scholarly journals Analysis of the Sagittal Root Angle and Its Correlation With Hard and Soft Tissue Indices in Anterior Teeth for Immediate Implant Evaluation - A Retrospective Study

2021 ◽  
Author(s):  
Mengru Shi ◽  
Xiaoshuang Wang ◽  
Peisheng Zeng ◽  
Haiwen Liu ◽  
Zhuohong Gong ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Alveolar Bone ◽  
Bone Thickness ◽  
Root Angle ◽  
Implant Placement ◽  
Anterior Teeth ◽  
Immediate Implant ◽  
Palatal Bone ◽  
Additional Reference ◽  
Plaster Models

Abstract Background: To assess the root angle characteristics of maxillary incisors, and to analyze the relationship between the root angle and other implant-related anatomical indices to use the sagittal root angle as an index for immediate implant evaluation and design. Methods: A random sample consisting of 400 cone-beam computed tomography (CBCT) images and 65 maxillary plaster models were selected for the present study. CBCT and stereolithography (STL) scan images were imported as DICOM files into coDiagnostiX software for matching the hard and soft tissue. The angle between the long axis of the anterior tooth and the corresponding alveolar bone and implant-related hard and soft tissue indices were measured in the sagittal section. Descriptive statistics, frequency analysis, multi-level comparisons, and correlation analyses were performed. Results: The average sagittal root angles were 15° at the central incisor and 19° at the lateral incisor. The root angle in males was significantly larger than that in females, and increased with age. The largest angle, 22.35º, was found in the lateral incisors of the oldest (> 50 years old) male group. The root angle was found to correlate with coronal buccal bone thickness, coronal palatal bone thickness, apical buccal bone thickness, palatal bone thickness, and the below apex bone thickness. Conclusions: The sagittal root angle could reflect the distribution of other implant-related anatomical indices, which may provide additional reference for the evaluation of immediate implant placement.

scholarly journals Analysis of the sagittal root angle and its correlation with hard and soft tissue indices in anterior teeth for immediate implant evaluation: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mengru Shi ◽  
Xiaoshuang Wang ◽  
Peisheng Zeng ◽  
Haiwen Liu ◽  
Zhuohong Gong ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Alveolar Bone ◽  
Bone Thickness ◽  
Root Angle ◽  
Implant Placement ◽  
Anterior Teeth ◽  
Immediate Implant ◽  
Palatal Bone ◽  
Additional Reference ◽  
Plaster Models

Abstract Background To assess the root angle characteristics of maxillary incisors, and to analyze the relationship between the root angle and other implant-related anatomical indices to use the sagittal root angle as an index for immediate implant evaluation and design. Methods A random sample consisting of 400 cone-beam computed tomography (CBCT) images and 65 maxillary plaster models were selected for the present study. CBCT and stereolithography (STL) scan images were imported as DICOM files into coDiagnostiX software for matching the hard and soft tissue. The angle between the long axis of the anterior tooth and the corresponding alveolar bone and implant-related hard and soft tissue indices were measured in the sagittal section. Descriptive statistics, frequency analysis, multi-level comparisons, and correlation analyses were performed. Results The average sagittal root angles were 15° at the central incisor and 19° at the lateral incisor. The root angle in males was significantly larger than that in females, and increased with age. The largest angle, 22.35°, was found in the lateral incisors of the oldest (> 50 years old) male group. The root angle was found to correlate with coronal buccal bone thickness, coronal palatal bone thickness, apical buccal bone thickness, palatal bone thickness, and the below apex bone thickness. Conclusions The sagittal root angle could reflect the distribution of other implant-related anatomical indices, which may provide additional reference for the evaluation of immediate implant placement.

scholarly journals Risk assessment of labial bone perforation in the anterior mandibular region: a virtual immediate implant placement study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yi-Wen Cathy Tsai ◽  
Ren-Yeong Huang ◽  
Chia-Dan Cheng ◽  
Wan-Chien Cheng ◽  
David L. Cochran ◽  
...  
Keyword(s):  
Estimating Equation ◽  
Class Ii ◽  
Multivariable Logistic Regression Analysis ◽  
Bone Thickness ◽  
Cavity Depth ◽  
Implant Placement ◽  
Anterior Teeth ◽  
Confounding Variables ◽  
Mandibular Region ◽  
Immediate Implant

Abstract Background This study investigated the prevalence of labial bone perforation (LBP) related to the associated anatomic factors in anterior mandibular region using a virtual immediate implant placement procedure. Methods Series qualified CBCT images of 149 participants (894 teeth) were selected to analyze the assigned anatomical parameters, including concavity depth, concavity angle, torque, and deep bone thickness. Four classes of crestal and radicular dentoalveolar bone phenotypes (CRDAPs) of mandibular anterior teeth were categorized according to the thickness of dentoalveolar bone at both crestal and radicular zones. Data were adjusted for categorical (gender and CRDAP) and continuous (age, cavity angle, cavity depth, and deep bone thickness) variables using a multivariable logistic regression analysis with generalized estimating equation method. Results The overall probability of LBP after virtual implant placement was 21.6%. There is statistically significant higher prevalence of LBP at canine (28.5%) and CRDAP class II (29.2%) regions (p < 0.001). After adjusting confounding variables, CRDAP class II and class IV regions are more likely to have LBP when compared with CRDAP class I (control) regions (p < 0.01). The risk of LBP at canine site is 6.31 times more likely than at the central incisor (control) (p < 0.01). Conclusions Using a virtual immediate implant placement technique, the prevalence of LBP is significantly higher at the mandibular canine site and thin radicular dentoalveolar phenotype in the anterior mandibular region.

Augmentation in Two Stages of Atrophic Alveolar Bone Prior to Dental Rehabilitation: A Case Report

2007 ◽  
Vol 8 (6) ◽  
pp. 57-63 ◽  
Author(s):  
Ahmed A. Zahrani
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Graft ◽  
Bone Grafting ◽  
Alveolar Bone ◽  
Alveolar Ridge ◽  
Implant Placement ◽  
Anterior Teeth ◽  
Dental Rehabilitation ◽  
Two Stages

Abstract Aim The aim of this report is to describe a significantly deficient case of alveolar bone that was managed by alveolar bone augmentation using a technique of distraction osteogensis and onlay bone grafting prior to dental implant placement. Background Injury to the teeth and alveolar ridge of the maxillary anterior region can cause a severe alveolar ridge deficiency resulting in ridge atrophy and maxillary retrognathism. The loss of these teeth and alveolar bone together with fibrotic scar formation can result in adverse changes of the interarch space, occlusal plane, arch relationship, and arch form which complicates rehabilitation and can compromise the esthetic outcome. While implant dentistry has become a new paradigm in oral reconstruction and replacement of missing teeth, ideal implant positioning can be compromised by inadequate alveolar bone in terms of bone height, width, and quality of the bone itself. Correction of osseous deficiencies with ridge augmentation allows ideal implant placement and creates a more natural soft tissue profile which influences crown anatomy and esthetics. Report A 20-year-old female presented with a complaint of poor esthetics resulting from oral injuries incurred in a traffic accident six years previously. In addition to a mandibular parasymphyseal fracture, five maxillary anterior teeth and the most of the alveolar ridge were lost. Clinical examination revealed severe loss of bone in the maxillary anterior region, an absence of a labial sulcus, loss of upper lip support, and a slight over eruption of the mandibular anterior teeth. In preparation for dental implants a distraction osteogenesis surgical procedure was done to lengthen the height of the alveolar ridge. After a three-month healing period, the width of the residual ridge was found to be insufficient for implant placement. To correct this deficiency, a bone graft of a cortiocancellous block was harvested from the chin and fixed to the labial aspect of the ridge. To facilitate revascularization, small perforations were made in the cortical bone of the alveolar ridge at the recipient site before cancellous bone retrieved from the donor site was gently placed between the bone block and the ridge. The patient was then appropriately medicated and healing was uneventful. After three months, the width of the residual ridge was assessed to be adequate for endosseous implants. Summary The clinical result reported here has shown several procedures may be necessary for the rehabilitation of a trauma patient. Distraction osteogenesis per se may not always satisfactorily improve the anatomical alveolar anatomy but it has advantages over other methods of augmentation. It can improve the height and also expand the soft tissue for further bone grafting. Augmentation of the alveolar bone with an onlay bone graft often provides the desired gain of bone, allows for the ideal placement of dental implants, and improves any discrepancy between the upper and lower arches. Citation Zahrani AA. Augmentation in Two Stages of Atrophic Alveolar Bone Prior to Dental Rehabilitation: A Case Report. J Contemp Dent Pract 2007 September;(8)6:057-063.

scholarly journals Gingival recession behavior with immediate implant placement in the anterior maxilla with buccal dehiscence without additional augmentation—a pilot study

2020 ◽  
Vol 24 (4) ◽  
pp. 1455-1464
Author(s):  
Veronika Pohl ◽  
Lukas Fürhauser ◽  
Robert Haas ◽  
Sebastian Pohl
Keyword(s):  
Pilot Study ◽  
Soft Tissue ◽  
Alveolar Bone ◽  
Clinical Results ◽  
Tissue Level ◽  
Anterior Maxilla ◽  
Implant Placement ◽  
Significant Difference ◽  
Immediate Implant ◽  
Observation Period

Abstract Background Immediate implant placement in the presence of intact extraction alveoli has frequently been reported, while hardly any reports on immediate implant placement in missing buccal bone can be found in literature. Objectives This pilot study evaluates esthetic outcome and soft and hard tissue level changes of immediate implant placement with immediate provisionalization in patients with partially/completely missing buccal bone without any further augmentation procedure in the maxillary anterior zone. Material and methods Twelve patients (TG) with partially to completely missing buccal bone designated for extraction and flapless immediate implant insertion in the anterior zone of the maxilla were included. Patients randomly selected out of a larger group of patients with immediate implants with intact alveoli served as controls (CG). Immediate provisionalization was done without any further augmentation of the alveolar ridge. Marginal hard and soft tissue levels, PES, and implant success were evaluated during a 1-year observation period. Results The defect of the buccal alveolar bone was 4.96 mm (min., 2.26 mm; max., 9.68 mm) and the mean mesio-distal extension 4.25 mm (min., 3.2 mm; max., 5.91 mm). Preoperative PES differed significantly between TG (9.68) and CG (12.25) and improved in TG postoperatively with no significant difference to CG after 1 year (TG, 10.91; CG, 11.3). The buccal soft tissue level remained almost unchanged over the observation period (TG preop, 0.86 mm ± 0.90 mm; 1 year, 0.91 mm ± 0.96 mm; CG preop, 0.98 mm ± 0.87 mm; 1 year, 0.98 mm ± 0.87 mm and did not show any correlation with either the mesial/distal bone level or the initial buccal vertical defect at any point of time. Conclusions These clinical results provide evidence that immediate implant placement without additional augmentation, but with immediate provisionalization might be a viable treatment alternative even with missing buccal plate in the esthetic maxillary zone.

Effects of Antibiotics on Bone and Soft-Tissue Healing Following Immediate Single-Tooth Implant Placement Into Sites With Apical Pathology

2015 ◽  
Vol 41 (5) ◽  
pp. e202-e211 ◽  
Author(s):  
Bashir Hosseini ◽  
Warren C. Byrd ◽  
John S. Preisser ◽  
Asma Khan ◽  
Derek Duggan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bacterial Resistance ◽  
Alveolar Bone ◽  
Controlled Trial ◽  
Double Blind ◽  
Implant Placement ◽  
Bonferroni Adjustment ◽  
Tissue Changes ◽  
Immediate Implant ◽  
Soft Tissue Changes

Overprescription of antibiotics can cause bacterial resistance problems, leading to life-threatening illnesses and public health crises. Clinicians often believe antibiotics can prevent dental implant failure and postoperative complications. In conjunction with implant surgery, antibiotics are therefore routinely prescribed for all cases. In this double-blind, randomized controlled trial, the effects of antibiotics on the clinical outcomes of immediate implant placement upon replacing a tooth with an apical pathology were examined to compare antibiotics (n = 10) and placebo (n = 10). In each subject, a tooth with a chronic apical lesion was extracted, thoroughly curetted, irrigated, and replaced with single implant with a screw-retained custom provisional abutment/crown. Postoperative pain/discomfort was measured at 1- and 4-week postsurgical follow-up visits using visual analog scales. Facial alveolar bone and soft-tissue changes were measured using pre- and postoperative cone-beam computerized tomography and impressions. We found survival rates of 100% (antibiotics) and 78% (control). However, there was no statistical difference in means for any clinical outcome (t tests with Bonferroni adjustment for multiple testing), except for midfacial soft-tissue changes: 0.43 mm (SD, 0.76) in the antibiotics group and 1.70 mm (SD, 1.06) in the placebo group (t15 = −2.89, P = .011). The average change of the midfacial alveolar plate was 0.62 mm (SD, 0.46) and 1.34 mm (SD, 0.91) for the antibiotic and placebo groups, respectively, which did not significantly differ statistically. No significant correlation (Spearman correlation) existed between the changes in facial alveolar bone and the facial gingival margin. Antibiotics appear to have little effect on immediate implant treatment outcomes.

Management of trauma to the anterior segment of the maxilla: alveolar fracture and primary incisors crown and root fracture

2021 ◽  
Vol 33 (2) ◽  
pp. 16-20
Author(s):  
Muna S Khalaf ◽  
Bayan S Khalaf ◽  
Shorouq M Abass
Keyword(s):  
Soft Tissue ◽  
Primary Teeth ◽  
Alveolar Bone ◽  
Anterior Segment ◽  
Dental Trauma ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Normal Position ◽  
Anterior Teeth ◽  
The Impact

Background: An injury to both the primary and permanent teeth and the supporting structures is one of the most common dental problems seen in children. Splinting is usually difficult or impossible to perform in the primary dentition (due to diminutive room size and lack of patient cooperation). Healing must, therefore, occur despite mobility at the fracture line, usually resulting in interposition of connective tissue. In some instances, infection will occur in the coronal pulp. The present study reported a case of trauma to the anterior primary teeth and alveolar bone in a four year old child. The trauma has caused fracture to the crowns and roots of the primary anterior teeth. The following case was managed in a procedure that may provide primary teeth subjected to trauma a better chance than extraction with a better prognosis. Case presentation: a 4 and a half year old child was subjected to trauma in anterior segment of maxilla. Suturing of the torn soft tissue was the first step followed by pulpotomy for the left primary lateral incisor. Fixation of the right primary central and lateral incisors was done by acid etch wire fixation. Both clinical and radiographic follow up was carried out for 6.4 years. Results: healing of the soft tissue was observed after one week and completed after two months. Fixation of the teeth continued for ten months. The fracture lines in the roots remained in position. Clinically there was no sign of any pulpal inflammation or necrosis. Radiographically, no signs of infection to the surrounding tissues could be seen, no resorption in the alveolar bone, external or internal resorption of the root did not happen also. After ten months fixation ended and the wire was removed. At that time there was normal resorption of the roots of the primary incisors in relation with the normal development of the permanent incisors. After 3 years both permanent central incisors erupted in their normal position. After 6.4 years all four permanent incisors erupted into occlusion in their normal position. Conclusion: primary teeth with root fractures and severely mobile coronal fragments can be treated by a conservative approach. The severity of the sequels is directly related to the degree of permanent tooth formation (child’s age), type of dental trauma and extent of the impact. Key words: trauma, primary incisors, fractured crown and root

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