Classification of the Root Position of the Maxillary Central Incisors and its Clinical Significance in Immediate Implant Placement

Xu, Duoling; Wang, Zhao; Sun, Lei; Lin, Zhenyan; Wan, Linzi; Li, Yang; Lin, Xuan; Wei, Pengcheng; Zhang, Zuyan; Gao, Yongbo

doi:10.1097/id.0000000000000438

Cited by 30 publications

(51 citation statements)

References 17 publications

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“…Several studies have investigated the root position of the maxillary central incisors in the alveolar bone and have reported that the buccal type was the predominant incisor root position. 2 5 14 15 16 In our study, the buccal type of root position was identified in more than 90% of cases and the palatal type was found in only 2 cases (5%) of the lateral incisors, similar to the results of previous reports. 5 14 16 …”

Section: Discussionsupporting

confidence: 91%

“…During immediate placement, the direction of placement more or less coincided with the long axis of the tooth. 14 17 In our study, buccal subtype I accounted for 64.3% of the central incisors and 8.0% of the lateral incisors. The buccal subtype II incisors had a thinner buccal bone wall than buccal subtype I, and immediate placement was more challenging than in patients with subtype I in such cases.…”

Section: Discussionmentioning

confidence: 50%

“…The buccal subtype II incisors had a thinner buccal bone wall than buccal subtype I, and immediate placement was more challenging than in patients with subtype I in such cases. 14 The buccal subtype III teeth not only had a very thin buccal plate, but the axis of the root apex was also angulated very buccally, passing anterior to the natural contour of the maxillary alveolar bone. 2 Therefore, patients with a subtype III root position may not be suitable for immediate placement.…”

Section: Discussionmentioning

confidence: 99%

“…The root position of the maxillary incisor in the alveolar bone was evaluated according to the position of the apex. 14 The root position of the incisors was classified as follows: buccal type, the apical point of the incisor was within the buccal third of the alveolar bone and the root was closer to the buccal bone wall; middle type, the apical point of the incisor was within the middle third of the alveolar bone and the buccal and palatal bone walls were approximately equal in thickness; and palatal type, the apical point of the incisor was within the palatal third of the alveolar bone and the root was closer to the palatal bone wall ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

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Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography

Jung

Hwang

2017

Imaging Sci Dent

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PurposeThe purpose of this study was to measure the buccal bone thickness and angulation of the maxillary incisors and to analyze the correlation between these parameters and the root position in the alveolar bone using cone-beam computed tomography (CBCT).Materials and MethodsCBCT images of 398 maxillary central and lateral incisors from 199 patients were retrospectively reviewed. The root position in the alveolar bone was classified as buccal, middle, or palatal, and the buccal type was further classified into subtypes I, II, and III. In addition, the buccolingual inclination of the tooth and buccal bone thickness were evaluated.ResultsA majority of the maxillary incisors were positioned more buccally within the alveolar bone, and only 2 lateral incisors (0.5%) were positioned more palatally. The angulation of buccal subtype III was the greatest and that of the middle type was the lowest. Most of the maxillary incisors exhibited a thin facial bone wall, and the lateral incisors had a significantly thinner buccal bone than the central incisors. The buccal bone of buccal subtypes II and III was significantly thinner than that of buccal subtype I.ConclusionA majority of the maxillary incisor roots were positioned close to the buccal cortical plate and had a thin buccal bone wall. Significant relationships were observed between the root position in the alveolar bone, the angulation of the tooth in the alveolar bone, and buccal bone thickness. CBCT analyses of the buccal bone and sagittal root position are recommended for the selection of the appropriate treatment approach.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography

Jung

Hwang

2017

Imaging Sci Dent

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“…This risk dramatically increases through the combination of immediate implant placement, flapless surgeries, and limited clinical experience. In these cases, the shape of the socket, and the change in resistance between the buccal and the palatal bone, may substantially influence accurate implant positioning . Recession of the facial mucosal margin was a common observation in several studies with immediate implant placement .…”

Section: Soft Tissue Complications Deriving From Improper Placement Omentioning

confidence: 99%

Soft tissue‐related complications and management around dental implants

Chackartchi

Romanos

Sculean

2019

Periodontology 2000

100

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Implant installation to replace missing teeth is a frequent treatment procedure in daily practice. Despite the well documented high success and survival rates of this medical procedure, 1 complications may still arise. The commonly accepted criteria for the assessment of implant success were proposed by Albrektsson and colleagues, 2 to identify clinical evidence of successful osseointegration and survival of implants. Over the past 3 decades, implant success has been assessed by survival rates, continuous prosthesis stability, radiographic bone loss, and absence of infection in the peri-implant soft tissues. 2-4 Since then, new parameters have been introduced to assess success according to current advances in contemporary oral implantology. Patients' high treatment expectations underline the necessity for more comprehensive definition of success criteria for implant/prosthodontics procedures. 5 These include health status and natural-looking peri-implant soft tissues, as well as prosthodontic parameters, esthetics, and patient satisfaction. 6 It became evident that implant survival rates per se, without consideration of a clinical outcome that reports on the implant/prosthodontic complex as a whole rather than its individual aspects, are no longer sufficient to assess the clinical efficacy of current implant-prosthetic methodologies. However, osseointegration remains the predominant parameter in implant dentistry. It thus seems reasonable that the current definition of success criteria should be comprehensive and should include these additional factors. 7-10 Esthetics also plays an important role in contemporary dentistry, underscoring the necessity for the inclusion of more factors in the success criteria assessment for implant prostheses. The focus has shifted from implant survival to the creation of life-like implant restorations with natural-looking peri-implant soft tissues, thus acknowledging the importance of the patient's satisfaction with the final result. For the assessment of esthetic outcomes, objective criteria like the pink esthetic score and the white esthetic score have been proposed, but they do not reflect the patient's subjective opinion about the outcome of therapy. 7,10 It became apparent that the clinician's objective evaluation and the patient's subjective perception of a successful outcome may not necessarily agree, 11 but should be aligned when assessing immediate and long-term treatment outcomes.

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The influence of maxillary incisor angles on the stress distributions of temporomandibular joints under incisal biting

Shao

Chong

et al. 2023

Numer Methods Biomed Eng

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Background and Objective: The incisal biting was one of the most regular jaw activities. The direction of bite force on the incisor tip and the mandible position were relevant to the incisor angle as biting. This study was carried out to explore the influence on the temporomandibular joint (TMJ) caused by the incisor angle. Methods: Twenty individuals belonging to three incisor subtypes of the buccal type were recruited. In addition, the 3D models including the maxillary, mandible and discs were established based on their cone-beam computed tomography and magnetic resonance imaging scannings. Then, the mandibular ligaments and the discal attachments were simulated in the finite element models to analyze the stress distributions of the TMJs under incisal biting. Results:The TMJ stresses of subtype I showed normal range and distribution. The stresses of the intermediate temporal bone tended to increase in subtype II. The intermediate and posterior bands of the discs sustained greater tensile stresses in subtype III.Conclusions: Abnormal stress distributions are harmful to TMJs, so the incisor cusp was not suggested to incline to the palatal side too much. K E Y W O R D Sfinite element analysis (FEA), incisal biting, incisor angles, maxillary incisor, temporomandibular joint (TMJ)

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Classification of the Root Position of the Maxillary Central Incisors and its Clinical Significance in Immediate Implant Placement

Abstract: In Chinese adults, the predominant type of sagittal root position of the maxillary central incisor is buccal. This classification system is useful in planning the implant site for immediate placement in the maxillary esthetic zone.

Cited by 30 publications

References 17 publications

Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography

Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography

Soft tissue‐related complications and management around dental implants

The influence of maxillary incisor angles on the stress distributions of temporomandibular joints under incisal biting

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