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Abstract
Background. The aims of this study were to investigate the ridge contour anterior to the nasopalatine canal, and the difference between the incidences of the nasopalatine canal perforation in dentate and partially edentulous patients by cone-beam computed tomography.Methods. Cone-beam computed tomography scan images from 72 patients were selected from database and divided into dentate and partially edentulous groups. The configuration of the ridge anterior to the canal including palatal concavity depth, palatal concavity height, palatal concavity angle, bone height coronal to the incisive foramen, and bone width anterior to the canal was measured. A virtual implant placement procedure was used, and the incidences of perforation were evaluated after implant placement in the cingulum position with the long axis along with the designed crown.Results. Comparing with variable values from dentate patients, the palatal concavity depth and angle were greater by 0.9 mm and 4°, and bone height was shorter by 1.1 mm in partially edentulous patients, respectively. Bone width in edentulous patients was narrower than in dentate patients by 1.2 mm at incisive foramen level and 0.9 mm at 8 mm subcrestal level, respectively. After 72 virtual cylindrical implants (4.1 × 12 mm) were placed, a total of 12 sites (16.7%) showed a perforation and three-fourths occurred in partially edentulous patients. After replacing with 72 tapered implants (4.3 × 13 mm), only 6 implants (8.3%) broke into the canal in the partially edentulous patient group.Conclusions. The nasopalatine canal may get close to the implant site and the bone width anterior to the canal decreases after the central incisor extraction. The incidence of nasopalatine canal perforation may occur more commonly during delayed implant placement in central incisor missing patients.
Highlights
Dental implant restoration has become a very common treatment in dental practices (Chung et al, 2009; Fugazzotto, Vlassis & Butler, 2004; Scheller et al, 1998)
Patients and images selected for this study had to fulfill the following inclusion criteria: (1) Chinese adults with either full teeth of anterior maxillary sextant or missing one maxillary central incisor in this sextant; (2) the present maxillary anterior teeth without obvious crowding or spacing; (3) no deep (>3 mm) overbite or increased (>3 mm) overjet in the anterior teeth area; (4) at least two pairs of posterior teeth which could be retained with occlusal contact on each side; (5) complete Cone-beam computed tomography (CBCT) scanning of premaxilla and nasopalatine canal (NPC) with clear images without scattering artifacts
Patients and images were excluded if: (1) both maxillary central incisor were present but the amount of alveolar bone loss exceeded one third of root length; (2) unhealed extraction sockets and the period after extraction was within 6 months; (3) any socket preservation procedures were performed in the missing maxillary central incisor sites; (4) both maxillary central incisors were missing; (5) alveolar ridge height of implant site was less than 14 mm or the ridge width was less than 3.5 mm at the level of 2 mm below the bone crest
Summary
Dental implant restoration has become a very common treatment in dental practices (Chung et al, 2009; Fugazzotto, Vlassis & Butler, 2004; Scheller et al, 1998). The implant placement is always based on a restorative-driven philosophy (Garber & Belser, 1995) According to this concept, the three-dimensional ideal implant position has been described (Buser, Martin & Belser, 2004; Funato et al, 2007; Grunder, Gracis & Capelli, 2005; Su et al, 2010; Tarnow, Cho & Wallace, 2000). The aims of this study were to investigate the ridge contour anterior to the nasopalatine canal, and the difference between the incidences of the nasopalatine canal perforation in dentate and partially edentulous patients by cone-beam computed tomography. The incidence of nasopalatine canal perforation may occur more commonly during delayed implant placement in central incisor missing patients
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