Buccal Bone Thickness in Anterior and Posterior Teeth—A Systematic Review

Abstract

(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery’s success and the patient’s safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.

Buccal bone thickness assessment for immediate anterior dental implant planning: A pilot study comparing cone‐beam computed tomography and 3D double‐echo steady‐state MRI

“…Thin buccal bone was noted mainly at the central and lateral incisors, while a thicker buccal bone was identified at the canines, which has been reported in previous works 32,34 . Furthermore, the results obtained in this study that the average bone thickness in the maxilla and mandible at the root apex level was >1 mm, are consistent with the data in the literature 31 . However, the data in the literature should be interpreted with caution, as the reported bone thickness measurements are heterogeneous with high standard deviations.…”

“…In contrast, the buccal bone thickness at the level of the root apex was consistently >2 mm in the maxillary and >4 mm in the mandibular anterior region in both imaging modalities. These findings confirm the results of previous CBCT studies, which showed that buccal bone thickness in the anterior maxilla and mandible was predominantly thin at measurement points 1–9 mm to the alveolar crest, ranging from 0.4 to 0.9 mm 28,31–33 . Thin buccal bone was noted mainly at the central and lateral incisors, while a thicker buccal bone was identified at the canines, which has been reported in previous works 32,34 .…”

“…The mean buccal bone thickness for all examined teeth at the measurement points M1 (2 mm from the cementoenamel junction) and M2 (middle of the root) was thin on CBCT and MRI for both maxillary (range: 0.99 ± 0.651 mm to 1.137 ± 0.378 mm) and mandibular (range: 0.53 ± 0.47 mm to 0.994 ± 0.438 mm) anterior teeth. The quantitative analysis at M1 revealed slightly higher values in our study than in the literature, as a recent systematic review suggests the presence of buccal bone thickness less than 1 mm in 74% of maxillary (mean ± SD, 0.76 ± 0.49 mm) and 61% of mandibular (mean ± SD, 0.95 ± 0.58 mm) central, lateral incisors and canines at a level of 1–3 mm apical to the alveolar ridge 31 . In contrast, the buccal bone thickness at the level of the root apex was consistently >2 mm in the maxillary and >4 mm in the mandibular anterior region in both imaging modalities.…”

“…However, the data in the literature should be interpreted with caution, as the reported bone thickness measurements are heterogeneous with high standard deviations. Some studies even report unintuitive results, stating that bone thickness is constant 1 to 5 mm from the alveolar crest regardless of the measurement level 31,33 . The generally slightly thicker buccal bone in our cohort compared with other studies could be explained by several factors; possibly the small cohort size and the younger mean age of our study population, as a decrease in bone thickness with age is probable 32 .…”

Densitometric assessment in the justification of rehabilitation of patients with atrophy of the bone tissue of the mandible, on the right side

“…This result is justified by the fact that the cortical layer of bone tissue of the buccal side is primarily affected by etiopathological factors, even with preserved dentition [6].…”