Evaluation of buccal alveolar bone dimension of maxillary anterior and premolar teeth: a cone beam computed tomography investigation

Abstract

Purpose: Clinical guidelines suggest that a minimal buccal alveolar bone thickness of 1 to 2 mm is required to maintain the tissue architecture following tooth extraction and implant placement. The aim of this study was to evaluate the thickness of buccal alveolar bone at the maxillary first premolars and anterior teeth using cone beam computed tomography (CBCT).

Materials and methods: CBCT images of the maxillae of 43 implant patients were obtained. Two examiners manually measured the distance from the cementoenamel junction (CEJ) to the buccal alveolar bone crest and the thickness of the buccal alveolar bone at the crest, midroot, and apex of the maxillary first premolars and anterior teeth. The absence of bone and presence of radiographic artifacts were recorded. Average bone thicknesses were calculated and compared. Both parametric and nonparametric statistics were used to analyze the findings.

Results: The median distance from the CEJ to the buccal alveolar bone crest was 2.79 mm, and measurements were similar among tooth positions. The median buccal alveolar bone thickness 1 mm apical to the alveolar bone was 1.13 mm in the premolar area and 0.83 mm for the anterior maxillary teeth. The median buccal alveolar bone thickness at the midroot was 1.03 mm in the premolar area and 0.70 mm for the other anterior maxillary teeth. Measurements of the buccal plate at 1 mm from the tooth apex were similar in all teeth positions, with a median thickness of 0.88 mm.

Conclusions: The presence or absence of buccal alveolar bone can be discerned by CBCT evaluation. Few maxillary anterior teeth displayed buccal alveolar bone thickness greater than 1 mm. The implications for implant therapy must be fully discerned regarding tissue biotypes and dental implant outcomes.