Reliability of a novel stent-based tomographic method to measure dimensional changes after alveolar ridge...

This study presents and evaluates the reliability of a novel standardized tomographic measurement method using a digitally designed stent to assess dimensional changes after alveolar ridge preservation in extraction sockets with buccal bone dehiscence.

Nine patients requiring extraction of a single-rooted tooth with 2-8 mm buccal bone dehiscence were included. A tomographic guide was digitally designed to fit the adjacent teeth and included a hyperdense element to identify the exact site of the bone defect. The guide was used during the initial pre-extraction scan to localize the defect. Six months after extraction and alveolar ridge preservation, and before implant placement, a second scan was performed with the same guide. Two calibrated examiners identified the corresponding slices from the pre- and post-extraction scans by locating the hyperdense marker. They digitally superimposed the images and performed measurements to evaluate changes in ridge dimensions. Each examiner repeated the measurements 3 times, 1 week apart. Intra- and inter-examiner reliability was assessed using intraclass correlation coefficients.

The intra-examiner intraclass correlation coefficients for dimensional changes ranged from 0.71 to 0.99. The inter-examiner coefficients were 0.94 for buccal bone height, 0.76 for palatal bone height, 0.87 for buccal ridge width, and 0.79 for palatal ridge width, although wide confidence intervals suggested some variability between examiners.

The proposed method enabled precise identification of the same anatomical site across scans. It provided a repeatable, reproducible approach for standardized measurement of alveolar ridge changes following preservation procedures in sockets with buccal bone dehiscence.