Abstract
ObjectivesAccurate description of buccal bone adjacent to mandibular anterior teeth is helpful for planning and monitoring periodontal and orthodontic treatment. Low-dose cone beam computed tomography (LD-CBCT) imaging has shown promising results for very small dental structures in animals. This study asserts that LD-CBCT is sufficiently accurate to measure buccal alveolar bone adjacent to human mandibular anterior teeth.Materials and methodsBuccal bone level adjacent to 16 mandibular anterior teeth from four human cadavers was measured radiographically using one high-dose (HD) CBCT protocol and two LD-CBCT protocols. The resulting radiographic measurements of buccal bone height (bl) and thickness (bt) were compared with reference probe and reflected-light microscopy measurements. Measurement medians and Bland–Altman plots were calculated, and a linear mixed model was used to compare raters and imaging modalities.ResultsAll regression coefficients were approximately 0, indicating high interrater, intrarater, and intermodality agreement. No significant differences were found between reference measurements and CBCT protocols. The mean differences for bl measurements were 0.07 mm (rater 1 [r1]) and 0.12 mm (rater 2 [r2]) for HD-CBCT; 0.07 mm (r1) and 0.13 mm (r2) for LD-CBCT-1; and 0.02 mm (r1) and 0.01 mm (r2) for LD-CBCT-2. For bt measurements, mean differences were 0.02 mm (r1) and 0.02 mm (r2) for HD-CBCT; 0.01 mm (r1) and 0.01 mm (r2) for LD-CBCT-1; and 0.00 mm (r1) and 0.01 mm (r2) for LD-CBCT-2.ConclusionsWithin the limitations of the present study, LD-CBCT seems to be a precise method for describing buccal bone and its thickness adjacent to mandibular anterior teeth in this experimental setting.Clinical relevanceFor the first time, this study showed LD-CBCT produces excellent results and is a reliable modality for imaging buccal bone in vitro. If clinical studies confirm these results, LD-CBCT could enable better treatment planning and monitoring at a radiation dose that is far lower than that of conventional HD-CBCT but similar to that of panoramic views.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00784-022-04389-x.
Highlights
The buccal bone adjacent to the mandibular anterior teeth is a highly sensitive periodontal structure
Three different cone beam computed tomography (CBCT) protocols were used to image a total of 16 sites on 16 mandibular human anterior teeth
The hypothesis that Low-dose cone beam computed tomography (LD-CBCT) is suitable for imaging buccal bone adjacent to mandibular anterior teeth in this specific experimental setting was confirmed for the two CBCT devices used
Summary
The buccal bone adjacent to the mandibular anterior teeth is a highly sensitive periodontal structure. It is characterized above all by its usually very delicate and thin anatomy [1, 2]. Precise knowledge of the individual anatomy of the bone can be of great value to the periodontist, enabling them to precisely plan periodontal regenerative surgery, for example. It might shorten the duration of surgery and possibly even allow more precise incision. Detailed knowledge of the nature of the buccal lamella in terms of bone thickness and the presence of fenestrations might enable dentists to avoid undesirable treatment-induced damage, such as gingival recession resulting from overextended vestibular tooth movement [8]
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