Reliability of A Surgical Stent in Assessing Alveolar Ridge Dimensions

Purpose: Alveolar ridge preservation procedures are routinely performed to prevent post-extraction bone loss when an immediate implant placement is not possible. This pilot study was designed to determine inter-examiner variability in assessing alveolar ridge dimensions prior to alveolar ridge preservation.

Methods: Eight patients who were scheduled to have single tooth extraction and implant placement were included (4 females, 4 males; aged 24 to 77 years). Exclusion criteria were contraindications for ridge preservation procedure, e.g., acute inflammation at the extraction site. An impression was taken prior to tooth extraction and a modified surgical stent with 3 integrated aluminum tubes (3 mm diameter) was prepared. Height, i.e., distance from occlusal plate to alveolar crest was measured using a periodontal probe placed through the tubes. Similarly, width of alveolar crest and defect entrance following extraction were determined using a periodontal probe. In addition, alveolar bone thickness at the crest was determined using a caliper. All measurements were repeated by two calibrated examiners. Repeated-measures ANOVA test was used to determine statistical differences between readings (P<0.05).

Results: Inter-examiner differences observed for height measurements averaged 0.67+/-0.5 mm and were all < or = 2 mm. Most consistent measurements between the two examiners were for buccal and lingual plate thickness at the crest, presenting no variation between readings.

Conclusion: A modified surgical stent prepared prior to tooth extraction can be used to examine alveolar ridge dimensions following extraction. Inter-examiner differences in determining ridge height, width, and thickness are minimal. (Supported by CTOC Program, NIDCR Grant T32 DE14320 and the OSU Section of Periodontology)