Analysis of maxillary aesthetic region morphology for immediate implant planning: A CBCT study

Aim: To evaluate morphometric characteristics relevant to immediate implant planning in the maxillary anterior region using cone-beam computed tomography (CBCT). Materials and Methods: In this retrospective study, CBCT images of 597 maxillary anterior teeth, including central incisors, lateral incisors, and canines, from 119 individuals were analyzed. Labial bone thickness, sagittal root position, apical bone height, labial concavity, undercut depth, and alveolar width were assessed. For each tooth, two virtual implant placement strategies were simulated: prosthetically driven and bone-driven. Results: Labial bone thickness was <1 mm in most cases, and sagittal root position predominantly exhibited a Class III distribution (77.8%). Apical bone height was generally adequate for primary stability. More pronounced undercuts and concavities were observed in the lateral incisors. Prosthetically driven implant placement was associated with an increased risk of facial bone compromise, whereas the bone-driven approach resulted in safer implant positioning. Conclusion: Immediate implant planning in the maxillary anterior region frequently requires a bone-driven approach, primarily because of thin labial bone and root-position characteristics. CBCT-based three-dimensional evaluation plays a critical role in achieving safe, predictable, and individualized implant planning.