Risk Assessment of Lingual Plate Perforation in Anterior Edentulous Mandibular Region: A Virtual Implant Placement Study Using Cone-Beam Computed Tomography.

Abstract

The aim of this study was to evaluate the prevalence of lingual cortical bone perforation caused by virtually placed implants on cone-beam computed tomography images in the edentulous mandibular canine region and determine the relationship between the morphological structure of the crest and the risk of perforation. Eight hundred dental implants were virtually inserted on 100 qualified cone-beam computed tomography scans. Crests were divided into 4 groups according to the crest morphology as Type U, Type L, Type P, and Type C. The distance between the implant tip and lingual plate was measured using a digital caliper. Incidence of lingual plate perforation and proximity of the implant tip to the lingual plate were measured for 4 types of the alveolar crest. A total of 800 virtual implant applications were performed in 100 patients who met the inclusion criteria. The incidence of lingual plate perforation was found to be significantly higher in Type U crests than in the other types. It was also found to be statistically significantly higher in Type L crests than in Type P and Type C crests. When the relationship between implant length and perforation was evaluated, perforation in 14 mm implants was significantly higher than 8, 10, and 12 mm implants. According to the results of this study, it was determined that high rates of perforation occurred in the U and L type crests and 14 mm implants during implant surgery in the mandibular anterior edentulous region.