Cone Beam Computerized Tomographic (CBCT) Assessment of Buccal Bone Thickness in Maxillary Aesthetic Region
CBCT: Buccal Bone Thickness in Maxillary Aesthetic Region
DOI:
https://doi.org/10.54393/pjhs.v7i4.3528Keywords:
Cone-Beam Computed Tomography, Buccal Bone Thickness, Maxillary Anterior Region, Dental Implant PlanningAbstract
Buccal bone thickness (BBT) in the maxillary aesthetic region is a key determinant of ridge remodeling and the chances of recession of the mucosa following implantation. Objectives: To measure BBT at standardized levels around maxillary central incisors, lateral incisors, and canines on CBCT scans of patients from Peshawar, Pakistan. Methods: This cross-sectional study assessed 96 CBCT scans of patients aged 18–60 years obtained from the Department of Oral and Maxillofacial Radiology, Rehman Medical Institute/Rehman College of Dentistry, Peshawar, over six months from 3 February 2025 to 3 August 2025. BBT was measured on sagittal reconstructions at the crestal level (L0) and at 1 mm (L1), 3 mm (L3), and 5 mm (L5) apical to the crest. Descriptive statistics were reported; gender differences were explored using independent-samples tests and age associations using Spearman correlation (α=0.05). Results: At L0, BBT was <1 mm in 90.6% of central incisors, 90.7% of lateral incisors, and 84.3% of canines. Males showed greater BBT than females at selected levels (central incisors: L1 and L5; lateral incisors: L5). Age showed statistically significant but weak correlations with BBT at L1 for central incisors and at L5 for lateral incisors and canines. Conclusions: In this sample, the buccal plate in the anterior maxilla was predominantly thin (<1 mm), particularly for lateral incisors and at the crest. Preoperative CBCT assessment should guide implant positioning and the anticipated need for augmentation, with consideration of patient sex and age.
References
Buser D, Martin W, Belser UC. Optimizing Esthetics for Implant Restorations in the Anterior Maxilla: Anatomic and Surgical Considerations. International Journal of Oral and Maxillofacial Implants. 2004 Nov; 19(7).
Belser UC, Schmid B, Higginbottom F, Buser D. Outcome Analysis of Implant Restorations Located in the Anterior Maxilla: A Review of the Recent Literature. International Journal of Oral and Maxillofacial Implants. 2004 Nov; 19(7).
Slagter KW, Raghoebar GM, Hentenaar DF, Vissink A, Meijer HJ. Immediate Placement of Single Implants with or without Immediate Provisionalization in the Maxillary Aesthetic Region: A 5‐Year Comparative Study. Journal of Clinical Periodontology. 2021 Feb; 48(2): 272-83. doi: 10.1111/jcpe.13398. DOI: https://doi.org/10.1111/jcpe.13398
Den Hartog L, Raghoebar GM, Stellingsma K, Vissink A, Meijer HJ. Immediate Loading of Anterior Single-Tooth Implants Placed in Healed Sites: Five-Year Results of a Randomized Clinical Trial. The International Journal of Prosthodontics. 2016 Nov; 29(6): 584-91. doi: 10.11607/ijp.4993. DOI: https://doi.org/10.11607/ijp.4993
Da Silva CF and Marcantonio Jr E. In Vitro Evaluation of the Influence of Bone Cortical Thickness on the Primary Stability of Conventional and Short-Sized Implants. Journal of Clinical and Experimental Dentistry. 2022 Feb; 14(2): e138. doi: 10.4317/jced.58886. DOI: https://doi.org/10.4317/jced.58886
Borges T, Fernandes D, Almeida B, Pereira M, Martins D, Azevedo L et al. Correlation Between Alveolar Bone Morphology and Volumetric Dimensional Changes in Immediate Maxillary Implant Placement: A 1‐Year Prospective Cohort Study. Journal of Periodontology. 2020 Sep; 91(9): 1167-76. doi: 10.1002/JPER.19-0606. DOI: https://doi.org/10.1002/JPER.19-0606
Farronato D, Pasini PM, Orsina AA, Manfredini M, Azzi L, Farronato M. Correlation Between Buccal Bone Thickness at Implant Placement in Healed Sites and Buccal Soft Tissue Maturation Pattern: A Prospective Three-Year Study. Materials. 2020 Jan; 13(3): 511. doi: 10.3390/ma13030511. DOI: https://doi.org/10.3390/ma13030511
Di Gianfilippo R, Valente NA, Toti P, Wang HL, Barone A. Influence of Implant Mucosal Thickness on Early Bone Loss: A Systematic Review with Meta-Analysis. Journal of Periodontal and Implant Science. 2020 Jun; 50(4): 209. doi: 10.5051/jpis.1904440222. DOI: https://doi.org/10.5051/jpis.1904440222
Xiang D, Wu D, Cao X, Chen S, Wang X. Hard and Soft Tissue Alterations After Immediate Implant Placement and Provisionalization with Customized Definite Abutment in Esthetic Zone: A Retrospective Study. International Journal of Oral and Maxillofacial Implants. 2023 May; 38(3). doi: 10.11607/jomi.9914. DOI: https://doi.org/10.11607/jomi.9914
Muñoz M, Busoms E, Vilarrasa J, Albertini M, Ruíz‐Magaz V, Nart J. Bone‐Level Changes Around Implants with 1‐Or 3‐Mm‐High Abutments and Their Relation to Crestal Mucosal Thickness: A 1‐Year Randomized Clinical Trial. Journal of Clinical Periodontology. 2021 Oct; 48(10): 1302-11. doi: 10.1111/jcpe.13505. DOI: https://doi.org/10.1111/jcpe.13505
Rosas-Díaz J, Guerrero ME, Galindo-Gómez M, García-Luna M, Espinoza-Figini E, Cayo-Rojas C. The Importance of Bone Quality Diagnostics in Preventing Displacement of Dental Implants within the Mandibular Body: A Case Report. Journal of the International Society of Preventive and Community Dentistry. 2024 Sep; 14(5): 429-35. doi: 10.4103/jispcd.jispcd_85_24. DOI: https://doi.org/10.4103/jispcd.jispcd_85_24
Monje A, Chappuis V, Monje F, Muñoz F, Wang HL, Urban IA et al. The Critical Peri-implant Buccal Bone Wall Thickness Revisited: An Experimental Study in the Beagle Dog. International Journal of Oral and Maxillofacial Implants. 2019 Nov; 34(6). doi: 10.11607/jomi.7657. DOI: https://doi.org/10.11607/jomi.7657
Dong T, Yuan L, Liu L, Qian Y, Xia L, Ye N et al. Detection of Alveolar Bone Defects with Three Different Voxel Sizes of Cone-Beam Computed Tomography: An in Vitro Study. Scientific Reports. 2019 May; 9(1): 8146. doi: 10.1038/s41598-019-44675-5. DOI: https://doi.org/10.1038/s41598-019-44675-5
Wang L, Ruan Y, Chen J, Luo Y, Yang F. Assessment of the Relationship Between Labial Gingival Thickness and the Underlying Bone Thickness in Maxillary Anterior Teeth by Two Digital Techniques. Scientific Reports. 2022 Jan; 12(1): 709. doi: 10.1038/s41598-021-04721-7. DOI: https://doi.org/10.1038/s41598-021-04721-7
Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth—A Systematic Review. In Healthcare. 2021 Nov; 9(12): 1663. doi: 10.3390/healthcare9121663. DOI: https://doi.org/10.3390/healthcare9121663
Tsigarida A, Toscano J, de Brito Bezerra B, Geminiani A, Barmak AB et al. Buccal Bone Thickness of Maxillary Anterior Teeth: A Systematic Review and Meta‐Analysis. Journal of Clinical Periodontology. 2020 Nov; 47(11): 1326-43. doi: 10.1111/jcpe.13347. DOI: https://doi.org/10.1111/jcpe.13347
El Nahass H, and Naiem S. Analysis of the Dimensions of the Labial Bone Wall in the Anterior Maxilla: A Cone‐Beam Computed Tomography Study. Clinical Oral Implants Research. 2015 Apr; 26(4): e57-61. doi: 10.1111/clr.12332. DOI: https://doi.org/10.1111/clr.12332
Fuentes R, Flores T, Navarro P, Salamanca C, Beltrán V, Borie E. Assessment of Buccal Bone Thickness of Aesthetic Maxillary Region: A Cone-Beam Computed Tomography Study. Journal of Periodontal and Implant Science. 2015 Oct 1; 45(5): 162-8. doi: 10.5051/jpis.2015.45.5.162. DOI: https://doi.org/10.5051/jpis.2015.45.5.162
López-Jarana P, Díaz-Castro CM, Falcão A, Falcão C, Ríos-Santos JV, Herrero-Climent M. Thickness of the Buccal Bone Wall and Root Angulation in the Maxilla and Mandible: An Approach to Cone Beam Computed Tomography. BioMed Central Oral Health. 2018 Nov 21; 18(1): 194. doi: 10.1186/s12903-018-0652-x. DOI: https://doi.org/10.1186/s12903-018-0652-x
Zhang W, Skrypczak A, Weltman R. Anterior Maxilla Alveolar Ridge Dimension and Morphology Measurement By Cone Beam Computerized Tomography (CBCT) For Immediate Implant Treatment Planning. BioMed Central Oral Health. 2015 Jun; 15(1): 65. doi: 10.1186/s12903-015-0055-1. DOI: https://doi.org/10.1186/s12903-015-0055-1
Song Y, Yang S, Wang C. Morphology and Thickness of the Buccal Bone Wall of the Maxillary Central Incisors in Population: A CBCT Study. Frontiers in Dental Medicine. 2024 Nov; 5: 1472028. doi: 10.3389/fdmed.2024.1472028. DOI: https://doi.org/10.3389/fdmed.2024.1472028
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments
