A Retrospective Study on the Transferring Accuracy of a Fully Guided Digital Template in the Anterior Zone

The accuracy of implant placement with a fully guided digital template can be influenced by many factors, such as arch difference, alveolar bone density, timing of implant placement and open flap. The purpose of this article was to evaluate the factors presumptively affecting the accuracy of implant placement assisted by the fully guided template in the anterior zone. In 40 patients with missing anterior teeth, a total of 52 implants were placed with tooth-borne, fully guided templates after CBCT evaluation, in West China Hospital of Stomatology, Sichuan University. After overlapping the pre-and post-operative DICOM data, measurements were taken in the dental implant planning software (Nobel Clinician®) to calculate linear and angular deviations between virtual placement plan and actual implant placement. Grouping was categorized according to three factors that possibly have an influence on accuracy: arch type (maxilla/mandible), timing of implant placement (immediate/delayed), surgical technique (open flap/flapless). The data was analyzed with independent sample t-test (p < 0.05). The results showed that the apical, coronal, depth and angular mean deviations of implant positions in anterior zone were 1.13 ± 0.39 mm, 0.86 ± 0.33 mm, 0.41 ± 0.66 mm, 3.32 ± 1.65° with the fully guided templates. The accuracy at apex level, coronal level and the angulation were similar between the maxilla and mandible, and the magnitude of all four deviations between immediate and delayed implantation, open flap and flapless technique were small. No statistically significant difference was observed (p > 0.05). Whereas there was significant difference in depth deviation between maxilla and mandible (p < 0.05). Conclusively, the implant site, alveolar bone density, timing of implant placement and surgical techniques merely compromise the implant placement accuracy under the assistance of a fully guided template.

Download Full-text

Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study

Head & Face Medicine ◽

10.1186/s13005-021-00277-z ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Qiannan Sun ◽

Wenhsuan Lu ◽

Yunfan Zhang ◽

Liying Peng ◽

Si Chen ◽

...

Keyword(s):

Orthodontic Treatment ◽

Alveolar Bone ◽

Morphological Changes ◽

Strong Positive Correlation ◽

Anterior Teeth ◽

Bone Width ◽

Lateral Cephalograms ◽

Labial Side ◽

Incisor Retraction ◽

Maxilla And Mandible

Abstract Backgroud To analyze the morphological changes of the anterior alveolar bone after the retraction of incisors in premolar extraction cases and the relationship between incisor retraction and remodeling of the alveolar base represented by points A and B displacements. Methods Pre- (T0) and post-treatment (T1) lateral cephalograms of 308 subjects in the maxilla and 154 subjects in the mandible who underwent the orthodontic treatment with extraction of 2 premolars in upper or lower arches were included. Alveolar bone width and height in both the maxillary and mandible incisor area were measured at T0 and T1 respectively. By superimposing the T0 and T1 cephalometric tracings, changes of points A and B, and the movement of the incisors were also measured. Then the correlation between incisor movement and the displacements of points A and B was analyzed. Results The alveolar bone width (ABW) showed a significant decrease in both maxilla and mandible (P < 0.001) except the labial side of the mandible (P > 0.05). The alveolar bone height (ABH) showed a significant increase in the labial side of maxilla and a significant decrease in the lingual side of maxilla and mandible. A strong positive correlation was verified between incisor movement and position changes of points A and B in both horizontal and vertical directions. Conclusions Anterior alveolar bone width and height generally decreased after orthodontic treatment. Incisor retraction led to significant position changes of points A and B. The decrease of anterior alveolar bone due to significant incisor retraction should be taken into account in treatment planning.

Download Full-text

A radiological evaluation of alveolar bone regeneration between the left and right mandibles and maxillae of the Chacma baboon

Journal of the South African Veterinary Association ◽

10.4102/jsava.v87i1.1310 ◽

2016 ◽

Vol 87 (1) ◽

Cited By ~ 1

Author(s):

Marthinus J. Kotze ◽

Kurt-W. Bütow ◽

Steve A. Olorunju ◽

Harry F. Kotze

Keyword(s):

Healing Rate ◽

Alveolar Bone ◽

Sufficient Information ◽

Digital Radiology ◽

Grey Scale ◽

Lack Of Information ◽

Significant Difference ◽

Left And Right ◽

Maxilla And Mandible ◽

The Right

There is a lack of information in comparing the healing rate between the left and right sides of the maxilla and mandible. Osteogenesis of alveolar bone was evaluated with digital radiology by comparing differences in bone density (BD) at different time points within the left and right maxilla and mandible. Alveolar bone defects were created in five healthy Chacma baboons. Standardised x-ray images were acquired over time and the densities of the selected trauma areas were measured pre-operatively, post-operatively and at 3 and 6 weeks post-operatively. Differences in densities were statistically tested. There was no significant difference when the grey scale averages of the combined first and fourth quadrants (right side) and combined second and third quadrants (left side) were compared pre-operatively (t = 0.70), immediately post-operatively (t = 0.34), 3 weeks post-operatively (t = 0.40) and 6 weeks post-operatively (t = 0.66). There was also no significant difference between the values for the first and second quadrants (maxilla) pre-operatively (t = 0.37), immediately post-operatively (t = 0.30), 3 weeks post-operatively (t = 0.30) and 6 weeks post-operatively (t = 0.38); the third and fourth quadrants (mandible) were also not significantly different pre-operatively (t = 0.29), immediately post-operatively (t = 0.69), 3 weeks post-operatively (t = 0.07) and 6 weeks postoperatively (t = 0.06). However, the results showed an increased predisposition of the right side to regenerate faster than the left side and indicated sufficient information to investigate the effect of laterality and preferred side of mastication on the rate of healing and alveolar BD in the maxilla and mandible.

Download Full-text

The combination of miacalcic, calcium lactate, and vitamin C as postextracted alveolar bone resorption inhibitor

Dental Journal (Majalah Kedokteran Gigi) ◽

10.20473/j.djmkg.v43.i3.p141-145 ◽

2010 ◽

Vol 43 (3) ◽

pp. 141

Author(s):

Sri Kentjananingsih

Keyword(s):

Vitamin D ◽

Bone Density ◽

Bone Resorption ◽

Vitamin C ◽

Group Treatment ◽

Alveolar Bone ◽

Vitamin D Supplementation ◽

Calcium Lactate ◽

Control Group ◽

Significant Difference

Background: Tooth extraction can cause alveolar resorption, and will reduce the denture retention. The process of bone resorption looks like the process of osteoporosis. Calcium and vitamin D supplementation is the rational therapy for minimizing bone loss. Miacalcic is the drug of choice for osteporotic patient. Purpose: This study is aimed to know whether the combination of miacalcic, calcium lactate, and vitamin C are effective in inhibiting post extracted alveolar resorption. Methods: Thirty three healthy postmenopausal women were chosen as samples and they were classified randomly into control group (without treatment), 1st experiment group (treatment was started 3 months post extraction), and 2nd experiment group (treatment was started at the 2nd day post extraction). The treatment was done by giving miacalcic nasal spray, calcium lactate 500 mg and vitamin C 100 mg tablets every morning in 10 days every month for 3 months. X-ray photo of the post extracted area were taken an hour, 3 months, and 6 months post-extraction. Results: After 6 month, there was significant difference in buccolingual thickness decreasing among three groups (p<0.05). The maximum mean difference of buccolingual thickness decreasing was 0.72 mm, between control and 2nd experiment groups. There was no significant difference about decreasing bone density among them (p>0.10). The maximum difference of the mean of density decreasing was 1,906 g/cm2/mm between control and 2nd experiment groups. The increasing density mostly occurred in the 2nd experiment group. Conclusion: The combination of miacalcic, calcium lactate, and vitamin C are effective for inhibiting alveolar resorption, although statistically there was no significant difference about bone density decreasing. The sooner this treatment is given the better result will be achieved.Latar belakang: Pencabutan gigi menyebabkan resorpsi tulang alveolaris, dan akan mengurangi retensi geligi tiruan. Proses resorpsi tulang alveol pada osteoporosis mirip dengan proses resorpsi tulang pada penyembuhan luka bekas pencabutan. Miacalcic adalah obat utama untuk penderita osteoporosis. Kalsium dan vitamin D merupakan terapi yang rasional untuk meminimalkan resorpsi tulang. tujuan: Membuktikan apakah kombinasi miacalcic, kalsium laktat, and vitamin C juga efektif menghambat resorpsi tulang alveol pasca pencabutan. Metode: Sampel 33 wanita postmenopause yang sehat, terbagi secara acak ke dalam kelompok kontrol (tanpa perlakuan), kelompok eksperimen 1 (perlakuan mulai 3 bulan pasca pencabutan) dan kelompok eksperimen 2 (perlakuan mulai hari kedua pasca pencabutan). Perlakuannya yaitu: pemberian miacalcic semprot hidung, tablet kalsium laktat 500 mg dan vitamin C 100 mg setiap pagi, 10 hari dalam sebulan, selama tiga bulan. Foto sinar-X dari regio pasca pencabutan dibuat satu jam, 3 bulan, dan 6 bulan pasca pencabutan. Hasil: 6 bulan pasca-cabut, ada beda bermakna perihal selisih tebal bukolingual tulang alveol antar ketiga kelompok (p<0,05). Rerata penurunan ketebalan ini maksimal sebanyak 0.72 mm, antara kelompok kontrol dan kelompok eksperimen 2. Penurunan kepadatan tulang antar ketiga kelompok tidak bermakna (p>0,10). Beda maksimum rerata kepadatan tulang antara kelompok kontrol dan kelompok eksperimen 2 sebesar 1,906 g/cm2/mm. Peningkatan kepadatan terbanyak dialami anggota kelompok eksperimen 2. Kesimpulan: Kombinasi miacalcic, kalsium laktat, vitamin C efektif menghambat resorpsi tulang alveolaris, walaupun secara statistik beda penurunan kepadatan tidak bermakna. Makin awal pemberian perlakuan, hasilnya akan lebih baik.

Download Full-text

Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study

10.21203/rs.2.11278/v2 ◽

2019 ◽

Author(s):

Qiannan Sun ◽

Si Chen ◽

Wenhsuan Lu ◽

Yunfan Zhang ◽

Liying Peng ◽

...

Keyword(s):

Orthodontic Treatment ◽

Alveolar Bone ◽

Morphological Changes ◽

Vertical Direction ◽

Strong Positive Correlation ◽

Anterior Teeth ◽

Bone Width ◽

Lateral Cephalograms ◽

Labial Side ◽

Maxilla And Mandible

Abstract Background: The morphology of the anterior alveolar bone may change after the retraction of incisors in premolar extraction cases in orthodontics. Methods: Pre- (T0) and post-treatment (T1) lateral cephalograms of 477 subjects in the maxilla and 226 subjects in the mandible who underwent the orthodontic treatment with extraction of 2 premolars in upper or lower arches were included. Alveolar bone width and height in both the maxillary and mandible incisor area were measured at T0 and T1 respectively. By superimposing the T0 and T1 cephalometric tracings, changes of points A and B, and the movement of the incisors were also measured. Results: The alveolar bone width (ABW) showed a significant decrease in both maxilla and mandible (P<0.001) except the labial side of the mandible, which exhibited slight increase, though statistically insignificant (P>0.05). The alveolar bone height (ABH) showed a significant increase in the labial side of maxilla and a significant decrease in the lingual side of maxilla and mandible. A strong positive correlation was observed between incisor movement and position changes of points A and B both in the horizontal and vertical direction. Conclusions: Anterior alveolar bone width and height generally decreased after orthodontic treatment. Incisor retraction led to a significant position changes of points A and B.

Download Full-text

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

10.21203/rs.3.rs-402608/v1 ◽

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.

Download Full-text

Quantitative Analysis of the Relationship between Maxillary Incisors and the Incisive Canal by Cone-Beam Computed Tomography in an Adult Population of Mangaluru

Austin Journal of Dentistry ◽

10.26420/austinjdent.2021.1156 ◽

2021 ◽

Vol 8 (2) ◽

Author(s):

Vaishnavi D ◽

◽

Harshitha V ◽

Kishore K ◽

◽

...

Keyword(s):

Orthodontic Treatment ◽

Alveolar Bone ◽

Root Resorption ◽

Interindividual Variation ◽

Cone Beam ◽

Maxillary Incisor ◽

Incisive Canal ◽

Anterior Teeth ◽

Significant Difference ◽

Maxillary Incisors

Background: Maxillary anterior teeth play a crucial role in aesthetics, phonetics, and mastication. For successful orthodontic treatment evaluating the morphology of the alveolar bone and incisive canal would help in avoiding root resorption, dehiscence, and fenestration. This study is aimed to research the configurational relationships among maxillary incisors, alveolar bone, and incisive canal through Cone Beam Computerated Tomography (CBCT). Methods: CBCT images of 35 orthodontic patients were evaluated for length of the canal (L); angles between the palatal plane and the maxillary alveolar border (01),the incisive canal (02), and maxillary incisor (03); distance from the right maxillary incisor to the incisive canal (D). All the measurements were performed on sagittal plane with the exception of (D) which was made on axial plane. Statistical analysis was performed on the above parameters using two sample test and Pearson’s correlation analysis. Results: There was no statistically significant difference between males and females for all the variables although there were large interindividual variation. There was a positive moderate correlation between 01 and 02 (0.480), 01 and 03 (0.487), 02 and 03 (0.345). The mean value for L and D were 10.38mm and 4.14mm respectively. Conclusion: There exists a large interindividual variability for incisive canal, proximity of incisors with that of incisive canal which could not be precisely predicted by the conventional cephalograms. The results of the study could be helpful clinically in planning orthodontic treatment for significant intrusion and retraction of maxillary incisors

Download Full-text

Evaluation of sagittal root positions and bone perforation in anterior teeth using cone beam computed tomography–an observational study

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00169 ◽

2020 ◽

Author(s):

Raghavendra Shrishail Medikeri ◽

Dr. KumarAnkit Sinha ◽

Dr. Shruti Chandak ◽

Dr. Pratiksha Ghogare

Keyword(s):

Class I ◽

Mandibular Arch ◽

Implant Positioning ◽

Implant Placement ◽

Anterior Teeth ◽

Significant Difference ◽

Root Position ◽

Delayed Implant Placement ◽

Maxillary Arch ◽

Class Iv

CBCT and virtual implant helps the clinician in assessing the implant positioning with nearby vital structures and in planning the implant surgical procedures. Thus, the current study aims to evaluate the anterior sagittal root position and assess labial bone perforations in CBCT images. This study was carried out using CBCT scans of 140 samples involving 1338 teeth. The DICOM files were imported into Care stream 3D Imaging software for analysis. All measurements were made in the appropriate section slice of 200 micro thickness in a darkened room. A standardized orientation was established by two examiners. The sagittal root positions (SRP) were assessed in maxillary and mandibular anterior teeth.LabialBone perforation (LBP) was assessed usingtapered implants in the virtual implant software. Overall, Class I SRP was highest (81.48 % &amp; 38.49%) in both sextants. SRP class I was most prevalent in canine teeth in both arches (87.96% and 56.45%), followed by incisors in other types in maxillary arch. In mandibular arch, both incisors were in Class IV and I. The overall LBP was 4.26% and more likely in the mandibular arch (5.64%) than in the maxillary arch (2.8%). The mandibular central incisors showed the highest rate of perforation (8.5 &ndash; 11.93 %). The SRP and LBP did not show a statistically significant difference between right and left sides in both arches. The correlation coefficient between SRP and LBP showed a statistically significant results (p<0.01).Class I SRP was the most prevalent in maxillary and mandibular arches. Significantly more number of perforations occurred with mandibular anterior teeth and in Class IV SRP types (approx. 10-30 %) suggesting implant placement requires careful presurgical planning and regenerative approaches or delayed implant placement may be considered.

Download Full-text

Palatal Bone Density in Adult Subjects: Implications for Mini-Implant Placement

The Angle Orthodontist ◽

10.2319/011909-40.1 ◽

2010 ◽

Vol 80 (1) ◽

pp. 137-144 ◽

Cited By ~ 37

Author(s):

Sung Hee Moon ◽

Sun Hyung Park ◽

Won Hee Lim ◽

Youn Sic Chun

Keyword(s):

Bone Density ◽

Computed Tomographic ◽

Mini Implants ◽

Implant Placement ◽

Palatal Implant ◽

Significant Difference ◽

Incisive Foramen ◽

Palatal Bone ◽

Implant Anchorage ◽

Selection Of

Abstract Objectives: To evaluate palatal bone density to allow for better selection of palatal implant anchorage sites. Materials and Methods: Computed tomographic (CT) images were obtained from 15 males and 15 females (mean age, 27 years; range, 23–35 years). Bone density was measured in Hounsfield units (HU) at 80 coordinates at regular mediolateral and anteroposterior intervals along the midpalatal suture. Results: Bone densities ranged from 805 to 1247 HU. A significant difference between male and female groups was noted, although no difference was found between left and right sides of individual palates. Palatal bone densities showed a tendency to decrease laterally and posteriorly. The midpalatal area within 3 mm of the midsagittal suture had the densest bone in the entire palate. Conclusion: Results suggest that mini-implants for orthodontic anchorage may be effectively placed in most areas with bone density equivalent to the palatal area if they are placed from 3 mm posterior to the incisive foramen and 1 to 5 mm to the paramedian side.

Download Full-text

Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study

10.21203/rs.2.11278/v3 ◽

2019 ◽

Author(s):

Qiannan Sun ◽

Si Chen ◽

Wenhsuan Lu ◽

Yunfan Zhang ◽

Liying Peng ◽

...

Keyword(s):

Orthodontic Treatment ◽

Alveolar Bone ◽

Morphological Changes ◽

Vertical Direction ◽

Strong Positive Correlation ◽

Anterior Teeth ◽

Bone Width ◽

Lateral Cephalograms ◽

Labial Side ◽

Maxilla And Mandible

Download Full-text

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

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-8-6-57 ◽

2007 ◽

Vol 8 (6) ◽

pp. 57-63 ◽

Cited By ~ 6

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.

Download Full-text