Title: A Retrospective Study Evaluating the Anterior Bone Wall Thickness Using Cone Beam Computed Tomography Images with a Three Dimensional Software

Authors: Dr Priyadershini Rangari, Dr Udaybhan Singh, Dr Nivedita Singh,  Dr Ashish Dewangan

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i4.142

Abstract

The aim of the study was to analyze the thickness of the facial bone wall at teeth in the anterior maxilla based on cone beam computed tomography (CBCT) images, since this anatomical structure is important for the selection of an appropriate treatment approach in patients undergoing post extraction implant placement.

Three dimensional (3D) images were reconstructed using cone-beam computed tomography (CBCT) scans from 45 Indian subjects of age group ranging between20-55 years, with a sample size of 90 teeth using On Demand 3D software. The thickness of the facial bone wall in the respective sagittal scan was measured perpendicular to the long axis of the tooth at two locations: at the crest level and at the middle of the root.

Mean thickness of buccal plate 3 mm below CEJ was 0.59 ±0.27mm at central incisor, 0.69 ±0.54 mm at lateral incisor, and 1.05 ±0.75mm at canine. Mean thickness of palatal plate 3 mm below CEJ was 1.23 ±0.45mm of central incisor, 1.04 ±0.59mm of lateral incisor, 1.49 ±0.61 mm of canine. Mesio-distal diameter 3 mm below CEJ was 4.66±0.39mm of central incisor, 4.09±0.45mm of lateral incisor, and 5.27±0.52 mm of canine. Buccal bony curvature angle below root apex was 114 ±16.5at central incisor, 144.0 ±12.9at lateral incisor, 145.0 ±8.9at canine. Distance between root apex and the deepest point of buccal bony curvature of central incisor was 3.49 ±1.17mm at central incisor, 3.49 ±1.17mm at lateral incisor, and 5.51 ±1.66mm at canine.

Conclusion for the study was that, there was a statistically significant increase in facial bone wall thickness from the central incisors to the canine. The facial bone wall in the crestal area of teeth in the anterior maxilla was either missing or thin in roughly all of patients.

Keywords: anterior maxilla, facial bone thickness, implant placement, cone beam computed tomography.

References

  1. Lee SL, Kim HJ, Son MK, Chung CH, Anthropometric analysis of maxillary anterior buccal bone of Korean adults using cone-beam CT, J Adv Prosthodont 2010;2:92-6.
  2. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004; 19:43-61.
  3. Nevins M, Camelo M, De Paoli S, Friedland B, Schenk RK, Parma-Benfenati S, Simion M, Tinti C, Wagenberg B. A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots. Int J Periodontics Restorative Dent 2006; 26:19-29.
  4. Cardaropoli G, Arau′jo M, Lindhe J. Dynamics of bone tissue formation in tooth extraction sites. An experimental study in dogs. J Clin Periodontol 2003; 30:809-18.
  5. Johnson K. A study of the dimensional changes occurring in the maxilla after tooth extraction. Part 2: Closed face immediate denture treatment. Aust Dent J 1964; 9:6-13.
  6. Arau′jo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 2005; 32:212-8.
  7. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003; 23:313-23.
  8. Swasty D, Lee JS, Huang JC, Maki K, Gansky SA, Hatcher D, Miller AJ. Anthropometric analysis of the human mandibular cortical bone as assessed by cone-beam computed tomography. J Oral Maxillofac Surg 2009; 67:491-500.
  9. Belser UC, Buser D, Hess D, Schmid B, Bernard JP, Lang NP. Aesthetic implant restorations in partially edentulous patientsa critical appraisal. Periodontol 2000 1998; 17:132-50.
  10. Buser D, von Arx T. Surgical procedures in partially edentulous patients with ITI implants. Clin Oral Implants Res 2000; 11:83100.
  11. Langer B, Sullivan DY. Osseo integration: its impact on the interrelationship of periodontics and restorative dentistry. Part 3. Periodontal prosthesis redefined. Int J Periodontics Restorative Dent 1989; 9:240-61.
  12. Becker W, Sennerby L, Bedrossian E, Becker BE, Lucchini JP. Implant stability measurements for implants placed at the time of extraction: a cohort, prospective clinical trial. J Periodontol 2005;76:391-7.
  13. London RM. The esthetic effects of implant platform selection. Compend Contin Educ Dent 2001;22:675-82.
  14. Kan JYK, Rungcharassaeng K. Immediate placement and provisionalization of maxillary anterior single implants: a surgical and prosthodontics rational. Pract Periodontics Aesthet Dent 2000; 12:817-24.
  15. Smukler H, Castellucci F, Capri D. The role of the implant housing in obtaining aesthetics: generation of peri-implant gingivae and papillae-Part 1. Pract Proceed Aesthet Dent 2003; 15:141-9.
  16. Esposito M, Ekestubbe A, Gro ¨ndahl K. Radiological evaluation of marginal bone loss at tooth surfaces facing single Branemark implants. Clin Oral Implants Res 1993; 4:151-7.
  17. Garber DA, Salama MA, Salama H. Immediate total tooth replacement. Compend Contin Educ Dent 2001; 22:210-6, 218.
  18. Saadoun AP, Le Gall MG. Periodontal implications in implant treatment planning for aesthetic results. Pract Periodontics Aesthet Dent 1998; 10:655-64.
  19. Gelb DA. Immediate implant surgery: three-year retrospective evaluation of 50 consecutive cases. Int J Oral Maxillofac Implants 1993; 8:388-99.

Corresponding Author

Dr Ashish Dewangan

B-7/1, Chouhan Green Valley, Junwani, Bhilai, Dist. Durg, Chhattisgarh, Pin Code 490020

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.