Using Cone Beam Computed Tomography Angle for Predicting the Outcome of Horizontal Bone Augmentation.
BACKGROUND
The aim of this study was to assess the influence of ridge morphology on the amount of horizontal bone augmentation achieved with the sandwich bone augmentation (SBA) technique in the reconstruction of buccal dehiscence defects on dental implants.


METHODS
Cone beam computed tomography (CBCT) was used to assess bone width changes in 26 patients who participated in a randomized controlled trial conducted in 2008 to 2011. The amount of horizontal bone gain was evaluated at four different levels (3, 6, 9, and 12 mm apical to the alveolar crest) and three different time points (T1: baseline, T2: at time of graft placement, and T3: 6 months later). Different morphological characteristics of the alveolar ridge were also evaluated to determine their influence on horizontal bone augmentation. A total of 78 CBCT scans were assessed.


RESULTS
Comparison of the changes in ridge morphology at all measurement locations showed an overall ridge width gain of 2.30 ± 2.20 mm after 6 months. The use of membranes and the angulation of the concavity played a role in influencing the outcomes of the SBA technique. Critical crest angulation (CA) is 150° for bone gain at 9 mm apical to the crest. When CA is smaller than 150°, the horizontal bone gain was 4.3 ± 2.2 mm; if CA is greater than 150°, the gain was significantly lower at 1.3 ± 1.7 mm (p = .001).


CONCLUSIONS
SBA is a reliable and predictable technique to gain horizontal ridge width with simultaneous implant placement. Crest ridge angulation can be used as a tool to predict bone gain at 9 mm apical to the bone crest.
Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Carlos
C
Garaicoa
Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Fernando
F
Suarez
Discipline of Periodontics, National University of Singapore, School of Dentistry, Singapore.
Jia-Hui
JH
Fu
Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Hsun-Liang
HL
Chan
Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Alberto
A
Monje
Department of Oral Surgery and Implantology, University of Granada, Granada, Spain.
Pablo
P
Galindo-Moreno
Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
Hom-Lay
HL
Wang
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D015921:Dental Implants; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D015921:Dental Implants
alveolar ridge reconstruction; bone allograft; bone augmentation; cone beam CT; guided bone regeneration; implant