Digital assessment of soft and hard tissue alterations after anterior maxillary tooth extraction

Abstract

Objectives: This study aimed to assess dimensional alterations in soft and hard tissues 12 weeks post-extraction using novel computerized methods. Secondary objectives included exploring potential correlations between soft tissue changes and underlying bone variations, as well as investigating relationships between soft and hard tissue alterations and various contributing factors.

Methods: For all patients, preoperative and postoperative CBCT scans and intra-oral scans were obtained. Soft and hard tissue dimensions before extraction and at 12 weeks post-extraction were measured using 3D-slicer software. Both DICOM and STL files were superimposed, and measurements were taken at 2mm and 4mm from the facial crestal level.

Results: At twelve weeks, soft tissue thickness increased by 73.5% at 2mm and 51.2% at 4mm from the facial crestal bone. In contrast, there was a 42.5% and 33% bone resorption at 2mm and 4mm, respectively. Furthermore, the study found that smokers had a higher rate of soft tissue thickening and hard tissue resorption compared to non-smokers. The female group exhibited greater soft tissue thickening and bone resorption than the male group. Finally, the central incisor showed the highest bone loss rate, followed by the canine and the lateral incisor.

Conclusions: Three months following tooth extraction, a physiological thickening of the facial soft tissue occurs concurrently with significant bone loss beneath it.

Clinical Significance: This article’s novel digital assessment methods for evaluating soft and hard tissue alterations offer the potential to optimize treatment planning, enhancing patient outcomes and minimizing complications. By providing a comprehensive understanding of post-extraction tissue changes, it empowers clinicians to tailor treatments for individual patients, improving predictability and personalized care.