Evaluation of buccal bone thickness and its influence on esthetic outcomes around anterior implants: A prospective CBCT study

Abstract

Facial bone thickness is a major determinant of peri-implant tissue stability in the esthetic zone, but the threshold associated with favorable clinical appearance remains uncertain. Therefore, it is of interest to evaluate the baseline buccal bone thickness around anterior maxillary implants and its association with 12-month facial bone remodeling, mucosal recession and Pink Esthetic Score in 72 adults receiving a single implant. Buccal bone thickness was measured by cone-beam computed tomography at implant placement and 12 months; sites were categorized as thin (<1.5 mm) or thick (≥1.5 mm) and midfacial recession, keratinized mucosal width, mucosal thickness, papilla level and Pink Esthetic Score were recorded. Thick-bone sites showed less buccal bone reduction (0.39 ± 0.21 mm vs 0.74 ± 0.28 mm), less midfacial recession (0.36 ± 0.25 mm vs 0.82 ± 0.37 mm) and a higher Pink Esthetic Score (12.6 ± 1.4 vs 10.8 ± 1.7; p<0.001), with baseline thickness remaining an independent predictor after adjustment. Thus, buccal bone thickness of at least 1.5 mm was associated with greater facial tissue stability and superior 12-month esthetic outcomes around anterior implants.