Background: The aim of this study was to compare ridge-mapping measurement before surgical flap reflection and measurement using images from cone beam computerized tomography (CBCT) to direct caliper measurement following surgical exposure of the bone.

Methods: Sixteen subjects with 25 sites for planned implant placement or ridge augmentation were recruited. An acrylic stent was fabricated for each subject. The stent provided three buccal/lingual pairs of consistent measurement points for each implant site located 4, 7, and 10 mm from the summit of the alveolar soft tissue. Two independent examiners participated.

Results: Comparisons of bucco-lingual ridge width using ridge-mapping versus direct caliper measurements showed that 94% and 89% of the pairs of measurement deviations were within ± 1 mm for examiners 1 and 2, respectively. The corresponding comparison of CBCT images versus direct caliper measurements showed 70% and 55% agreement for examiners 1 and 2, respectively. CBCT image measurements provided lower levels of agreement than ridge-mapping measurements because of the more frequent and larger magnitudes of deviations compared to direct caliper measurements.

Conclusions: Most often, ridge mapping provides measurements of the bucco-lingual ridge width consistent with those obtained by direct caliper measurement following surgical exposure of the bone. As applied in this study, CBCT was less consistent compared to direct caliper measurements and did not provide any additional, significant diagnostic information.