429 Poster

Efficacy of bone sounding as a diagnostic aid for measuring facial osseous-gingival relationship of
maxillary anterior teeth
Y. Kim,1 J. Kan,2 K. Rungcharassaeng3
1
Department of Periodontics, Loma Linda University, Loma linda, CA, USA, 2Department of Restorative Dentistry, Loma Linda
University, Loma linda, CA, USA, 3Department of Orthodontics, Loma Linda University, Loma linda, CA, USA

Background: Immediate implant placement has been considered a viable treatment option for replacing maxillary anterior failing
teeth. One of the keys to achieve successful facial gingival esthetics following immediate implant placement is to have a socket
with an intact facial bone and a normal facial osseous-gingival relationship (3 mm). Bone sounding is a common diagnostic
method to evaluate the facial osseous-gingival relationship of the failing tooth prior to extraction for immediate implant place-
ment. However, there is a lack of scientific information regarding efficacy of bone sounding at the mid facial aspect of maxillary
anterior teeth.
Aim/Hypothesis: The aim of this study is to evaluate the efficacy of bone sounding as a diagnostic aid in assessing the facial
osseous-gingival relationship of the failing tooth prior to extraction and immediate implant placement.
Material and methods: Dental records of patients who received immediate implant placements at the maxillary anterior area
(canine to canine) from 2000 to 2013 in the Loma Linda University School of Dentistry, Center for Implant dentistry were
screened. Patients were included in the study if the mid-facial bone to free gingival margin (FBG) dimension was evaluated
before tooth extraction using the bone sounding (BS) technique, and immediately after extraction using the direct bone level
measurement (DBL) technique. Teeth with facial plate and/or gingival tissue alteration during the extraction process were
excluded from the study. All measurements were recorded to the nearest mm. The BS and DBL measurements were compared
using paired t-test and their correlation was expressed in Pearson correlation coefficient at a = 0.05. The frequency distribution
of measurement discrepancy was also assessed.
Results: A total of 150 (93 female and 57 male) patients with a mean age of 48 years old (range, 1980) were included in the
study. A total of 176 maxillary anterior teeth (105 central incisors, 49 lateral incisors and 12 canines) were subjected to analysis.
The mean FBG dimensions obtained from BS and DBL were 3.20
0.73 (range, 37) mm and 3.49
1.33 (range, 312) mm
respectively (P = 0.005). The measurement discrepancy (BS-DBL) ranged from 9 to +3 mm. Eighty-three per cent of the

2014 The Authors

Clinical Oral Implants Research 2014 John Wiley & Sons A/S 447 | Clin. Oral Impl. Res. 25 (Suppl. 10), 2014
measurements was identical, 4% recorded
1 mm discrepancy, and 13% recorded more than
1 mm discrepancy. When dis-
crepancy was observed, BS underestimated DBL value 14.2% and overestimated 2.8% of the time. The percentage of deviated
measurement per tooth type, central incisors, lateral incisors and canines was 14%, 14% and 25% respectively. Though statisti-
cally significant, the correlation between the two measurement methods was low (r = 0.234, P = 0.0018).
Conclusion and clinical implications: BS is not effective (only 83%) in measuring FBG dimension for the maxillary anterior teeth.
Although the mean difference between BS and DBL measurements is small (0.29 mm), the large range of difference, up to 9 mm
is alarming. In 14%, BS measurement was smaller (actual crest of bone was more apical) than DBL measurement. Because of
this potential error, clinicians should always prepare alternative treatment options besides immediate implant placement prior
to extraction.

2014 The Authors

448 | Clin. Oral Impl. Res. 25 (Suppl. 10), 2014 Clinical Oral Implants Research 2014 John Wiley & Sons A/S