The Journal of Advanced Prosthodontics

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Restoration-oriented anatomical analysis of alveolar bone at mandibular first molars and implications for immediate implant placement surgery: a CBCT study

  • Quan Shi (Department of Stomatology, The First Medical Center, Chinese PLA General Hospital) ;
  • Yang Huang (Department of Stomatology, The First Medical Center, Chinese PLA General Hospital) ;
  • Na Huo (Department of Stomatology, The First Medical Center, Chinese PLA General Hospital) ;
  • Yi Jiang (Department of Stomatology, The First Medical Center, Chinese PLA General Hospital) ;
  • Tong Zhang (Department of Stomatology, The First Medical Center, Chinese PLA General Hospital) ;
  • Juncheng Wang (Department of Stomatology, The First Medical Center, Chinese PLA General Hospital)
  • Received : 2024.03.19
  • Accepted : 2024.07.31
  • Published : 2024.08.31
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Abstract

PURPOSE. This cone-beam computed tomography (CBCT) study aimed to analyze the anatomical characteristics of alveolar bone at mandibular first molar (MFM) and their implications for immediate implant placement surgery. MATERIALS AND METHODS. 100 patients with 140 MFMs were reviewed retrospectively. We first performed a 3D reconstruction of the patient's CBCT data to determine a reference plane with ideal implant placement and orientation. The following parameters of MFM region were analyzed: mesial-distal socket size (MDSS), buccal-lingual socket size (BL-SS), root furcation fornix to inferior alveolar nerve (IAN) distance (RF-I), interradicular bone thickness (IRB), mesial/distal root apex to the IAN distance (MRA-I/DRA-I), thickness of the buccal/lingual bone of the mesial root (MR-B/MR-L), thickness of the buccal/lingual bone of the distal root (DR-B/DR-L). RESULTS. The MD-SS of MFM was 8.74 ± 0.76 mm, and the BLSS was 8.26 ± 0.72 mm. The MR-B, DR-B was 1.01 ± 0.40 mm and 1.14 ± 0.50 mm, and the difference was statistically significant (P = .001). The values of the MR-L, DR-L were 2.71 ± 0.78 mm and 3.09 ± 0.73 mm, and the difference was also statistically significant (P < .001). The mean distance of RF-I was 15.68 ± 2.13 mm, and the MRA-I was 7.06 ± 2.22 mm, which was greater than that of DRA-I (6.48 ± 2.30 mm, P < .001). The IRB at 2 mm, 4 mm apical from the furcation fornix, and at apex level was 2.81 ± 0.50 mm, 3.30 ± 0.62 mm, and 4.44 ± 1.02 mm, respectively. CONCLUSION. There is relatively sufficient bone mass in interradicular bone in height, but an adequate width is lacking for the bone between the mesial and distal root after the extraction of the MFM for immediate implantation. The thickness of the MFM buccal bone is relative thin, especially for the mesial root.

Keywords

Acknowledgement

This research was supported by the Military Health Care Project (22BJZ22) and Beijing Natural Science Foundation (L222109).

References

  1. Pjetursson BE, Bragger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res 2007;18 Suppl 3:97-113.
  2. Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000 2017;73:84-102.
  3. Blanco J, Carral C, Argibay O, Linares A. Implant placement in fresh extraction sockets. Periodontol 2000 2019;79:151-67.
  4. Baik UB, Jung JY, Jung HJ, Kim YJ, Chae HS, Park KS, Vaid NR, Nanda R. Alveolar bone changes after molar protraction in young adults with missing mandibular second premolars or first molars. Angle Orthod 2022;92:64-72.
  5. Saber AM, Altoukhi DH, Horaib MF, El-Housseiny AA, Alamoudi NM, Sabbagh HJ. Consequences of early extraction of compromised first permanent molar: a systematic review. BMC Oral Health 2018;18:59.
  6. ADA Division of Communications; Journal of the American Dental Association; ADA Council on Scientific Affairs. For the dental patient. Tooth eruption: the permanent teeth. J Am Dent Assoc 2006;137:127.
  7. Chrcanovic BR, de Carvalho Machado V, Gjelvold B. Immediate implant placement in the posterior mandible: a cone beam computed tomography study. Quintessence Int 2016;47:505-14.
  8. Haj Yahya B, Chaushu G, Hamzani Y. Computed tomography for the assessment of the potential risk after implant placement in fresh extraction sites in the posterior mandible. J Oral Implantol 2021;47:2-8.
  9. Sayed AJ, Shaikh SS, Shaikh SY, Hussain MA, Tareen SUK, Awinashe V. Influence of inter-radicular septal bone quantity in primary stability of immediate molar implants with different length and diameter placed in mandibular region. a cone-beam computed tomography-based simulated implant study. J Pharm Bioallied Sci 2021;13(Suppl 1):S484-91.
  10. Padhye NM, Shirsekar VU, Bhatavadekar NB. Three-dimensional alveolar bone assessment of mandibular first molars with implications for immediate implant placement. Int J Periodontics Restorative Dent 2020;40:e163-7.
  11. Garcia-Sanchez R, Dopico J, Kalemaj Z, Buti J, Pardo Zamora G, Mardas N. Comparison of clinical outcomes of immediate versus delayed placement of dental implants: a systematic review and meta-analysis. Clin Oral Implants Res 2022;33:231-77.
  12. Donos N, Asche NV, Akbar AN, Francisco H, Gonzales O, Gotfredsen K, Haas R, Happe A, Leow N, Navarro JM, Ornekol T, Payer M, Renouard F, Schliephake H. Impact of timing of dental implant placement and loading: Summary and consensus statements of group 1-The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021;32 Suppl 21:85-92.
  13. Becker W. Immediate implant placement: diagnosis, treatment planning and treatment steps/or successful outcomes. J Calif Dent Assoc 2005;33:303-10.
  14. Lee W. Immediate implant placement in fresh extraction sockets. J Korean Assoc Oral Maxillofac Surg 2021;47:57-61.
  15. Saltzburg N, Kang P. Observed healing of an immediately placed implant in a molar site without bone replacement graft or primary closure. Compend Contin Educ Dent 2020;41:326-30.
  16. Gober DD, Fien MJ. Flapless extraction socket healing around an immediate implant placed into a mandibular molar site without the use of regenerative materials: a case report. Int J Periodontics Restorative Dent 2016;36:e26-32.
  17. Sayed AJ, Shaikh SS, Shaikh SY, Hussain MA. Inter radicular bone dimensions in primary stability of immediate molar implants - a cone beam computed tomography retrospective analysis. Saudi Dent J 2021;33:1091-7.
  18. Ragucci GM, Elnayef B, Criado-Camara E, Del Amo FS, Hernandez-Alfaro F. Immediate implant placement in molar extraction sockets: a systematic review and meta-analysis. Int J Implant Dent 2020;6:40.
  19. Rebele SF, Zuhr O, Hurzeler MB. Pre-extractive interradicular implant bed preparation: case presentations of a novel approach to immediate implant placement at multirooted molar sites. Int J Periodontics Restorative Dent 2013;33:89-96.
  20. Scarano A. Traditional postextractive implant site preparation compared with pre-extractive interradicular implant bed preparation in the mandibular molar region, using an ultrasonic device: a randomized pilot study. Int J Oral Maxillofac Implants 2017;32:655-60.
  21. Crespi R, Cappare P, Crespi G, Lo Giudice G, Gastaldi G, Gherlone E. Immediate implant placement in sockets with asymptomatic apical periodontitis. Clin Implant Dent Relat Res 2017;19:20-7.