engleski

Thickness of the facial bone wall at natural teeth in the anterior maxilla – A radiographic study on 125 patients using Cone Beam Tomography.

Abstract Introduction The preoperative risk assessment of implant patients in the anterior maxilla often requires a 3-dimensional radiographic analysis of the local anatomy. Today, Cone Beam Tomography (CBT) is preferred since this new technology offers improved image quality and a lower radiation exposure when compared to dental CTs. The purpose of this radiographic study was to analyze the thickness of the facial bone wall at natural teeth in the anterior maxilla, since this anatomical structure plays an important role as decision criteria for an appropriate treatment selection in patients with post-extraction implant placement. Materials and methods The present study included CBT scans (Accuitomo, Morita, Kyoto, Japan) from patients treated with dental implants at the Department of Oral Surgery and Stomatology, University of Bern, between January and December 2009. A total of 125 CBT scans met the inclusion criteria and were analyzed with the according image processing software (Idixel, Morita, Kyoto, Japan). The thickness of the facial bone wall in the respective scans was measured at two points: at the middle of the root (measuring point 1, MP1) and 4 mm apical to the CEJ (measuring point 2, MP2). All measurements were performed in the sagittal plane, perpendicular to the long axis of the root. Results The respective analysis provided a sample size of 498 teeth. No existing bone wall was found in 50 teeth at MP1(10.04%) and in 128 teeth at MP2(25.70%). Mean values of the facial bone wall thickness at MP1 were 0.66mm for premolars, 0.61 for canines, 0.54 for lateral incisors and 0.59 for central incisors, while at MP2 they were 0.74, 0.55, 0.54 and 0.48mm, respectively. The majority of the examined teeth showed facial bone wall thickness < 1mm (80.12% at MP1, 62.85% at MP2), but the highest % was observed for central incisors (89.31% at MP1 and 67.94% at MP2) followed by lateral incisors (83.11% at MP1 and 65.54% at MP2). Bone wall ≥1mm was found in only 9.84% of examined teeth at MP1 and 11.45% at MP2. Conclusion According to the findings in the present study, the thickness of the facial bone wall at natural teeth in the anterior maxilla is seldom greater than 1mm, roughly in 10% of the patients. The evaluation of the facial bone wall thickness is clinically important and affects the planning of implant surgery in post-extraction sites.

preoperative evaluation; CBCT; bone thickness

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