DOI QR코드

DOI QR Code

Cone-beam computed tomographic analysis of the alveolar ridge profile and virtual implant placement for the anterior maxilla

  • Lim, Hyun-Chang (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Kang, Do-Uk (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Baek, Hyehyeon (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Hong, Ji-Youn (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Shin, Seung-Yun (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Chung, Jong-Hyuk (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Herr, Yeek (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry) ;
  • Shin, Seung-Il (Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry)
  • Received : 2019.05.13
  • Accepted : 2019.08.23
  • Published : 2019.10.30

Abstract

Purpose: To analyze the ridge profile of the anterior maxilla using cone-beam computed tomography and to assess the clinical significance of the ridge profile by performing virtual implant placement. Methods: Thirty-two cone-beam computed tomography scans of anterior maxillae were included. For each tooth, a vertical line was made along the longitudinal axis, and 3 horizontal lines at 1-, 3-, and 5-mm levels below the labial bone crest were drawn perpendicularly to the vertical reference. At these levels, the thickness of the alveolar ridge (RT), and the labial (LT) and palatal bone plate (PT) were measured. Then, virtual implant placement using standard and tapered implants was performed. A generalized linear mixed model was used for statistical analysis. Results: The teeth were located labially based on the proportion of LT and PT with respect to RT. At the 1-mm level, the value of LT was between $1.0{\pm}0.4mm$ for central incisors and $1.3{\pm}0.6mm$ for canines. A large number of teeth had area(s) with less than 1-mm-thick labial bone between the 1- and 5-mm levels below the crest. The mean PT was generally thicker than the LT in all tooth types. The greatest mean value of labial concavity was observed for canines, compared to other tooth types. Men had a greater RT than did women, but had a comparable LT. Less apical fenestration was observed when tapered implants were used. Conclusions: Most teeth in the anterior maxilla had a thin labial bone plate, with no significant difference between sexes. Tapered implants may be advantageous for the anterior maxilla.

Keywords

References

  1. Quirynen M, Herrera D, Teughels W, Sanz M. Implant therapy: 40 years of experience. Periodontol 2000 2014;66:7-12. https://doi.org/10.1111/prd.12060
  2. Hammerle CH, Chen ST, Wilson TG Jr. Consensus statements and recommended clinical procedures regarding the placement of implants in extraction sockets. Int J Oral Maxillofac Implants 2004;19 Suppl:26-8.
  3. Avila-Ortiz G, Elangovan S, Kramer KW, Blanchette D, Dawson DV. Effect of alveolar ridge preservation after tooth extraction: a systematic review and meta-analysis. J Dent Res 2014;93:950-8. https://doi.org/10.1177/0022034514541127
  4. Cha JK, Song YW, Park SH, Jung RE, Jung UW, Thoma DS. Alveolar ridge preservation in the posterior maxilla reduces vertical dimensional change: a randomized controlled clinical trial. Clin Oral Implants Res 2019;30:515-23. https://doi.org/10.1111/clr.470_13509
  5. Lee JS, Cha JK, Kim CS. Alveolar ridge regeneration of damaged extraction sockets using deproteinized porcine versus bovine bone minerals: a randomized clinical trial. Clin Implant Dent Relat Res 2018;20:729-37. https://doi.org/10.1111/cid.12628
  6. Arora H, Ivanovski S. Immediate and early implant placement in single-tooth gaps in the anterior maxilla: a prospective study on ridge dimensional, clinical, and aesthetic changes. Clin Oral Implants Res 2018;29:1143-54. https://doi.org/10.1111/clr.13378
  7. Covani U, Ricci M, Bozzolo G, Mangano F, Zini A, Barone A. Analysis of the pattern of the alveolar ridge remodelling following single tooth extraction. Clin Oral Implants Res 2011;22:820-5. https://doi.org/10.1111/j.1600-0501.2010.02060.x
  8. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003;23:313-23.
  9. Braut V, Bornstein MM, Belser U, Buser D. Thickness of the anterior maxillary facial bone wall-a retrospective radiographic study using cone beam computed tomography. Int J Periodontics Restorative Dent 2011;31:125-31.
  10. Bulyalert A, Pimkhaokham A. A novel classification of anterior alveolar arch forms and alveolar bone thickness: a cone-beam computed tomography study. Imaging Sci Dent 2018;48:191-9. https://doi.org/10.5624/isd.2018.48.3.191
  11. Januario AL, Duarte WR, Barriviera M, Mesti JC, Araujo MG, Lindhe J. Dimension of the facial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res 2011;22:1168-71. https://doi.org/10.1111/j.1600-0501.2010.02086.x
  12. Zekry A, Wang R, Chau AC, Lang NP. Facial alveolar bone wall width - a cone-beam computed tomography study in Asians. Clin Oral Implants Res 2014;25:194-206. https://doi.org/10.1111/clr.12096
  13. Zhang W, Skrypczak A, Weltman R. Anterior maxilla alveolar ridge dimension and morphology measurement by cone beam computerized tomography (CBCT) for immediate implant treatment planning. BMC Oral Health 2015;15:65. https://doi.org/10.1186/s12903-015-0055-1
  14. Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 2005;32:212-8. https://doi.org/10.1111/j.1600-051X.2005.00642.x
  15. Tao R, Meng M, Niu LN, Chen JH, Nico CF, Ma C. Investigation of sagittal root position in relation to the anterior maxillary alveolar bone: a cone-beam CT study in 300 cases with normal occlusion. Zhonghua Kou Qiang Yi Xue Za Zhi 2017;52:631-6.
  16. Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000 2017;73:84-102. https://doi.org/10.1111/prd.12170
  17. Kan JY, Rungcharassaeng K, Deflorian M, Weinstein T, Wang HL, Testori T. Immediate implant placement and provisionalization of maxillary anterior single implants. Periodontol 2000 2018;77:197-212. https://doi.org/10.1111/prd.12212
  18. Testori T, Weinstein T, Scutella F, Wang HL, Zucchelli G. Implant placement in the esthetic area: criteria for positioning single and multiple implants. Periodontol 2000 2018;77:176-96. https://doi.org/10.1111/prd.12211
  19. Grunder U, Gracis S, Capelli M. Influence of the 3-D bone-to-implant relationship on esthetics. Int J Periodontics Restorative Dent 2005;25:113-9.
  20. Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol 2000;5:119-28. https://doi.org/10.1902/annals.2000.5.1.119
  21. Kan JY, Roe P, Rungcharassaeng K, Patel RD, Waki T, Lozada JL, et al. Classification of sagittal root position in relation to the anterior maxillary osseous housing for immediate implant placement: a cone beam computed tomography study. Int J Oral Maxillofac Implants 2011;26:873-6.
  22. Lau SL, Chow J, Li W, Chow LK. Classification of maxillary central incisors-implications for immediate implant in the esthetic zone. J Oral Maxillofac Surg 2011;69:142-53. https://doi.org/10.1016/j.joms.2010.07.074
  23. Pascual A, Barallat L, Santos A, Levi P Jr, Vicario M, Nart J, et al. Comparison of periodontal biotypes between maxillary and mandibular anterior teeth: a clinical and radiographic study. Int J Periodontics Restorative Dent 2017;37:533-9. https://doi.org/10.11607/prd.2848
  24. Fuentes R, Flores T, Navarro P, Salamanca C, Beltran V, Borie E. Assessment of buccal bone thickness of aesthetic maxillary region: a cone-beam computed tomography study. J Periodontal Implant Sci 2015;45:162-8. https://doi.org/10.5051/jpis.2015.45.5.162
  25. El Nahass H, Naiem SN. Analysis of the dimensions of the labial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res 2015;26:e57-61. https://doi.org/10.1111/clr.12332
  26. Lee SL, Kim HJ, Son MK, Chung CH. Anthropometric analysis of maxillary anterior buccal bone of Korean adults using cone-beam CT. J Adv Prosthodont 2010;2:92-6. https://doi.org/10.4047/jap.2010.2.3.92
  27. Schroeder HE. The periodontium. London: Springer; 1986.
  28. Hubar JS. Quantification of the lamina dura. J Can Dent Assoc 1993;59:997-1000.
  29. Chen ST, Darby IB, Reynolds EC. A prospective clinical study of non-submerged immediate implants: clinical outcomes and esthetic results. Clin Oral Implants Res 2007;18:552-62. https://doi.org/10.1111/j.1600-0501.2007.01388.x
  30. Kan JY, Rungcharassaeng K, Sclar A, Lozada JL. Effects of the facial osseous defect morphology on gingival dynamics after immediate tooth replacement and guided bone regeneration: 1-year results. J Oral Maxillofac Surg 2007;65:13-9.
  31. Chappuis V, Engel O, Shahim K, Reyes M, Katsaros C, Buser D. Soft tissue alterations in esthetic postextraction sites: a 3-dimensional analysis. J Dent Res 2015;94:187S-193S. https://doi.org/10.1177/0022034515592869

Cited by

  1. Buccal bone thickness of maxillary anterior teeth: A systematic review and meta‐analysis vol.47, pp.11, 2020, https://doi.org/10.1111/jcpe.13347
  2. Morphological Characteristics of the Nasopalatine Canal and the Relationship with the Anterior Maxillary Bone-A Cone Beam Computed Tomography Study vol.11, pp.5, 2019, https://doi.org/10.3390/diagnostics11050915