The dimensions of the facial alveolar bone at tooth sites with local pathologies: a retrospective cone-beam CT analysis

To assess the impact of various local pathologies on facial alveolar bone dimensions at tooth sites.

Cone-beam computed tomography images of 60 patients were analyzed. Healthy teeth and teeth with local pathologies (i.e., endodontically treated, periodontally diseased teeth, and teeth with periapical lesions) were included. The thickness of the facial alveolar bone was measured at five locations: (1) the bone crest (W0), (2) 25% (W25), (3) 50% (W50), (4) 75% (W75) of the distance from the bone crest to the root apex (A), and (5) in the A region (W100). The results were considered statistically significant at p < 0.0008 (adjustment according to the statistical correction for multiple testing).

A total of 1174 teeth (707 healthy and 467 with the local pathologies) were assessed. Periodontally diseased maxillary premolars and anterior teeth in the mandible in the W0 position, as well as maxillary molars in the W25 position, tended to have a lower facial bone thickness when compared to the healthy teeth (0.68 mm vs. 0.84 mm, p = 0.008; 0.47 mm vs. 0.55 mm, p = 0.004; and 1.27 mm vs. 1.72 mm; p = 0.009, respectively). In contrast, the observed tendency pointed towards thicker facial bone wall for the periodontally diseased mandibular anterior teeth in the W50 position (0.74 vs. 0.52, p = 0.001). Healthy maxillary molars tended to display a thicker facial alveolar bone compared to the teeth with local pathologies in the W25, W50, and W75 positions (p = 0.001, p = 0.005, and p = 0.004, respectively).

The present analysis has indicated that local pathologies are commonly associated with a compromised socket morphology.

The facial bone thickness was particularly reduced at periodontally diseased teeth, which may challenge implant therapy.