Evaluation of Alveolar Bone Dimensions and Root Positioning of Anterior Teeth in the Maxilla.

Buccal bone walls present significant resorption after tooth extraction, possibly related to the smaller bone thickness, length, and the sagittal position of the root, as well as the bone morphology. The goal of the present study was to measure the thickness of the cortical bone of the vestibular and palatal walls in the anterior maxilla by means of CBCT images. Measurements were taken from CBCT scans of 300 maxillary anterior teeth from 50 patients (25 women, 25 men) aged 18 to 30 years. The parameters evaluated included the thickness of the buccal and palatal cortical bone in the cervical, apical, and middle thirds of the root, as well as six specific angular measurements from each tooth. The lateral incisors showed a significant difference in thickness between each of the buccal and palatal thirds, and measurements were also significantly smaller than the central and canine incisors. Bone anatomy is tooth-and location-specific, and thus the sagittal root position within the alveolus influences the regional bone morphology and may explain the gingival zenith position in the anterior maxilla. These specific buccal and palatal anatomic parameters should be carefully taken into consideration for surgical planning and intervention in the esthetic area.

Characteristics of periodontal biotype, its dimensions, associations and prevalence: a systematic review.

AIM: The objectives of this review were as follows: What are characteristics used to define various forms of periodontal biotypes? What are their anatomic dimensions in relation to the definition? In addition, what is the association between these various characteristics in relation to the periodontal biotypes? Furthermore, what is the prevalence of various forms of periodontal biotypes in the population? MATERIAL AND METHODS: The PubMed-MEDLINE, the Cochrane-CENTRAL and EMBASE databases were searched through up and till June 2013 to identify any appropriate studies regarding the aim. Appropriate studies were those reporting characteristics of various forms of periodontal biotype and its dimensions. These characteristics were gingival thickness (GT), gingival morphotype (GM), tooth dimensions (TD), keratinized tissue (KT) and bone morphotype (BM). RESULTS AND CONCLUSIONS: The search yielded 2581 unique papers, after selection resulted in 12 publications that met the eligibility criteria. In general, the available definitions are found to be unclear and sometimes inconsistent. However, based on the available literature, the three biotypes thin scalloped, thick flat and thick scalloped seem a comprehensive categorization in defining periodontal biotypes in the population. The dental, gingival and osseous dimensions have a weak to moderate association. Only between gingival thickness, keratinized tissue and bone morphotype uniform positive associations are found.

Significance of crown shape in the replacement of a central incisor with a single implant-supported crown.

OBJECTIVE: When utilizing a single implant-supported crown to replace a central incisor, understanding the final shape of the implant restoration is an important factor to help achieve a successful esthetic outcome. In today's dentistry, tooth shape is a critical factor when dental implant prostheses are considered in the esthetic zone. The major esthetic goal for this type of restoration is to achieve the closest possible symmetry with the adjacent tooth, both at the soft and at the hard tissue levels. The goal of this study was to objectively analyze the significance of natural crown shape when replacing a central incisor with a single implant-supported crown. METHOD AND MATERIALS: In this study, we investigated the shape of the crowns of maxillary central incisors in 60 individuals who presented to our clinics with an untreatable central incisor. The presence of a dental diastema, "black triangle," presence or absence of gingival symmetry, and the presence or absence of dental symmetry were recorded in the pre- and postoperative photographs. RESULTS: Out of 60 patients, 33.3% had triangular-shaped crowns, 16.6% square/tapered, and 50% square-shaped crown form. After treatment was rendered, 65% of the triangular group, 40% of the square/tapered group, and 13.3% of the square group required an additional restoration on the adjacent central incisor in order to fulfill the esthetic needs of the patients. CONCLUSION: Data analysis revealed that if there is a "black triangle," a diastema, or presence of dental or gingival asymmetry, an additional restoration on the adjacent central incisor is often required in order to fulfill esthetic goals. The additional restoration is highly recommended in situations with a triangular crown shape, while it is suggested in cases of square/tapered and square tooth shapes in the presence of a dental diastema.

Anterior maxillary and mandibular biotype: relationship between gingival thickness and width with respect to underlying bone thickness.

PURPOSE: : Periodontal biotype is considered to be a significant factor related to successful dental treatments. The purpose of this study was to determine the relationship between gingival thickness (GT) and width with respect to the underlying bone thickness in the maxillary and mandibular anterior sextant. MATERIALS AND METHODS: : Overall, 180 anterior teeth within healthy patients were assessed. GT and buccal bone thickness (BT) were measured at 3 locations: crestal/gingival margin, tooth apex, and a midpoint between the 2. In addition, the apicoincisal gingival width (GW) was recorded. Clinical and cone beam CT measurements were compared and correlated. RESULTS: : No statistically significant relations were observed between GT and BT measures at any of the 3 positions. The mean GT at crestal mid and apical position for the maxillary teeth was 1.01 (±0.58) mm, 1.06 (±0.48) mm, and 0.83 (±0.47) mm, respectively, and the corresponding mean BT was 1.24 (±0.90) mm, 0.81 (±0.33) mm, and 2.78 (±1.62) mm, respectively. The GW is directly related (R = 0.007; P < 0.05) to the crestal BT. CONCLUSION: : In this study, the GT is not linked to the BT. However, the GW seems to be associated with the crestal BT.

Analysis of the shapes of maxillary central incisors in a Caucasian population.

The purpose of this study was to objectively define and quantify triangular, square, and square/tapered maxillary central incisors. In this study, the shape of maxillary central incisor crowns was investigated in 100 healthy individuals. The results showed that when the contact surface/crown length ratio is less than 43%, the tooth is triangular in shape; when the ratio is more than 57%, the tooth is square in shape; and when the ratio is between 43% and 57%, the tooth is defined as square/tapered. Since it has been shown that the morphologic characteristics of the gingiva and periodontium are partly related to the shape of the teeth, a means of truly defining the shapes of the incisors is now available. This is significant in predicting esthetics, bone volume, and susceptibility to recession, pocketing in the natural dentition, and ridge shrinkage for prosthetic tooth replacement.

Intraosseous anchorage of dental prostheses: an early 20th century contribution.

A thorough literature review of root form implants yielded a paucity of information regarding the true pioneers of this discipline. Numerous articles have been written on the history of endosseous implants, although little information is available describing the individuals to whom we attribute the major developments in implant dentistry. This article will present information regarding significant contributors to modern-day implant dentistry. Initially, articles and textbooks printed early in the 20th century were reviewed, and the relevance of implant-related information was ranked based on current concepts. This article highlights four major contributors in implant dentistry: E.J. Greenfield (1913), who developed many of the surgical techniques and principles used today; Alvin Edward Strock (1939), who introduced the first biocompatible material; Per-Ingvar Brånemark (1969), who proved the long-term success of titanium implants; and André Schroeder (1976), who introduced the roughened implant surface.

Connective tissue graft: a classification for incision design from the palatal site and clinical case reports.

A classification system for connective tissue graft incisions is proposed. It categorizes the design of the palatal incision into three classes. In addition to the basic classification, two subclasses are mentioned in this article. Additional descriptions are included to further define the incision design. The use of such a classification should assist future communication among clinicians and researchers. This article presents representative clinical cases to aid the clinician in applying the classification for incision design from the palatal site.