Ridge alterations post-extraction in the esthetic zone: a 3D analysis with CBCT.

Area of Science:

• Dentistry
• Oral Surgery
• Periodontology

Background:

• Facial bone dimensional changes after tooth extraction impact esthetic zone treatment outcomes.
• Understanding these alterations is crucial for predictable clinical results.

Purpose of the Study:

• To investigate three-dimensional (3D) facial bone alterations in the esthetic zone during the first 8 weeks post-extraction.
• To identify risk zones and critical factors influencing bone resorption following flapless tooth extraction.

Main Methods:

• Prospective study involving 39 patients.
• Novel 3D analysis using two consecutive cone beam computed tomographies (CBCTs).
• Assessment of facial bone wall thickness and vertical bone loss.

Main Results:

• A specific risk zone for significant bone resorption was identified in central areas.
• Facial bone wall thickness ≤ 1 mm was a critical factor for bone resorption.
• Thin-wall phenotypes showed significantly greater vertical bone loss (median 7.5 mm) compared to thick-wall phenotypes (median 1.1 mm).

Conclusions:

• This is the first study to document 3D dimensional alterations of the facial bone wall in the esthetic zone post-extraction using 3D analysis.
• Thin-wall phenotypes are prone to pronounced bone resorption, with vertical bone loss being substantially more severe than previously reported.