sdj-10101

Characterization of Mandibular First Molar Extraction Space for Dental Implant Placement Using CBCT Imaging – A Retrospective Analysis

Dler A. Khursheed *

*Department of Periodontics, College of Dentistry, Sulaimani University, Sulaimani, Iraq.

Submitted: 10/01/2020; Accepted: 24/01/2020; Published 01/06/2020

DOI: https://doi.org/10.17656/sdj.10101

Abstract

Objective: The aim of this study was to evaluate the consequences of untreated mandibular first molar extraction space on alveolar bone and adjacent teeth to suggest appropriate implant size selection and direction of its placement to achieve a favorable relationship between the prosthetic part, the implant fixture, and the adjacent teeth.          

Methods: This observational study evaluated 183 CBCT of mandibular first molar extraction spaces to measure adjacent teeth angulations, height, width, and length of interdental crestal bone. Besides interdental distance, unopposed teeth overeruption, and inferior alveolar nerve canal position were measured, and the continuous data have been subjected to the normality test to calculate the Mean and median of the variables.

Results: Mean molar-premolar, molar-bone crest, and premolar bone crest angles were 48.5±12.14◦, 46.4±11.9◦ , and 84.8±9.0◦ , respectively. Mean molar-premolar crestal bone lengths 11.66 ± 2.32 mm. The median bone width was 6.46 mm, and the median interdental distance was 7.54 mm. The mean alveolar crest to the roof of the inferior alveolar nerve canal was 16.42 ± 2.82 mm.

Conclusions: Untreated mandibular first molar extraction spaces significantly compromised interdental spaces and bone properties for proposing proper implant size, positions, and angulations.

                                                                                                                                                                                                                                                                                                                                             

Keywords: CBCT, Mandibular first molar, Extraction space, Dental implant.                                                                                                                                                                                             Full Article - PDF                                                                                                                                                                                                                                   

                                                                                                                                                                                                                                                                                                                                                   

References:

1. Savara BS, Steen JC. Timing and sequence of eruption of permanent teeth in a longitudinal sample of children from Oregon. J Am Dent Assoc. 1978;97(2):209-14.

2. Carvalho W, Casado PL, Caúla AL, Barboza EP. Implants for single first molar replacement: important treatment concerns. Implant Dent. 2004;13(4):328-35.

3. Rao W, Benzi R. Single mandibular first molar implants with flapless guided surgery and immediate function: preliminary clinical and radiographic results of a prospective study. J Prosthet Dent. 2007;97(6 Suppl):S3-14.

4. Ay S, Aǧar U, Bıçakçı AA, Köşger HH. Changes in mandibular third molar angle and position after unilateral mandibular first molar extraction. Am J Orthod Dentofacial Orthop. 2006;129(1):36-41.

5. Scheid RC. Woelfel's dental anatomy. Lippincott Williams & Wilkins, 2012.

6. Geiger AM, Wasserman BH. Relationship of occlusion and periodontal disease: part XI. Relation of axial inclination (mesial‐distal) and tooth drift to periodontal status. J periodontal. 1980;51(5):283-90.

7. Çağlaroğlu M, Kilic N, Erdem A. Effects of early unilateral first molar extraction on skeletal asymmetry. Am J Orthod Dentofac Orthop. 2008;134(2):270-5.

8. Kim YK, Yun PY, Lee HJ, Ahn JY, Kim SG. Ridge preservation of the molar extraction socket using collagen sponge and xenogeneic bone grafts. Implant dent. 2011;20(4):267-72.

9. Love WD, Adams RL. Tooth movement into edentulous areas. J Prosthet Dent. 1971;25(3):271- 8.

10. Payer M, Kirmeier R, Jakse N, Pertl C, Wegscheider W, Lorenzoni M. Surgical factors influencing mesiodistal implant angulation. Clin Oral Impl Res. 2008;19(3):265-70.

11. Lamas JP, Peñarrocha MD, Martí EB. Intraoperative complications during oral implantology. Med Oral Patol Oral Cir Bucal. 302. 2008;13(4):E239-43. 

12. Almog DM, Torrado E, Meitner SW. Fabrication of imaging and surgical guides for dental implants. J Prosthet Dent. 2008;85(5):504-8. 

13. D'haese J, Van De Velde T, Komiyama AI, Hultin M, De Bruyn H. Accuracy and complications using computer‐designed stereolithographic surgical guides for oral rehabilitation by means of dental implants: a review of the literature. Clin Implant Dent Relat Res. 2012;14(3):321-35. 

14. Correa LR, Spin‐Neto R, Stavropoulos A, Schropp L, da Silveira HE, Wenzel A. Planning of dental implant size with digital panoramic radiographs, CBCT‐generated panoramic images, and CBCT cross‐sectional images. Clin Oral Implants Res. 2014;25(6):690-5. 

15. Naitoh M, Ariji E, Okumura S, Ohsaki C, Kurita K, Ishigami T. Can implants be correctly angulated based on surgical templates used for osseointegrated dental implants? Clin Oral Implants Res. 2000;11(5):409-14. 

16. Wilson JP, Johnson TM. Frequency of adequate mesiodistal space and buccolingual alveolar width for implant placement at anterior tooth positions. J Am Dent Assoc. 2019;150(9):779-87.

17. Schneider D, Marquardt P, Zwahlen M, Jung RE. A systematic review on the accuracy and the clinical outcome of computer‐guided template‐ based implant dentistry. Clin Oral Implants Res. 2009;20(Suppl 4):73-86.

18. Weiss R, Read-Fuller A. Cone beam computed tomography in oral and maxillofacial surgery: an evidence-based review. Dent J. 2019;7(2):52.

19. Machtei EE, Oettinger-Barak O, Horwitz J. Axial relationship between dental implants and teeth/implants: a radiographic study. J Oral Implantol. 2014;40(4):425-31.

20. Schropp L, Stavropoulos A, Gotfredsen E, Wenzel A. Comparison of panoramic and conventional cross‐sectional tomography for preoperative selection of implant size. Clin Oral Implants Res. 2011;22(4):424-9.

21. Rinke S, Roediger M, Eickholz P, Lange K, Ziebolz D. Technical and biological complications of single‐molar implant restorations. Clin Oral Implants Res. 2015;26(9):1024-30.

22. Brånemark PI, Breine U, Adell R, Hansson BO, Lindström J, Ohlsson Å. Intra-osseous anchorage of dental prostheses: I. Experimental studies. Scand J Plast Recons. 1969;3(2):81-100.

23. Balshi TJ, Wolfinger GJ. Two-implant-supported single molar replacement: interdental space requirements and comparison to alternative options. Int J Periodont Rest. 1997;17(5):427-36.

24. Tunison W, Flores-Mir C, ElBadrawy H, Nassar U, El-Bialy T. Dental arch space changes following premature loss of primary first molars: a systematic review. Pediatr Dent. 2008;30(4):297-302

25. Heij DG, Opdebeeck H, van Steenberghe D, Kokich VG, Belser U, Quirynen M. Facial development, continuous tooth eruption, and mesial drift as compromising factors for implant placement. Int J Oral Maxillofac Implants. 2006;21(6):867-78.

26. Hoffmann J, Westendorff C, Gomez‐Roman G, Reinert S. Accuracy of navigation‐guided socket drilling before implant installation compared to the conventional free‐hand method in a synthetic edentulous lower jaw model. Clin Oral Implants Res. 2005;16(5):609-14.

27. Vermeulen j. The accuracy of implant placement by experienced surgeons: guided vs freehand approach in a simulated plastic model. Int J Oral Maxillofac Implants. 2017;32(3):617-24.

28. Joda T, Brägger U. Digital vs. conventional implant prosthetic workflows: a cost/time analysis. Clin Oral Implants Res. 2015;26(12):1430-5.

29. Kim YK, Ahn KJ, Yun PY, Yi YJ, Kim SG. The clinical prognosis of implants that are placed against super-erupted opposing dentition. J Korean Assoc Oral Maxillofac Surg. 2016;42(3):139-43.

30. Hanif A, Qureshi S, Sheikh Z, Rashid H. Complications in implant dentistry. Eur J Dent. 2017;11(1):135-40.

31. Akça K, İplikçioǧlu H, Çehreli MC. A surgical guide for accurate mesiodistal paralleling of implants in the posterior edentulous mandible. J Prosthet Dent. 2002;87(2):233-5.

32. Kopp KC, Koslow AH, Abdo OS. Predictable implant placement with a diagnostic/surgical template and advanced radiographic imaging. J Prosthet Dent. 2003;89(6):611-5.

33. Rose TP, Jivraj S, Chee W. The role of orthodontics in implant dentistry. Brit Dent J. 2006;201(12):753-64.

34. Jivraj S, Chee W. Treatment planning of implants in posterior quadrants. Brit Dent J. 2006;201(1):13-23.

35. Craddock HL. An investigation of overeruption of posterior teeth with partial occlusal contact. J Oral Rehabil. 2007;34(4):246-50.

36. Chana H, Briggs P, Watson RM. The occlusal management of maxillary anterior single-unit implant-supported restorations. Dental update. 2000;27(2):215-21.

37. Kiliaridis S, Lyka I, Friede H, Carlsson GE, Ahlqwist M. Vertical position, rotation, and tipping of molars without antagonists. Int J Prosthodont. 2000;13(6):480-6.

38. Steigenga JT, Al-Shammari KF, Nociti FH, Misch CE, Wang HL. Dental implant design and its relationship to long-term implant success. Implant Dent. 2003;12(4):306-17.

39. Gowgiel JM. The position and course of the mandibular canal. J Oral Implantol. 1992;18(4):383-5.

40. Teughels W, Merheb J, Quirynen M. Critical horizontal dimensions of interproximal and buccal bone around implants for optimal aesthetic outcomes: a systematic review. Clin Oral Impl Res. 2009;20(S4):134–5.

 © The Authors, published by University of Sulaimani, College of Dentistry

This work is licensed under a Creative Commons Attribution 4.0 International License.