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Vasiljevic M, Selakovic D, Rosic G, Stevanovic M, Milanovic J, Arnaut A, Milanovic P. Anatomical Factors of the Anterior and Posterior Maxilla Affecting Immediate Implant Placement Based on Cone Beam Computed Tomography Analysis: A Narrative Review. Diagnostics (Basel) 2024; 14:1697. [PMID: 39125573 PMCID: PMC11311595 DOI: 10.3390/diagnostics14151697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/01/2024] [Accepted: 08/03/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND The aim of this narrative review was to provide insights into the influence of the morphological characteristics of the anatomical structures of the upper jaw based on cone beam computed tomography (CBCT) analysis on the immediate implant placement in this region. MATERIAL AND METHODS To conduct this research, we used many electronic databases, and the resulting papers were chosen and analyzed. From the clinical point of view, the region of the anterior maxilla is specific and can be difficult for immediate implant placement. FINDINGS Anatomical structures in the anterior maxilla, such as the nasopalatine canal and accessory canals, may limit and influence the implant therapy outcome. In addition to the aforementioned region, immediate implant placement in the posterior maxilla may be challenging for clinicians, especially in prosthetic-driven immediate implant placement procedures. Data presented within the recently published materials summarize the investigations performed in order to achieve more reliable indicators that may make more accurate decisions for clinicians. CONCLUSION The possibility for immediate implant placement may be affected by the NPC shape in the anterior maxilla, while the presence of ACs may increase the incidence of immediate implant placement complications. The variations in IRS characteristics may be considered important criteria for choosing the implant properties required for successful immediate implant placement.
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Affiliation(s)
- Milica Vasiljevic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Dragica Selakovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Gvozden Rosic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Momir Stevanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Jovana Milanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Aleksandra Arnaut
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Pavle Milanovic
- Department of Dentistry, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
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Aljabr AA, Almas K, Aljofi FE, Aljabr AA, Alzaben B, Alqanas S. A CBCT Study of Labial Alveolar Bone Thickness in the Maxillary Anterior Region in a Teaching Hospital Population in the Eastern Province of Saudi Arabia. Biomedicines 2023; 11:1571. [PMID: 37371666 DOI: 10.3390/biomedicines11061571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/19/2023] [Accepted: 05/27/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Labial alveolar bone thickness in the maxillary anterior region is the key factor in the placement of implants. Differences in the thickness of the bone are reported among different ethnic groups. Thus, the present study was aimed at assessing labial alveolar bone thickness in the maxillary anterior region in the population of the eastern province of Saudi Arabia. MATERIALS AND METHODS The six anterior teeth in each of the 186 CBCT sagittal images were analyzed at three points: Point A from the facial plate at the level of the bone crest to the coronal root third, Point B to the mid-root surface, and Point C to the apical third. Crest height (Point D) was measured as the distance from the CEJ to the alveolar bone crest. The analysis was done using SPSS version 20. A p-value of <0.05 was considered statistically significant. RESULTS The bone thickness at any given point (Point A, Point B, or Point C) was less than the preferred bone thickness of 2 mm in all six teeth. The thickness was minimum at Point B, maximum at Point C, and intermediate at Point A. This difference was found to be statistically significant (p-value < 0.05). The crestal height (Point D) was less than 3 mm, and it was not statistically significant. Comparison of bone thickness on the right and left sides for any given point was not statistically significant except at Point A in the central incisor, where it was statistically significant (p-value = 0.035). Gender comparison of bone thickness showed no difference at Point A; however, at Points B and C, it showed statistical significance (p-value < 0.05). CONCLUSIONS The alveolar bone thickness being <2 mm in the labial anterior region warns of the importance of the proper assessment of bone during implant placement to have a predictable outcome.
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Affiliation(s)
- Abdulmajeed A Aljabr
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Khalid Almas
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Faisal E Aljofi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Abdullah A Aljabr
- Department of Medical Education, College of Dentistry, Majmaah University, P.O. Box 1712, Al Majma'ah 15341, Saudi Arabia
| | - Bader Alzaben
- Fellowship in Periodontics Program, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sarah Alqanas
- College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Vyas R, Khurana S, Khurana D, Singer SR, Creanga AG. Cone Beam Computed Tomography (CBCT) Evaluation of Alveolar Bone Thickness and Root Angulation in Anterior Maxilla for Planning Immediate Implant Placement. Cureus 2023; 15:e37875. [PMID: 37213997 PMCID: PMC10199654 DOI: 10.7759/cureus.37875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE This retrospective study aimed to measure the labial, palatal, mesial, and distal bone thickness around maxillary central and lateral incisors and canines and height from crest to apex, using cone beam computed tomography (CBCT) images and compare the results based on gender. The second objective of the study was to measure root angulation on CBCT images and its relation with the labial cortical thicknesses. Material and Methods: After the Institutional Review Board (IRB) approval, a total of 140 CBCT volumes were included in this study according to the set criteria. On each scan, right-side maxillary central, lateral incisors, and canine were selected for the measurements. All the measurements were done at three levels at the alveolar crest (L1), mid-root (L2), and apical region (L3) for each tooth. Results: The Student's t-test was performed to compare the result of buccal, palatal, mesial, and distal bone thickness, angulation, and height of all subjects. Buccal alveolar bone thickness was minimum at the mid-root region, and the palatal bone thickness was minimum at the crestal region. The mesial bone thickness was minimum at the mid-root level, and distal bone thickness was minimum at the crest level. The available bone height was maximum at the lateral incisor and equal for the central incisor and canine. The canine was the most angulated tooth. CONCLUSION Cone beam computed tomography is a reliable imaging modality to evaluate pre-surgical immediate implant sites and measure alveolar bone thickness. The canine was the most angulated tooth with more buccal alveolar bone thickness.
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Affiliation(s)
- Rutvi Vyas
- Oral and Maxillofacial Radiology, University of Florida Health, Gainesville, USA
| | - Sonam Khurana
- Oral Pathology, Radiology, and Medicine, New York University (NYU) College of Dentistry, New York, USA
| | - Dhruv Khurana
- Addiction Psychiatry, University of California Los Angeles David Geffen School of Medicine, Los Angeles, USA
| | - Steven Rrrrr Singer
- Diagnsotic Sciences, Rutgers, Newark, USA
- Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, USA
| | - Adriana G Creanga
- Oral and Maxillofacial Radiology, Rutgers School of Dental Medicine, Newark, USA
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Ikbal M, Shen YW, Ruslin M, Fuh LJ, Hsu JT. Assessment of sagittal root position, alveolar bone concavity, and labial bone perforation in the mandibular anterior tooth region for immediate implant placement. J Dent Sci 2023. [DOI: 10.1016/j.jds.2023.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
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Hassan NA, Al-radha ASD. CBCT Evaluation of Quality and Quantity of Bones for Immediate Implant Treatment Planning in Central Incisor Area in relation to Arch Form. ScientificWorldJournal 2023; 2023:8863318. [PMID: 37101786 PMCID: PMC10125741 DOI: 10.1155/2023/8863318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/01/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
Understanding the quality of the ridge and facial cortical bone in the aesthetic zone is important for treatment with an immediate dental implant. This study aimed to analyze bone density and widths of the facial cortical bone and alveolar ridge at the central incisors in relation to arch form. A total of 400 teeth from 100 cone-beam CT images were divided equally between the upper and lower central incisors. The central incisor area was assessed for the width of the facial cortical and alveolar bones at three different points (3 mm, 6 mm, and 9 mm from the cementoenamel junction). Arch forms and densities of cortical and cancellous bones in the interradicular regions were evaluated. The difference in facial cortical bone thickness at 3 points was smaller for the upper teeth than for the lower teeth on both sides. The alveolar bone width was higher in the maxilla than the mandible with highly significant differences (P < 0.001). The highest bone density was at the buccal aspect of the mandible (897.36 ± 136.72 HU), while the lowest density was at the cancellous bone of the maxilla (600.37 ± 126.63 HU). The dominant arch form was ovoid 71%, followed by square 20% and the tapering arch form 10%. The tapering arch form has the highest alveolar bone width in the upper jaw without statistical significance. The facial cortical bone thickness needs to be evaluated before implantation in the anterior region because it is less than two millimeters in both jaws. CBCT is important for the immediate implant. The ovoid shape was the dominant arch form.
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Affiliation(s)
- Nuhad A. Hassan
- Oral Medicine Department, College of Dentistry, Al-Mustansiriyah University, Baghdad, Iraq
| | - Afya Sahib Diab Al-radha
- Oral Surgery and Periodontology Department, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
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Bungthong W, Amornsettachai P, Luangchana P, Chuenjitkuntaworn B, Suphangul S. Bone Dimensional Change Following Immediate Implant Placement in Posterior Teeth with CBCT: A 6-Month Prospective Clinical Study. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27030608. [PMID: 35163869 PMCID: PMC8838578 DOI: 10.3390/molecules27030608] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/17/2022] [Accepted: 01/17/2022] [Indexed: 02/01/2023]
Abstract
This prospective clinical study aimed to evaluate the peri-implant hard tissue dimensional change at 6 months of immediate implant placement with bone graft materials in the posterior area using cone-beam computed tomography (CBCT). Twelve dental implants were placed concurrently following tooth extraction in the posterior area and filled with xenograft particles. The CBCT images were taken immediately after surgical procedures and then at 6 months follow-up. To evaluate the hard tissue changes, the vertical and horizontal bone thickness were analyzed and measured using ImageJ software. Paired t-test or Wilcoxon match-pair signed-rank test was done to analyze the changes of hard tissue values at the same level between immediately and 6 months following immediate implant placement. Independent t-test or Mann-Whitney U test was used to analyze the dimensional change in the vertical and horizontal direction in buccal and lingual aspects. The level of significance was set at p value = 0.05. All implants were successfully osseointegrated. At 6 months follow-up, the vertical bone change at the buccal aspect was -0.69 mm and at the lingual aspect -0.39 mm. For horizontal bone thickness, the bone dimensional changes at 0, 1, 5, and 9 mm levels from the implant platform were -0.62 mm, -0.70 mm, -0.24 mm, and -0.22 mm, respectively. A significant bone reduction was observed in all measurement levels during the 6 months after implant placement (p value < 0.05). It was noted that even with bone grafting, a decrease in bone thickness was seen following the immediate implant placement. Therefore, this technique can be an alternative method to place the implant in the posterior area.
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Affiliation(s)
- Witchayani Bungthong
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
| | - Parinya Amornsettachai
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
| | - Penporn Luangchana
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand;
| | - Boontharika Chuenjitkuntaworn
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
| | - Suphachai Suphangul
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Yothi Road, Ratchathewi District, Bangkok 10400, Thailand; (W.B.); (P.A.); (B.C.)
- Correspondence: ; Tel.: +66-2200-7853
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