Buccal Plate Thickness Research Articles

Feasibility of Immediate Implant Placement in Maxillary First Premolars: Prediction of Implant Locations Using Restorations- A Radiographic Study.

Maxillary premolars have a unique anatomical location. This is an CBCT based study where the suitability of maxillary premolars for immediate implant placement (IIP) is evaluated. Based on prosthetically driven treatment treatment planning a simple classification system is put forth. 150 CBCTs of maxillary first premolars were analysed in BlueskyBio software. The topographic position of the tooth was determined by analysing the dimensions of the buccal and lingual cortical plates, the distance between the bucco-lingual plates and the residual bone height from the root apex to the floor of the sinus. Virtual placement of an implant was carried out such that the implant would be positioned 1 mm apical to the buccal bone crest, would engage 3 mm of bone apical to the root apex, and would have a trajectory so that the abutment access was from the central fossa. Four categories were identified and the classification was proposed. It was observed that 74% of cases had buccal bone<1mm,26% had buccal bone >1mm. 79% cases had an average distance >3mm between root apex and maxillary sinus, 21% had an average distance of root apex and maxillary sinus <3mm. The categorizations of implant placement were as follows -Type 1- 24%, Type 2- 56.6%, Type 3-43.3%, Type 4- 0%. In majority of maxillary 1st premolars an IIP is possible with the implants to be placed in the palatal sockets or the furcation area. In cases were the buccal plate thickness is inadequate, simultaneous grafting should be considered between the implant position and buccal plate.

Evaluation of the buccal bone thickness in the anterior maxillary region using cone-beam computed tomography

Aim: This study aimed to analyze the buccal plate thickness of maxillary anterior teeth using cone-beam computed tomography (CBCT) images. Methodology: This study involved a retrospective analysis of CBCT images from 104 randomly selected patients aged 20–50 years who had not experienced loss of their maxillary central and lateral incisors and canine teeth. The bone thicknesses of six anterior maxillary teeth were measured at 1 mm, 3 mm, and 5 mm distances apical to the alveolar bone crest (ABC) and between the cemento-enamel junction (CEJ) and ABC for six anterior maxillary teeth. The association between buccal bone plate width and distance from the CEJ to the ABC was examined across genders and among different age groups. Results: The mean buccal bone thicknesses were 1.13 mm, 1.22 mm, and 1.04 mm at distances of 1 mm, 3 mm, and 5 mm, respectively. The mean distance from the CEJ to the ABC was 2.09 mm. A negative correlation was observed between age and the distance from the CEJ to the ABC. No correlation was found between buccal bone thickness and gender, and a negative correlation existed between age and buccal bone thickness. Women displayed a significantly lower distance from the CEJ to the ABC compared to men, and a negative correlation between buccal bone thickness and distance from the CEJ to the ABC was present across all tooth groups. Conclusion: This study revealed that the bone width in the maxillary anterior region was remarkably thin. Therefore, achieving the minimum bone thickness of 2 mm necessary for optimal aesthetic and functional outcomes is seldom feasible in this area. Considering these findings, additional research utilizing larger patient cohorts is essential to fully comprehend how age and gender affect buccal bone thickness and CEJ-ABC distance. Additionally, utilizing preoperative CBCT for radiographic analysis to identify risk factors and select the appropriate treatment approach is strongly recommended. How to cite this article: Sağlıklı A, İpek F. Evaluation of the buccal bone thickness in the anterior maxillary region using cone-beam computed tomography. Int Dent Res 2023;13(S1):1-10. https://doi.org/10.5577/idr.2023.vol13.s1.1 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Comparison of Marginal Bone Loss in Simultaneous Versus Delayed Implant Placement Following Horizontal Ridge Augmentation with Autogenous Lateral Ramus Bone Block.

Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement. This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible. This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time. There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p< 0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36). According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement.

Estimating the occurrence of labial bone perforation and implantation into the maxillary sinus maxillary premolars based on the morphology of maxillary premolars: A clinical study

Statement of problemPrevious studies have classified the sagittal root position of the maxillary anterior teeth and measured buccal plate thickness to aid treatment planning. A thin labial wall and buccal concavity may cause buccal perforation, dehiscence, or both in maxillary premolars. However, data on the restoration-driven principle to classify the maxillary premolar region are lacking. PurposeThe purpose of this clinical study was to investigate the occurrence of labial bone perforation and implantation into the maxillary sinus between various tooth-alveolar classifications with respect to the crown axis in maxillary premolars. Material and methodsCone beam computed tomography images of 399 participants (1596 teeth) were analyzed to determine the probability of labial bone perforation and implantation into the maxillary sinus when associated with variables that included tooth position and tooth-alveolar classification. ResultsThe morphology in the maxillary premolars was classified as straight, oblique, or boot-shaped. The first premolars were 62.3% straight, 37.0% oblique, and 0.8% boot-shaped, and labial bone perforation occurred in 4.2% (21 of 497) of the straight, 54.2% (160 of 295) of the oblique, and 83.3% (5 of 6) of the boot-shaped first premolars when the virtual implant was 3.5×10 mm. When the virtual tapered implant was 4.3×10 mm, labial bone perforation occurred in 8.5% (42 of 497) of the straight, 68.5% (202 of 295) of the oblique, and 83.3% (5 of 6) of the boot-shaped first premolars. The second premolars were 92.4% straight, 7.5% oblique, and 0.1% boot-shaped, and labial bone perforation occurred in 0.5% (4 of 737) of the straight, 33.3% (20 of 60) of the oblique, and 0% (0 of 1) of the boot-shaped, respectively, when the virtual tapered implant was 3.5×10 mm; and labial bone perforation occurred in 1.3% (10/737) of the straight, 53.3% (32/60) of the oblique, and 100% (1/1) of the boot-shaped second premolars when the virtual tapered implant was 4.3×10 mm. ConclusionsWhen an implant is placed in the long axis of a maxillary premolar, the tooth position and tooth-alveolar classification should be considered when assessing the risk of labial bone perforation. Attention should be paid to the implant direction, diameter, and length in the oblique and boot-shaped maxillary premolars.

Determining the periodontal phenotype-Probe transparency versus actual: A diagnostic study.

Assessment of the validity of the transparency of the periodontal probe as a tool for determining the periodontal phenotype. The periodontal phenotype was assessed at the six upper anterior teeth of 75 subjects using two methods. One is through assessing the transparency of the periodontal probe upon insertion into the gingival sulcus. The second method was through the assessment and clustering of the width of keratinized gingiva clinically and the gingival and buccal plate thickness on Cone Beam Computed Tomography scan. The probe transparency approach correctly identified thick periodontal phenotype in most cases (41 out of 43 [95%]). However, this was not the case for thin periodontal phenotype; probe transparency approach identified 64% of the thin sites (261 out of 407) and misclassified nearly one third of the patients. The probe transparency approach is a valid approach in identifying the phenotype in subjects with thick phenotype but not in subjects with thin phenotype. The definition of periodontal phenotype has recently changed. Accurate designation has been shown to affect treatment outcomes especially esthetic ones in different disciplines of dentistry. Probe transparency is commonly used by clinicians and researchers. Assessment of the validity of this method based on the most recent definition and compared to actual assessment of bone and gingival thickness is of great clinical value.

Buccal plate thickness as a predictor for endodontic microsurgery outcomes: A retrospective cohort study

The aim of the study was to determine the relationship between preoperative buccal plate thickness (BPT) and radiographic healing at the osteotomy site after endodontic microsurgery (EMS) with and without guided tissue regeneration (GTR) using cone beam computed tomography (CBCT) imaging. The retrospective sample of 143 individuals who had EMS with pre- and postoperative CBCT scans availablewere divided into 2 groups: group 1 (GTR) and group 2 (no GTR), which were further divided into teeth where BPT was >1.0 mm or ≤1.0 mm. Bone healing was assessed by subjective evaluation of bone formation attheresected root surface (I1), periapical bone formation (I2), cortical plate formation (I3), and a derived index (Author2-Author1 Indices) (I4), calculated by a composite score of I1 and I2. There was no significant impact on surgical healing with the use of GTR when BPT is >1.0 mm. The GTR had a significant impact on surgical healing when the BPT was ≤1.0 mm. This study supported the use of CBCT to evaluate three-dimensional healing after EMS. The Author2-Author1 index was found to be a clinically relevant method for assessing healing. To improve healing rate, the EMS cases with a preoperative BPT of ≤1.0 mm may benefit from GTR.

Classification of premolars sagittal root position and angulation for immediate implant placement: a cone beam computed tomography study

Sagittal root position (SRP) and buccal plate thickness are important considerations in implant treatment planning. The objective of this study was to classify the relationship of the SRP and angulation to the osseous housing to assist treatment plan making for immediate implant placement in the premolar region. We classified the SRP and angulations of the maxillary and mandibular premolars and measured the buccal plate thickness of 150 patients using cone beam computed tomography to support clinical decision making. Regarding SRP types, 41.67%, 51.83%, 3.67%, and 2.83% of maxillary premolars and 84.33%, 15%, 0%, and 0.67% of mandibular premolars were classified as types B, M, L, and N, respectively. In terms of angulation, 20.83%, 46%, 32.17%, and 1% of maxillary premolars and 2%, 5.33%, 36.67%, and 56% of mandibular premolars were grouped into classes 1, 2, 3, and 4, respectively. The buccal bone thickness at most locations in premolar regions was <1 mm. The classification of SRP and angulation will assist in treatment plan making for immediate implant placement in the premolar region.

Correlations of Alveolar Bone Surrounding Central Incisors in Adults

To find correlations between alveolar bones of central incisors with gender, age, central incisor shape, dental arch shape, buccolingual inclination, and effective length of premaxilla/length of the mental protuberance. We selected 36 out of 308 CBCT patients’ cases (18 males & 18 females, aged 18-38 years), and measured crest height, plate thickness, and ridge width at 1) coronal third, 2) middle third, 3) apical third of the root. We identified significant differences between many sites of alveolar bones according to the abovementioned factors. Alveolar crest height was greater in males. In the mandible, alveolar bone was thinner than in the maxilla and the lingual plate at third 1 was thin (<1 mm) in most cases. We found: a) Moderate positive correlations: 1. In maxilla: Between crest height and age. Between buccal plate thickness and ELP. Between lingual plate thickness at third 2&3 and inclination. 2. In mandible: Between buccal crest height and age / LMP. Between buccal plate thickness at third 2&3, ridge width and inclination; b) Moderate negative correlations: 1. In maxilla: between buccal plate thickness, lingual plate thickness at third 1, and age. Between buccal plate thickness at third 3 and inclination. Between lingual plate thickness at third 3 and ELP. 2. In mandible: Between buccal plate thickness at third 3, lingual plate thickness, ridge width, and LMP. Between lingual plate thickness at third 1, ridge width at third 2&3, and age. No strong correlations were found between the alveolar bone and studied variables. However, this topic needs further studying.

A three-in-one alveolar process reconstruction protocol for maxillary molar sites with severe residual bone height deficiency: A proof-of-concept pilot study.

Implant placement in maxillary molar sites with severe height deficiency often requires multiple surgeries, which was time-consuming, invasive, and subject to serious postoperative complications. To introduce and assess a three-in-one technique (extraction, alveolar ridge preservation [ARP], and sinus elevation) for augmenting deficiency maxillary molar alveolar ridges. Fourteen patients with severe posterior maxillary ridge height deficiency underwent extraction, sinus elevation via an intrasocket window and ARP using sticky bone and then covered with acellular dermal matrix (ADM). Primary closure was intentionally not obtained. Cone-beam computed tomography and periapical radiography were used to measure dimensional ridge changes over time. Bone biopsies were taken at implant placement 7-21 months after surgery, which proceeded without additional grafting. Peri-implant soft tissue was assessed after 8-12 months of functional loading. Maxillary molar sites (13 first molars, 1 second molar) with a mean sinus floor height of 1.73 ± 0.86 mm and mean buccal plate thickness of 1.62 ± 1.15 mm were elevated and grafted. Immediately after surgery, the mean sinus floor height was 14.03 ± 1.97 mm and the alveolar thickness at virtual implant platform level was 12.99 ± 1.88 mm. After 5-9 months healing, those measurements decreased by 2.45 ± 1.73 mm (p= 0.000) and 3.88 ± 3.95 mm (p= 0.006), respectively. Healed ridges were composed of 18.74% ± 4.34% mean vital bone and 19.08% ± 9.10% mean residual graft. After 8-12 months of functional loading, the peri-implant tissue appeared healthy, and there was a mean marginal bone loss of 0.12 ± 0.11 mm. For maxillary first molar sites with severe sinus floor height deficiency, this minimally invasive three-in-one treatment allows for uncomplicated implant placement and short-term functional stability.

Evaluation of Maxillary Alveolar Ridge Morphology and Residual Bone for Implant Placement by Cone Beam Computed Tomography (CBCT)

The aim of this study was to assess the morphology and dimension of maxillary alveolar ridge at anterior and posterior regions using cone beam computed tomography (CBCT) prior to the placement of immediate implants. CBCT scans of 192 patients were evaluated. Measurements were taken at the cross sectional views in the maxillary central incisor, lateral incisor, canine incisor, first and second premolars and first and second molars regions. Alveolar ridge width and height, buccal plate thickness, buccal undercut, inter-root septum height, and root penetration to sinus floor were measured. Independent T-test was used for statistical analysis. The mean value of alveolar height in the maxillary incisors were higher than the posterior teeth with central incisors having the highest value of 19.23 ± 8.74 mm. At anterior maxilla, the lateral incisor with the mean value of 1.07 ± 0.64 mm exhibits the highest buccal undercut and the thinnest ridge width. At the site of posterior regions premolars had higher buccal undercut than molars. Canine with the mean value of 0.19 ± 0.31 mm thickness at the mid-alveolar of buccal plate, had the thinnest plate among other maxillary incisors. Sinus penetration and inter-root septum height were higher in premolar teeth than molars. The mean value of ridge width at all levels was significantly different between men and women, except at the level of crest in central incisor. CBCT evaluation presents accurate measurements for ridge assessment prior to immediate implant insertion. The recommended appropriate size of implant platform would be 5 mm in the incisor and almost 6 mm in premolar region.

Influential Factors in Buccal and Lingual Plate Perforation around Dental Implants Using Cone-Beam Computed Tomography.

This study determined the influential factors in buccal and lingual plate perforation around dental implants using cone-beam computed tomography (CBCT). In this retrospective, cross-sectional study, CBCT scans of dental implants taken for purposes not related to this study from 2017 to 2018 were retrieved from the archives of a private dental clinic. Demographic information, implant site, length, diameter, shape, and angulation, buccal and lingual plate thickness, buccolingual diameter of bone, and presence of crestal bone resorption were all assessed on CBCT scans. Data were analyzed using chi-squared, Mann-Whitney, Kruskal-Wallis, and independent t-tests. Of 604 implants, 88 had caused bone perforation in 41 females (46.6%) and 47 males (53.4%) with a mean age of 54.97 ± 13.99 years; 83% of perforations were in the maxilla; 55.7% of implants causing perforation were cylindrical and 44.3% were conical. The mean length and diameter of implants was 11.78 ± 1.91 mm, and 4.49 ± 0.76 mm, respectively; 38.9% of perforations were in the buccal and 18.2% in the lingual plate, and 42% were in the apical region. Crestal bone loss was noted in 58% of perforation cases. The mean angular deviation of implants was 19.13 ± 12.41°. Implant length and diameter had a significant association with the occurrence of perforation in the mandible (P < 0.05). Perforations had a higher frequency in the posterior maxilla, and mainly in the apical region. The buccal plate was thin in the anterior maxilla, with minimum thickness in the apical region. Lingual plate perforation had the highest frequency in the mandible.

Do immediately placed implants have better outcomes when placed with a minimal split-thickness envelope flap?

Design Randomised, controlled, single-blind, single-centre clinical trial.Case selection Adult patients in need of a single tooth extraction in the anterior maxillary and premolar region. Full mouth plaque scores below 25% and bleeding scores below 10%, with no active periodontal disease. As assessed by cone beam computed tomography; intact buccal plate, adequate mesiodistal space and adequate quality of bone.Data analysis Patients had immediate implant placement following extraction, either with a flap with no vertical releasing incision (control group) or a minimal split-thickness envelope flap (test group). The trial compared clinical, radiographic, aesthetic and patient-reported outcomes of immediately placed implants. Primary outcomes were measured using the pink (PES) and white (WES) aesthetic score. JMP Pro 13 was the statistical software used. Statistical comparisons were conducted at a 0.05 level of significance.Results In total, 28 patients were enrolled in the study, after exclusions. The total PES and WES scores were similar in the control and test groups. Implant survival and success rate after 12 months was 100%. Buccal plate thickness at 12 months post-loading was 2.78 mm in the control group and 2.54 mm in the test group, so there was no statistically significant difference between them. The majority of patients in both groups responded as 'positive' in the patient satisfaction questionnaire and visual analogue scale.Conclusions When comparing PES/WES scores, success/modified success rate, survival, mean buccal plate resorption and patient satisfaction, there were no differences between immediate implants placed with a flap or with a minimal split-thickness envelope flap.

Interradicular distance and alveolar bone thickness for miniscrew insertion: a CBCT study of Persian adults with different sagittal skeletal patterns

BackgroundThis study aimed to assess the interradicular distance and alveolar bone thickness of Persian adults with different sagittal skeletal patterns for miniscrew insertion using cone-beam computed tomography (CBCT).MethodsThis cross-sectional study was conducted on maxillary and mandibular CBCT scans of 60 patients (18–35 years) in three groups (n = 20) of class I, II and III sagittal skeletal pattern. Anatomical and skeletal parameters were measured at 2, 4 and 6 mm apical to the cementoenamel junction (CEJ) by one examiner. The intra- and inter-class correlation coefficients were calculated to assess the intra, and interobserver reliability. Data were analyzed by ANOVA and Tukey’s test (alpha = 0.05).ResultsThe intra- and interobserver reliability were > 0.9 for all parameters. The largest inter-radicular distance in the maxilla was between the central incisors (1–1) in classes I and III, and between premolars (4–5) in class II patients. The largest inter-radicular distance in the mandible was between molar teeth (6–7) in all three classes. The buccal cortical plate thickness was maximum at the site of mandibular first and second molars (6–7). The posterior maxilla and mandible showed the maximum thickness of cancellous bone and alveolar process. Wide variations were noted in this respect between class I, II and III patients.ConclusionsThe area with maximum inter-radicular distance and optimal alveolar bone thickness for miniscrew insertion varies in different individuals, depending on their sagittal skeletal pattern.

Variations in Soft and Hard Tissues following Immediate Implant Placement versus Delayed Implant Placement following Socket Preservation in the Maxillary Esthetic Region: A Randomized Controlled Clinical Trial.

Introduction Although retrospective analysis has shown immediate placement of implants (IIP) in the maxillary esthetic zone showing promising outcomes compared to delayed placement of implants following socket preservation (DIP), a direct comparison in a prospective, well-designed randomized fashion with adequate power analysis between the two implant placement protocols is still lacking. This study is aimed at radiographically evaluating the effect of IIP after extraction as compared to implant placed in preserved sockets 4 months following extraction (DIP) in terms of changes in buccal plate thickness(CBT) after 6 months of healing and evaluation of pink esthetic score (PES) for assessment of soft tissue changes and patient-related outcome measures (PROMs) using visual analogue scale (VAS). Materials and Methods 25 implants were placed immediately following extraction in the IIP group, and 25 implants were placed four months following socket preservation with demineralized bovine bone mineral (DBBM) and advanced platelet-rich fibrin (A-PRF) in the DIP group, control group, in the maxillary esthetic region. CBCT was taken preoperatively and 6 months postoperatively to assess the dimensional changes in the buccal bone plates(CBT). PES and PROMs for pain threshold and patient satisfaction using VAS were evaluated at the time of implant placement and 6 months postoperatively. Results Significant differences in mean reduction in buccal plate thickness (CBT) were found in the test group (IIP) 0.2 ± 0.02 compared to the control group (DIP) which showed a mean reduction in CBT of 0.4 ± 0.1 (p < 0.001) at the end of 6 months. Although there was no statistically significant difference in PES between the groups, there was a significant difference between the groups when individual values of PES were compared at p < 0.001. Conclusion The IIP group showed lesser reduction in CBT and a better PES which is an important clinical information which could be translated clinically in situations where implant placement is planned in the maxillary esthetic region. This trial is registered with CTRI/2019/06/019723.

Evaluation of alveolar process resorption after tooth extraction using the socket shield technique without immediate installation of implants: a randomised controlled clinical trial

Our aim was to evaluate resorption of the alveolar ridge using the socket shield technique (SST) without immediate placement of dental implants. This randomised controlled clinical trial included 27 patients: 14 maxillary non-molar teeth were partially extracted using the SST (test group) and 13 were extracted using a minimally traumatic extraction approach (control group). Alterations in height and thickness of the alveolar ridge were evaluated by cone beam computed tomograms taken immediately after, and 100 days after, surgery. Minor resorption was observed in the height of the buccal and palatal plates, without intergroup difference (p ≥ 0.10). The test group showed significantly better preservation of the buccal-to-palatal crest dimension (p ≤ 0.05). In the control group, preservation of buccal plate thickness was significantly greater (p ≤ 0.05), but intragroup vertical resorption of the buccal plate and reduction in the buccal-to-palatal crest distance were greater (p ≤ 0.05). The SST without the immediate placement of implants showed greater preservation of the buccal-to-palatal crest dimension and lower preservation of buccal wall thickness compared with minimally traumatic extraction. In addition, it provided superior maintenance of the baseline buccal wall height. The modified SST is a promising approach, but factors that interfere with the results should be investigated.

The use of CBCT to asses buccal bone thickness overlying mandibular anterior teeth

Objectives: the aim of this study was to determine the relationship between gingival width with respect to the underlying bone thickness in mandibular anterior sextant.Material and metods: 40 CBCT were included. Buccal bone thickness was measured at 3, 4.5, 6, 8 mm apical to the cement–enamel junction (CEJ). In addition, the apicoincisal gingival width was measured.Results: at 3 mm from the cement-enamel junction, the buccal bone plate was in 69.4% of cases, the average thickness of buccal bone plate for all teeth was less than 1.0 mm, at the level of 4.5 and 6 mm in 30,6% of cases “Absence” of the external cortical plate, the thickness of which gradually increased in the apical direction (8 mm). When the efficiency is less than 2 mm, the effect of the absence of the external cortical plate according to CBCT data was more often observed.Conclusion: in this study revealed the relationship between the gingival width and the anatomical features of the buccal bone plate.

PES in relation to buccal plate thickness and jumping distance: A 8 year cohort retrospective study

PES in relation to buccal plate thickness and jumping distance: A 8 year cohort retrospective study

Potential of Using an Implant Fixture as a Ridge Expander for Minor Ridge Augmentation: An Ex Vivo Randomized Controlled Study.

To place implants with minimal trauma is what the patient and clinician are seeking. Hence, the aim of this study was to quantify the potential of using an implant fixture as a ridge expander in an underprepared osteotomy. Thirty-eight edentulous sites in 12 human cadaver jaws with ridge widths ranging from 4 to 6 mm and with type 3 or type 4 bone density were randomly assigned into 2 groups. In the ridge expansion group (RE), each osteotomy was drilled to a width of 2.8 mm and depth of 11.5 mm. In the non-ridge expansion (NE) control group, each osteotomy was drilled to a width of to 3.4 mm and depth of 11.5 mm. A 3.7 mm × 11.5 mm tapered implant was inserted into each site. The ridge width before (RW1) and after (RW2) implant placement as well as the buccal plate thickness (BPT) post-insertion were measured and analyzed. In the RE group, the average RW1 and RW2 were 4.69 ± 0.45 mm and 5.54 ± 0.35 mm, respectively, corresponding to a statistically significant ridge expansion of 0.85 mm (P < .01). In the NE group, no ridge width gain was observed (RW1: 4.79 ± 0.40 mm, RW2: 4.88 ± 0.42 mm). Compared to NE, RE resulted in a statistically greater BPT (1.08 ± 0.28 mm after RE vs 0.71 ± 0.37 mm after NE, P < .001). Our study determined that it was physically possible to widen a ridge by an average of 0.85 mm by osteotomy underprepation in ridge with type 3 or type 4 bone density, which effectively turned the implant upon insertion into a ridge expander. The physiological consequences of this method of ridge expansion in a living person must be established before drawing further conclusions about its clinical indications or efficacy.

Management of Thick and Thin Periodontal Phenotypes for Immediate Dental Implants in the Esthetic Zone: A Controlled Clinical Trial.

The goal of the study was to compare the outcome of immediate single-implant placement in esthetic sites of patients with thick or thin tissue phenotypes. Forty-one patients underwent implant surgery with guided bone regeneration including peri-implant gap and overcontour grafting. A connective tissue graft was added only for patients with a thin tissue phenotype. Twenty-six patients completed the 12-month follow-up examination (thick, n = 14; thin, n = 12). The thick-phenotype group gained 0.01 ± 1.56 mm of midfacial soft tissue height, while the thin-phenotype group lost 0.20 ± 1.14 mm (P = .21). There was no significant difference in buccal plate thickness achieved at time of uncovery, pink and white esthetic scores, radiographic bone levels, and clinical parameters between the two groups. These results suggest that when the suggested treatment protocol is followed, there are no significant differences in the outcomes of immediate implant placement for patients with different soft tissue phenotypes.

Thickness of Buccal and Lingual Alveolar Bone Plates According to the Position of Impacted Mandibular Third Molars on Cone-Beam Computed Tomography Scans

Objectives: This study sought to assess the thickness of buccal and lingual alveolar bone plates according to the position of impacted mandibular third molars on cone-beam computed tomography (CBCT) scans.&#x0D; Materials and Methods: Eighty-four CBCT scans of impacted mandibular third molars were evaluated in this retrospective study. All images had been obtained by ProMax 3D CBCT system with the exposure settings of 78 kVp, 12 mA, 16 s time, 0.2 mm voxel size and 10 × 9 cm field of view. The impaction angle of teeth and the thickness of buccal and lingual cortical plates were determined on images by drawing lines in the anterior, middle, posterior, superior, central and inferior regions. Thickness of bone plates was analyzed according to the position of impacted molars relative to the buccal and lingual plates using the Student t-test and relative to the second molars using one-way ANOVA and Tukey’s test.&#x0D; Results: In the buccolingual direction, the buccal plate thickness was maximum in lingual position followed by central position, and minimum in buccal position of the teeth. The lingual plate thickness was minimum in horizontal and distoangular positions and maximum in the mesioangular position of impacted teeth.&#x0D; Conclusion: Risk of lingual plate preformation is higher in surgical removal of impacted third molars with distoangular and horizontal positions. Thus, further attention must be paid by the surgeons to such cases.