Revised, Computed Tomography–Based Lekholm and Zarb Jawbone Quality Classification

Al-Ekrish, Asma’a Abdurrahman; Widmann, Gerlig; Alfadda, Sara A.

doi:10.11607/ijp.5714

Cited by 27 publications

(26 citation statements)

References 12 publications

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“… 11 , 10 These authors also reported greater losses in width than in height, but with the greatest impact in the basal part of the mandibular body. 31 , 28 In our present study, Cawood-Howell classes I and II were not represented, and patients were most frequently class IV (n = 40), followed by class III (n = 38).…”

Section: Discussioncontrasting

confidence: 49%

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Cone beam computed tomography analysis of the edentulous mandibular symphysis

Mense

Saliba-Serre

Ferrandez

et al. 2021

Journal of Dental Sciences

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Background/purpose Overdenture with single symphyseal implant is one of the useful clinical approach for elderly edentulous patients. We aimed to evaluate edentulous patients with regards to the relationship between dimensions, bone characteristics, cancellous densities, and cortical thickness of the mandibular symphyseal region using cone beam computed tomography (CBCT). Material and methods We analyzed 103 CBCT from pre-implant investigations. All included patients were healthy without any disorders affecting bone metabolism. We performed 13 measurements for each patient: 9 of height, width, and thickness (mm) and 4 of density (Hounsfield Units; HU). Fisher's exact test was applied to examine the association between two categorical variables, the Pearson correlation coefficient to measure the strength of linear relationship between two quantitative variables. We used the two-sample Student's t-test to compare mean symphysis height between men and women, the paired Student's t-test to compare mean lingual and buccal cortical thickness. For all tests, the threshold of significance was fixed at 5%. Results Men and women significantly differed with regards to mean total symphysis height ( p = 0.004) and the distribution of Cawood and Howell classifications ( p = 0.033). Symphysis height was negatively correlated with mean density of cancellous bone (r = −0.453, p < 0.001). Mean lingual cortical thickness significantly differed from mean vestibular thickness ( p < 0.001, paired Student's t-test). Conclusion Present findings supported that symphyseal measurements are parameters that reflect the symphysis bone characteristics, and can guide the choice of a suitable implant design.

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Section: Discussioncontrasting

confidence: 49%

“…developed a modification of the classification of the Lekholm & Zarb classification, which included five classes. 28 Since the works of Misch, computed tomography has been considered a valid and precise method of measuring cancellous and cortical bone density. 29 , 30 …”

Section: Discussionmentioning

confidence: 99%

Cone beam computed tomography analysis of the edentulous mandibular symphysis

Mense

Saliba-Serre

Ferrandez

et al. 2021

Journal of Dental Sciences

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“…Information on patient's demographic characteristics and clinical assessments was collected after screening files and radiographs (peri‐apical film and cone‐beam CT) from patients that received dental implant restoration from March 2011 to March 2019, at the Shanghai Ninth People's Hospital. The following categorical information was collected: length of the implant (8.0 mm or 10.0 mm); diameter of the implant (3.3 mm, 4.1 mm, and 4.8 mm); implant type (Tissue level or Bone level); location of the implant (4 categories: anterior maxilla, posterior maxilla, anterior mandible, and posterior mandible); bone graft (presence or absence); periodontal disease status (classified into 3 categories: mild: 1–2 mm clinical attachment loss (CAL), moderate: 3–4 mm CAL, and severe: ≥5 mm CAL) 26 ; quality of the bone (classified into 4 categories according to CBCT: type 1: entirely homogenous compact bone, type 2: thick layer of compact bone surrounding a core of dense trabecular bone; type 3: thin layer of compact bone surrounding a core of dense trabecular bone; and type 4: thin layer of compact bone surrounding a core of low‐density trabecular bone) 27 ; and insertion torque (classified into 3 categories: <15 Ncm, 15 to 50 Ncm, and ≥50 Ncm).…”

Section: Methodsmentioning

confidence: 99%

Survival rate and potential risk indicators of implant loss in non‐smokers and systemically healthy periodontitis patients: An up to 9‐year retrospective study

Wang¹,

Fan²,

Lin³

et al. 2021

J of Periodontal Research

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Background An increasing number of patients with chronic periodontitis (CP) have received implant restoration. However, very few studies have evaluated the probable risk indicators of implant loss in patients with CP. Objective The aim of this study is to evaluate implant long‐term survival rates in patients with CP. The results are analyzed to discern potential risk indicators of implant loss. Methods A total of 1549 implants were inserted in 827 non‐smokers and systemically healthy CP patients between March 2011 and March 2019. Clinical variables (age; sex; implant location; implant diameter; implant length; implant type; bone quality; bone graft, periodontal disease status, and insertion torque) were recorded. Kaplan‐Meier survival curves illustrated the cumulative survival rate. The relationship between variables and implant loss was discerned by univariate analysis. Further multivariate Cox proportional hazard regression analysis was carried out for the variables with P < 0.2. Results The cumulative survival rates were 98.8% after 3 months, 97.9% after 6 months, 97.7% after 1 year, and 97.4% after 2 to 9 years. After adjusting possible confounders, the multivariable Cox regression model revealed statistically significant influences of implant location, history of bone graft, and insertion torque on implant loss. Implants with history of bone graft were more likely to loss. Implants inserted in the anterior area had a higher implant loss risk; insertion torque of <15 Newton‐centimeter (Ncm) showed a relatively high risk of being lost. Conclusions The study represented public hospital insight into long‐term implant results of patients with CP. Under the premise of strict periodontal control, patients with the history of CP exhibited relatively high implant survival rate. Anterior implant location, history of bone graft, and insertion torque <15 Ncm are associated with a lower implant survival rate and could be considered at a higher risk of implant failure in patients with CP.

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“…The bone tissue was evaluated and categorized over the years, by different authors. [11][12][13][14][15] However, not a single classification was directly correlated to the implant therapy success. It is not possible to predict the subtle differences in bone quality when applying either the Lekholm and Zarb [11] or Misch [12] classifications, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…[11][12][13][14][15] However, not a single classification was directly correlated to the implant therapy success. It is not possible to predict the subtle differences in bone quality when applying either the Lekholm and Zarb [11] or Misch [12] classifications, respectively. For this reason, Trisi and Rao [13] and Norton and Gamble [14] demonstrated that subjective methods of evaluating bone quality assessment are useful only when clinically assessing up to three classes of bone quality [15].…”

Section: Resultsmentioning

confidence: 99%

Microcomputed tomography cortical bone evaluation for craniofacial implantology

Ivanjac

Konstantinović

2020

Srp Arh Celok Lek

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Introduction/Objective. Good implant stability is one of the most important factors for successful implant therapy. This precondition is important to all kind of implants, oral and extra-oral (EO) ie. Craniofacial implants as well. One of the most important factors for satisfactory implant stability is the bone quality, particularly of the cortical bone, which is determined by its microarchitectural parameters. The aim of this paper was to assess cortical bone microarchitectural parameters in the targeted regions for craniofacial implant placement. Methods. Bone quality on targeted localisations was determined by Micro CT method on cadaver model. The target places for implant placement were: periorbital, perinasal and periauricular region. Microarchitectural parameters included cortical thickness (Ct.Th), cortical porosity (Ct.Po), pore diameter (Po.Dm) and pore separation (Po.Sp). Results. The smallest cortical porosity, (Ct.Po. 4.1 %) and the largest pore separation (Po.Sp. 0.5 mm), were determined in glabella. The maximum cortical thickness was found in the zygomatic region (Ct.Th. 2.7 mm) as well as pore diameter (Po.Dm. 0.2 mm). The mastoid part of the temporal bone showed the smallest cortical thickness (Ct.Th.1.2 mm) and pore separation (Po.Sp. 0.3 mm). Highest cortical porosity was in the perinasal region (Ct.Po. 8.5%). Conclusion. The bone quality measured through microarchitectural parameters was good in all the regions of interest for the disk and screw shape EO implant anchorage. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 41008]

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Revised, Computed Tomography–Based Lekholm and Zarb Jawbone Quality Classification

Abstract: The high reproducibility of the proposed revised CT-based Lekholm and Zarb classification obtained in the current study suggests its efficacy in distinguishing between the various combinations of compact and trabecular bone.

Cited by 27 publications

References 12 publications

Cone beam computed tomography analysis of the edentulous mandibular symphysis

Cone beam computed tomography analysis of the edentulous mandibular symphysis

Survival rate and potential risk indicators of implant loss in non‐smokers and systemically healthy periodontitis patients: An up to 9‐year retrospective study

Microcomputed tomography cortical bone evaluation for craniofacial implantology

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