Abstract
BackgroundThis study investigated the prevalence of labial bone perforation (LBP) related to the associated anatomic factors in anterior mandibular region using a virtual immediate implant placement procedure.MethodsSeries qualified CBCT images of 149 participants (894 teeth) were selected to analyze the assigned anatomical parameters, including concavity depth, concavity angle, torque, and deep bone thickness. Four classes of crestal and radicular dentoalveolar bone phenotypes (CRDAPs) of mandibular anterior teeth were categorized according to the thickness of dentoalveolar bone at both crestal and radicular zones. Data were adjusted for categorical (gender and CRDAP) and continuous (age, cavity angle, cavity depth, and deep bone thickness) variables using a multivariable logistic regression analysis with generalized estimating equation method.ResultsThe overall probability of LBP after virtual implant placement was 21.6%. There is statistically significant higher prevalence of LBP at canine (28.5%) and CRDAP class II (29.2%) regions (p < 0.001). After adjusting confounding variables, CRDAP class II and class IV regions are more likely to have LBP when compared with CRDAP class I (control) regions (p < 0.01). The risk of LBP at canine site is 6.31 times more likely than at the central incisor (control) (p < 0.01).ConclusionsUsing a virtual immediate implant placement technique, the prevalence of LBP is significantly higher at the mandibular canine site and thin radicular dentoalveolar phenotype in the anterior mandibular region.
Highlights
Placing an implant immediately into an extraction socket is still believed to be a techniquesensitive procedure, even though high survival and success rates of immediate implant treatment have been reported [1,2,3]
The purpose of this study was to investigate the prevalence of crestal and radicular dentoalveolar bone phenotype (CRDAP) and evaluate anatomic factors contributing to the prospect of labial bone perforation (LBP) in the anterior mandibular region using a virtual immediate implant placement in cone beam computed tomography (CBCT) images
Frequency distribution of labial bone perforation (LBP) The overall probability of LBP of all investigated teeth was 21.6% (193 teeth), and the LBP was most likely to occur in canines (85 teeth; 28.5%) when compared with central and lateral incisors (Table 2)
Summary
Placing an implant immediately into an extraction socket is still believed to be a techniquesensitive procedure, even though high survival and success rates of immediate implant treatment have been reported [1,2,3]. With regard to anatomic risks during immediate implant placement, many regions of interest have been studied previously [10,11,12,13,14,15]. In the anterior maxilla region, labial bone deficiency, and the particular relationship between teeth and alveolar process may increase the risk of perforation of the facial cortical bone [10, 11, 17]. Soft tissue recession for the thin labial bone thickness of anterior maxillary teeth potentially compromised the esthetic outcomes [13, 18, 19]. This study investigated the prevalence of labial bone perforation (LBP) related to the associated anatomic factors in anterior mandibular region using a virtual immediate implant placement procedure
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