Three-Dimensional Alveolar Bone Assessment of Mandibular First Molars with Implications for Immediate Implant Placement

Padhye, Ninad Milind; Shirsekar, Vinayak Umesh; Bhatavadekar, Neel

doi:10.11607/prd.4614

Cited by 12 publications

(18 citation statements)

References 13 publications

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“…Previous studies, evaluating the risk for immediate implant placement in the posterior mandible, have mainly focused on the prevention of lingual plate perforation or IAN injury [ 6 – 12 ]. According to the authors' knowledge, no other paper has tried to discuss the optimal surgical position, and it’s relation to the inter-radicular septum.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study

2021

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Background To elucidate the anatomical features of the mandibular molar region to allow safe immediate implant placement. Methods Cone-beam computed tomography images of 150 patients (600 teeth) were reviewed retrospectively. The virtual implants were placed in the mandibular first and second molar region. The anatomic structures of the mandible and inter-radicular septum were both categorized into three types. The relationship between implant and inferior alveolar nerve (IAN), and the horizontal distance from the implant surface to the bone wall were analyzed. Variables were compared using a student’s t-test, or Mann–Whitney U test. Results Type U (39.0%) and type S (56.0%) were the most common in the first molar, while type U (67.7%) and type M (54.7%) had the highest prevalence rate in the second molar. The mean distance from the level where the virtual implant was completely surrounded by bone to IAN was 7.06 mm. The mean horizontal widths from the implant to the mesial and distal socket wall were 1.59 mm and 1.89 mm. The widths of the inter-radicular septum and the distances from implant to the buccal and lingual plate on different sections were significantly associated with tooth position (P < .05). Conclusions In the first molar region, the implant is suggested to be placed in the center of the inter-radicular septum, while in the second molar region, the mesial root socket could be considered. Immediate implant placement in the mandibular second molar sockets shows a high risk of IAN injury, lingual perforation, and inadequate primary stability.

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Section: Introductionmentioning

confidence: 99%

Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study

2021

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“…For the same purposes, we also performed the analysis of the metrics obtained in the axial view for both M1 ( Table 5 ) and M2 ( Table 6 ). Again, following the previously established criteria for the minimal required IRS surface for the immediate implant placement [ 32 ], it could be noted that the critical values for the surface area should be expected at all IRS levels (for all IRS shapes), except for the palatal convergence shape on the C and D level ( Table 5 ). However, it should be noted that the most insufficient space, when compared to the implant surface, appeared at level A, especially for the drop-shaped IRS.…”

Section: Resultsmentioning

confidence: 94%

“…Following the previously established criteria that emphasized numeric borders for the prognosis of the immediate implant placement success, which had set the minimal value for IRS width at 3 mm [ 32 ] and the vertical axis value at 10 mm [ 21 ], we presented the analysis of our results on the basis of IRS shape influence on those determinants obtained in the coronal views. The analysis of the average values of the appropriate parameters for M1 ( Table 3 ) showed that critical criteria were not supposed to be achieved in the drop-shaped IRS at level A, whereas the risks for the immediate implant placement complications, according to the total distance between the IR furcation and the sinus floor, were the lowest in the buccal-convergence-shaped IRS.…”

Section: Resultsmentioning

confidence: 99%

Criteria for the Classification of the Interradicular Septum Shape in Maxillary Molars with Clinical Importance for Prosthetic-Driven Immediate Implant Placement

et al. 2022

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The aim of this study was to use cone-beam computed tomography (CBCT) to evaluate the morphometric properties of the interradicular septum (IRS) in the maxillary molar region that may be indicative for prosthetic-driven implant placement. Following the repetitive algorithm based on the visual identification of IRS shapes, we described the following IRS shapes: arrow, boat, drop, and palatal and buccal convergence. The incidence of IRS shapes showed significant differences for the first and second maxillary molars (the highest frequency for the arrow shape, and the lowest for the drop shape) with no significant difference between the molars. The most prominent width indicative for implant placement was observed in the palatal convergence shape, whereas the height criteria were the most satisfying in the buccal convergence-shaped IRS for both molars. Apart from the parameters in the coronal view, the image analysis in the axial view revealed that IRS surface area, required for the implant placement, was the most prominent in the palatal convergence shape for the first, and boat shape for the second molars. Our results showed the benefits of CBCT diagnostics in posterior maxilla morphometric analysis. IRS shape classification may be helpful in achieving more rapid and accurate planning for interventions in this region.

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“…Regarding the implant length suitable for a single standing implant IIP, 10 mm was found to be the minimum for sufficient bone anchorage that could handle posterior mandible occlusal forces [ 31 ]. However, a recent study reported that in 24% of the examined sites, the IAN-to-furcation length was less than 10 mm, warranting vertical bone augmentation or the use of short implants of 8 mm or 6 mm [ 24 ]. Short implants should be used adjacent to other implants to allow for splinting and to achieve more durability [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Smith and Tarnow [ 12 ] classified the molar extraction sockets from types A to C by amount of septal bone available for stabilization of the IIP. Another potential way to achieve primary stability is to engage the available bone with implants that are wider and shorter than the extracted root [ 23 , 24 ]. The aim of the present study was to verify, based on cone beam computed tomography (CBCT) scans, the implant dimensions that allow for circumferential bone engagement without additional apical drilling in each position in the posterior mandible.…”

Section: Introductionmentioning

confidence: 99%

Potential Circumferential Bone Engagement following Tooth Extraction in the Posterior Mandible: Computed Tomography Assessment

et al. 2021

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Background and Objectives: Immediate implant placement (IIP) is a popular surgical procedure with a 94.9–98.4% survival rate and 97.8–100% success rate. In the posterior mandible, it poses a risk of injury to adjacent anatomical structures if the implant engages apical bone. This study sought to assess the implant dimensions that allow for circumferential bone engagement at each position in the posterior mandible without additional apical drilling. Materials and Methods: An observational, cross-sectional study design was used. The pre-extraction cone beam computed tomography scans of 100 candidates for IIP were analyzed. Measurements of each root of the posterior mandibular second premolar, first molar, and second molar were taken from three aspects: buccolingual, mesiodistal, and vertical. Two-sided p values < 0.05 were considered statistically significant. Results: A total of 478 mandibular teeth and 781 roots were assessed. Based on Straumann® BLX/BLT implant-drilling protocols, predicted rates of radiological circumferential engagement (RCE) were 96% for implants 5 mm in diameter in the second premolar root position; 94% for implants 4.0–4.2 mm in diameter in the first molar root position; and 99% for implants 4.5–4.8 mm in diameter in the second molar root position. Corresponding rates of achieving an available implant length (AIL) of 10 mm were 99%, 90%, and 86%. Patients <40 years old were at higher risk of lower RCE and lower AIL (p < 0.005) than older patients for all roots measured. Conclusions: The high primary stability prediction rates based on the calculation of RCE and AIL support the use of IIPs without further apical drilling in the posterior mandible in most cases.

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Three-Dimensional Alveolar Bone Assessment of Mandibular First Molars with Implications for Immediate Implant Placement

Cited by 12 publications

References 13 publications

Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study

Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study

Criteria for the Classification of the Interradicular Septum Shape in Maxillary Molars with Clinical Importance for Prosthetic-Driven Immediate Implant Placement

Potential Circumferential Bone Engagement following Tooth Extraction in the Posterior Mandible: Computed Tomography Assessment

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