differences between genders at all sites. The alveolar thickness demonstrated similar significant differences between genders except for the crest site. Conclusions. Iraqi participants had about 1 mm buccal bone thickness at 3 mm apical from the CEJ in right and left central incisors with a progressive rise in bone thickness to be less than 2 mm at the apex. Alveolar bone also showed the same increase in bone thickness from crest to apex. Bone thickness was greater in males than females. The present study provided valuable CBCT data on bone thickness of the esthetic maxillary region as a preoperative analysis for establishing an immediate implant treatment plan with aesthetically pleasing long-term outcomes.
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The Role of Morphometric Characteristics of Anterior Maxilla in Planning the Interventions Accompanied by Orthodontic Teeth Movement – An Overview. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2021-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
The anterior maxilla or premaxilla is part of the upper jaw and the most significant content of this region, from the aspect of orthodontic therapy, are the incisor teeth. The frequency of complications during orthodontic movement of the upper incisors refers to a more detailed evaluation of the anatomical structures of the premaxilla. The aim of this study was to investigate morphological and morphometric characteristics of the anterior maxilla by cone beam computed tomography, which could be of interest for planning orthodontic teeth movement. By reviewing the available literature, we compared the values of the alveolar bone height, the distance between the alveolar crest and enamel – cement boundary, total alveolar bone width, the thickness of the buccal, and palatal plate, nasopalatine canal, and accessory canals of the anterior maxilla. The results of our study show changes in the labial and palatal aspects of the alveolar bone height during orthodontic interventions. Different results of the alveolar bone width are in correlation with gender, age, and type of orthodontic tooth movement. Distance between the nasopalatine canal and maxillary central incisors was estimated at the value from 4 to 6 mm, which is below the recommended value for maximum incisal retraction by Proffit. Research results show variations in shape, length, and diameter of the nasopalatine canal, which indicates individual varieties detected on cone beam computed tomography. Other anatomical structures and measures show an insignificant correlation with orthodontic teeth movement. According to the contradictory results of the available articles, it is required to achieve an individual approach to orthodontic interventions in the area of the anterior maxilla.
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Botermans A, Lidén A, de Carvalho Machado V, Chrcanovic BR. Immediate Implant Placement in the Maxillary Aesthetic Zone: A Cone Beam Computed Tomography Study. J Clin Med 2021; 10:jcm10245853. [PMID: 34945150 PMCID: PMC8708737 DOI: 10.3390/jcm10245853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the factors that could be associated with the risk of labial cortical bone wall perforation with immediate implant placement (IIP) in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study. CBCT exams from 126 qualified subjects (756 teeth) were included. Implants were virtually positioned in two different positions: in the long axis of the tooth (prosthetically-driven position) and in an ideal position in relation to adjacent anatomical structures (bone-driven position). Two different implant diameters were planned for each tooth position, namely, 3.75 and 4.3 mm for central incisors and canines, and 3.0 and 3.3 mm for lateral incisors. The incidence of perforation was nearly 80% and 5% for prosthetically- and bone-driven position, respectively. Factors associated with a higher risk of cortical bone wall perforation (bone-driven position), according to logistic regression analysis, were women, wider implants, Sagittal Root Position class IV, and decrease of the labial concavity angle. Perforation of the labial cortical bone wall can be greatly minimized when the implant is placed in a bone-driven position compared to a prosthetically-driven position. It is important to preoperatively evaluate the morphological features of the implant site for risk assessment and to individualize the treatment plan.
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Affiliation(s)
- Anna Botermans
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (A.B.); (A.L.)
| | - Anna Lidén
- Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden; (A.B.); (A.L.)
| | | | - Bruno Ramos Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, 214 21 Malmö, Sweden
- Correspondence:
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Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
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Mao Z, Lee CT, He SM, Zhang S, Bao J, Xie ZG. Buccal bone dimensional changes at immediate implant sites in the maxillary esthetic zone within a 4-12-month follow-up period: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2021; 23:883-903. [PMID: 34761503 DOI: 10.1111/cid.13051] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 09/15/2021] [Accepted: 10/09/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the changes in buccal bone dimensions (CBD) following immediate implant placement in the maxillary esthetic zone and to identify the factors influencing the degree of buccal bone resorption for different placement and restoration protocols. MATERIAL AND METHODS An electronic search was conducted using the EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (PubMed) databases, combined with a manual and gray literature search, up to January 2021. Selected clinical studies had to report the changes in horizontal buccal bone dimension in maxillary immediate implantation sites (premolar to premolar) at baseline and at follow-up visits within a year of implantation. A meta-analysis was conducted to calculate the mean value of the changes in horizontal and vertical buccal bone dimensions (CHBD and CVBD) around implants. To further investigate the heterogeneity and identify factors associated with buccal bone loss after immediate implant placement, subgroup analysis and univariate meta-regression were performed. RESULTS From a total of 3498 articles, 4 randomized controlled trials and 12 nonrandomized controlled trials were included for analysis. The mean survival rate of 568 implants was 99.6%. The mean CHBD and CVBD values were 0.71 mm (95% confidence interval: [0.56, 0.86]) and 0.58 mm (95% confidence interval: [0.43, 0.72]), respectively. For possible factors that related to bone resorption, including buccal bone thickness, flap design, bone grafting, horizontal defect dimension, and restoration protocol, bone grafting was the only variable that significantly influenced CHBD. CONCLUSIONS This study demonstrated that immediate implant placement in the esthetic zone does not prevent buccal bone from resorption. Due to data heterogeneity and the small sample size of the studies included in the analysis, further well-conducted, randomized controlled trials with homogeneous samples are required to investigate the correlation of CBD with different variables.
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Affiliation(s)
- Zhen Mao
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Si Meng He
- Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Shu Zhang
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Jibo Bao
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Zhi Gang Xie
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
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Tanaka Y, Dutra V, Lin WS, Levon J, Hamada Y. Evaluation of the accuracy of buccal bone thickness measurement from cone beam computed tomography compared with histologic analysis. J Prosthet Dent 2021:S0022-3913(21)00499-6. [PMID: 34756426 DOI: 10.1016/j.prosdent.2021.08.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Three-dimensional radiographic assessment of buccal bone thickness and its integrity from cone beam computed tomography (CBCT) plays an essential role in immediate implant placement. However, the accuracy of CBCT measurements for the assessment of buccal bone thickness adjacent to maxillary anterior teeth is not well understood. PURPOSE The purpose of this observational study was to evaluate the accuracy of measuring the buccal bone thickness of maxillary anterior teeth from CBCT compared with direct measurement from histologic sections. A secondary objective was to analyze whether a minimal level of buccal bone thickness of maxillary anterior teeth can be detected from the CBCT scan. MATERIAL AND METHODS Five embalmed human cadavers with a complete anterior dentition were included in this study, providing 30 teeth for evaluation. After preparing reference notches at the gingival margin of each tooth, the anterior segments were scanned. The buccal bone thickness at 3, 5, and 7 mm from the notches was measured on the cross-sections obtained from the CBCT and histomorphometric images for a total of 90 sites. The CBCT measurements were compared with the histomorphometric measurements, and their agreement was assessed by using the Bland-Altman plots and intraclass correlation coefficients. The sensitivity and specificity of buccal bone detection were calculated from the CBCT scan. RESULTS Histologic examination showed absence of the buccal bone in 29 sites (32%). The mean ±standard deviation thickness of the buccal bone was 0.52 ±0.05 mm (range: 0 to 1.97 mm) from the CBCT analysis and 0.40 ±0.05 mm (range: 0 to 1.67 mm) from histology. Measurements obtained from the CBCT sections significantly overestimated the buccal bone thickness when compared with the histologic evaluation (P=.001). The intraclass correlation coefficient of buccal bone thickness between the CBCT and histology was ≤0.53, an agreement considered as poor. The sensitivity of the CBCT as a diagnostic tool to detect the presence or absence of the buccal bone was 75.4%, and the specificity was 65.5%. CONCLUSIONS The buccal bone thickness of maxillary anterior teeth was less than 2 mm at all sites as measured with both CBCT and histology evaluations. CBCT measurements had relatively low accuracy and reliability for the measurement of buccal bone thickness. These findings should be considered when using CBCT as a measuring tool for thin bone structures.
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Affiliation(s)
- Yoshiatsu Tanaka
- Resident, Postdoctoral Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Ind
| | - Vinicius Dutra
- Clinical Associate Professor, Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, Ind
| | - Wei-Shao Lin
- Associate Professor, Program Director, and Interim Chair, Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Ind
| | - John Levon
- Clinical Associate Professor, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Ind
| | - Yusuke Hamada
- Assistant Professor and Program Director, Advanced Education Program in Periodontics, Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Ind.
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Risk assessment of labial bone perforation in the anterior mandibular region: a virtual immediate implant placement study. Int J Implant Dent 2021; 7:68. [PMID: 34308500 PMCID: PMC8310813 DOI: 10.1186/s40729-021-00351-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigated the prevalence of labial bone perforation (LBP) related to the associated anatomic factors in anterior mandibular region using a virtual immediate implant placement procedure. METHODS Series qualified CBCT images of 149 participants (894 teeth) were selected to analyze the assigned anatomical parameters, including concavity depth, concavity angle, torque, and deep bone thickness. Four classes of crestal and radicular dentoalveolar bone phenotypes (CRDAPs) of mandibular anterior teeth were categorized according to the thickness of dentoalveolar bone at both crestal and radicular zones. Data were adjusted for categorical (gender and CRDAP) and continuous (age, cavity angle, cavity depth, and deep bone thickness) variables using a multivariable logistic regression analysis with generalized estimating equation method. RESULTS The overall probability of LBP after virtual implant placement was 21.6%. There is statistically significant higher prevalence of LBP at canine (28.5%) and CRDAP class II (29.2%) regions (p < 0.001). After adjusting confounding variables, CRDAP class II and class IV regions are more likely to have LBP when compared with CRDAP class I (control) regions (p < 0.01). The risk of LBP at canine site is 6.31 times more likely than at the central incisor (control) (p < 0.01). CONCLUSIONS Using a virtual immediate implant placement technique, the prevalence of LBP is significantly higher at the mandibular canine site and thin radicular dentoalveolar phenotype in the anterior mandibular region.
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A Cross-Sectional Study of Labial Bone and Covering Soft Tissue in Maxillary Anterior Segment: A Dilemma in Orthodontics. Int J Dent 2021; 2021:5553301. [PMID: 34335771 PMCID: PMC8289589 DOI: 10.1155/2021/5553301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/03/2021] [Accepted: 07/03/2021] [Indexed: 11/22/2022] Open
Abstract
Purposes The thickness of the buccal bone and its covering gingiva is pivotal in determining the prognosis of implant therapy as well as fixed orthodontic appliances, especially nonextraction treatments. The purpose of this study was to evaluate the buccal bone thickness and covering soft tissue in the maxillary anterior segment. Methods This study measured the hard tissue thickness at 2 and 5 mm more apical from the crest and at the root apical apex, as well as the distance from the CEJ to the alveolar crest, using 80 CBCT images divided into three age groups. In addition, the distance from free gingiva to alveolar crest and from free gingiva to CEJ was measured. The acquired data then was analyzed using an ANOVA, t-test, and Pearson correlation to investigate any associations or statistically significant differences between parameters. Results The highest mean soft tissue thickness at the 5 mm level was for central incisors and the least for canine. The highest mean thickness of soft tissue at the crest level and its 2 mm apical level was related to central incisors and the lowest mean thickness at these levels was related to canine. Analysis of hard tissue variables showed the lower thickness of hard tissue at higher ages compared to the young patients group, but the thickness of the soft tissue increases with age. Conclusion The highest mean thickness of the buccal hard tissue in the maxillary anterior segment was in lateral and central incisors. Also, the most prominent thickness of the labial soft tissue was in the central and lateral incisors at levels close to the crest.
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Zhang LQ, Zhao YN, Zhang YQ, Zhang Y, Liu DG. Morphologic analysis of alveolar bone in maxillary and mandibular incisors on sagittal views. Surg Radiol Anat 2021; 43:1009-1018. [PMID: 34023911 DOI: 10.1007/s00276-020-02640-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/29/2020] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of this study was to analyze the morphologic features of alveolus in relatively healthy maxillary and mandibular incisors using cone-beam-computed tomography (CBCT). METHODS CBCT images of 318 patients were retrospectively acquired. Alveolar bone in incisive area was divided into: type 1 (thick), type 2 (relatively thick with mono-plate concavity), type 3 (thin with double-plate concavities), and type 4 (vulnerably thin). Alveolus prevalence and widths were analyzed statistically relative to age, gender, and molar relationship. RESULTS Prevalence of type 1 alveolus was 78.9% in maxillary central incisors, 15.1% in maxillary lateral incisors, 24.1% in mandibular central incisors, and 5.0% in mandibular lateral incisors. Type 2 alveolus was commonly observed in the maxillary lateral incisors (82.2%), mandibular central incisors (66.2%), and mandibular lateral incisors (87.9%). Prevalence of type 3 and 4 alveoli ranged from 0.0 to 9.4%. As for maxillary central incisors, type 1 was the widest both at the alveolar crest (7.77 ± 0.58 mm) and apical area (9.05 ± 1.86 mm), while type 3 had the lowest width at the apical region (4.08 ± 0.51 mm). Among maxillary central incisors, prevalence of type 1 tended to decrease with age. At all maxillary and mandibular incisor sites, alveolus widths were significantly thicker in males than in females. At maxillary lateral incisor and mandibular incisor sites, prevalence of alveolus type was significantly different among three molar relationships. CONCLUSION A 4-type classification system was suggested for alveolus morphology in incisive region. Identification of alveolus type might aid in the corresponding treatment.
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Affiliation(s)
- Li-Qi Zhang
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Ya-Ning Zhao
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Ya-Qiong Zhang
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Deng-Gao Liu
- Dept. of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China.
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López-Jarana P, Díaz-Castro CM, Falcão A, Falcão C, Ríos-Santos JV, Fernández-Palacín A, Herrero-Climent M. Height difference between the vestibular and palatal walls and palatal width: a cone beam computed tomography approach. BMC Oral Health 2021; 21:118. [PMID: 33722235 PMCID: PMC7958492 DOI: 10.1186/s12903-020-01322-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/10/2020] [Indexed: 11/15/2022] Open
Abstract
Background The objective of this study was to measure two parameters involved in tri-dimensional implant planning: the position of the buccal and palatal bone wall and the palatal thickness. Methods Cone beam computed tomography (CBCT) images (Planmeca ProMax 3D) of 403 teeth (208 upper teeth and 195 lower teeth) were obtained from 49 patients referred to the Dental School of Seville from January to December 2014. The height difference between the palatal and buccal walls was measured on the most coronal point of both walls. The thickness of the palatal wall was measured 2 mm from the most coronal point of the palatal wall. Results The mean values in the maxilla were 1.7 ± 0.9 mm for central and lateral incisors, 2.2 ± 1.7 mm for canines, 1.6 ± 0.9 mm for premolars and 1.9 ± 1.5 mm for molars. In the lower jaw, the mean values were 1.3 ± 0.8 mm for incisors, 1.7 ± 1.2 mm for canines, 2.3 ± 1.3 mm for premolars, and 2.6 ± 1.7 mm for molars. In the upper jaw, more than 55% of maxillary teeth (excluding second premolars and molars) presented mean height differences greater than 1 mm. In the mandible, more than 60% of incisors showed a buccal bone thickness of 1 mm from the apical to lingual aspect. All teeth except the second premolar presented a buccal wall located more than 1 mm more apically than the lingual bone wall. Conclusions The buccal bone wall is located more apically (greater than 1 mm) than the palatal or lingual table in most of the cases assessed. The thickness of the palatal or lingual table is also less than 2 mm in the maxilla and mandible, except in the upper canines and premolars and the lower molars.
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Affiliation(s)
| | | | - A Falcão
- Porto Dental Institute, Porto, Portugal.,Faculty of Dentistry Oporto University (FMDUP), Porto, Portugal
| | - C Falcão
- Health Sciences Faculty, Fernando Pessoa University, Porto, Portugal
| | - J V Ríos-Santos
- School of Dentistry, Universidad de Sevilla, C/ Avicena S/N, 41009, Seville, Spain.
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Tsigarida A, Toscano J, Brito Bezerra B, Geminiani A, Barmak AB, Caton J, Papaspyridakos P, Chochlidakis K. Buccal bone thickness of maxillary anterior teeth: A systematic review and meta‐analysis. J Clin Periodontol 2020; 47:1326-1343. [DOI: 10.1111/jcpe.13347] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Alexandra Tsigarida
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Jeremy Toscano
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Beatriz Brito Bezerra
- Advanced Education Program in General Dentistry UCLA School of Dentistry Los Angeles CA USA
| | - Alessandro Geminiani
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Abdul B. Barmak
- Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Jack Caton
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Panos Papaspyridakos
- Division of Postgraduate Prosthodontics Tufts University School of Dental Medicine Boston MA USA
- Department of Prosthodontics Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics Eastman Institute for Oral Health University of Rochester Rochester NY USA
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Rezallah N, Dahaba M, Ahmed EE, Mahmoud E. Radiographic evaluation of bone and mucosa using low-dose CBCT with radiopaque X-resin stent versus CT and ridge mapping: A Validity study. J Int Oral Health 2020. [DOI: 10.4103/jioh.jioh_59_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Lee JE, Jung CY, Kim Y, Kook YA, Ko Y, Park JB. Analysis of Alveolar Bone Morphology of the Maxillary Central and Lateral Incisors with Normal Occlusion. ACTA ACUST UNITED AC 2019; 55:medicina55090565. [PMID: 31484416 PMCID: PMC6780569 DOI: 10.3390/medicina55090565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/25/2019] [Accepted: 08/30/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: This study investigated the morphology of the labial and palatal bony wall of the maxillary central and lateral incisors using cone-beam computed tomography (CBCT). The difference between males and females and the measurement between right and left sides were measured. Materials and Methods: Twenty participants, consisting of 11 females and 9 males having normal occlusion, were used for the analysis. The mean age was 21.9 ± 3.0 years. The thickness of the labial bony wall and palatal bony wall, perpendicular to the long axis of the root, were evaluated at 3 and 5 mm apical from the cemento-enamel junction (CEJ) and at the root apex. The available bony wall below the apex of the central and lateral incisors, and the angulation between the long axis of the tested tooth and outer surface of the labial bone were measured. Results: The mean labial bony wall thickness at the 3 and 5 mm apical from the CEJ were 1.1 ± 0.3 mm and 1.0 ± 0.4 mm for central incisors, respectively, as well as 1.2 ± 0.4 mm and 1.0 ± 0.4 mm for lateral incisors, respectively. The mean palatal bony wall thickness at 5 mm from the CEJ was above 2 mm in the central and lateral incisors. The percentage of labial bony wall thickness 2 mm or greater at the root apex in central incisors was higher than in lateral incisors (62.5% vs. 55.0%). The percentage of palatal bony wall thickness ≥2 mm at 3 mm apical from the CEJ in the central incisors was higher than in the lateral incisors (37.5% vs. 15.0%). The results on the left and right sides did not show statistically significant differences, except in the labial and palatal bony wall thickness at 3 mm from the CEJ in the lateral incisor. Generally, no significant differences were seen between males and females, but males had a significantly higher labial bony wall thickness at 3 and 5 mm from the CEJ in the central and lateral incisors when compared with females. Conclusions: This study showed that a majority of the cases of Korean participants had less than 2 mm of labial bony wall thickness at 3 and 5 mm apical from the CEJ at central and lateral incisors, and this should be kept in mind while performing dental practices, including tooth extraction or immediate implantation in anterior regions. Preoperative analysis using CBCT may be beneficial for establishing the treatment plan.
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Affiliation(s)
- Ji-Eun Lee
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Chang Yoon Jung
- Department of Orthodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Yoonji Kim
- Department of Orthodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Youngkyung Ko
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
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Han Y, Li XG, Zhu J, Li JW, Hu SN, Li C, Zhao J, Liang YH. [Cone-beam computed tomography digital for measuring the inclination angle to the long axis of healthy maxillary anterior teeth and morphologically characterizing their labial bone plates]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:412-416. [PMID: 31512836 DOI: 10.7518/hxkq.2019.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We aim to determine the thickness of the labial plate, the distance between the cement-enamel junction (CEJ) and alveolar crest, and the inclination angle of the long axis of healthy maxillary anterior teeth by using cone- beam computed tomography (CBCT). METHODS A total of 345 CBCT volumes obtained by Newtom VGI® CBCT were analyzed by using the NNT software. The digital measurements of the labial bone plate thickness at level 4 mm below the CEJ, the midpoint of tooth root and the radiological tooth apex, the distance between the CEJ and alveolar crest, and the angle between the long axis of the teeth and the long axis of alveolar process were obtained from the mid-sagittal planes of maxillary incisors and canines. Plate thickness 4 mm below the CEJ was measured, and values below ≥1 mm were recorded. RESULTS In the central incisor, 1) the angle between the long axis of the teeth and alveolar bone was 15.2°±6.2°, the distance between the CEJ and alveolar crest was (1.5±1.0) mm, labial bone plate thick-ness at 4 mm below the CEJ was (0.8±0.4) mm, the midpoint of tooth root was (0.6±0.4) mm, and the radiological tooth apex was (1.3±0.7) mm; in the lateral incisor, 16.2°±8.8°, (1.6±1.0) mm, (0.7±0.5) mm, (0.4±0.6) mm, and (1.1±0.7) mm, respectively; and in the canine, 19.0°±6.2°, (1.8±1.0) mm, (0.9±0.6) mm, (0.4±0.6) mm, and (1.2±0.7) mm, respectively. 2) The frequencies of plate thickness ≥1 mm were 28.3%, 25.8%, and 42.7% in the central incisor, lateral incisor, and canine, respectively. 3) The distance between the CEJ and alveolar crest was positively correlated with age. The correlation coefficients was 0.42 (P<0.01) in the central incisor, 0.50 (P<0.01) in the lateral incisor, and 0.62 (P<0.01) in the canine. CONCLUSIONS The thickness of labial bone plate is thin, the distance from CEJ to alveolar crest increases with age, and the long axis of the teeth is more inclined than the long axis of alveolar process. Knowledge of these special morphological characteristics can improve the safety and result for many dental procedures.
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Affiliation(s)
- Yang Han
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Xiao-Guang Li
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Jie Zhu
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Jing-Wen Li
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Su-Ning Hu
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Cong Li
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Jing Zhao
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China
| | - Yu-Hong Liang
- Dept. of Stomatology, Peking University International Hospital, Beijing 102206, China;Dept. of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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