Associations between the keratinized mucosa width and the underlying alveolar bone dimensions at partial edentulous molar sites: a retrospective cross-sectional study

TL;DR

This study finds that the width of keratinized mucosa at toothless molar sites is linked to the shape of the underlying alveolar bone, which is important for planning dental implants.

Contribution

The study reveals a significant association between keratinized mucosa width and alveolar bone height discrepancy, but not with overall bone height.

Findings

Keratinized mucosa width is significantly lower when the alveolar bone height discrepancy exceeds 2 mm.

Maxillary sites have lower average alveolar bone dimensions compared to mandibular sites.

Alveolar bone height alone does not significantly affect keratinized mucosa width.

Abstract

The assessment of hard and soft tissue at edentulous sites is important for subsequent implant treatment design. The aim of the present study was to explore the associations between the keratinized mucosa width (KMW) and the underlying alveolar bone dimensions at partial edentulous molar sites.

In this retrospective study, a total of 110 patients with at least one missing molar were selected. The buccal KMW of the edentulous molar sites was evaluated. Cone-beam computed tomography scans were collected, and the height discrepancy between the alveolar crest and the buccal bone plate (HC−B) as well as the alveolar bone height (ABH) were measured. The KMW was compared among the HC−B and ABH groups at both maxillary and mandibular sites. Linear regression and generalized estimation equations (GEEs) were used to explore the associations between the KMW and alveolar bone dimensions at α = 0.05.

Among the 110 patients, 158 edentulous molar sites were analyzed. The average HC−B and ABH were significantly lower at the maxillary sites (1.26 ± 1.62 mm, 11.62 ± 3.94 mm) than at the mandibular sites (3.67 ± 2.85 mm, 14.91 ± 3.01 mm, p < 0.001). The KMW was significantly lower at sites with HC−B > 2 mm than at sites with HC−B ≤ 2 mm both in the maxilla and mandible (p < 0.001). No significant differences were found between the KMW at sites with ABH < 10 mm and sites with ABH ≥ 10 mm (p > 0.05). Linear regression and GEEs analyses revealed that the HC−B was significantly associated with the KMW (B = -0.339, p < 0.001), while the association between the KMW and the ABH was not statistically significant (B = -0.046, p = 0.352).

The buccal KMW at edentulous molar sites was significantly associated with the HC−B. Alveolar ridges presenting with a sloped configuration were more prone to possess a narrower band of keratinized mucosa. Both hard and soft tissue augmentation should be considered for implant treatment at these sites. The correlations of dynamic changes between the KMW and alveolar bone dimensions after tooth extraction should be further investigated.

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