Buccal Plate Thickness Research Articles

Is socket healing conditioned by buccal plate thickness? A clinical and histologic study 4 months after mineralized human bone allografting

The aim of this study was to clinically and histologically analyze the healing of grafted sockets by mineralized human bone allograft (MHBA) and nongrafted sockets, correlating the results with buccal plate thickness. Thirty-one sockets were randomly split into control (CG) and treatment (MHBA grafted) (TG) groups and, subsequently, into four subgroups according to buccal plate thickness: a ≤ 1 mm and b > 1 mm. Ridge thickness, depth, and height were monitored. Four months after, at implant placement, a bone core biopsy for histologic and morphometric analyses was taken. The differences of buccal height (TG-a -0.27 and CG-a -1.17 mm) and width (TG-a 0.55 and CG-a 2.67 mm, TG-b 0.12 and CG-b 1.17 mm) were statistically significant. The increase in bone amount CG-b (28.17%) compared with CG-a (16.98%) was statistically significant. Soft tissue amount of TG-b (54.21%) and TG-a (56.91%) was lower than that of CG-b (71.83%) and CG-a (83.01%), both being statistically significant (P = 0.002). The results proved that thin buccal plates had a worse outcome on socket healing and that network formation by MBHA not only predisposes a successful implant insertion but also acts as size keeper.

Ridge Preservation With or Without an Osteoinductive Allograft: A Clinical, Radiographic, Micro‐Computed Tomography, and Histologic Study Evaluating Dimensional Changes and New Bone Formation of the Alveolar Ridge

The aim of this randomized, controlled clinical trial is to determine whether ridge preservation using an osteoinductive allograft (test) would prevent ridge resorption and promote bone maturation compared to extraction alone (control). Seventeen patients (20 total sites), in need of a non-molar extraction and delayed implant placement were randomly selected to receive either ridge preservation or extraction alone. A cone-beam computed tomography was completed with a radiographic stent in place before extraction and 10 to 12 weeks postoperatively for dimensional and buccal plate analyses. Bone cores were taken for micro-computed tomography (microCT) and histologic analyses. Resorption of the alveolar ridge occurred at all sites with no statistically significant differences found between test and control sites. A significant correlation was found between the initial buccal plate thickness and the loss of vertical ridge height. microCT and histologic analyses found a mean new bone volume of 44.9% with microCT and 37.4% with histology in test sites and 39% and 35.5%, respectively, in control sites. The residual graft volume was 2.4% with microCT and 4.5% with histology. Test and control sites lost similar amounts of alveolar ridge, with the loss of buccolingual width occurring predominantly at the expense of the buccal bone. A thicker buccal plate was associated with less ridge loss in the vertical dimension. The percentage of new bone was not statistically significant between either the test or control sites, using either microCT or histologic analyses.

Immediate Placement and Provisionalization With Buccal Plate Preservation: A Case Report of a New Technique

Abstract Abstract Post-extraction resorption of the alveolar ridge is known particularly to affect the buccal plate, increasing the risk of facial soft-tissue recession and other adverse clinical effects. The authors have developed a simple technique for buccal plate preservation that involves surgically creating a pouch facial to the buccal plate that is filled with xenograft material. This technique can also be utilized in cases for which immediate implant placement and provisionalization are planned. A case report illustrating this approach is presented.

Anthropometric analysis of maxillary anterior buccal bone of Korean adults using cone-beam CT.

PURPOSEThe aim of this study was to evaluate the thickness of buccal and palatal alveolar bone and buccal bony curvature below root apex in maxillary anterior teeth of Korean adults using Cone-beam CT images.MATERIALS AND METHODSThe 3D image was reconstructed with dicom file obtained through CBCT from 20 - 39 year old Korean subjects (n = 20). The thickness of buccal and palatal plate, root diameter, the buccal bony curvature angle below root apex and the distance from root apex to the deepest point of buccal bony curvature were measured on maxillary anterior teeth area using OnDemand3D program.RESULTSMean thickness of buccal plate 3 mm below CEJ was 0.68 ± 0.29 mm at central incisor, 0.76 ± 0.59 mm at lateral incisor, and 1.07 ± 0.80 mm at canine. Mean thickness of palatal plate 3 mm below CEJ was 1.53 ± 0.55 mm of central incisor, 1.18 ± 0.66 mm of lateral incisor, 1.42 ± 0.77 mm of canine. Bucco-lingual diameter 3 mm below CEJ was 5.13 ± 0.37 mm of central incisor, 4.58 ± 0.46 mm of lateral incisor, and 5.93 ± 0.47 mm of canine. Buccal bony curvature angle below root apex was 134.7 ± 17.5° at central incisor, 151.0 ± 13.9° at lateral incisor, 153.0 ± 9.5° at canine. Distance between root apex and the deepest point of buccal bony curvature of central incisor was 3.67 ± 1.28 mm at central incisor, 3.90 ± 1.51 mm at lateral incisor, and 5.13 ± 1.70 mm at canine.CONCLUSIONWithin the limitation of this study in Korean adults, the thickness of maxillary anterior buccal plate was very thin within 1mm and the thickness of palatal plate was thick, relatively. The buccal bony curvature below root apex of maxillary central incisor was higher than that of lateral incisor and canine and it seems that the buccal bony plate below root apex of central incisor is most curved.

Comparison of Dermal Matrix and Polytetrafluoroethylene Membrane for Socket Bone Augmentation: A Clinical and Histologic Study

Remodeling and resorption of the alveolar crest, specifically at the buccal aspect, characterize the healing extraction socket. These result in narrowing and shortening of the alveolar ridge, which compromise esthetics and complicate restoration. Alveolar ridge augmentation has been proposed to facilitate future site restoration by minimizing ridge resorption. Therefore, the purpose of this study was to compare extraction socket healing and alveolar ridge alteration after socket augmentation using bone allograft covered with an acellular dermal matrix (ADM) or polytetrafluoroethylene (PTFE) membrane. Twenty non-smoking healthy subjects were selected. Each subject required maxillary premolar, canine, or central incisor tooth extraction. The extraction sites were debrided and grafted with a mineralized bone allograft that was covered with an ADM or PTFE membrane. Postoperative appointments were scheduled at 2, 4, and 8 weeks. After 16 weeks of healing, final measurements were performed, and trephine core biopsies were obtained for histomorphometric analysis. Implants were placed immediately after biopsy harvesting. Eighteen subjects completed the study. All sites healed without adverse events and allowed for implant placement. PTFE membranes exfoliated prematurely, with an average retention time of 16.6 days, whereas the ADM membranes appeared to be incorporated into the tissues. Buccal plate thickness loss was 0.44 and 0.3 mm, with a vertical loss of 1.1 and 0.25 mm, for ADM and PTFE, respectively. Bone quality assessment indicated D3 to be the most prevalent (61%). Histomorphometric analysis revealed 41.81% versus 47.36% bone, 58.19% versus 52.64% marrow/fibrous tissue, and 13.93% versus 14.73% particulate graft remaining for ADM and PTFE, respectively. No statistical difference was found between the two treatment groups for any of the parameters. All sites evaluated showed minimal ridge alterations, with no statistical difference between the two treatment modalities with respect to bone composition and horizontal and vertical bone loss, indicating that both membranes are suitable for alveolar ridge augmentation.