Critical buccal bone dimensions along implants

The buccal bone plate is a component of the alveolar process tightly related to the tooth it supports. A plethora of physiological and pathological events can induce its remodeling. Understanding this remodeling process and its extent is of major importance for the practitioner as it can affect the functional and esthetic outcome of implant surgery at the involved sites. Bone remodeling and resorption of the buccal bone plate are inevitable after tooth loss or extraction. To limit resorption, several ridge-preservation techniques of varying efficacy have been described. Bone resorption is equally found to occur upon implant placement and is thought to be a result of the surgical trauma inflicted as well as an adaptation process of the tissues to the new foreign body. Because of the implications of bone resorption on the soft-tissue levels and the general esthetic outcome, it is of primary importance for the practitioner to be able to evaluate the hard tissues and the inherent resorption risks in an effort to optimize the treatment strategies. Based on limited short-term data, the present general opinion advises the need for a 2-mm-thick buccal bone plate in order to avoid vertical bone resorption.