Lateral cephalometric analysis of patients with maxillary alveolar protrusion and advanced periodontitis treated with immediate implants and cross-arch fixed prostheses

Abstract

Objective: To investigate the changes of the lateral cephelometric landmarks of soft tissue and hard tissue of patients with maxillary alveolar protrusion and advanced periodontitis treated with immediate implants and cross-arch fixed prostheses. Methods: From January 2013 to October 2016, consecutive patients with advanced periodontitis and maxillary alveolar protrusion in need of immediate implants and cross-arch fixed prostheses were included in this study. All the patients were treated with provisional cross-arch fixed prostheses supported with 4 to 6 immediate implants after extraction of all the residual teeth and reduction of excessive alveolar bone. After 6 months, a final cross-arch fixed prosthesis was delivered. The lateral cephalometric landmarks of soft tissue and hard tissue at the time of pre-operation and final prosthesis delivery were analyzed. The change of patients' facial aesthetics was assessed using visual analogue scale (VAS). Results: Ten patients were included in the study. All the patients underwent full arch rehabilitation of both jaws supported by a total of 89 dental implants. In the maxillae, the average number of inserted implants were 4.5. The mean height of alveolar bone reduction was (6.3±1.8) mm. Both the distance of U1-NA (the upper incisor to nasion-A point line) and U1-PP (the upper incisor to palatal plane) were significantly reduced by (5.5±2.7) mm and (1.6±1.2) mm, respectively. The angle of U1-SN (between upper incisor to sella-nasion line) was reduced by 9.6°±8.1°palatally. The nasolabial angles were significantly increased by 10.5°±6.4°. Both the patients and dentists considered that the facial aesthetics was improved greatly after the treatment. Conclusions: With the reduction of excessive alveolar bone and the realignment of artificial teeth, the treatment of immediate implants and cross-arch fixed prostheses could improve the facial aesthetics of the patients with advanced periodontitis and maxillary alveolar protrusion.