TY - JOUR
T1 - Risk assessment of inferior alveolar nerve injury for immediate implant placement in the posterior mandible
T2 - A virtual implant placement study
AU - Lin, Ming Hung
AU - Mau, Lian Ping
AU - Cochran, David L.
AU - Shieh, Yi Shing
AU - Huang, Po Hsien
AU - Huang, Ren Yeong
PY - 2014/3
Y1 - 2014/3
N2 - Objectives: To investigate the prevalence and morphological parameters of lingual concavity, and whether these factors are related to a higher risk of inferior alveolar nerve (IAN) injury when performing an immediate implant surgery in posterior mandible region. Methods: The CBCT images from 237 subjects (1008 teeth) were analysed the shape of the mandibles (C, P, U type), dimensional parameters of lingual concavity (angle, height, depth), and its relation to inferior alveolar canal (IAC) (A, B, C zone), RAC (distance from root apex to IAC) and probability of IAN injury. Multiple logistic regression modelling to determine the odds ratio of variables that made an important contribution to the probability of IAN injury and to adjust for confounding variables. Results: The U type ridge (46.7%) and the most concave point located at C zone (48.8%) are most prevalent in this region. The mandibular second molar presents highest risk for IAN injury than other tooth type (p < 0.001), which were 3.82 times to occur IAN injury than the mandibular second premolar. The concave point located at A zone and B zone were 7.82 and 3.52 times than C zone to have IAN damage, respectively. The probability of IAN injury will reduce 26% for every 1 mm increase in RAC (p < 0.001). Conclusions: The tooth type, morphological features of lingual concavities, and RAC are associated with risks of IAN injury during immediate implant placement. Clinical significance Pre-surgical mapping of the IAC and identification of its proximity relative to the lingual concavity in the posterior mandible regions may avoid unpleasant complications, specifically when performing immediate implant procedures.
AB - Objectives: To investigate the prevalence and morphological parameters of lingual concavity, and whether these factors are related to a higher risk of inferior alveolar nerve (IAN) injury when performing an immediate implant surgery in posterior mandible region. Methods: The CBCT images from 237 subjects (1008 teeth) were analysed the shape of the mandibles (C, P, U type), dimensional parameters of lingual concavity (angle, height, depth), and its relation to inferior alveolar canal (IAC) (A, B, C zone), RAC (distance from root apex to IAC) and probability of IAN injury. Multiple logistic regression modelling to determine the odds ratio of variables that made an important contribution to the probability of IAN injury and to adjust for confounding variables. Results: The U type ridge (46.7%) and the most concave point located at C zone (48.8%) are most prevalent in this region. The mandibular second molar presents highest risk for IAN injury than other tooth type (p < 0.001), which were 3.82 times to occur IAN injury than the mandibular second premolar. The concave point located at A zone and B zone were 7.82 and 3.52 times than C zone to have IAN damage, respectively. The probability of IAN injury will reduce 26% for every 1 mm increase in RAC (p < 0.001). Conclusions: The tooth type, morphological features of lingual concavities, and RAC are associated with risks of IAN injury during immediate implant placement. Clinical significance Pre-surgical mapping of the IAC and identification of its proximity relative to the lingual concavity in the posterior mandible regions may avoid unpleasant complications, specifically when performing immediate implant procedures.
KW - Cone beam computed tomography
KW - Dental implants
KW - Immediate placement
KW - Inferior alveolar nerve
KW - Mandible
KW - Risk assessment
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U2 - 10.1016/j.jdent.2013.12.014
DO - 10.1016/j.jdent.2013.12.014
M3 - Article
C2 - 24394585
AN - SCOPUS:84900623185
SN - 0300-5712
VL - 42
SP - 263
EP - 270
JO - Journal of Dentistry
JF - Journal of Dentistry
IS - 3
ER -