Immediate implants and labial bone in the maxilla

A great article in the most recent edition of JADA.  A must read!

We always obtain CBCT in these esthetic zone of the maxilla for this precise reason.  What is the condition of the labial bone (the bone in front of the teeth) in immediate maxillary implant cases.?


  • Maxillary central incisors are 2.37 more likely to have labial bone perforation (LBP), than canines
  • Maxillary teeth with Sagittal Root Position (SRP) in class I were 4.9 times more likely to have Labial Bone Perforation (LBP)

CONCLUSION: beware of SRP class I!

We are starting to see more and more SRP class IV cases in patients that have undergone Invisalign treatment by non-orthodontist, whom prior to the initiation of the Invisalign did not fully assess the patients anatomy in 3D using CBCT.  The teeth were literally move outside of the bony housing.  See 3rd picture below.


Labial bone assessment_Page_02 Labial bone assessment_Page_04 Labial bone assessment_Page_05