Assessment of Labial Alveolar Bone Thickness of Central Maxillary Incisors from DentiiScan Cone Beam Computed Tomography Machine
Esthetic and primary stability are two of the major concerns in immediate implant placement, especially in the anterior region of the maxilla. Esthetic is derived from appropriate thickness of labial alveolar bone and dental implant positions, meanwhile, the primary stability can be from bone grafting along with applying the dental implant into the tooth socket. The aims of this study were to measure the thickness of labial alveolar bone at central maxillary incisal regions which are common areas of immediate implant potential sites and also to find the relationship between age and labial alveolar bone thickness. A total of selected 120 cone beam computed tomographs which produced by DentiiScan® machine were used in this study. Measuring of labial alveolar bone thickness in the sequent sagittal slices was done in three different locations; 4 mm apical to CEJ (A), middle of root (B) and apical of root (C). The results showed that the average of the labial alveolar bone thickness at (A), (B), (C) were 0.92±0.43, 0.84±0.38 and 1.49±0.61 mm, respectively. (A) and (B) were the locations where the labial alveolar bone thickness was commonly lesser than 2 mm. There was a statistically significant reduction of labial alveolar bone thickness at 4 mm apical to CEJ (A) in older samples. In conclusion, the bone grafting is strongly recommended in immediate implant placement case, especially in aging patient, in order to create the esthetic and primary stability.
1. Branemark PI. Osseointegration and its experimental background. J Prosthet Dent. Sep 1983; 50(3): 399-410.
2. Schulte W. The Intra-Osseous Al2O3 (Frialit) Tuebingen Implant. Developmental Status after Eight Years (I). Quintessence Int. 1984; 15(1): 9-26.
3. Chen ST, Wilson TG, Jr., Hammerle CH. Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes. Int J Oral Maxillofac Implants. 2004; 19 Suppl: 12-25.
4. Viswambaran M, Arora V, Tripathi RC, et al. Clinical evaluation of immediate implants using different types of bone augmentation materials. Med J Armed Forces India. Apr 2014; 70(2): 154-162.
5. Wagenberg B, Froum SJ. A retrospective study of 1925 consecutively placed immediate implants from 1988 to 2004. Int J Oral Maxillofac Implants. Jan-Feb 2006; 21(1): 71-80.
6. Khzam N, Mattheos N, Roberts D, et al. Immediate placement and restoration of dental implants in the esthetic region: clinical case series. J Esthet Restor Dent. Sep-Oct 2014; 26(5): 332-344.
7. Gamborena I, Blatz M. Current clinical and technical protocols for single-tooth immediate implant procedures. QuintessenceDent Technol. 2008; 31: 49-60.
8. Masaki C, Nakamoto T, Mukaibo T, et al. Strategies for alveolar ridge reconstruction and preservation for implant therapy. Journal of Prosthodontic Research. 2015.
9. Sanz M, Cecchinato D, Ferrus J, et al. A prospective, randomized-controlled clinical trial to evaluate bone preservation using implants with different geometry placed into extraction sockets in the maxilla. Clin Oral Implants Res. Jan 2010; 21(1): 13-21.
10. Ferrus J, Cecchinato D, Pjetursson EB, et al. Factors influencing ridge alterations following immediate implant placement into extraction sockets. Clin Oral Implants Res. Jan 2010; 21 (1): 22-29.
11. Zekry A, Wang R, Chau A, et al. Facial alveolar bone wall width–a cone-beam computed tomography study in Asians. Clinical oral implants research. 2014; 25(2): 194-206.
12. Braut V, Bornstein MM, Belser U, et al. Thickness of the anterior maxillary facial bone wall-a retrospective radiographic study using cone beam computed tomography. Int J Periodontics Restorative Dent. Apr 2011; 31(2): 125-131.
13. Viswambaran M, Arora V, Tripathi RC, et al. Clinical evaluation of immediate implants using different types of bone augmentation materials. Med J Armed Forces India. 2014; 70(2): 154-162.
14. Spinato S, Galindo-Moreno P. Evaluation of buccal plate after human bone allografting: clinical and CBCT outcomes of immediate anterior implants in eight consecutive cases. Int J Periodontics Restorative Dent. May-Jun 2014; 34(3): e58-66.
15. Lau SL, Chow J, Li W, et al. Classification of maxillary central incisors-implications for immediate implant in the esthetic zone. J Oral Maxillofac Surg. Jan 2011; 69(1): 142-153.
16. Zhou Z, Chen W, Shen M, et al. Cone beam computed tomographic analyses of alveolar bone anatomy at the maxillary anterior region in Chinese adults.
17. Thongvigitmanee SS, Pongnapang, N., Aootaphao, S., Yampri, P., Srivongsa, T., Sirisalee, P., Thajchayapong, P. Radiation dose and accuracy analysis of newly developed cone-beam CT for dental and maxillofacial imaging. Paper presented at the Engineering in Medicine and Biology Society (EMBC), 2013 35th Annual International Conference of the IEEE. 2013.
18. Thongvigitmanee SS, Kasemsarn, S., Sirisalee, P., Aootaphao, S., Rajruangrabin, J., Yampri, P., Thajchayapong, P. DentiiScan: The first conebeam CT scanner for dental and maxillofacial imaging developed in Thailand. Paper presented at the Nuclear Science Symposium and Medical Imaging Conference (NSS/MIC), 2013 IEEE. 2013.
19. Prapayasatok S, Janhom A, Verochana K, et al. Subjective Image Quality of Cone-Beam CT, Developed by NSTDA, Thailand. CM Dent J. 2014; 35(1): 35-49. (in Thai.)
20. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. The International journal of oral & maxillofacial implants. 2003; 19: 43-61.
21. El Nahass H, Naiem SN. Analysis of the dimensions of the labial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res. Apr 2015; 26(4): e57-61.
22. Miyamoto Y, Obama T. Dental cone beam computed tomography analyses of postoperative labial bone thickness in maxillary anterior implants: comparing immediate and delayed implant placement. Int J Periodontics Restorative Dent. Jun 2011; 31(3): 215-225.
23. Nowzari H, Molayem S, Chiu CHK, et al. Cone beam computed tomographic measurement of maxillary central incisors to determine prevalence of facial alveolar bone width≥ 2 mm. Clinical implant dentistry and related research. 2012; 14(4): 595-602.
24. Schei O, Waerhaug J, Lovdal A, et al. Alveolar Bone Loss as Related to Oral Hygiene and Age. Journal of Periodontology. 1959; 30(1): 7-16.
25. Papapanou PN, Wennstrom JL, Grondahl K. Periodontal status in relation to age and tooth type. A cross-sectional radiographic study. J Clin Periodontol. Aug 1988; 15(7): 469-478.
26. Huynh-Ba G, Pjetursson BE, Sanz M, et al. Analysis of the socket bone wall dimensions in the upper maxilla in relation to immediate implant placement. Clinical oral implants research. 2010; 21(1): 37-42.
27. Pagni G, Pellegrini G, Giannobile WV, et al. Postextraction alveolar ridge preservation: biological basis and treatments. Int J Dent. 2012; 2012: 151030.
28. Tomasi C, Sanz M, Cecchinato D, et al. Bone dimensional variations at implants placed in fresh extraction sockets: a multilevel multivariate analysis. Clinical Oral Implants Research. 2010; 21(1): 30-36.
29. Caneva M, Salata LA, de Souza SS, et al. Influence of implant positioning in extraction sockets on osseointegration: histomorphometric analyses in dogs. Clin Oral Implants Res. Jan 2010; 21(1): 43-49.