Vestibular Bone Thickness Research Articles

Changes in Periodontal Tissues With Periodontally Accelerated Orthodontics: A Systematic Review and Meta-Analysis.

Periodontally accelerated orthodontic (PAO) therapy has been found to increase hard tissue, helping to decrease orthodontic relapse rates and improve retention capacity. The aim of this study was to synthesize available evidence on clinical and tomographic changes in periodontal tissues when using PAOtechniques. A systematic review with meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered in the International Prospective Register of Systematic Reviews (PROSPERO). The search was carried out in PubMed, Embase, Cochrane, Web of Science, Scopus, and Google Scholar. Randomized and non-randomized clinical trials comparing PAO versus conventional orthodontics were included. Quality assessment was performed using the Downs & Black scale, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool. Mean differences and 95% confidence intervals (CIs) were calculated, and the mean difference was divided by a t-test. During the initial search, 465 studies were identified. Five articles studying 130 patients were included, which assessed both clinical and tomographic changes, along with treatment duration. PAO was administered to patients with skeletal class III in three studies, to class II patients in one study, and to individuals with dental crowding in another study. Two studies showed a moderate risk of bias, and the rest showed a low risk. The meta-analysis revealed a vestibular bone thickness increase of 0.32 mm (0.56-008; P = 0.008), a reduction of 3.12 mm (2.15-4.08; P= 0.001) in gingival retraction, and a treatment duration that was 7.07 months (8.79-5.36;P = 0.001) shorter in patients subjected to PAO compared to those undergoing conventional orthodontic treatment. Considering the limitations of the study and acknowledging that definitive conclusions cannot be drawn, the findings suggest that treatment time decreased in patients undergoing PAO, with an increase in vestibular bone thickness and less gingival retraction observed in those undergoing this intervention.

Concordancia del espesor óseo vestibular a nivel del Punto A entre Telerradiografía y Tomografía computarizada de haz cónico

Objective: The aim of this study was to determine the concordance of the vestibular bone thickness measured at the level of point A between Teleradiography and Cone Beam Computed Tomography (CBCT). Materials and Methods: This study consisted of a cross-sectional analytical design of concordance that evaluated the teleradiographies and CBCTs of 32 patients. The measurements were performed by three evaluators, specialists in orthodontics. Two of them measured the CBCTs and one evaluated the teleradiographs. The concordance of both tests was determined using the Concordance Correlation Coefficient. Results: When evaluating the value of the vestibular bone thickness at the level of point A between the CBCT and the teleradiography, it was observed that the mean value of the absolute difference between the two was 0.95±0.74, 95%CI [0.68–1.22], being statistically significant (p=0.0027). When the concordance between both tests was analyzed, it was observed that it was poor (CCC=0.204 95%CI [0.014–0.394]), although statistically significant (p<0.00001). Conclusions: It was possible to conclude that there is no concordance in the measurement of the vestibular bone thickness at the level of Point A between the Teleradiography and the CBCT. Keywords: Cone-beam computed tomography; Orthodontics; Cephalometry; Incisor; Patients; Cross-sectional studies

Esthetic outcomes of immediate implants placement following immediate restoration: Controlled clinical trial

The aim of this controlled clinical trial was to evaluate the variation in the thickness of the buccal bone plate and the position of the gingival margin in single implants installed in extraction socket and in healed ridges, both with immediate loading in aesthetic region. Materials and Methods: individuals in group 1 (n=7) were treated with minimally invasive tooth extraction, cone morse implant (Neodent®), xenogene bone “gap” filling (Bio Oss®) and cementation of provisional crown. Individuals in group 2 (n=3), in edentulous unitary ridges, received a cone morse implant (Neodent®) and provisional crown cementation. The coronal (C), mid (M) and apical (A) points of the buccal bone plate (BBP) were measured by means of computed tomography and, with the aid of a probing guide, the measurements of the position of the gingival margin (PGM) were performed at the mesial (M), vestibular (V) and distal (D) points, both analyzes were assessed in the preoperative (T0), immediate postoperative (T1) and six months postoperatively (T2). Results: in the analysis of buccal bone plate (BBP), no statistical differences were observed in the interaction of period and group factors, the same happened when comparing only the different periods. Group 1, when compared to group 2 in T1, presented higher averages in the buccal bone plate (p <0.05), and this statistical difference was significant. In the PGM analysis, there was no significant statistical difference between the groups and periods interaction, the same could be observed when comparing the groups with each other (p> 0.05). A statistical difference between time T0 and T2 was observed, with time T2 having a mean of the measurements greater than the time T0 in both groups. Conclusions: the treatment conferred in group 1 was shown to be a reliable option, with results of vestibular bone thickness and gingival level stable in the observed periods, when compared with group 2 treatment. With similar results between groups, the advantages of immediate implant as reduction of postoperative morbidity, reduction of medication use and maintenance of the perimplant framework become attractive for indication of the technique tested

Cone beam computed tomography analysis of maxillary vestibular bone thickness in the esthetic region

Background/Aim. Insufficient buccal bone thickness (thickness less than 2 mm) frequently leads to fenestration and dehiscence, and their consequences are additional bone resorption. That represents an additional problem during implant placement. Cone beam computed tomography (CBCT) is becoming a priority in the diagnosis of bone thickness needed for implant placement since it has proven to be an accurate and largely reliable diagnostic tool in the image of morphology and buccal wall thickness. The aim of this study was to measure the vestibular bone thickness of the anterior maxillary region in the Serbian population and compare the difference between men and women, as well as between the left and right sides of the jaw. Methods. CBCT images of 68 patients were examined from the existing database. The length from the cementoenamel junction to the beginning of the alveolar bone was measured, followed by the thickness of the vestibular bone at various clinically relevant locations. The data were statistically processed and analyzed. Results. A total of 373 teeth of the frontal region of the upper jaw, including 128 central incisors, 124 lateral incisors, and 121 canines, were analyzed. The thickness of the buccal bone in more than 88% of cases was less than 1.5 mm at all reference points, with mean values from 0.72 to 1.02 mm. Conclusion. A very small number of maxillary teeth have a vestibular bone thickness greater than 2 mm; therefore, the criterion to provide at least 2 mm of thickness needed for implant placement is difficult to meet. That increases the use of auxiliary methods of bone augmentation during immediate implant placement.

Vestibular bone thickness of the mandible in relation to the mandibular canal in a population from Bosnia and Herzegovina

Introduction: Dental implantology is the branch of dentistry that is gaining greater significance because a larger number of patients come with requests of implant placements. During dental implant placements, with patients with whom operation is carried out in the mandible, very frequently nervus alveolaris inferior can be injured. The nerve injury may occur during the implant placement, but the nerve may also be injured in case of harvesting of intraoral bone graft. During the bone graft harvesting, but also during any other procedure in the dentistry that entails working on vestibular side of corpus of the mandible, in order not to injure the nervus alveolaris inferior, it is important to familiarize oneself with the distance of the nerve from the outer vestibular cortex of the mandible. The objective of the study was to assess the vestibular bone thickness of the mandible in relation to the mandibular canal with the help of analysis of cone-beam computed tomography (CBCT) images.Methods: It was accessed the database of CBCT images taken at the School of Dental Medicine at the University of Sarajevo, where out of 700 reviewed CBCT images, an analysis of 322 CBCT images was conducted that satisfied inclusion criteria of the study. CBCT images were taken using of ORTHOPHOS SLX imaging unit. The measurement was conducted by Sidexis program on cross-section of CBCT image. The measurement of vestibular bone thickness was performed, by measuring the distance from the lateral wall of the mandibular canal to buccal mandibular compact bone, in the region of the second premolar, of the first and the second molar.Results: There were statistically significant differences in vestibular bone thickness between men and women on both sides in the region of the second premolar (p < 0.001) and first molar (p = 0.016 right, p = 0.018 left). T-test demonstrated no statistically significant difference in the vestibular bone thickens between men and women on either side in the case of vestibular bone thickness of the center of the second molar (p = 0.397 right, p = 0.743 left).Conclusion: Values of vestibular thickness of the mandible are larger with men than with women in all measuring points; however, statistically more significant differences between genders have been detected in the second premolar and center of the first molar.

Buccal Bone Changes Around First Permanent Molars and Second Primary Molars after Maxillary Expansion with a Low Compliance Ni-Ti Leaf Spring Expander.

Background: Vestibular bone thickness changes and dento-alveolar buccal tipping of second primary molars and of first molars after maxillary expansion performed with a slow maxillary expansion protocol was investigated. Methods: Twenty patients (mean age 7.3 ± 0.9 years old; 9 male and 11 female) were treated according to the Leaf Expander protocol. Buccal alveolar bone thickness (BT), buccal alveolar bone height (BH), inter-dental angle (TIP), and inter-molar width (IW) regarding first molars and second primary molars were calculated before and after expansion on cone beam computed tomography (CBCT) images. Descriptive statistics and paired t-tests were used to assess changes between the pre-treatment and post-treatment measurements. Results: Bone thickness vestibular to second primary molars and intermolar width of both teeth were the only variables that showed statistically significant changes. Conclusions: It appears that buccal bone thickness vestibular to first molars was not significantly reduced after maxillary expansion with the Leaf Expander. The clinical use of a slow maxillary expander with Ni–Ti springs appears efficient and safe in in the correction of maxillary hypoplasia during mixed dentition.

Vestibular bone thickness of the mandible in relation to the mandibular canal\u2014a retrospective CBCT-based study

BackgroundThe aim of this study was to assess vestibular bone thickness of the mandible in relation to the mandibular canal and position of the mental foramen in relation to the neighbouring teeth. Measurements were performed on radiographic cone-beam computed tomography (CBCT) images.MethodsThis retrospective study analysed 314 CBCTs, having been taken at the Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, Switzerland.ResultsCBCTs from 168 female and 146 male patients (median age 40.2 years) were analysed. Median bone thickness lateral to the nerve canal to the buccal mandibular cortical plate was ~ 4 mm immediately posterior to the mental foramen, increased to ≤ 6 mm over the next 30 mm, then decreased to ~ 3 mm at the level of the mandibular foramen. In two thirds of cases, both mental foramina were located near the second premolar (66.2% right, 67.7% left). Bone thickness and the position of the mental foramen showed marked intra- and interindividual variance.ConclusionsA preoperative CBCT is recommended for detailed planning of surgical interventions that may reach the mandibular canal (e.g. wisdom teeth removal, root resection, implant placement, bone block harvesting).

Evaluation of Vestibular Bone Thickness in Class I Malocclusion Treatment With Corticotomy-Assisted Rapid Orthodontics.

Corticotomy-assisted rapid orthodontics is a widely used method for speeding up conventional orthodontics. This study (i) evaluates the effects of corticotomy alone, corticotomy combined with bone graft, and corticotomy with platelet-rich fibrin (PRF) on vestibular alveolar bone thickness in patients with class I malocclusion; (ii) compares the treatment time with a conventional orthodontic therapy group, and (iii) investigates the periodontal health of patients who have undergone corticotomy-assisted rapid orthodontics. The patients were divided into 3 groups: Group 1 (n = 10) underwent corticotomy alone; Group 2 (n = 10) underwent corticotomy combined with bone graft, and Group 3 (n = 10) underwent corticotomy combined with PRF. In the following stage, vestibular alveolar bone thicknesses were evaluated using 3-dimensional cone-beam computed tomography images. The findings showed that Group 2 achieved a more significant augmentation of the vestibular alveolar bone than Groups 1 and 3 (P = 0.001, P = 0.003), while corticotomy-assisted rapid orthodontics decreased treatment times. Sufficient alveolar bone thickness and preservation of the periodontal health were achieved when the corticotomy procedure was either combined with a bone graft or with PRF in the Class-I malocclusion patients. Bone grafts provided better bone thickness at the buccal surface of the anterior teeth of the mandible and maxilla, whereas the thickness of the keratinized gingiva was better with PRF.

Bone Healing in Extraction Sockets Covered With Collagen Membrane Alone or Associated With Porcine-Derived Bone Graft: a Comparative Histological and Histomorphometric Analysis.

ABSTRACTObjectivesThe present paper reports data of a randomized study aimed to analyse and compare the histologic and histomorphometric aspects of bone healing in extraction sites covered with collagen membrane alone or associated with porcine-derived bone graft.Material and MethodsThirty patients, with single extraction sockets without severe bone wall defects in the premolar/molar region, were included. Ten extraction sockets were grafted with porcine-derived bone and covered with collagen membrane (group 1), 10 sites were covered with collagen membrane alone (group 2), and 10 sites healed spontaneously (group 3). After 4 months of healing, 26 (8 in group 1, 9 in group 2, and 9 in group 3) bone core specimens were harvested for histologic evaluation, then dental implants were placed.ResultsSites in the group 1 and in the group 2 showed similar histologic and histomorphometric results without significantly differences in the percentage of vital bone (57.43% [SD 4.8] vs. 60.01% [SD 3.2]), and non-mineralized connective tissue 22.99% (SD 5.3) vs. 18.53% (SD 6.2). In group 1 a 16.57% (SD 3.8) of residual material was found. ConclusionsResults showed that the use of collagen membrane alone or associated to porcine-derived bone improves the healing bone process compared to that of extraction sites spontaneously healed. Moreover, histomorphometric data related to bone quality, indicated that extraction sites without severe walls defects and with a vestibular bone thickness > 1.5 mm, treated with a low resorbtion rate collagen membrane alone, do not need more than 4 months for dental implant insertion.

Relationship between anterior mandibular bone thickness and the angulation of incisors and canines\u2014a CBCT study

ObjectivesThe morphology of the maxillary and mandibular alveolar cortex plays an important role in the planning of orthodontic treatment. Cone-beam computed tomography (CBCT) provides a precise demonstration of anatomical structures. Therefore, the aim of this paper was to evaluate what influence the position of incisors and canines have on the dimensions of the cortical and spongious bone of the anterior mandibular alveolar process.Materials and methodsThe material consisted of 100 CBCT volumes (61 females and 39 males, aged 18–71 years) obtained by means of a Gendex GXCB-500 machine and analysed using i-CAT Vision and CorelDRAW 9 software. Several linear and angular measurements were taken of cortical and spongious mandibular, vestibular and lingual alveolar bone.ResultsThe thickness of the vestibular spongious bone increased around lateral incisors and canines together with dental axis inclination, as did the thickness of the lingual spongious bone around central incisors and canines with greater angles of vestibular cortex curvature. In all teeth, the thickness of lingual cancellous bone decreased along with increase of the angle of tooth inclination. In the case of almost all groups of teeth, the thickness of lingual cancellous bone around teeth declined as the angle of curvature of the cortical bone decreased. The rotation of mandibular incisors and canines did not affect the thickness of the surrounding bone.ConclusionsThe position of teeth has little influence on vestibular bone thickness and is only significant around central incisors. In the case of almost all groups of teeth, the thickness of lingual spongious bone around teeth declined as the angle of curvature of the cortical bone decreased.Clinical relevanceCBCT is a diagnostic tool that provides detailed information on the dimensions of the anterior dentate mandibular alveolar process.

Esthetic risk assessment of immediate implant: position paper and proposal of a novel diagnostic parameter

ObjectivesThe aim of this paper is to assess the risk factors that could influence the esthetic and long term results of implant placement in fresh extraction sockets. Materials and methodsThe immediate implant risk factors that could influence the final outcome are analyzed and could be summarized in: the peri-implant soft tissue biotype, the vestibular bone thickness, the alveolar host infected site, the residual peri-implant gap and the final implant position. Furthermore a diagnostic parameter that could influence the therapeutic approach is proposed. DiscussionSeveral factors have been proposed as being important in determining the stability of the peri-implant mucosa, including implant shoulder position in the bucco-lingual and apico-coronal direction and tissue biotype. The initial thickness of the buccal crestal bone may be a factor in determining the extent of the vestibular bone resorption. Thick soft and hard peri-implant tissues could contribute to marginal stability. Infected alveolar site is not a contradiction to implant placement and the peri-implant gap should be grafted in order to minimize the horizontal resorption. The implant position and diameter should be carefully analyzed in order to preserve peri-implant soft tissue stability. ConclusionsMarginal tissue recession, occurred at both thin and thick biotype sites. When implants are placed immediately after tooth extraction, the implant-vestibular plate distance is a critical parameter to evaluate, and can be a useful diagnostic parameter that guides the clinician in the choice of the most appropriate grafting procedure. Grafting the marginal defects may limit the horizontal resorption, however “overbuilding” the buccal aspect may be a suitable technique to compensate for the physiological alveolar bone changes.