Abstract

Background This study used CBCT images to evaluate the suitability of maxillary first and second molar sites to receive immediate implants. Buccopalatal and mesiodistal widths of maxillary molar inter-radicular septum were evaluated at three different levels (crestal, middle, and apical), in addition to assessments of the root apex and furcation proximities to the sinus floor and comparisons of these measurements between the first and second upper molar sites before extraction.Methods A total of 427 dental sites from 223 patients were used to measure the buccopalatal and mesiodistal widths of inter-septal/furcal (IRS) bone of maxillary first and second molars and vertical distances from the furcation and from all the root apices to the sinus floor (SF).Results Mean coronal-most buccopalatal/mesiodistal IRS widths were 7.33/6.52 mm for the first and 6.86/5.85 mm for the second molars (P=0.008). Corresponding mean FSD (furcation-sinus floor) values were 9.69 mm (range: 2.02-24.68 mm) and 8.84 mm (range: 1.48-25.09 mm). Mean distances from all the root apices to SF were <3 mm. The palatal roots of the first molars had higher sinus intrusion rates (28.85%) than their buccal counterparts, while for the second molars, the mesiobuccal roots showed the highest sinus intrusion (37.65%).Conclusion In the current patient sample, 61.7% of the first and 34% of the second molars had a sufficiently broad IRS to encase a 5-mm-diameter IMI (immediate molar implant) completely. The mean FSD of 9 mm for both molars indicated that some sinus floor elevation would likely be needed unless short implants were used.

Highlights

  • Cone-beam computed tomographic (CBCT) scans are universally considered the gold standard for implant site assessment and treatment planning.[1]

  • Regarding mesiodistal widths of inter-radicular septal bone (IRS), the mean crestal (CMDD), middle (MMDD), and apical (AMDD) values for maxillary first molars were 6.52, 6.17, and 5.22 mm, respectively, compared to the corresponding values for second molars (5.85, 5.34, and 3.97 mm); and, once again all these parameters were significantly different between the two molar sites (P=0.014, P

  • It was of interest for us to estimate the percentage of molar IRS values that could be classified as Types A, B, and C

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Summary

Introduction

Cone-beam computed tomographic (CBCT) scans are universally considered the gold standard for implant site assessment and treatment planning.[1] These three-dimensional cross-sectional images help the surgeon optimize implant positioning and avoid complications.[2] The placement of dental implants at the time of tooth extraction (immediate implantation) was introduced in 1989 by Lazzara[3] and is widely used. The advantages of this approach include a reduction in the number of surgical interventions and overall treatment times. Keen interest has developed in employing immediate maxillary mo-

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