Evaluation of WALA ridge in different facial patterns: A cone-beam computed tomography study

This retrospective study evaluated the buccal bone thickness in mandibular canine, premolar, and molar areas, using as a reference the WALA ridge in patients with various facial patterns.

The sample comprised 51 cone-beam computerized tomography scans of subjects divided into 3 groups according to the facial pattern, determined by the Ricketts' VERT index, brachyfacial (group 1), mesofacial (group 2), and dolichofacial (group 3). A quantitative analysis of the buccal bone thickness was made in cone-beam computerized tomography scans in the region of the mandibular dental arch corresponding to the WALA ridge. The intergroup comparison of buccal bone thickness was performed with a 1-way analysis of variance and Tukey tests.

Buccal bone thickness was similar among the groups, and it increased progressively from the mandibular first to the second molars. In the canine and premolar regions, the thickness was less and often not visible on tomography. There was no difference in the buccal bone thickness in the mandibular dental arch region corresponding to the WALA ridge reference among facial patterns, except for the mesial roots of the second molars, which were thicker in brachyfacial subjects than in dolichofacial subjects.

The use of the WALA ridge as a clinical reference for individualized orthodontic arch diagramming should be made with caution and independent of the facial pattern.