The dimensions of the facial alveolar bone at tooth sites with local pathologies- A cone-beam CT analysis

Background

The thickness of the facial alveolar bone wall was shown to be crucial for long-term successful esthetic outcomes of implants immediately placed into extraction sockets. Currently available investigations report on the thickness of the facial alveolar bone at healthy tooth sites. Information regarding the facial bone dimensions at compromised teeth is scarce.

Aim/Hypothesis

To assess the impact of various local pathologies on facial alveolar bone dimensions at tooth sites.

Material and Methods

Cone-beam computed tomography images of 60 patients were analyzed. Healthy teeth and teeth with local pathologies (i.e., endodontically treated, periodontally diseased teeth and teeth with periapical lesions) were included. The thickness of the facial alveolar bone was measured at five locations- 1) the bone crest (W0) + 2) 25% (W25), 3) 50% (W50), 4) and 75% (W75) of the distance from the bone crest to the root apex (A) + and 5) in the A region (W100).

Results

A total of 1396 teeth (847 healthy and 549 with the local pathologies) were assessed. Periodontally diseased teeth had significantly lower facial bone thickness in W0 and W25 positions of the anterior mandible and maxillary molar regions, respectively (0.55 mm versus 0.47 mm, P = 0.004, and 0.84 mm versus 1.0 mm, P = 0.008, respectively). In contrast, periodontally diseased mandibular anterior teeth in the W50 position and maxillary premolars in the W0 area were associated with a significantly thicker facial bone wall (0.74 versus 0.52, P = 0.001, and 1.0 versus 0.84 mm, P = 0.008, respectively). Healthy maxillary molars had significantly thicker facial alveolar bone compared to the teeth with one of the local pathologies in the W25, W50, and W75 positions (P = 0.001, P = 0.005, and P = 0.004, respectively).

Conclusion and Clinical Implications

The present analysis has indicated that local pathologies are commonly associated with a compromised socket morphology. The facial bone thickness was particularly reduced at periodontally diseased sites, which may challenge implant therapy.