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Three-Dimensional buccal bone anatomy and aesthetic outcome of single dental implants replacing maxillary incisors

Journal article
Authors Mario Veltri
Annika Ekestubbe
Ingemar Abrahamsson
Jan Wennström
Published in Clinical Oral Implants Research
Volume 27
Issue 8
Pages 956-963
ISSN 0905-7161
Publication year 2016
Published at Institute of Odontology
Institute of Odontology, Section 1
Institute of Odontology, Section 2
Pages 956-963
Language en
Keywords CBCT, dental implants, aesthetics, alveolar process, beam computed-tomography, soft-tissue dimensions, tooth implants, anterior maxilla, follow-up, in-vitro, restorations, replacements, artifacts, crown, Dentistry, Oral Surgery & Medicine, Engineering
Subject categories Dentistry


ObjectivesThis case series investigated by means of CBCT, buccal bone three-dimensional anatomy at delayed, two-stage implants in the maxillary incisal tooth region. Moreover, the relation between buccal bone anatomy and soft tissue aesthetics was assessed. Material and methodsTwelve implants were analysed after on average 8.9years in function. Baseline and re-evaluation photographs were assessed using the pink aesthetic score (PES). Marginal bone changes were measured from intraoral X-rays. The buccal bone volume associated with the implant and the implant surface not covered by visible buccal bone was computed on CBCT data sets. Buccal bone thickness and level were assessed, as well as the thickness of the crest distally and mesially of the implant. Changes in soft tissue forms and correlation between aesthetics and bone anatomy were calculated by nonparametric statistics. ResultsBuccal bone level was located 3.8mm apical of the implant shoulder, and none of the implants had complete bone coverage. Buccal bone volume was 144.3mm(3), and 4.29mm(3) in the more coronal 2mm portion. PES did not differ at re-evaluation (9.7) and baseline (9.2). PES was directly correlated with crestal thickness mesially and distally of the implant shoulder. No other significant correlations were observed between bone anatomy and PES or buccal peri-implant health. Marginal bone gain over time was associated with greater coronal bone volume buccally and with greater buccal and marginal bone thickness, while loss was related to less or no bone. ConclusionsWithin present limitations, acceptable and stable aesthetics are not jeopardized by a thin or missing buccal bone.

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