Analysis of the dimensions of the labial bone wall in the anterior maxilla: a cone‐beam computed tomography study

Abstract

Immediate implant placement in extraction socket does not appear to prevent the resorption of the labial wall. It has been recommended that a minimal thickness of 1-2 mm of buccal bone should be available to preclude the resorption of the facial vertical dimension of the socket wall. The aim was to determine the dimension of the facial buccal plate of bone in the anterior esthetic zone at different levels and relate it to immediate implant placement. Seventy-three patients' cone-beam tomographic scans were included in the study (42 female and 31 male, mean age 39.6 years). The images were acquired using OnDemand software. The measurements taken included: 1. Distance between the CEJ and the alveolar crest. 2. The labial bone thickness at different levels in relation to alveolar crest: at 1, 2, and 4 mm. The measurements demonstrated that the distance between the CEJ and the crest was 2.10 ± 0.85 for the central and 2.09 ± 0.72 for the lateral incisor. The measurement taken at M0 (crestal level) revealed that only 1% of the incisors showed a thick labial bone (1-2 mm) and 73% showed a thin bony wall (0.5-1 mm) and 25% showed very thin wall <0.5 mm. At the M1, 7% showed very thin bony wall and 86% showed a thin bony wall while only 6% exhibited a thick bony wall. The M2 showed only 1% of very thin bony wall, and about 85% showed a thin bony wall and 14% exhibited a thick bony level. The M4 demonstrated very thin bony wall and about 75% thin bony wall and 23% showed thick bony wall. Males showed statistically significantly higher mean distance between cemento-enamel junction and alveolar crest (CEJ-AC) than females at the central as well as lateral incisors. To obtain good results, meticulous preoperative analysis is recommended. Thus, to chose an adequate treatment approach, the utilization of CBCT is recommended.