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Affendi NHK, Babiker J, Mohd Yusof MYP. CBCT assessment of alveolar bone wall morphology and its correlation with tooth angulation in the anterior mandible: a new classification for immediate implant placement. J Periodontal Implant Sci 2023; 53:453-466. [PMID: 37038832 PMCID: PMC10761280 DOI: 10.5051/jpis.2105000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 04/03/2023] Open
Abstract
PURPOSE This study aimed to quantify alveolar bone morphology, demonstrate the relationship between tooth angulation and alveolar bone thickness, and introduce a new classification for anterior mandibular teeth related to immediate implant placement (IIP). METHODS Cone-beam computed tomography (CBCT) images of 211 anterior mandibular teeth were analyzed in sagittal slices to measure the thickness of the facial alveolar bone crest (FAB1) and apex (FAB2), and the lingual alveolar bone crest (LAB1) and apex (LAB2). Tooth angulation was classified as 1°-10°, 11°-20°, and >20° according to the tooth's long axis and alveolar bone wall. Spearman correlation coefficients were used to evaluate correlations between the variables. RESULTS FAB1 and LAB1 were predominantly thin (<1 mm) (84.4% and 73.4%, respectively), with the lateral incisors being thinnest. At the apical level, FAB2 and LAB2 were thick in 99.5% and 99.1% of cases, respectively. Significant differences were documented in FAB2 (P=0.004), LAB1 (P=0.001), and LAB2 (P=0.001) of all mandibular teeth. At all apical levels of the inspected teeth, a significant negative correlation existed between TA and FAB2. Meanwhile, TA showed a significant positive correlation with LAB2 of the lateral incisors and canines. These patterns were then divided into class I (thick facial and lingual alveolar bone), class II (facially inclined teeth) with subtype A (1°-10°) and subtype B (11°-20°), and class III (lingually inclined teeth) with subtype A (1°-10°) and subtype B (11°-20°). CONCLUSIONS Mandibular anterior teeth have predominantly thin facial and lingual crests, making the lingual bone apical thickness crucial for IIP. Although anchorage can be obtained from lingual bone, tooth angulation and tooth types had an impact on IIP planning. Hence, the new classification based on TA and alveolar bone wall may enable rational clinical planning for IIP treatment.
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Affiliation(s)
- Nur Hafizah Kamar Affendi
- Unit of Prosthodontics, Centre of Restorative Dentistry Studies, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Kampus Sungai Buloh, Jalan Hospital, Selangor, Malaysia.
| | - Jumanah Babiker
- Faculty of Dentistry, Universiti Teknologi MARA(UiTM), Kampus Sungai Buloh, Jalan Hospital, Selangor, Malaysia
| | - Mohd Yusmiaidil Putera Mohd Yusof
- Centre of Oral & Maxillofacial Diagnostics & Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Kampus Sungai Buloh, Jalan Hospital, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Selangor, Malaysia
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2
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Yang H, Xu L, Jiang J, Xu Y, Li X, He F. Clinical effect of Nobel Biocare angulated screw channel crown compared with cement crown in the aesthetic area: A retrospective cohort study with a mean 32 months follow-up (range 12 to 70 months). Clin Implant Dent Relat Res 2023; 25:1178-1186. [PMID: 37605302 DOI: 10.1111/cid.13264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/17/2023] [Accepted: 07/29/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE The objective of this study is to compare the clinical efficacy of angulated screw channel abutment applied in the anterior area with regular cemented crowns. MATERIALS AND METHODS Forty-eight patients were included and divided into two groups: the angulated screw channel group (ASC) and regular cemented group (RC) in this retrospective cohort study. The evaluation criteria included implant/restoration survival rate, keratinized mucosa width (KMW), bleeding on probing rate (BOP%), probing depth (PD), pink aesthetic score (PES), mechanical/biological complications, emergence angle (EA), the site of implant axis penetrate (SA), marginal bone loss (MBL), and buccal bone thickness (BBT) at 0 mm, 1 mm, 3 mm, 5 mm below the implant shoulder were evaluated in immediate postoperative (T0) and follow-up period (T1). RESULTS This retrospective cohort study included a total of 48 patients, with a mean 32 months follow-up period range from 12 months to 70 months. The study did not find any cases of implant failure or restoration failure. EA was significantly wider in the RC group than ASC group (RC: 33.53° ± 8.36° vs ASC: 27.43° ± 8.08°, p = 0.016*). While the BOP% was statistically significant higher in the RC group than ASC group (RC: 28.35% ± 22.92% vs ASC: 13.18% ± 20.00%, p = 0.027*). No significant differences were observed in the other measurements of comparison. CONCLUSION Within the limitations of the study, angulated screw channel (Nobel Biocare) crowns might allow the implant axis aim at incisal edge to reduce the emergence angle in the anterior area and benefit the soft-tissue during the 12-70 months follow-up period.
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Affiliation(s)
- Hang Yang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Lehan Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jimin Jiang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Yuzi Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Xiaojun Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Disease of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
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Araújo MG, Dias DR, Matarazzo F. Anatomical characteristics of the alveolar process and basal bone that have an effect on socket healing. Periodontol 2000 2023; 93:277-288. [PMID: 37533162 DOI: 10.1111/prd.12506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 08/04/2023]
Abstract
Following tooth extraction, a sequence of events takes place in order to close the wound and restore tissue homeostasis, a process called socket healing. The outcome of socket healing includes a marked reduction of the ridge dimensions. The amount of tissue loss that occurs during healing is influenced by several local and systemic factors. Thus, the aim of the present review was to describe the effect of anatomical characteristics of the alveolar process and basal bone on the socket healing outcome. The studies included showed that the quantity (number) and quality (composition) of socket walls exhibited a significant influence on the ridge diminution. A damaged socket (3 walls or less), as well as a thin buccal bone wall, which quickly resorbs negatively affected the healing outcome. Periodontally compromised sockets appeared to promote more extensive dimensional changes. Angulation between tooth and basal bone in addition to basal bone dimensions may also have altered the wound environment and influenced socket healing. The findings from the present review suggest that some anatomical characteristics of the alveolar process and basal bone have an effect on socket healing.
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Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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AlAli F, Atieh MA, Hannawi H, Jamal M, Harbi NA, Alsabeeha NHM, Shah M. Anterior Maxillary Labial Bone Thickness on Cone Beam Computed Tomography. Int Dent J 2023; 73:219-227. [PMID: 35527034 PMCID: PMC10023538 DOI: 10.1016/j.identj.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/26/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
AIM The objective of this research was to measure the labial bone thickness (LBT) in relation to the 6 anterior maxillary teeth at different levels along the long axis and the distance between cementoenamel junction and bone crest (CEJ-BC) based on cone beam computed tomography (CBCT) scans retrieved from patients of Arab ethnicity and identify any association with patients' characteristics. MATERIALS AND METHODS A total of 100 CBCT scans were evaluated by one calibrated examiner. The thickness of the labial bone was measured perpendicular to the long axis of the tooth at 1, 3, and 5 mm from the alveolar crest (LBT-1, LBT-3, and LBT-5, respectively) and CEJ-BC using a medical imaging viewer. RESULTS CBCT scans of 58 female patients and 42 male patients with a mean age of 39.7 ± 9.5 years were included. A high variation of CEJ-BC was observed (range, 0.55-3.90 mm). Statistically significant higher CEJ-BC values were associated with men and increased age (>50 years). The overall means of LBT-1 were 0.76 ± 0.26, 0.79 ± 0.26, and 0.83 ± 0.37 mm; LBT-3: 0.92 ± 0.36, 1.05 ± 0.46, and 1.03 ± 0.48 mm; LBT-5: 1.17 ± 0.52, 0.80 ± 0.45, and 0.81 ± 0.40 mm for central incisors, lateral incisors, and canines, respectively. The LBT was <1 mm in 74.2% of all maxillary anterior teeth, with central incisors showing the highest predilection (85% with LBT <1 mm). No significant association between LBT and patient characteristics was observed. CONCLUSIONS The CEJ-BC distance is greater in men and increases with age, particularly in those aged 50 years and older. The LBT in the 6 maxillary anterior teeth is predominantly thin (<1 mm) and has no correlation to age or sex. An increased LBT was observed at a 3-mm level when compared with LBT-1 and LBT-5. Such variability should be taken into consideration when planning for implant placement.
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Affiliation(s)
- Fawaghi AlAli
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | - Momen A Atieh
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates; Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Haifa Hannawi
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates; Emirates Health Services, Dubai, United Arab Emirates
| | - Mohamad Jamal
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates
| | | | | | - Maanas Shah
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Healthcare City, Dubai, United Arab Emirates.
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5
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Todorovic VS, Postma TC, Hoffman J, van Zyl AW. Buccal and palatal alveolar bone dimensions in the anterior maxilla: A micro-CT study. Clin Implant Dent Relat Res 2023; 25:261-270. [PMID: 36596566 DOI: 10.1111/cid.13175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Anterior maxillary immediate implant placement has become a popular procedure. It has aesthetic and functional risks. A prerequisite for success is sufficient alveolar bone for primary stability. Many cone-beam computed tomography (CBCT) studies have assessed alveolar bone dimensions in the anterior maxilla, with varying results. More accurate information on the alveolar bone dimensions in the anterior maxilla is required. The objective of the present study was to evaluate bone dimensions in the anterior maxilla using micro-CT, a high-resolution imaging tool. MATERIALS AND METHODS Seventy-two human skulls were scanned using micro-CT at the South African Nuclear Energy Corporation. Specialized software was used for 3-D rendering, segmentation, and visualization of the reconstructed volume data. Axial planes were created over each alveolus/tooth from canine to canine. Buccal and palatal bone dimensions were measured at crestal, 3 mm, 6 mm, and 9 mm levels. RESULTS Buccal bone rarely exceeded 0.5 mm, consisting of bundle bone only for all investigated teeth at all levels. Up to a third of teeth showed buccal fenestrations. Alveolar bone on the palatal side was thicker than buccal and increased from <1 mm at crestal level up to 3.77 mm, 4.56 mm, and 5.43 mm for centrals, laterals, and canines at the 9 mm level, respectively. CONCLUSIONS Immediate implants in the anterior maxillae has anatomical risks. Alveolar bone on the buccal aspect is very thin, with fenestrations in certain positions. Therefore, a thorough planning and individual approach are needed to avoid possible complications and achieve stable aesthetic and functional results in the long-term.
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Affiliation(s)
- Vladimir S Todorovic
- School of Dental Medicine, University of Belgrade, Belgrade, Serbia.,Department of Periodontics and Oral Medicine, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Thomas C Postma
- Department of Dental Management Sciences, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Jakobus Hoffman
- Necsa (The South African Nuclear Energy Corporation), Pretoria, South Africa
| | - Andre W van Zyl
- Private Practice, Western Cape, South Africa.,Department of Oral Medicine and Periodontology, University of Pretoria, Pretoria, South Africa
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Song SJ, Chu SM, Chu SJ, Saito H, Levin BP, Egbert NL, Sarnachiaro GO, Tarnow DP. A comparative analysis of dual-axis implants placed into maxillary anterior extraction sockets versus virtual planning with uniaxial implants: A simulated cone beam computed tomography study of implant length and diameter. J ESTHET RESTOR DENT 2023; 35:206-214. [PMID: 36628940 DOI: 10.1111/jerd.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The biaxial nature of the anterior maxilla poses a surgical and restorative challenge in implant dentistry. The present study sought to investigate the apical socket perforation rate (ASPR) from a simulated uniaxial implant placement and to determine the effect of implant length and diameter on ASPR when a uniaxial implant was placed compared with the orientation of the pre-existing dual-axis implant. MATERIAL AND METHOD Cone beam computed tomography (CBCT) scans from the database of three private practices were searched for patients who received dual-axis implants within the esthetic zone in immediate tooth replacement therapy. A uniaxial implant was virtually placed using the pre-existing screw access channel of the dual-axis implant as a reference. The closest length and diameter were selected for the simulated implant. ASPR by the uniaxial implant was recorded. In addition, the affordable maximum length of a corresponding uniaxial implant that would avoid apical socket perforation was measured. RESULT Eighty-one patients with a total of 101 dual-axis dental implants were selected for analysis. A simulated virtual surgical planning with uniaxial implants revealed high ASPR (48.51%). When the length of the uniaxial implant was reduced to 11 and 9 mm, ASPR was decreased to 41.58% and 20.79%, respectively. CONCLUSION Dual-axis implant design effectively evades anatomical challenges in the anterior maxilla (esthetic zone). Considering the current evidence, efforts should be made to carefully consider the angular disparity between the extraction socket-alveolus complex and the future restorative emergence so that a harmonious biologic-esthetic result may be more predictably and consistently obtained.
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Affiliation(s)
- Seung Jun Song
- Division of Prosthodontics, Columbia University College of Dental Medicine, New York, New York, USA
| | - Stephanie M Chu
- Post-Graduate Periodontics, New York Harbor Healthcare System, US Department of Veterans Affairs, New York, New York, USA.,Private Practice
| | - Stephen J Chu
- Private Practice.,Ashman Department of Periodontology and Implant Dentistry, Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
| | - Hanae Saito
- Department of Advanced Sciences & Therapeutics, Division of Periodontics, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - Barry P Levin
- Private Practice.,Department of Periodontology, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania, USA
| | - Nicholas L Egbert
- Private Practice.,General Dentistry (AEGD) Residency, College of Dental Medicine at Roseman University of Health Sciences, South Jordan, Utah, USA
| | - Guido O Sarnachiaro
- Private Practice.,Ashman Department of Periodontology and Implant Dentistry, Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
| | - Dennis P Tarnow
- Private Practice.,Division of Periodontics, Columbia University College of Dental Medicine, New York, New York, USA
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Lin Y, Shi M, Xiang D, Zeng P, Gong Z, Liu H, Liu Q, Chen Z, Xia J, Chen Z. Construction of an end-to-end regression neural network for the determination of a quantitative index sagittal root inclination. J Periodontol 2022; 93:1951-1960. [PMID: 35150132 DOI: 10.1002/jper.21-0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/18/2021] [Accepted: 02/01/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Immediate implant placement in the esthetic area requires comprehensive assessments with nearly 30 quantitative indexes. Most artificial intelligence (AI)-driven measurements of quantitative indexes depend on segmentation or landmark detection, which require extra labeling of images and contain possible intraclass errors. METHODS For the initial attempt, the method was tested on sagittal root inclination measurement. This study had developed an accurate and efficient end-to-end model incorporating a convolutional neural network (CNN) based on unlabeled cone-beam computed tomography (CBCT) images for immediate implant placement diagnosis and treatment. The model took pretrained ResNeXt101 as the backbone and was constructed based on 2,920 CBCT images with corresponding angles of the tooth axis and bone axis. The performance of our CNN model was evaluated on a separate test set. RESULTS Our model exhibited high prediction accuracy in sagittal root inclination measurements, as evidenced by the low mean average error of 2.16°, the high correlation coefficient of 0.915 to manual measurement, and the narrow 95% confidence interval shown by Bland-Altman plots. The intraclass correlation coefficient further confirmed the measurement accuracy of our model was comparable with that of junior clinicians. The model took merely 0.001 seconds for each CBCT image, making it highly efficient. To better understand the model's quality, we visualized our end-to-end CNN model through Guided Backpropagation, Grad-CAM, and Guided Grad-CAM, and confirmed its effectiveness in region recognition. CONCLUSIONS We succeeded in taking the first step in constructing the end-to-end immediate implant placement AI tool through sagittal root inclination measurements without intermediate steps and extra labeling on images.
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Affiliation(s)
- Yixiong Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Mengru Shi
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Dawei Xiang
- School of Mathematics, Sun Yat-sen University, Guangzhou, China
| | - Peisheng Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhuohong Gong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Haiwen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Quan Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Juan Xia
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
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Thickness of the Buccal and Alveolar Bones Overlying Central Incisors: A Radiographic Iraqi Study. ScientificWorldJournal 2022; 2022:7226998. [PMID: 35185395 PMCID: PMC8849938 DOI: 10.1155/2022/7226998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/22/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background. Initial bone thickness has a substantial impact on the success of dental implant treatments. The objective of the current study was to analyze the thickness of the buccal and alveolar bone at the central incisors using CBCT in relation to gender and side to determine the anatomical features and choose the best implant treatment option for minimizing the surgical complications. Methods. One hundred CBCT images were investigated (50 females and 50 males, aged 20 to 50 years old). The buccal bone thickness and alveolar bone thickness were evaluated for right and left sides of each subject at three sites; C: crest (3 mm); M: middle (6 mm); A: apical (9 mm) from the cementoenamel junction. Results. The mean thickness of buccal bone was less than 2 mm on the incisors according to side and gender. Buccal bone thickness revealed a statistically significant difference between right and left sides at the apical point in both females and males with
values of (
) and (0.001), respectively. The buccal bone thickness displayed statistically significant differences between genders at all sites. The alveolar thickness demonstrated similar significant differences between genders except for the crest site. Conclusions. Iraqi participants had about 1 mm buccal bone thickness at 3 mm apical from the CEJ in right and left central incisors with a progressive rise in bone thickness to be less than 2 mm at the apex. Alveolar bone also showed the same increase in bone thickness from crest to apex. Bone thickness was greater in males than females. The present study provided valuable CBCT data on bone thickness of the esthetic maxillary region as a preoperative analysis for establishing an immediate implant treatment plan with aesthetically pleasing long-term outcomes.
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Shi M, Wang X, Zeng P, Liu H, Gong Z, Lin Y, Li Z, Chen Z, Chen Z. 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. BMC Oral Health 2021; 21:494. [PMID: 34607581 PMCID: PMC8491410 DOI: 10.1186/s12903-021-01848-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/19/2021] [Indexed: 12/04/2022] Open
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.
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Affiliation(s)
- Mengru Shi
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Xiaoshuang Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Peisheng Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Haiwen Liu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhuohong Gong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yixiong Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
- Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China
| | - Zhipeng Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
| | - Zetao Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
- Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, China.
| | - Zhuofan Chen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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Shafizadeh M, Tehranchi A, Shirvani A, Motamedian SR. Alveolar bone thickness overlying healthy maxillary and mandibular teeth: A systematic review and meta-analysis. Int Orthod 2021; 19:389-405. [PMID: 34366263 DOI: 10.1016/j.ortho.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To systematically review and meta-analyse the Alveolar Bone Thickness (ABT) overlying healthy teeth. The secondary objective was to review the association of ABT with gender, age, and smoking. MATERIALS AND METHODS The PubMed, Embase, Scopus, ProQuest, Web of Science, and Cochrane Library databases were searched up to July 2020. English articles (sample size≥10) which had used CT or CBCT to measure the ABT at clearly defined reference points were included. The maximum likelihood approach meta-analysis was used to estimate the means (95% CIs). RESULTS A total of 68 articles were included. The meta-analysis results were as follows: In the anterior maxilla, the mean labial plate thickness ranged from 0.42-1.75mm, while it was thicker for the posterior teeth (0.78-4.31mm). The palatal plate thickness ranged from 0.97-8.13mm. In the anterior mandible, the thickness of labial and lingual plates ranged from 0.4-3.71mm and 0.38-5.44mm, respectively. The alveolar bone was thicker for the posterior teeth both at the labial (0.66-6.31mm) and lingual (2.31-7.77mm) sides. Meta-regression revealed a significant relationship between gender and ABT at several points. There was a controversy regarding the association of ABT with age. No significant difference was evidenced between smokers and non-smokers. CONCLUSIONS This study presents a clear image of the alveolar bone structure. Since it has pooled ABT values from various populations, outcomes could be acknowledged as global averages. Therefore, it could provide perspective for several dental procedures, including orthodontic treatments and immediate implant placement.
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Affiliation(s)
- Marziyeh Shafizadeh
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Azita Tehranchi
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Armin Shirvani
- Department of Orthodontics, School of Dentistry, Dental Research Centre, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran
| | - Saeed Reza Motamedian
- Dentofacial Deformities Research Centre, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran; Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran.
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Alqhtani N, Alqahtani F, Almalki A, Alanazi A, Alkhuriaf H, Alkhtani F, AlEnazi A. Relationship between buccal alveolar bone thickness and crown-to-root dimensions around mandibular first and second molars: A cone-beam-computed tomography-based study. Technol Health Care 2020; 29:725-733. [PMID: 33185619 DOI: 10.3233/thc-202587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Assessment of buccal alveolar bone thickness (ABT) and crown-to-root dimensions are essential in implant density; therefore, three-dimensional evaluation of these parameters provides a superior visualization than conventional radiographs. OBJECTIVE The present cross-sectional cohort study aims to investigate the relationship between buccal ABT and crown-to-root dimensions around the mandibular first and second molars using cone-beam-computed tomography (CBCT). METHODS Initially, CBCT-based scans from 271 individuals were assessed. Based on the inclusion and exclusion criteria, 171 CBCT-based scans were excluded. In total, 100 CBCT-scans were included in the present investigation and processed for data extraction. On the mandibular first and second molars, the mesial and distal root lengths and mesiodistal diameter of the crowns were measured. The pulpal floor served as a reference point for assessment of root length. The buccal ABT was measured at the coronal, middle and apical one-third of the root. Statistical analysis was performed and the level of significance was set at P< 0.01. One-hundred CBCT-scans from 294 mandibular teeth (137 first molars and 157 second molars) were included. One hundred and eighty-nine and 105 teeth were from males and females, respectively. RESULTS The normality plot showed a normal data distribution. The mesiodistal crown width showed a weak yet significant correlation with mesial root length (r= 0.137), bone thickness at mesial apical third (r= 0.180), distal apical (r= 0.157) and distal coronal third (r= 0.161). Bone thickness at mesial, middle and apical third correlated significantly with one other (r= 0.786). CONCLUSION There is a direct correlation between the buccal ABT and tooth dimensions around the mandibular first and second molars.
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Affiliation(s)
- Nasser Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Fawaz Alqahtani
- Department of Prosthodontics, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Abdulrahman Almalki
- College of Dentistry, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Ahmed Alanazi
- College of Dentistry, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Hamad Alkhuriaf
- College of Dentistry, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Fahad Alkhtani
- Department of Prosthodontics, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
| | - Adel AlEnazi
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, School of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi-Arabia
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12
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Tsigarida A, Toscano J, Brito Bezerra B, Geminiani A, Barmak AB, Caton J, Papaspyridakos P, Chochlidakis K. Buccal bone thickness of maxillary anterior teeth: A systematic review and meta‐analysis. J Clin Periodontol 2020; 47:1326-1343. [DOI: 10.1111/jcpe.13347] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Alexandra Tsigarida
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Jeremy Toscano
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Beatriz Brito Bezerra
- Advanced Education Program in General Dentistry UCLA School of Dentistry Los Angeles CA USA
| | - Alessandro Geminiani
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Abdul B. Barmak
- Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Jack Caton
- Department of Periodontology Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Panos Papaspyridakos
- Division of Postgraduate Prosthodontics Tufts University School of Dental Medicine Boston MA USA
- Department of Prosthodontics Eastman Institute for Oral Health University of Rochester Rochester NY USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics Eastman Institute for Oral Health University of Rochester Rochester NY USA
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Jeon KJ, Lee C, Choi YJ, Han SS. Anatomical analysis of mandibular posterior teeth for endodontic microsurgery: a cone-beam computed tomographic evaluation. Clin Oral Investig 2020; 25:2391-2397. [PMID: 32901333 DOI: 10.1007/s00784-020-03562-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/01/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze the anatomical structures relevant for endodontic microsurgery in the mandibular posterior teeth using a cone-beam computed tomography (CBCT). MATERIAL AND METHODS A total of 963 mandibular posterior teeth were analyzed in CBCT scans from 133 patients. The buccolingual and mesiodistal dimensions of the root and the buccal bone thickness overlying the root were measured at the site of root resection (apical 3 mm). At this location, the relationship between the buccal cortical bone and root was classified into three types (separated, contact, and exposed), and the distance from the root apex to the mandibular canal was measured. RESULTS The thickest buccolingual dimension of the roots was found in the mesial roots of first molars, at 5.59 ± 0.97 mm. The buccal bone thickness overlying the root became thicker in posterior tooth locations. In the first premolar and first molar mesial root, contact was the most common type of relationship between the buccal cortical bone and root. As the position of the teeth became more posterior, the distance from the apex to the mandibular canal became shorter. CONCLUSIONS As the position of the teeth became more posterior, the buccal bone thickness increased and the distance to the mandibular canal became closer; therefore, particular attention is required for posterior teeth. The first premolar and the first molar mesial root are often in contact with the buccal cortical bone, which may allow infections to spread to the buccal structure more easily and negatively affect for post-surgical healing. CLINICAL RELEVANCE When planning and performing endodontic microsurgery, understanding the anatomical structure of the surgical site will help minimize tissue damage and reduce complications.
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Affiliation(s)
- Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, Korea.
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