The occurrence of dental implant malpositioning and related factors: A cross-sectional cone-beam computed tomography survey

Abstract

Purpose Dental implants are widely used for the rehabilitation of edentulous sites. This study investigated the occurrence of dental implant malpositioning as shown on post-implantation cone-beam computed tomography (CBCT) and to identify related factors. Materials and Methods Samples with at least 1 malpositioned dental implant were collected from a central radiology clinic in Tehran, Iran from January 2017 to January 2019. Variables such as demographic characteristics, length and diameter of implants, type of implant, sites of implant insertion, different types of implant malpositioning problems (cortical plate perforation, interference with anatomical structures), angulation of the implant, and the severity of malpositioning were assessed. In addition, the incidence of implant fracture and over-drilling was evaluated. Data were statistically analyzed using the chi-square test, 1-sample t-test, and Spearman correlation coefficients. Results In total, 252 patients referred for implant postoperative CBCT evaluations were assessed. The cases of implant malpositioning included perforation of the buccal cortical plate (19.4%), perforation of the lingual cortical plate (14.3%), implant proximity to an adjacent implant (19.0%), implant proximity to an adjacent tooth (3.2%), interference with anatomical structures (maxillary sinus: 18.3%, mandibular canal: 11.1%, nasal cavity: 6.3%, mental foramen: 5.6%, and incisive canal: 0.4%). Implant fracture and over-drilling were found in 1.6% and 0.8% of cases, respectively. Severity was categorized as mild (9.5%), moderate (35.7%), severe (37.7%), and extreme (17.1%), and 52.4% of implants had inappropriate angulation. Conclusion CBCT imaging is recommended for detecting dental implant malpositioning. The most common and severe type of malpositioning was buccal cortex perforation.

Complications and Solution Suggestions Before and After Treatment in Dental Implanology

“…This may cause the following complications: If the implant is placed too deep, bone resorption, nerve damage, sinus perforation and loss of soft tissue height; if the implant is placed mesiodistally, it prevents damage to adjacent teeth, bone resorption and formation of gingival papilla; if the implant is placed palatally or buccally, gingival recession, bone fenestration and aesthetic problems in the buccal region; aesthetic problems such as inability to create a crown of sufficient height or exposure of the abutment if it is placed at insufficient depth; if less than incorrect angulation of the implant, damage to the surrounding anatomical formations, functional problems and aesthetic problems with the implant may occur (15)(16)(17).…”

“…In the presence of buccal dehiscence, the implant should be repositioned urgently and simultaneously grafted with a collagenous membrane and slowly resorbing bone particles. In case of an angulation error during the operation, a side-cutting drill should be used (15)(16)(17).…”

“…If the drill gets stuck, the broken piece should be carefully removed from the socket to cause minimum damage to the bone. If the stabilization of the socket is not complete or damaged due to heating, the implant process should be postponed and it should be planned after bone reconstruction is achieved (17)(18)(19).…”

Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies

“…Due to improved modern understanding of biomechanical aspects that primarily encompass the influence of load distribution on the biochemistry and physiology at the implant-bone interface [3], diagnostic and planning technologies [4], surgical techniques [5,6], and loading protocols [7,8], a high level of predictability can be achieved with dental implants to attain favorable treatment outcomes. For an implant to be stable in the long term and esthetically pleasing, it is imperative that it should be placed accurately in the correct three-dimensional position, with proper angulation [9] and optimum depth with respect to the surrounding bone and adjacent/opposing teeth [10]. Traditional freehand osteotomy preparation for conventional dental implants has been centered on two-dimensional or three-dimensional radiographic images.…”

Multi-planar 2.5D U-Net for image quality enhancement of dental cone-beam CT

“…Cone-beam computed tomography (CBCT) is widely used in the dental field for purposes ranging from disease diagnosis to preoperative simulation and surgical guide construction [ 1 , 2 ]. CBCT can provide three-dimensional (3D) images of the targeted area with the advantage of lower dosage than multidetector computed tomography (MDCT) [ 3 , 4 ].…”