The Relevance of the Use of Radiographic Planning in Order to Avoid Complications in Mandibular Implantology: A Retrospective Study
Identifieur interne : 006792 ( Ncbi/Merge ); précédent : 006791; suivant : 006793The Relevance of the Use of Radiographic Planning in Order to Avoid Complications in Mandibular Implantology: A Retrospective Study
Auteurs : Gilberto Sammartino [Italie] ; Juan Carlos Prados-Frutos [Espagne] ; Francesco Riccitiello [Italie] ; Pietro Felice [Italie] ; Vincenzo Cerone [Italie] ; Roberta Gasparro [Italie] ; Hom-Lay Wang [États-Unis]Source :
- BioMed Research International [ 2314-6133 ] ; 2016.
Abstract
The aim of this retrospective radiological study was to evaluate the variability of the mandibular anatomy in the presence and absence of teeth and to consider how it could influence implant planning. 187 mandibular CT DentaScans were selected from our department archive according to the inclusion criteria. The axial height, vertical height, angulation of the bone crest, and the bone available for ideal implant placement were measured. The analysis of the data shows that the mandible contour presents a constant degree of angulation. The variation of angulation in the absence of teeth was statistically significant only in the region between the canine and the first premolar and in that between the second premolar and the first molar. The difference between the crest height and the available distance to place the implant was greater in the region of the second molar while in the other regions the implant planning was made complex by postextraction resorption. Alveolar bone resorption after tooth loss can be considered as a risk factor for lingual cortical perforation during the insertion of an implant. To avoid potential intra/postoperative complications, 3D radiographic examination is recommended in order to study the mandibular anatomy and identify the risk areas.
Url:
DOI: 10.1155/2016/8175284
PubMed: 27294136
PubMed Central: 4880709
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<front><div type="abstract" xml:lang="en"><p>The aim of this retrospective radiological study was to evaluate the variability of the mandibular anatomy in the presence and absence of teeth and to consider how it could influence implant planning. 187 mandibular CT DentaScans were selected from our department archive according to the inclusion criteria. The axial height, vertical height, angulation of the bone crest, and the bone available for ideal implant placement were measured. The analysis of the data shows that the mandible contour presents a constant degree of angulation. The variation of angulation in the absence of teeth was statistically significant only in the region between the canine and the first premolar and in that between the second premolar and the first molar. The difference between the crest height and the available distance to place the implant was greater in the region of the second molar while in the other regions the implant planning was made complex by postextraction resorption. Alveolar bone resorption after tooth loss can be considered as a risk factor for lingual cortical perforation during the insertion of an implant. To avoid potential intra/postoperative complications, 3D radiographic examination is recommended in order to study the mandibular anatomy and identify the risk areas.</p>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Biomed Res Int</journal-id>
<journal-id journal-id-type="iso-abbrev">Biomed Res Int</journal-id>
<journal-id journal-id-type="publisher-id">BMRI</journal-id>
<journal-title-group><journal-title>BioMed Research International</journal-title>
</journal-title-group>
<issn pub-type="ppub">2314-6133</issn>
<issn pub-type="epub">2314-6141</issn>
<publisher><publisher-name>Hindawi Publishing Corporation</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27294136</article-id>
<article-id pub-id-type="pmc">4880709</article-id>
<article-id pub-id-type="doi">10.1155/2016/8175284</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>The Relevance of the Use of Radiographic Planning in Order to Avoid Complications in Mandibular Implantology: A Retrospective Study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Sammartino</surname>
<given-names>Gilberto</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Prados-Frutos</surname>
<given-names>Juan Carlos</given-names>
</name>
<xref ref-type="aff" rid="I2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Riccitiello</surname>
<given-names>Francesco</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Felice</surname>
<given-names>Pietro</given-names>
</name>
<xref ref-type="aff" rid="I3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cerone</surname>
<given-names>Vincenzo</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gasparro</surname>
<given-names>Roberta</given-names>
</name>
<xref ref-type="aff" rid="I1"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor1"><sup>*</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wang</surname>
<given-names>Hom-Lay</given-names>
</name>
<xref ref-type="aff" rid="I4"><sup>4</sup>
</xref>
</contrib>
</contrib-group>
<aff id="I1"><sup>1</sup>
Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples, Via Pansini 5, Edificio 14, 80131 Naples, Italy</aff>
<aff id="I2"><sup>2</sup>
Stomatology Department, Rey Juan Carlos University, Madrid, Spain</aff>
<aff id="I3"><sup>3</sup>
Department of Periodontology and Implantology, University of Bologna, Bologna, Italy</aff>
<aff id="I4"><sup>4</sup>
School of Dentistry, University of Michigan, Ann Arbor, MI, USA</aff>
<author-notes><corresp id="cor1">*Roberta Gasparro: <email>roberta.gasparro88@gmail.com</email>
</corresp>
<fn fn-type="other"><p>Academic Editor: Ayhan Cömert</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>12</day>
<month>5</month>
<year>2016</year>
</pub-date>
<volume>2016</volume>
<elocation-id>8175284</elocation-id>
<history><date date-type="received"><day>21</day>
<month>12</month>
<year>2015</year>
</date>
<date date-type="rev-recd"><day>17</day>
<month>3</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>11</day>
<month>4</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2016 Gilberto Sammartino et al.</copyright-statement>
<copyright-year>2016</copyright-year>
<license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>The aim of this retrospective radiological study was to evaluate the variability of the mandibular anatomy in the presence and absence of teeth and to consider how it could influence implant planning. 187 mandibular CT DentaScans were selected from our department archive according to the inclusion criteria. The axial height, vertical height, angulation of the bone crest, and the bone available for ideal implant placement were measured. The analysis of the data shows that the mandible contour presents a constant degree of angulation. The variation of angulation in the absence of teeth was statistically significant only in the region between the canine and the first premolar and in that between the second premolar and the first molar. The difference between the crest height and the available distance to place the implant was greater in the region of the second molar while in the other regions the implant planning was made complex by postextraction resorption. Alveolar bone resorption after tooth loss can be considered as a risk factor for lingual cortical perforation during the insertion of an implant. To avoid potential intra/postoperative complications, 3D radiographic examination is recommended in order to study the mandibular anatomy and identify the risk areas.</p>
</abstract>
</article-meta>
</front>
<floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>Regions of interest.</p>
</caption>
<graphic xlink:href="BMRI2016-8175284.001"></graphic>
</fig>
<fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label>
<caption><p>(a) The distance between the most coronal and medial point of the ridge and the lowest point along the axis of the crest; (b) the height from the most coronal and medial point of the ridge to the projection of the lowest point on the perpendicular to the CT reference plane; (c) the angle between the axis of the crest and the line perpendicular to the CT reference plane.</p>
</caption>
<graphic xlink:href="BMRI2016-8175284.002"></graphic>
</fig>
<fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label>
<caption><p>(a) The distance between the most coronal and medial point of the ridge and the lowest point along the axis of the crest; (b) the available distance to place the implant.</p>
</caption>
<graphic xlink:href="BMRI2016-8175284.003"></graphic>
</fig>
<fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label>
<caption><p>(a) The distance from the most coronal and medial point of the ridge to the inferior alveolar nerve; (b) the available distance for implant positioning.</p>
</caption>
<graphic xlink:href="BMRI2016-8175284.004"></graphic>
</fig>
<fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label>
<caption><p>Different ranges of angulation.</p>
</caption>
<graphic xlink:href="BMRI2016-8175284.005"></graphic>
</fig>
<table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label>
<caption><p>Angulation means revealing statistically significant difference between the canine-first premolar region and second premolar-first molar region relating to the presence or absence of teeth.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Presence of teeth</th>
<th align="center" rowspan="1" colspan="1">Absence of teeth</th>
<th align="center" rowspan="1" colspan="1"><italic>P</italic>
value</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Symphysis</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 111) 9.26 ± 6.63</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 76) 11.07 ± 8.84</td>
<td align="center" rowspan="1" colspan="1">0.374</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Canine-first premolar</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 270) 7.43 ± 4.77</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 104) 10.96 ± 4.99</td>
<td align="center" rowspan="1" colspan="1">0.000632</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Second premolar-first molar</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 252) 9.38 ± 5.38</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 122) 12.49 ± 5.94</td>
<td align="center" rowspan="1" colspan="1">0.000617</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Distal site of second molar</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 178) 16.06 ± 5.99</td>
<td align="center" rowspan="1" colspan="1">(<italic>n</italic>
= 196) 16.37 ± 7.47</td>
<td align="center" rowspan="1" colspan="1">0.768</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label>
<caption><p>Difference between the axial height and the available distance at the level of symphysis revealing similarity in both groups (presence or absence of teeth). </p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Presence of teeth</th>
<th align="center" rowspan="1" colspan="1">Absence of teeth</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Axial height</td>
<td align="center" rowspan="1" colspan="1">28.23 ± 5.32</td>
<td align="center" rowspan="1" colspan="1">26.84 ± 4.67</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Available distance</td>
<td align="center" rowspan="1" colspan="1">24.54 ± 4.73</td>
<td align="center" rowspan="1" colspan="1">22.90 ± 3.78</td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Difference</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>3.69</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>3.94</italic>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label>
<caption><p>Difference between the axial height and the available distance at the level of the canine-first premolar.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Presence of teeth</th>
<th align="center" rowspan="1" colspan="1">Absence of teeth</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Axial height</td>
<td align="center" rowspan="1" colspan="1">27.12 ± 3.62</td>
<td align="center" rowspan="1" colspan="1">24.22 ± 4.13</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Available distance</td>
<td align="center" rowspan="1" colspan="1">23.45 ± 4.50</td>
<td align="center" rowspan="1" colspan="1">19.66 ± 3.93</td>
</tr>
<tr><td align="center" colspan="3" rowspan="1"><hr></hr>
</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>Difference</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>3.67</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>5.30</italic>
</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap-group id="tab4" orientation="portrait" position="float"><label>Table 4</label>
<caption><p>(a) Difference between the nerve distance and the available distance in the presence of teeth. (b) Difference between the nerve distance and the available distance in the absence of teeth.</p>
</caption>
<table-wrap id="tab4a" orientation="portrait" position="anchor"><label>(a)</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Distance from the nerve (mm)</th>
<th align="center" rowspan="1" colspan="1">Available distance (mm)</th>
<th align="center" rowspan="1" colspan="1">Difference</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Regions 5-6 (252 samples)</td>
<td align="center" rowspan="1" colspan="1">16.94 ± 4.17</td>
<td align="center" rowspan="1" colspan="1">14.83 ± 3.55</td>
<td align="center" rowspan="1" colspan="1">2.11</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Region 7 (178 samples)</td>
<td align="center" rowspan="1" colspan="1">15.10 ± 3.93</td>
<td align="center" rowspan="1" colspan="1">12.64 ± 4.21</td>
<td align="center" rowspan="1" colspan="1">2.46</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="tab4b" orientation="portrait" position="anchor"><label>(b)</label>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Distance from the nerve (mm)</th>
<th align="center" rowspan="1" colspan="1">Available distance (mm)</th>
<th align="center" rowspan="1" colspan="1">Difference</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">Regions 5-6 (122 samples)</td>
<td align="center" rowspan="1" colspan="1">14.32 ± 3.45</td>
<td align="center" rowspan="1" colspan="1">12.16 ± 3.56</td>
<td align="center" rowspan="1" colspan="1">2.16</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">Region 7 (196 samples)</td>
<td align="center" rowspan="1" colspan="1">12.6 ± 4.11</td>
<td align="center" rowspan="1" colspan="1">10.44 ± 3.72</td>
<td align="center" rowspan="1" colspan="1">2.16</td>
</tr>
</tbody>
</table>
</table-wrap>
</table-wrap-group>
<table-wrap id="tab5" orientation="portrait" position="float"><label>Table 5</label>
<caption><p>The proposed classification of mandibular angulation based upon the potential risk of lingual plate perforation.</p>
</caption>
<table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1"> </th>
<th align="center" rowspan="1" colspan="1">Angle</th>
<th align="center" rowspan="1" colspan="1">Risk assessment</th>
</tr>
</thead>
<tbody><tr><td align="left" rowspan="1" colspan="1">LMI</td>
<td align="center" rowspan="1" colspan="1"><10°</td>
<td align="center" rowspan="1" colspan="1">Low risk</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1">MMI</td>
<td align="center" rowspan="1" colspan="1">10° < angle < 17°</td>
<td align="center" rowspan="1" colspan="1">Medium risk</td>
</tr>
<tr><td align="left" rowspan="1" colspan="1"><italic>HMI</italic>
</td>
<td align="center" rowspan="1" colspan="1"><italic>>17</italic>
°</td>
<td align="center" rowspan="1" colspan="1"><italic>High risk</italic>
</td>
</tr>
</tbody>
</table>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Espagne</li>
<li>Italie</li>
<li>États-Unis</li>
</country>
<region><li>Communauté de Madrid</li>
<li>Michigan</li>
</region>
<settlement><li>Madrid</li>
</settlement>
</list>
<tree><country name="Italie"><noRegion><name sortKey="Sammartino, Gilberto" sort="Sammartino, Gilberto" uniqKey="Sammartino G" first="Gilberto" last="Sammartino">Gilberto Sammartino</name>
</noRegion>
<name sortKey="Cerone, Vincenzo" sort="Cerone, Vincenzo" uniqKey="Cerone V" first="Vincenzo" last="Cerone">Vincenzo Cerone</name>
<name sortKey="Felice, Pietro" sort="Felice, Pietro" uniqKey="Felice P" first="Pietro" last="Felice">Pietro Felice</name>
<name sortKey="Gasparro, Roberta" sort="Gasparro, Roberta" uniqKey="Gasparro R" first="Roberta" last="Gasparro">Roberta Gasparro</name>
<name sortKey="Riccitiello, Francesco" sort="Riccitiello, Francesco" uniqKey="Riccitiello F" first="Francesco" last="Riccitiello">Francesco Riccitiello</name>
</country>
<country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Prados Frutos, Juan Carlos" sort="Prados Frutos, Juan Carlos" uniqKey="Prados Frutos J" first="Juan Carlos" last="Prados-Frutos">Juan Carlos Prados-Frutos</name>
</region>
</country>
<country name="États-Unis"><region name="Michigan"><name sortKey="Wang, Hom Lay" sort="Wang, Hom Lay" uniqKey="Wang H" first="Hom-Lay" last="Wang">Hom-Lay Wang</name>
</region>
</country>
</tree>
</affiliations>
</record>
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