Tomographic evaluation on bone morphology in posterior mandibular region for safe placement of dental implant

Abstract

The aim of this study was to examine the morphology of submandibular fossae at edentulous posterior regions of dried mandibles and to determine a safe range for proper lingual angulation during the placement of a dental implant in the posterior mandibular region, with a computerized tomographic scan study. Spiral computed tomographic images of 77 dry adult human mandibles were evaluated to determine the deepest area in the submandibular fossa. Then, the proper lingual angulations for the placement of a dental implant at these regions were measured. Pearson's correlation coefficient was calculated to show the relation between the depths of submandibular fossa and lingual implant angulations. "Paired t test" was used for differences between the lingual implant angulations and the depths of submandibular fossa on each side of the mandibles. Depths of the submandibular fossa and lingual implant angulations were varied between 1.1 and 4.6 mm: 62°-84° on right side of the mandibles, and 1.1-4.5 mm, 65°-83° on left side of the mandibles. There were statistically medium negative correlations between the degree of lingual implant angulations and the depth of submandibular fossa on each side of the mandible (r = -0.44, p < 0.001, and r = -0.38, p = 0.001). There was a statistically significant difference between the right and left sides of the mandibles in terms of the depth of submandibular fossa (p = 0.01). Within the limits of this study, the depth of submandibular fossa was measured as ≥ 2 mm in around 71.5 % of examined regions, and lingual implant angulations were between 62° and 84°. These results may be considered by clinicians who are planning the dental implant placement in posterior mandible to avoid potential risk of lingual cortical plate perforation.

Influence of bone anatomical morphology of mandibular molars on dental implant based on CBCT

“…An oral surgeon is required to fully understand the morphology of the planting area to prevent complications [ 1 , 4 , 5 ]. The mandibular posterior lingual concavity is a common finding.…”

“…Now a days, implant treatment adopts the "crown-down" approach to focus on aesthetic restoration and long-term stability [ 1 , 2 , 6 ]. The long axis of occlusal forces of the implant should be as consistent as the original long axis of occlusal force of the missing teeth, because the jawbone can resist more compressive force than the tensile and shear stress [ 1 , 5 , 6 ]. The design idea and classification of this study was from the perspective of occlusal forces.…”

“…Therefore, it is of great significance to study the morphology and bone thickness of the buccal-lingual fracture of the posterior teeth of the mandible, aiming to improve the success rate of implantation and reduce the risk of intraoperative complications. Currently, the most commonly used imaging examination method is panoramic radiography, whereas it is limited to two-dimensional images, which lacks buccal and lingual information and has the disadvantages of image distortion and enlargement [ 5 , 10 ]. Therefore, some stomatologists advocate the application of computed tomography (CT) for preoperative implant planning, whereas traditional CT also has the disadvantages of high cost and large radiation [ 1 , 15 ].…”

Submandibular fossa augmentation in implant dentistry

“…There are two limiting factors for determining the dental implant fixture length in mandibular posterior edentulous region: Inferior dental canal and submandibular fossa. [ 1 ]…”

Особливості Конусно-ПроменеОсобливості Конусно-Пвої Комп’ютерної Томографії (КПКТ) Дистальних Відділів Нижньої Щелепи Та Можливості Встановлення Дентальних Імплантатів «в Обхід» Нижнього Альвеолярного Нерва: Огляд Літератури Та Результати Власного Досвіду

“…Подібну інформацію стосовно поширеності U-подібної конфігурації (64,2 %) наводять й іспанські дослідники, вказуючи, що середня глибина піднижньощелепної ямки становить (4,5±2,3) мм у чоловіків та (3,1±1,7) мм в жінок (p>0,05), і наголошуючи на тому, що наявність будь-якої язикової увігнутості в дистальних відділах нижньої щелепи несе потенційні ризики перфорації язикової кортикальної пластинки під час встановлення імплантатів [4]. тотожну думку висловлюють і S. Yildiz et al [26], які констатували наявність язикової увігнутості понад 2 мм у 71,5 % обстежених і акцентували увагу на доцільності ангульованого введення дентальних імплантатів з метою попередження ушкодження язикової кортикальної пластинки.…”