Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment: A retrospective cross-sectional study

Zhuwei Huang; Jiamin Shi; Guangqi Gao; Mengru Shi; Zhuohong Gong; Haiwen Liu; Peisheng Zeng; Shijie Chen; Xuejing Gan; Jianfeng Ding; Yan Wang; Zetao Chen

doi:10.1016/j.jormas.2023.101634

Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment: A retrospective cross-sectional study

J Stomatol Oral Maxillofac Surg. 2023 Dec;124(6S):101634. doi: 10.1016/j.jormas.2023.101634. Epub 2023 Sep 13.

Authors

Affiliations

¹ Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China.
² Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China. Electronic address: wangyan9@mail.sysu.edu.cn.
³ Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology and Guangdong Research Center for Dental and Cranial Rehabilitation and Material Engineering, Guangzhou, 510055, China. Electronic address: chenzet3@mail.sysu.edu.cn.

PMID: 37709143
DOI: 10.1016/j.jormas.2023.101634

Abstract

Background: Apical palatal bone is important in immediate implant evaluation. Current consensus gives qualitative suggestions regarding it, limiting its clinical decision-making value.

Objectives: To quantify the apical palatal bone dimension in maxillary incisors and reveal its quantitative correlation with other implant-related hard tissue indices to give practical advice for pre-immediate implant evaluation and design.

Material and methods: A retrospective analysis of immediate implant-related hard tissue indices in maxillary incisors obtained by cone beam computed tomography (CBCT) was conducted. Palatal bone thickness at the apex level (Apical-P) on the sagittal section was selected as a parameter reflecting the apical palatal bone. Its quantitative correlation with other immediate implant-related hard tissue indices was revealed. Clinical advice of pre-immediate implant assessment was given based on the quantitative classification of Apical-P and its other correlated immediate implant-related hard tissue indices.

Results: Apical-P positively correlated with cervical palatal bone, whole cervical buccal-palatal bone, sagittal root angle, and basal bone width indices. while negatively correlated with apical buccal bone, cervical buccal bone, and basal bone length indices. Six quantitative categories of Apical-P are proposed. Cases with Apical-P below 4 mm had an insufficient apical bone thickness to accommodate the implant placement, while Apical-P beyond 12 mm should be cautious about the severe implant inclination. Cases with Apical-P of 4-12 mm can generally achieve satisfying immediate implant outcomes via regulating the implant inclination.

Conclusions: Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment can be achieved, providing a quantitative guide for immediate implant placement in the maxillary incisor zone.

Keywords: Alveolar bone; Apical palatal bone; Immediate implant placement; Maxillary incisor; Quantitative study.

MeSH terms

Alveolar Process* / diagnostic imaging
Alveolar Process* / surgery
Cross-Sectional Studies
Humans
Incisor* / diagnostic imaging
Incisor* / surgery
Maxilla / diagnostic imaging
Maxilla / surgery
Palate
Retrospective Studies