Clinical and Radiographic Evaluation of Bone Profile Around Dental Implants Placed in the Esthetic Zone

Overview

Journal J Multidiscip Healthc

Publisher Dove Medical Press

Specialty Health Services

Date 2025 Feb 11

PMID 39931647

Authors

Lamees Alssum

Reem Al-Kattan

Nouf Al-Shibani

Hafsah Al Ali

Farah Aldossari

Eman Allam

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the bone profile around dental implants placed in the esthetic zone through periodontal assessment and radiographic analysis using cone-beam computed tomography (CBCT).

Methods: We conducted a clinical observational study of 35 subjects who received dental implants placed in the esthetic zone to replace lost anterior teeth. Clinical evaluation included a comprehensive periodontal examination. The esthetic outcomes of the soft tissue around the implants were assessed using the pink esthetic score (PES). Patient satisfaction was assessed by using a specially designed questionnaire. The Oral Health Impact Profile (OHIP)-14 was used to assess the quality of life. The bone profile around the implant was assessed using CBCT. All the values were compared and statistically analyzed.

Results: A soft tissue graft (STG) was associated with the presence of > 2 mm of bone thickness 1 mm from the implant shoulder (p < 0.01). The STG was also significantly associated with bone thickness at 3 and 5 mm (p = 0.04). PES was not significantly associated with the bone thickness, OHIP score, or satisfaction score. Patients with fenestrations had significantly higher scores for functional limitations and pain than those without fenestrations (p = 0.01 and 0.04 respectively).

Conclusion: The bone profile around the anterior implant is not ideal. Although the buccal bone was thin around the implant placed in the esthetic zone, it did not affect the esthetic outcomes or overall satisfaction of the patient. However, fenestration defects may affect patients' quality of life.

References

Ferrus J, Cecchinato D, Pjetursson E, Lang N, Sanz M, Lindhe J . Factors influencing ridge alterations following immediate implant placement into extraction sockets. Clin Oral Implants Res. 2009; 21(1):22-9. DOI: 10.1111/j.1600-0501.2009.01825.x. View

Linkevicius T, Apse P, Grybauskas S, Puisys A . The influence of soft tissue thickness on crestal bone changes around implants: a 1-year prospective controlled clinical trial. Int J Oral Maxillofac Implants. 2009; 24(4):712-9. View

Chan H, Garaicoa-Pazmino C, Suarez F, Monje A, Benavides E, Oh T . Incidence of implant buccal plate fenestration in the esthetic zone: a cone beam computed tomography study. Int J Oral Maxillofac Implants. 2014; 29(1):171-7. DOI: 10.11607/jomi.3397. View

Hadzik J, Blaszczyszyn A, Gedrange T, Dominiak M . Soft-Tissue Augmentation around Dental Implants with a Connective Tissue Graft (CTG) and Xenogeneic Collagen Matrix (CMX)-5-Year Follow-Up. J Clin Med. 2023; 12(3). PMC: 9917401. DOI: 10.3390/jcm12030924. View

Tyndall D, Price J, Tetradis S, Ganz S, Hildebolt C, Scarfe W . Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 113(6):817-26. DOI: 10.1016/j.oooo.2012.03.005. View

Cho H, Lee J, Um H, Chang B . Esthetic evaluation of maxillary single-tooth implants in the esthetic zone. J Periodontal Implant Sci. 2010; 40(4):188-93. PMC: 2931307. DOI: 10.5051/jpis.2010.40.4.188. View

Brullmann D, Schulze R . Spatial resolution in CBCT machines for dental/maxillofacial applications-what do we know today?. Dentomaxillofac Radiol. 2014; 44(1):20140204. PMC: 4614158. DOI: 10.1259/dmfr.20140204. View

Schulze R, Heil U, Gross D, Bruellmann D, Dranischnikow E, Schwanecke U . Artefacts in CBCT: a review. Dentomaxillofac Radiol. 2011; 40(5):265-73. PMC: 3520262. DOI: 10.1259/dmfr/30642039. View

Naiem S, Hosny M, ElNahass H . Esthetics and bone changes of immediate implants with or without vascularized interpositional periosteal connective tissue grafting: A 2-year randomized controlled trial. Clin Oral Implants Res. 2023; 34(5):498-511. DOI: 10.1111/clr.14056. View

10.

Kim Y, Kim H, Yi Y, Yun P . Evaluation of subjective satisfaction of dental implant patients. J Korean Assoc Oral Maxillofac Surg. 2014; 40(3):130-4. PMC: 4095807. DOI: 10.5125/jkaoms.2014.40.3.130. View

11.

Schulze R, Couso-Queiruga E, Katsaros C . Accuracy of cone-beam computed tomography in imaging the components of the periodontal phenotype. Periodontol 2000. 2024; . DOI: 10.1111/prd.12556. View

12.

Masaki C, Nakamoto T, Mukaibo T, Kondo Y, Hosokawa R . Strategies for alveolar ridge reconstruction and preservation for implant therapy. J Prosthodont Res. 2015; 59(4):220-8. DOI: 10.1016/j.jpor.2015.04.005. View

13.

Merheb J, Quirynen M, Teughels W . Critical buccal bone dimensions along implants. Periodontol 2000. 2014; 66(1):97-105. DOI: 10.1111/prd.12042. View

14.

Todorovic V, Postma T, Hoffman J, van Zyl A . Buccal and palatal alveolar bone dimensions in the anterior maxilla: A micro-CT study. Clin Implant Dent Relat Res. 2023; 25(2):261-270. DOI: 10.1111/cid.13175. View

15.

Lopez-Jarana P, Diaz-Castro C, Falcao A, Falcao C, Rios-Santos J, 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. PMC: 6249849. DOI: 10.1186/s12903-018-0652-x. View

16.

Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G . Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005; 16(6):639-44. DOI: 10.1111/j.1600-0501.2005.01193.x. View

17.

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. BMC Oral Health. 2015; 15:65. PMC: 4460662. DOI: 10.1186/s12903-015-0055-1. View

18.

Patcas R, Muller L, Ullrich O, Peltomaki T . Accuracy of cone-beam computed tomography at different resolutions assessed on the bony covering of the mandibular anterior teeth. Am J Orthod Dentofacial Orthop. 2011; 141(1):41-50. DOI: 10.1016/j.ajodo.2011.06.034. View

19.

Schulze R . CBCT artefact-burden of zirconia-based as compared to titanium implants for different beam energies: an analytical approach. Sci Rep. 2022; 12(1):15276. PMC: 9464216. DOI: 10.1038/s41598-022-19379-y. View

20.

Al-Khabbaz A, Griffin T, Al-Shammari K . Assessment of pain associated with the surgical placement of dental implants. J Periodontol. 2007; 78(2):239-46. DOI: 10.1902/jop.2007.060032. View