Initial Bone Thickness Research Articles

Analysis of factors affecting bone volume changes after immediate implantation in the maxillary central incisor.

This study aimed to evaluate the clinical outcomes of immediate implantation of single maxillary central incisor and explore factors affecting post-implant bone volume. Clinical data and imaging records from pre-surgery, the day of surgery, and 6 months post-surgery of 100 patients (100 implants) with non-salvageable maxillary central incisors who underwent immediate implantation were collected. Bone thickness at the cervical, middle, and apical regions of the implant's labial and palatal sides were measured immediately post-surgery and at 6 months, and bone volume changes were observed. A regression analysis model was used to assess predictive factors for labial and palatal bone plate thickness. At 6 months post-surgery, the labial bone thicknesses at the cervical, middle, and apical regions were 2.35, 2.29, and 3.28 mm, respectively, and those of the palatal side were 0.00, 2.40, and 6.05 mm, respectively. The cervical region had the highest alveolar crest collapse rates, with 32.87% on the labial side and 62.20% on the palatal side. The regression model indicated that factors influencing the thickness of bone at the cervical labial side of the implant included initial bone thickness, the implant center to adjacent tooth center angle, implant diameter, and the type of implant closure (P<0.05). The initial bone thickness on the palatal side was the sole predictor for bone thickness on the palatal side (P<0.05). Immediate implantation of single maxillary central incisors yields effective clinical results. The thickness of new bone around the implant is influenced by multiple factors. A comprehensive consideration of these factors in the planning of immediate implantation is necessary to achieve optimal therapeutic outcomes.

Horizontal bone augmentation using a mixture of cortico-cancellous allograft and bovine bone mineral with a collagen membrane: a retrospective study

Aim: The study aimed to evaluate the clinical outcomes of bone augmentation with a mixture of cortico-cancellous allograft and xenograft with a collagen membrane in horizontal augmentation of knife-edge alveolar crests.&#x0D; Material and Method: Patients with a ridge thickness of less than 4 mm by preoperative tomography were included in the study. Twelve patients (10 Female, 2 Male) were treated with a mixture of Cortico-Cancellous Allograft and Bovine Bone Mineral with a collagen membrane.&#x0D; Results: Thirty-nine implants were placed in twelve patients. The initial bone thickness is between 1 and 4 cm (mean: 3±0.89440). Nine months after horizontal augmentation, bone thickness varies between 4.53 and 9.15 cm (mean: 4.62±1.16782). The gained bone thickness varies between 1.27 and 7.72 cm (mean 3.66±1.21041).&#x0D; Conclusion: Augmentation of alveolar bones knife-edge crestal margins with a mixture of Cortico-Cancellous Allograft and Bovine Bone Mineral with a collagen membrane is simple, successful, and feasible.

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 ≤ 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.

Buccal alveolar bone changes following rapid maxillary expansion and fixed appliance therapy.

To assess factors that may be associated with buccal bone changes adjacent to maxillary first molars after rapid maxillary expansion (RME) and fixed appliance therapy. Pretreatment (T1) and posttreatment (T2) cone-beam computed tomography scans were obtained from 45 patients treated with RME and preadjusted edgewise appliances. Buccal alveolar bone thickness was measured adjacent to the mesiobuccal root of the maxillary first molar 4 mm, 6 mm, and 8 mm apical to the cementoenamel junction, and anatomic defects were recorded. Paired and unpaired t-tests were used to compare alveolar bone thickness at T1 and T2 and to determine whether teeth with posttreatment anatomic defects had thinner initial bone. Correlation analyses were used to examine relationships between buccal alveolar bone thickness changes and amount of expansion, initial bone thickness, age at T1, postexpansion retention time, and treatment time. There was a statistically significant reduction in buccal alveolar bone thickness from T1 to T2. Approximately half (47.7%) of the teeth developed anatomic defects from T1 to T2. These teeth had significantly thinner buccal bone at T1. Reduction in alveolar bone thickness was correlated with only one tested variable: initial bone thickness. RME and fixed-appliance therapy can be associated with significant reduction in buccal alveolar bone thickness and an increase in anatomic defects adjacent to the expander anchor teeth. Anchor teeth with greater initial buccal bone thickness have less reduction in buccal bone thickness and are less likely to develop posttreatment anatomic defects of buccal bone.

Minimal Invasive Flapless Piezotome Alveolar Crest Horizontal Split Technique: Preliminary Results

Alveolar split crest is an established surgical technique to enable implant insertion into narrow and atrophic alveolar crest. This surgical technique is adopted to position standard or large implants so that postextractive anatomy compromises with this attempt. The aim of this study was to evaluate the horizontal alveolar bone augmentation and its stability along time with a minimally invasive flapless technique. Twenty-four implants were inserted in 10 patients during a 15-month period. Clinical parameters such as horizontal bone augmentation, intrasurgical complications, patient morbidity, implant loss, and vertical bone loss (VBL) were recorded in the first 3 years after surgery. Using cone-beam computed tomography (CBCT), alveolar bone width was measured for both implants position and bone reconstructions. 6 months later, at the time of implant integration, a new low-dose CBCT was performed. Implant survival (IS) and VBL were evaluated radiographically for 3 years. The initial bone thickness measured on the ridge is between 0.82 mm and 5.40 mm (average 2.43 mm), after the split crest the bone width is between 4.65 mm and 8.09 mm (average 6.39 mm). This leads to an increase in the alveolar bone width of between 0.80 mm and 6.01 mm (average 3.71 mm) on the ridge. No implant was lost at 3 years, and all implants are stable at the end of the study. Three years after the surgery, controls showed a VBL of between 0.0 mm and 1.2 mm (average 0.63 mm) around the inserted implants. These parameters suggest using a flapless technique to reduce bone resorption around the implant neck. A minimally invasive approach allows to reduce the surgical trauma and postsurgical discomfort. The complete vascular supply is maintained, the bone resorption is reduced, and the connective epithelium does not undergo postsurgical retraction, achieving the full maintenance of the residual keratinized gingiva. A technique such as split crest can be a valid option to avoid autologous or heterologous bone grafts.

Proclination-induced changes in the labial cortical bone thickness of lower incisors.

We sought to objectivize the overall alveolar bone thickness changes in lower incisors after orthodontic intervention. The effect of orthodontic treatment on the cortical bone, specifically the clinical implications of proclination-induced change, have long been a matter of dispute. Cone-beam computed tomographs of 58 patients were obtained before and after treatment and labial cortical bone thickness and overall alveolus width were measured in sagittal sections in the distance of 3, 6, 9 and 12 mm apically from the cemento-enamel junction. A statistically significant decrease of the cortical bone thickness in all four incisors was found at the levels 3, 6 and 9 mm (p 0.05). Moreover, no correlation was found between bone thickness change and extent of the incisor movement. Our results point to a marked cortical bone loss after proclination of lower incisors, furnishing a sound basis for caution in treatment planning due to the considerable risk of alveolar defect development, especially in patients with low initial bone thickness (Tab. 6, Fig. 2, Ref. 25).

Evaluation of maxillary buccal alveolar bone before and after orthodontic alignment without extractions: A cone beam computed tomographic study.

To assess the changes in the maxillary buccal alveolar bone during alignment without extractions. Secondarily, to evaluate the changes in arch dimensions and buccolingual inclinations of teeth and to identify risk factors for bone loss. Twenty-two adolescents with crowded permanent dentitions were treated without extractions with Damon 3MX brackets. Cone beam computed tomographic scans were taken before treatment (T0) and after alignment (T1). Bone thickness (BT) and height from the cementoenamel junction to the alveolar crest (BH) were evaluated at the maxillary central incisors, second premolars, and buccal roots of first molars. Changes in all variables from T0 to T1 were assessed. Correlations between bone changes and initial bone thickness, initial arch widths, initial crowding, amount of expansion, amount of tipping, and amount of molar rotation were calculated. BT decreased and BH increased significantly for the incisors and mesiobuccal root of the first molars. Arch dimensions generally increased together with tipping. Bone loss was correlated with crowding and amount of expansion in the premolar region. Initially thinner BT was correlated with greater apical migration of bone for the incisors. Nonextraction alignment with self-ligating brackets led to arch expansion associated with tipping of teeth. Expansion related to alignment resulted in horizontal and vertical bone loss at the incisors and mesiobuccal root of the first molars. Thinner BTs and more severe crowding before treatment increased the risk for buccal bone loss.

The fate of buccal bone around dental implants. A 12-month postloading follow-up study.

Buccal bone thickness is considered to be an important factor during implant surgery. Its resorption might have an effect on the soft tissue stability and eventually on implant survival. This study aimed to investigate the resorption of the buccal bone over the first 12months after implant loading. Twenty-four subjects (47 implants) were included. The buccal bone thickness was measured during implant surgery at several distances from the implant shoulder using a specifically designed device which allows buccal bone thickness measurements without the elevation of a muco-periostal flap. These measurements were repeated after 12months of loading. Sixteen implants were placed flapless and 31 with the elevation of a flap. Of the latter, 19 were placed following a one-stage protocol and 12 following a two-stage protocol. The mean reduction in buccal bone thickness, when all groups pooled, was 0.26, 0.36, 0.35 and 0.27mm at the shoulder and 2, 4 and 6mm apically. Implants with initial bone thickness <1mm (thin buccal plate) did not lose significantly more bone than those with an initial thickness ≥1mm (thick bone plate) except in the 'open-flap, one-stage' group (P=0.009). A flapless procedure leads to less bone resorption compared to an open-flap procedure (P=0.03). However, the number of surgeries (one stage vs. two stages) did not influence the rate of bone resorption (P=0.23). Within the limitations of this study, one might question the necessity of having a thick bone plate at the vestibular site of the implant.

Maxillary sinus floor elevation: review of anatomy and two techniques.

A review of maxillary sinus floor elevation as an integral part of restoring the posterior maxilla is discussed. The related anatomy of the area and the current techniques available are reviewed. The classic lateral antrostomy pioneered by Tatum appears to be the most common sinus lift procedure. The more conservative crestal approach, advocated by Summers, provides another effective way of allowing implant fixture placement in the atrophic maxilla.