Relevant factors of posterior mandible lingual plate perforation during immediate implant placement: a virtual implant placement study using CBCT

Abstract

Background To explore the influence of cross-sectional type and morphological parameters at the mandibular molar sites on lingual plate perforation (LPP) during the immediate implant placement (IIP). Methods 181 implants were virtually placed in the mandibular molar sites on the cone beam computed tomography (CBCT). Each cross-section of the implantation site was divided into the Undercut (U)/Parallel (P)/Convex (C) types. Morphologically relevant parameters were measured on the cross-sections, including width of the upper end (Wb), width of the lower end (Wc), vertical height (V), angle between the natural crown axis and the alveolar bone axis (∠β), LC depth (LCD), LC height, and angle between the horizontal line and the line connecting the most prominent point and the most concave point of lingual plate (∠α). Besides, the distance from the end of the virtual implant and the lingual bone plate of the cross-section (DIL) was calculated. Relationships between all the morphologically relevant parameters and the DIL were further analyzed. Results A total of 77 (42.5%) cross-sections were classified as U-type, which was the most common one, accounting for 63% of the second molar regions. All LPP cases and most of the nearly LPP (87.9%) cases occurred at the U-type cross-sections, and the relationship between the DIL and the morphological parameters can be expressed by a multivariate linear equation. Conclusions The occurrence rate of U-type cross-sections in the second molar region was very high, and the risk of LPP should be considered during IIP. Except for the U-type, significant large LCD, small Wc, and large ∠β were the important relevant factors. CBCT and multivariate linear equations could help to assess the LPP risk and provide a reference for implant placement design pre-surgery.

Quantitative and qualitative 3D analysis of mandibular lingual concavities: Implications for dental implant planning in the posterior mandible

“…The most prevalent ridge types in the present study are type C in the first molar region and type U in the second molar region, a matter that necessitates paying emphasis and special care while placing dental implants in the second molar region. Huang et al ( 2015 ) and Sun et al ( 2023 ) supported such findings. Exactly the opposite, the most prevalent ridge type in Tan et al ( 2021 ) and Watanabe et al ( 2010 ) studies was type C in the first and second molar areas.…”

“…A comprehensive understanding of mandibular lingual concavities and their variations is paramount in implant dentistry (Bodart et al, 2020 ; Nawwar, 2022 ; Sun et al, 2023 ; Tan et al, 2021 ; Yoon et al, 2017 ). These concavities are crucial in determining the success and longevity of dental implants in the mandibular arch.…”

Incidental Findings Following Dental Implants Procedures in Mandible: A New Post-processing CBCT Software Analysis

“…The posterior region of the mandible, due to the presence of the inferior alveolar nerve and the submandibular fossa, represents a high-risk zone during implant installation, due to the potential for injury to the neurovascular bundle and perforation of the lingual cortex [16,17]. Inadvertent manipulation of the lingual cortex can cause arterial damage, leading to subsequent hematoma formation in the submandibular and sublingual spaces [18][19][20].…”

“…Perforations in adjacent teeth can cause endodontic injuries and lead to the development of chronic pathologies [13]. Injuries to the incisive canal or accessory neurovascular canals can result in neurosensory disturbances and pain [17,21].…”

Accuracy in osteotomy drilling using a new universal and disposable drill-stop device for dental implant drills: an in vitro study using a bovine rib model

“…This increased use of dental implants for the aesthetic and functional rehabilitation of tooth loss increases the risk of iatrogenic injury. In this regard, to ensure the correct performance of osteotomies in the maxilla and to carry out safe and effective implant treatments, it is essential that clinicians receive surgical training in implant dentistry, as well as adequate pre-surgical planning [5]. There are numerous factors that can in uence the development of an incorrect ostectomy: radiological discrepancies in the pre-surgical study, factors associated to the implantologist (anxiety, lack of practice, errors in planning), and factors associated to the patient (nervousness that can cause involuntary movements, saliva or blood that impede the visibility of the depth marks on the surgical drills, and having low bone density that facilitates over-drilling due to lack of resistance from the bone) [6].…”