Assessment of Buccal Bone Thickness in the Anterior Maxilla: A Cone Beam Computed Tomography Study

Thickness of the Buccal and Alveolar Bones Overlying Central Incisors: A Radiographic Iraqi Study

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 $p$ values of ( $p\le 0.001$ ) 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.

Alveolar bone thickness overlying healthy maxillary and mandibular teeth: A systematic review and meta-analysis

OBJECTIVE

To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with gender, age, and smoking.

MATERIALS AND METHODS

The PubMed, Embase, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched up to July 2020. English articles (sample size≥10) which had used CT or CBCT to measure the ABT at clearly defined reference points were included. The maximum likelihood approach meta-analysis was used to estimate the means (95% CIs).

RESULTS

A total of 68 articles were included. The meta-analysis results were as follows: In the anterior maxilla, the mean labial plate thickness ranged from 0.42-1.75mm, while it was thicker for the posterior teeth (0.78-4.31mm). The palatal plate thickness ranged from 0.97-8.13mm. In the anterior mandible, the thickness of labial and lingual plates ranged from 0.4-3.71mm and 0.38-5.44mm, respectively. The alveolar bone was thicker for the posterior teeth both at the labial (0.66-6.31mm) and lingual (2.31-7.77mm) sides. Meta-regression revealed a significant relationship between gender and ABT at several points. There was a controversy regarding the association of ABT with age. No significant difference was evidenced between smokers and non-smokers.

CONCLUSIONS

This study presents a clear image of the alveolar bone structure. Since it has pooled ABT values from various populations, outcomes could be acknowledged as global averages. Therefore, it could provide perspective for several dental procedures, including orthodontic treatments and immediate implant placement.

Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies

BACKGROUND

Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest.

METHODS

An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Qh test and I2 index for heterogeneity was estimated.

RESULTS

2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75-1.05 mm) and 1-2 mm in premolars. Patients over 50 years of age, females and thin gingival phenotype was associated with thinner FAB at some apico-coronal locations of maxillary incisors and canines. The geographical setting was an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2-2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. Evidence certainty has shown moderate quality in most analysis subsets.

CONCLUSIONS

Facial alveolar bone at anterior maxillary teeth is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.

Assessment of prevalence and volumetric estimation of possible Stafne bone concavities on cone beam computed tomography images

OBJECTIVES

Our study aimed to determine the prevalence and volumetric estimates of Stafne bone cavities (SBC) on cone beam computed tomography (CBCT) images.

METHODS

This retrospective study, which involved the CBCT images of 1141 men and 1260 women with an age range of 10-90 years, aimed to determine the prevalence of SBCs and to calculate their volumes using the semi-automatic segmentation method.

RESULTS

A total of 15 SBCs were diagnosed in 14 patients. Among the detected SBCs, 7.14% were found in a female patient and 92.86% were found in 13 male patients. Of the total number of SBCs, 6.67% were anteriorly located and 93.33% were posteriorly located. Bilateral SBCs had a prevalence of 0.04%; unilateral posterior SBCs 0.54% and anterior SBCs 0.04%. The mean SBC volume was calculated as 338.05 mm³.

CONCLUSIONS

The results of our study showed that SBC is a rare anomaly. In contrast to two-dimensional imaging techniques, CBCT allows a precise determination of SBCs' pattern of impact on adjacent bony structures, relationship with the mandibular canal and dimensions.