Cone Beam Computed Tomography Assessment of the Buccal Bone Thickness in Anterior Maxillary Teeth: Relevance to Immediate Implant Placement

Purpose: Peri-implant bone thickness is an important local factor that could influence esthetic outcomes in immediate implant therapy. The aim of this study was to assess the thickness of the buccal bone overlying the anterior maxillary teeth in Kenyans. Materials and Methods: A total of 184 cone beam computed tomography (CBCT) scans that met the inclusion criteria were retrospectively studied. Buccal bone thickness of all maxillary anterior teeth was assessed, resulting in a total of 1,104 teeth. Measurements were taken on sagittal views at a point 4 mm below the cementoenamel junction (M1) and at the mid-root level (M2). The data were analyzed using SPSS software (version 20, IBM), and statistical significance was set at P ≤ .05. Results: Mean buccal bone thickness of the teeth studied was 0.55 ± 0.38 mm at M1 and 0.60 ± 0.30 mm at M2. Missing buccal bone wall was observed in 31.61% (349 teeth) of all teeth at M1 and in 21.38% (236 teeth) of all teeth at M2. The majority of the teeth had a thin buccal bone wall ( 1 mm) at M1 (56.34%) and at M2 (68.48%), whereas a thick buccal bone (≥ 1 mm) was only observed in 12.05% of teeth at M1 and in 10.14% of teeth at M2. Thin buccal bone was mainly found in central incisors, while thick buccal bone wall was found mainly in canines. The thickness of buccal bone at M1 decreased with an increase in age. Conclusion: Contour augmentation would be necessary in most of these cases, as the buccal bone was typically thin. The thickness at the cervical portion was inversely correlated with age. One in every four of the cases would not be ideal for flapless immediate implant placement due to a missing buccal bone wall. Preoperative CBCT analysis of the buccal wall is recommended for appropriate treatment planning. Keywords: bone resorption, dental implants, esthetics, tooth extraction