Natural Bone Healing In Compromised Sockets After Tooth Extraction: Digital Measurement Methods With Cone-Beam Computed Tomography
This study aimed to evaluate bone regeneration within infected extraction sockets with bone defects using cone-beam computed tomography (CBCT) at a 1-year follow-up after implant placement in a prosthetically driven implant position. Forty-eight patients requiring premolar or molar tooth extraction due to bone defects caused by periodontal diseases were included. Vertical and horizontal bone volumes were assessed by overlapping the CBCT scan images with the full digital process. At 1-year post-extraction, a prosthetically-driven implant was planned using virtual implant planning software. At 1 year after extraction, CBCT revealed significant horizontal and vertical bone gains; an overall mean buccolingual bone width gain of 5.46 ± 2.87 mm, and an overall mean vertical bone gain of 0.27 ± 1.28 mm for the lingual bone plate level and 3.50 ± 1.81 mm for the buccal bone plate level were observed. Except for 4 (out of 48) sites, implants were virtually positioned in the center of the edentulous spaces. In summary, despite the dimensional changes after tooth extraction in compromised posterior sockets, there was sufficient bone for placing an implant using the prosthetically driven approach.
Cone-beam computed tomography data obtained after extraction were converted to 3D images. Two planes were added to the 3D image: One plane parallel to the patient's occlusal plane and another perpendicular to the occlusal plane and the palatal or lingual side to the buccal side at the coronal portion of the defect.
Fusion of the edited digital standard template library file image and cone-beam computed tomography data using 3 points.
Lingual and buccal crest heights were measured from a first plane line as the reference line. To measure the lingual and buccal crest heights, lines were drawn from the most lingual and buccal crest points of the alveolar bone perpendicular to the reference line. To measure the buccolingual width, a line was drawn parallel to the reference line from the lingual surface line to the buccal surface line in the 1-year images.
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