Labial Cortical Bone Thickness in the Anterior Region: A Systematic Review

Abstract

Context: The labial cortical bone may influence the outcomes of several treatments including fresh socket implant placement and orthodontic treatments. A thin labial plate may contribute to increased risks of periodontal consequences during dental procedures. Acknowledgment of the average values may guide clinicians to take particular considerations in making treatment decisions. Therefore, this study aimed to systematically review the labial cortical bone thickness (LBT) in the anterior maxillary teeth. Objective: The primary purpose of this study was to review the LBT in the anterior maxillary teeth to present the range of average LBT in the global population. Evidence Acquisition: An electronic search was conducted in PubMed, Embase, ProQuest, Web of Science, and Scopus databases. English studies that measured the LBT in the maxillary anterior teeth using CT or CBCT scans were deemed relevant. Only studies performed on adult patients with a lack of periodontal disease were included. Results: A total of 49 studies were included. Mean LBT ranged 0.13 - 3.08, 0.29 - 4.2, and 0.36 - 4.5 mm in maxillary central incisor, lateral incisor, and canine, respectively. Expectedly, LBT was affected by the vertical level of the measurement point and increased toward the apex. In total, the LBT in the anterior maxilla ranged from 0.13 to 4.5 mm. In comparison with other populations, a relatively thin labial plate was evidenced in the Iranian populations. Conclusions: This study showed a wide range of LBT in the esthetic zone. A thin plate in the esthetic area necessitates caution in orthodontic treatments, particularly when tooth expansion or proclination is required. Additionally, wide ranges of reported values which are mostly under 2 mm, highlight the importance of CBCT acquisition before any fresh socket implant placement.