Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies

Julio Rojo-Sanchis; David Soto-Peñaloza; David Peñarrocha-Oltra; Miguel Peñarrocha-Diago; José Viña-Almunia

doi:10.1186/s12903-021-01495-2

journal article Open Access Mar 22, 2021

Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies

Julio Rojo-Sanchis

David Soto-Peñaloza

David Peñarrocha-Oltra Miguel Peñarrocha-Diago

José Viña-Almunia

BMC Oral Health Vol. 21 No. 1 · Springer Science and Business Media LLC

View at Publisher Save 10.1186/s12903-021-01495-2

Abstract

Abstract

Background
Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest.

Methods

An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Q
h
test and I
2
index for heterogeneity was estimated.

Results
2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75–1.05 mm) and 1–2 mm in premolars. Patients over 50 years of age, females and thin gingival phenotype was associated with thinner FAB at some apico-coronal locations of maxillary incisors and canines. The geographical setting was an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2–2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. Evidence certainty has shown moderate quality in most analysis subsets.

Conclusions
Facial alveolar bone at anterior maxillary teeth is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.

Topics

No keywords indexed for this article. Browse by subject →

References

73

[1]

Araújo MG, Silva CO, Misawa M, Sukekava F. Alveolar socket healing: What can we learn? Periodontol. 2005;68(1):122–34. https://doi.org/10.1111/prd.12082. 10.1111/prd.12082

[2]

Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol. 2005;32(2):212–8. https://doi.org/10.1111/j.1600-051X.2005.00642.x. 10.1111/j.1600-051x.2005.00642.x

[3]

Clinical relevance of dimensional bone and soft tissue alterations post‐extraction in esthetic sites

Vivianne Chappuis, Mauricio G. Araújo, Daniel Buser

Periodontology 2000 2017 10.1111/prd.12167

[4]

Amler MH. The time sequence of tissue regeneration in human extraction wounds. Oral Surg Oral Med Oral Pathol. 1969;27(3):309–18. 10.1016/0030-4220(69)90357-0

[5]

Dynamics of bone tissue formation in tooth extraction sites

G. Cardaropoli, M. Araújo, J. Lindhe

Journal of Clinical Periodontology 2003 10.1034/j.1600-051x.2003.00366.x

[6]

Chappuis V, Engel O, Shahim K, Reyes M, Katsaros C, Buser D. Soft tissue alterations in esthetic postextraction sites: a 3-dimensional analysis. J Dent Res. 2015;94(9 Suppl):187S-193S. https://doi.org/10.1177/0022034515592869. 10.1177/0022034515592869

[7]

Farmer M, Darby I. Ridge dimensional changes following single-tooth extraction in the aesthetic zone. Clin Oral Implants Res. 2014;25(2):272–7. https://doi.org/10.1111/clr.12108. 10.1111/clr.12108

[8]

Vera C, De Kok IJ, Chen W, Reside G, Tyndall D, Cooper LF. Evaluation of post-implant buccal bone resorption using cone beam computed tomography: a clinical pilot study. Int J Oral Maxillofac Implants. 2012;27(5):1249–57.

[9]

Ridge Alterations Post-extraction in the Esthetic Zone

V. Chappuis, O. Engel, M. Reyes et al.

Journal of Dental Research 2013 10.1177/0022034513506713

[10]

Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: When immediate, when early, when late? Periodontol. 2017;73(1):84–102. https://doi.org/10.1111/prd.12170. 10.1111/prd.12170

[11]

Analysis of the socket bone wall dimensions in the upper maxilla in relation to immediate implant placement

Guy Huynh‐Ba, Bjarni E. Pjetursson, Mariano Sanz et al.

Clinical Oral Implants Research 2010 10.1111/j.1600-0501.2009.01870.x

[12]

Farahamnd A, Sarlati F, Eslami S, Ghassemian M, Youssefi N, Jafarzadeh Esfahani B. Evaluation of impacting factors on facial bone thickness in the anterior maxillary region. J Craniofac Surg. 2017;28(3):700–5. https://doi.org/10.1097/SCS.0000000000003643. 10.1097/scs.0000000000003643

[13]

Zhang CY, DeBaz C, Bhandal G, Alli F, Buencamino Francisco MC, Thacker HL, Palomo JM, Palomo L. Buccal bone thickness in the esthetic zone of postmenopausal women. Implant Dent. 2016;25(4):478–84. https://doi.org/10.1097/ID.0000000000000405. 10.1097/id.0000000000000405

[14]

Demircan S, Demircan E. Dental cone beam computed tomography analyses of the anterior maxillary bone thickness for immediate implant placement. Implant Dent. 2015;24(6):664–8. https://doi.org/10.1097/ID.0000000000000340. 10.1097/id.0000000000000340

[15]

Morad G, Behnia H, Motamedian SR, Shahab S, Gholamin P, Khosraviani K, Nowzari H, Khojasteh A. Thickness of labial alveolar bone overlying healthy maxillary and mandibular anterior teeth. J Craniofac Surg. 2014;25(6):1985–91. https://doi.org/10.1097/SCS.0000000000001022. 10.1097/scs.0000000000001022

[16]

Zekry A, Wang R, Chau AC, Lang NP. Facial alveolar bone wall width—a cone-beam computed tomography study in Asians. Clin Oral Implants Res. 2014;25(2):194–206. https://doi.org/10.1111/clr.12096. 10.1111/clr.12096

[17]

El Nahass H, Naiem S. Analysis of the dimensions of the labial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res. 2015;26(4):e57–61. https://doi.org/10.1111/clr.12332. 10.1111/clr.12332

[18]

Esfahanizadeh N, Daneshparvar N, Askarpour F, Akhoundi N, Panjnoush M. Correlation between bone and soft tissue thickness in maxillary anterior teeth. J Dent (Tehran). 2016;13(5):302–8.

[19]

Ghassemian M, Nowzari H, Lajolo C, Verdugo F, Pirronti T, D’Addona A. The thickness of facial alveolar bone overlying healthy maxillary anterior teeth. J Periodontol. 2012;83(2):187–97. https://doi.org/10.1902/jop.2011.110172. 10.1902/jop.2011.110172

[20]

Braut V, Bornstein MM, Belser U, Buser D. Thickness of the anterior maxillary facial bone wall-a retrospective radiographic study using cone beam computed tomography. Int J Periodontics Restorative Dent. 2011;31(2):125–31.

[21]

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. J Periodontal Implant Sci. 2015;45(5):162–8. https://doi.org/10.5051/jpis.2015.45.5.162. 10.5051/jpis.2015.45.5.162

[22]

Kheur MG, Kantharia NR, Kheur SM, Acharya A, Le B, Sethi T. Three-dimensional evaluation of alveolar bone and soft tissue dimensions of maxillary central incisors for immediate implant placement: a cone-beam computed tomography assisted analysis. Implant Dent. 2015;24(4):407–15. https://doi.org/10.1097/ID.0000000000000259. 10.1097/id.0000000000000259

[23]

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. BMC Oral Health. 2018;18(1):194. https://doi.org/10.1186/s12903-018-0652-x. 10.1186/s12903-018-0652-x

[24]

Cone Beam Computed Tomographic Measurement of Maxillary Central Incisors to Determine Prevalence of Facial Alveolar Bone Width ≥2 mm

Hessam Nowzari, Shervin Molayem, Ching Hsiu Ketty Chiu et al.

Clinical Implant Dentistry and Related Research 2012 10.1111/j.1708-8208.2010.00287.x

[25]

Wang HM, Shen JW, Yu MF, Chen XY, Jiang Q, He FM. Analysis of facial bone wall dimensions and sagittal root position in the maxillary esthetic zone: a retrospective study using cone beam computed tomography. Int J Oral Maxillofac Implants. 2014;29(5):1123–9. https://doi.org/10.11607/jomi.3348. 10.11607/jomi.3348

[26]

Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement

David Moher, Alessandro Liberati, Jennifer Tetzlaff et al.

International Journal of Surgery 10.1016/j.ijsu.2010.02.007

[27]

Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005;331(7524):1064–5. https://doi.org/10.1136/bmj.38636.593461.68. 10.1136/bmj.38636.593461.68

[28]

Alpiste-illueca F. Morphology and dimensions of the dentogingival unit in the altered passive eruption. Med Oral Patol Oral Cir Bucal. 2012;17(5):e814–20. https://doi.org/10.4317/medoral.18044. 10.4317/medoral.18044

[29]

Chappuis V, Bornstein MM, Buser D, Belser U. Influence of implant neck design on facial bone crest dimensions in the esthetic zone analyzed by cone beam CT: a comparative study with a 5-to-9-year follow-up. Clin Oral Implants Res. 2016;27(9):1055–64. https://doi.org/10.1111/clr.12692. 10.1111/clr.12692

[30]

ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions

Jonathan AC Sterne, Miguel A Hernán, Barnaby C Reeves et al.

BMJ 2016 10.1136/bmj.i4919

[31]

Bias in meta-analysis detected by a simple, graphical test

Matthias Egger, George Davey Smith, Martin Schneider et al.

BMJ 1997 10.1136/bmj.315.7109.629

[32]

Methods to estimate the between‐study variance and its uncertainty in meta‐analysis

Areti Angeliki Veroniki, Dan Jackson, Wolfgang Viechtbauer et al.

Research Synthesis Methods 2016 10.1002/jrsm.1164

[33]

Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018;45(Suppl 20):S68–77. https://doi.org/10.1111/jcpe.12940. 10.1111/jcpe.12940

[34]

Li H, Wallin M, Barregard L, Sallsten G, Lundh T, Ohlsson C, Mellström D, Andersson EM. Smoking-induced risk of osteoporosis is partly mediated by cadmium from Tobacco Smoke: the MrOS Sweden study. J Bone Miner Res. 2020. https://doi.org/10.1002/jbmr.4014.10.1002/jbmr.4014. 10.1002/jbmr.4014.10.1002/jbmr.4014

[35]

Leite FRM, Nascimento GG, Scheutz F, López R. Effect of smoking on periodontitis: a systematic review and meta-regression. Am J Prev Med. 2018;54(6):831–41. https://doi.org/10.1016/j.amepre.2018.02.014. 10.1016/j.amepre.2018.02.014

[36]

Fokas G, Vaughn VM, Scarfe WC, Bornstein MM. Accuracy of linear measurements on CBCT images related to presurgical implant treatment planning: a systematic review. Clin Oral Implants Res. 2018;29(Suppl 16):393–415. https://doi.org/10.1111/clr.13142. 10.1111/clr.13142

[37]

Gluckman H, Pontes CC, Du Toit J. Radial plane tooth position and bone wall dimensions in the anterior maxilla: a CBCT classification for immediate implant placement. J Prosthet Dent. 2018;120(1):50–6. https://doi.org/10.1016/j.prosdent.2017.09.005. 10.1016/j.prosdent.2017.09.005

[38]

Januário AL, Duarte WR, Barriviera M, Mesti JC, Araújo MG, Lindhe J. Dimension of the facial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res. 2011;22(10):1168–71. https://doi.org/10.1111/j.1600-0501.2010.02086.x. 10.1111/j.1600-0501.2010.02086.x

[39]

Jung YH, Cho BH, Hwang JJ. Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography. Imaging Sci Dent. 2017;47(3):181–7. https://doi.org/10.5624/isd.2017.47.3.181. 10.5624/isd.2017.47.3.181

[40]

Koç A, Kavut İ, Uğur M. Assessment of buccal bone thickness in the anterior maxilla: a cone beam computed tomography study. Cumhur Dent J. 2019;22(1):102–7. https://doi.org/10.7126/cumudj.494676. 10.7126/cumudj.494676

[41]

Rojo-Sanchis J, Viña-Almunia J, Peñarrocha-Oltra D, Peñarrocha-Diago M. Facial alveolar bone width at the first and second maxillary premolars in healthy patients: a cone beam computed tomography study. J Oral Implantol. 2017;43(4):261–5. https://doi.org/10.1563/aaid-joi-D-16-00195. 10.1563/aaid-joi-d-16-00195

[42]

Sheerah H, Othman B, Jaafar A, Alsharif A. Alveolar bone plate measurements of maxillary anterior teeth: a retrospective Cone Beam Computed Tomography study, AlMadianh. Saudi Arabia Saudi Dent J. 2019;31(4):437–44. https://doi.org/10.1016/j.sdentj.2019.04.007. 10.1016/j.sdentj.2019.04.007

[43]

Temple KE, Schoolfield J, Noujeim ME, Huynh-Ba G, Lasho DJ, Mealey BL. A cone beam computed tomography (CBCT) study of buccal plate thickness of the maxillary and mandibular posterior dentition. Clin Oral Implants Res. 2016;27(9):1072–8. https://doi.org/10.1111/clr.12688. 10.1111/clr.12688

[44]

Amid R, Mirakhori M, Safi Y, Kadkhodazadeh M, Namdari M. Assessment of gingival biotype and facial hard / soft tissue dimensions in the maxillary anterior teeth region using cone beam computed tomography. Arch Oral Biol. 2017;79:1–6. https://doi.org/10.1016/j.archoralbio.2017.02.021. 10.1016/j.archoralbio.2017.02.021

[45]

Cook DR, Mealey BL, Verrett RG, Mills MP, Noujeim ME, Lasho DJ, Cronin RJ Jr. Relationship between clinical periodontal biotype and labial plate thickness: an in vivo study. Int J Periodontics Restorative Dent. 2011;31(4):345–54.

[46]

D’Silva E, Fraser D, Wang B, Barmak AB, Caton J, Tsigarida A. The association between gingival recession and buccal bone at maxillary anterior teeth. J Periodontol. 2020;91(4):484–92. https://doi.org/10.1002/JPER.19-0375. 10.1002/jper.19-0375

[47]

Joseph G, Adnaan M, Edward M. Cone beam computed tomography assessment of the buccal bone thickness in anterior maxillary teeth: relevance to immediate implant placement. Int J Oral Maxillofac Implants. 2018;33(4):880–7. https://doi.org/10.11607/jomi.6274. 10.11607/jomi.6274

[48]

Ganji Kiran K, Alswilem Rayan O, Abouonq Anas O, Alruwaili Abdulrahman A, Alam MK. Noninvasive evaluation of the correlation between thickness of the buccal bone and attached gingiva of maxillary premolars. J Esthet Restor Dent. 2019;31(3):240–5. https://doi.org/10.1111/jerd.12395. 10.1111/jerd.12395

[49]

Buccal Bone Thickness Overlying Maxillary Anterior Teeth

Joe Khoury, Nabil Ghosn, Nadim MOKBEL et al.

Implant Dentistry 2016 10.1097/id.0000000000000427

[50]

Raber A, Kula K, Ghoneima A. Three-dimensional evaluation of labial alveolar bone overlying the maxillary and mandibular incisors in different skeletal classifications of malocclusion. Int Orthod. 2019;17(2):287–95. https://doi.org/10.1016/j.ortho.2019.03.011. 10.1016/j.ortho.2019.03.011

Showing 50 of 73 references

Metrics

32

Citations

73

References

Details

Published: Mar 22, 2021
Vol/Issue: 21(1)
License: View

Authors

David Peñarrocha-Oltra

M

Miguel Peñarrocha-Diago

J

José Viña-Almunia

Cite This Article

Julio Rojo-Sanchis, David Soto-Peñaloza, David Peñarrocha-Oltra, et al. (2021). Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies. BMC Oral Health, 21(1). https://doi.org/10.1186/s12903-021-01495-2

Facial alveolar bone thickness and modifying factors of anterior maxillary teeth: a systematic review and meta-analysis of cone-beam computed tomography studies

You May Also Like