Bedeutung von Alveolar- kammhöhe und -breite für die Implantologie am zahnlosen Oberkiefer

Abstract

Consideration of alveolar profiles and clinical experience demonstrate that the transversal dimension has been neglected in dental implantology so far. For a comprehensive evaluation of the impact of alveolar bone height and width, 95 edentulous bony maxillae with standardized, measured, and classified cross-sections were analyzed. With four types of implants (minimum length, 10 mm), 1076 insertions were simulated at 269 cross-sections and evaluated with regard to type of implant, position of cross-section, and class of atrophy. Similar evaluation was carried out in the clinical part of the study on 24 consecutive patients with edentulous maxillae. Implant insertion could only be simulated in 35% of the cadaver cross-sections, but had been expected in an additional 4.5% based on their sufficient bone height; length reductions were necessary in another 6%. These results depended largely on the class of atrophy. Anterior cross-sections offered better conditions than posterior ones. In contrast, implant insertion was impossible in all 24 patients. Height was primarily inadequate in 22 patients, and in two patients with sufficient bone height inadequate transversal dimensions were only recognised intraoperatively. These results allow a quantification of the impact of vertical and transversal maxillary alveolar bone dimensions. This impact primarily depends on bone height, but even with sufficient height, reductions of implant length often become necessary. Both for the cadaver maxillae (12% of the cross-sections with expected implant insertion) and for the patients (8%), alveolar profiles remain in which height measurement alone leads to incorrect assessment and may even result in the interruption of precisely planned surgical procedures. The complexity and expense of implant-borne rehabilitation and the consequences resulting from incorrect preoperative planning therefore generally justify extended cross-sectional diagnostic measuring.

Localization of mandibular canal and assessment of the remaining alveolar bone in posterior segment of the mandible with single missing tooth using cone-beam computed tomography: a cross sectional comparative study

“…Following tooth extraction, wound healing of the socket is subjected to modeling and remodeling processes, leading to dimensional alterations of the residual ridge5. The dimensional changes can lead to reduced height and width of the bone, thus limiting the insertion of a DI of desired length and diameter67. Furthermore, the complications involved with any other surgical procedure can also be seen with DI surgery89.…”

Virtual Implant Rehabilitation of the Severely Atrophic Maxilla: A Radiographic Study

“…Unfortunately, totally or partially edentulous maxillae often show a significant degree of sinus pneumatization and/or alveolar bone atrophy [9,10]. This lack of bone may complicate the implant's placement and could influence the final results [11]. For these reasons, several aspects should be considered before an implant surgery and a 3D volume bone evaluation is essential to plan a proper implant rehabilitation [12,13].…”