Assessment of Buccal Bone Plate Thickness at Potential Implant Sites in the Maxilla and Mandible Using Cone Beam Computed Tomography: A Retrospective Study in a Local Population

Abstract

Background: Buccal bone plate thickness (BBPT) is a clinically relevant factor in implant treatment planning because thin crestal bone may affect implant positioning and the need for augmentation. Aim: This Retrospective cross-sectional observational study assessed BBPT at potential implant sites in the maxilla and mandible using cone-beam computed tomography (CBCT) and examined the influence of gender, age, arch, and tooth region. Place and Duration of Study: The study was conducted at the Department of Prosthodontics, Adhiparasakthi Dental College and Hospital, Tamil Nadu, India, between January 2025 and December 2025. Methodology: Archived CBCT scans obtained for implant treatment planning were retrospectively analysed. From a pool of 200 consecutive CBCT scans, 128 CBCT scans (one potential implant site per patient) that fulfilled the eligibility criteria were included. Buccal bone plate thickness was measured at 1 mm, 3 mm, and 5 mm apical to the alveolar crest using BlueSkyPlan software. Statistical analysis was performed using descriptive statistics, independent-samples t-tests, and one-way analysis of variance (ANOVA). Results: Mean buccal bone thickness increased progressively from 1.13 ± 0.33 mm at 1 mm to 1.48 ± 0.34 mm at 3 mm and 1.80 ± 0.37 mm at 5 mm from the alveolar crest. At the 1-mm level, 39.8% of sites exhibited a thickness <1 mm. Male participants demonstrated significantly greater thickness than female participants at 1 mm (p = 0.030) and 3 mm (p = 0.040). The mandible showed significantly greater thickness than the maxilla (p ≤ 0.002), while posterior sites exhibited greater thickness than anterior sites at all levels (p < 0.001). No significant age-related differences were observed (p > 0.05). Conclusion: Buccal bone thickness increased progressively from the coronal to the apical aspect of the alveolar process and was significantly influenced by gender, arch, and tooth region, but not by age. The high prevalence of thin crestal buccal bone highlights the importance of preoperative CBCT evaluation and site-specific implant treatment planning, with consideration of augmentation procedures.