Alveolar Bone Morphology and variations in the Maxillary Central incisor (MCI) in CBCT Scans for Immediate Implant Treatment Planning – A Pilot Study

Author: Shah Rohit, Kamble Seema, ChaudhariAmit, Vaishnav Kalpesh, Mitra Dipika and Surve Neha

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Abstract

Implants have been widely used to restore missing teeth. The success of implant placement in this region can be influenced by various factors, including the anatomical considerations specific to this area. In the current study, Cone Beam Computerized Tomography (CBCT) was used to measure alveolar ridge and buccal undercut dimensions at the maxillary central incisors in the local population for immediate implant treatment planning (IIP). CBCT scans were screened in 150 subjects with full dentition at maxilla. Measurements were taken at the cross sectional views: Buccolingual width at crest and at apex, apico-coronal height, angulation of tooth in socket, thickness of labial bony plate and thickness of palatal bony plate at crest, middle and at apex, location of buccal undercut, buccal undercut depth and the percentage of teeth showing buccal undercuts were measured. Mean buccolingual width at crest and at apex was 6.23 and 7.39. Mean apico-coronal height was found to be 15.412. Mean thickness of labial bony plate at crest, at middle and at apex is 0.91, 0.67, 1.618. Mean thickness of palatal bony plate at crest, at middle and at apex is 1.21, 3.28 and 6.01. Mean Angulation within the socket is 8.21. Mean buccal undercut location is 4.99. Mean buccal undercut depth is 1.32. The maximum percentage of undercuts was seen in females at 26%. Our study showed statistically significant differences between different age-groups and genders for parameters: Bucco-lingual width at apex., thickness of palatal bony plate at middle, Thickness of palatal bony plate at apex and Angulation within socket. Also, statistically significant differences between males and females in Buccal undercut depth. (p value <0.05). This study showed that the quality of maxillary bone in the local population around maxillary central incisors was compromised and deficient as compared to other populations and requires careful preoperative treatment planning including augmentation procedures to successfully manage the same. There is a wide variance in the dimensions of the alveolar bone amongst different ethnicities, population, age and gender groups and hence it is difficult to standardize surgical drilling protocols. Precautions and suitable modifications need to be undertaken when placing implants in this region because of its varied anatomy and a detailed study of the ridge based on the parameters is a prerequisite to avoid potential complications and failures.

Keywords

Dental implant, Immediate placement, CBCT, Maxillary Central Incisors, Esthetics

Conclusion

This study showed that the quality of maxillary bone in the local study population around maxillary central incisors was compromised and deficient as compared to other populations and requires careful preoperative treatment planning to successfully manage the same. Implants that are commercially available appear to be oversized and not always dimensionally suitable for the deficient bone around the maxillary central incisors in our local population. This study emphasizes the importance of measuring a host of parameters in the CBCT scan for predictable treatment planning in the esthetic zone. This research gives an insight about the measurements, quantity and quality of bone around the maxillary central incisor in our study population. More research is needed to print customized implant sizes, personalized specific membranes and bone scaffolds for bone augmentation for application in immediate implant placement in aesthetic areas in our local study population.

References

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How to cite this article

Shah Rohit, Kamble Seema, ChaudhariAmit, Vaishnav Kalpesh, Mitra Dipika and Surve Neha (2023). Alveolar Bone Morphology and variations in the Maxillary Central incisor (MCI) in CBCT Scans for Immediate Implant Treatment Planning – A Pilot study. Biological Forum – An International Journal, 15(4): 854-860.