Cone-beam computed tomographic analysis of the alveolar ridge profile and virtual implant placement for the anterior maxilla

Purpose: To analyze the ridge profile of the anterior maxilla using cone-beam computed tomography and to assess the clinical significance of the ridge profile by performing virtual implant placement. Methods: Thirty-two cone-beam computed tomography scans of anterior maxillae were included. For each tooth, a vertical line was made along the longitudinal axis, and 3 horizontal lines at 1-, 3-, and 5-mm levels below the labial bone crest were drawn perpendicularly to the vertical reference. At these levels, the thickness of the alveolar ridge (RT), and the labial (LT) and palatal bone plate (PT) were measured. Then, virtual implant placement using standard and tapered implants was performed. A generalized linear mixed model was used for statistical analysis. Results: The teeth were located labially based on the proportion of LT and PT with respect to RT. At the 1-mm level, the value of LT was between $1.0{\pm}0.4mm$ for central incisors and $1.3{\pm}0.6mm$ for canines. A large number of teeth had area(s) with less than 1-mm-thick labial bone between the 1- and 5-mm levels below the crest. The mean PT was generally thicker than the LT in all tooth types. The greatest mean value of labial concavity was observed for canines, compared to other tooth types. Men had a greater RT than did women, but had a comparable LT. Less apical fenestration was observed when tapered implants were used. Conclusions: Most teeth in the anterior maxilla had a thin labial bone plate, with no significant difference between sexes. Tapered implants may be advantageous for the anterior maxilla.