Evaluation of labial alveolar bone thickness in the maxillary anterior esthetic zone: a retrospective CBCT study

BACKGROUND: The maxillary anterior esthetic zone is of particular importance in implant dentistry because the thickness of the labial alveolar bone influences implant positioning, facial soft tissue support, and post-extraction dimensional stability. Cone-beam computed tomography (CBCT) provides a reliable method for assessing labial alveolar bone thickness (LABT) before treatment planning. Although similar studies have been reported in other Saudi regions, region-specific data from the Central Province remain limited. METHODS: This retrospective cross-sectional study evaluated CBCT scans retrieved from the institutional database of the College of Dentistry, Majmaah University. The labial alveolar bone thickness of the six maxillary anterior teeth was assessed on sagittal sections at three standardized root levels: Point A at the coronal third, Point B at the mid-root level, and Point C at the apical third. Comparisons were performed according to tooth type, side, sex, and age group. RESULTS: The labial alveolar bone was generally thin throughout the maxillary anterior region, with mean values below 2 mm. Thickness was lowest at the mid-root level and greatest at the apical level. No consistent significant differences were observed between the right and left sides or between age groups, whereas selected sex-based differences were observed, particularly in the canine region. These findings suggest that thin facial bone is common in the anterior maxilla of this cohort. CONCLUSIONS: In this Central Province cohort, labial alveolar bone thickness in the maxillary anterior region was generally less than the commonly cited 2 mm threshold. These findings underscore the value of careful CBCT-based assessment before immediate implant placement in the esthetic zone, particularly where thin facial bone may increase the risk of resorption, esthetic compromise, or the need for augmentation.