Maxillary Central Incisor– Incisive Canal Relationship: a Cone Beam Computed Tomography Study

Total Page:16

File Type:pdf, Size:1020Kb

Maxillary Central Incisor– Incisive Canal Relationship: a Cone Beam Computed Tomography Study Maxillary Central Incisor– Incisive Canal Relationship: A Cone Beam Computed Tomography Study Joseph Y.K. Kan, DDS, MS Professor, Department of Restorative Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA. Kitichai Rungcharassaeng, DDS, MS Associate Professor, Department of Orthodontics and Dentofacial Orthopedics, Loma Linda University School of Dentistry, Loma Linda, California, USA. Phillip Roe, DDS, MS Assistant Professor, Department of Restorative Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA. Juan Mesquida, DDS Private Practice, Marlow, United Kingdom. Pakawat Chatriyanuyoke, DDS, MS Assistant Professor, Department of Restorative Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA. Joseph M. Caruso, DDS, MS, MPH Professor and Chair, Department of Orthodontics and Dentofacial Orthopedics, Loma Linda University School of Dentistry, Loma Linda, California, USA. Correspondence to: Dr Joseph Kan Center for Prosthodontics and Implant Dentistry, Loma Linda University School of Dentistry, 11092 Anderson St, Loma Linda, CA 92350. Email: [email protected] 180 THE AMERICAN JOURNAL OF ESTHETIC DENTISTRY © 2012 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER. The purpose of this study was to determine the maxillary central incisor–incisive canal (CI-IC) relationship by comparing the visibility of the incisive canal on the two-dimensional sagittal images of the central incisors acquired from two cone beam computed tomography (CBCT) reconstruction modalities. A retrospective review of CBCT images from 60 patients (30 men and 30 women) with a mean age of 57.9 years (range: 19 to 83 years) was conducted. The CBCT images were evaluated using the manufacturer’s recommended method (MRM) and a modified method (MM). The CI-IC relationship was classified as invisible, partially visible, or completely visible. The frequency distribution of the CI-IC relationships of the 60 samples indicated that the visibility of the incisive canal is significantly greater at all locations when using the MRM compared to the MM and on the right central incisor versus the left central incisor. Evaluation of the CI-IC relationship using the proposed method may allow the clinician to better determine whether additional surgical procedures are necessary when planning immediate implant placement and provisionalization at the maxillary central incisor positions. (Am J Esthet Dent 2012;2:180–187.) he success of immediate implant placement and provisionalization is greatly Tdependent on the initial implant stability.1,2 Initial stability for immediate im- plant placement in the anterior maxilla requires the implant to engage 4 to 5 mm of bone apical to the root tip socket and palatal bone.3,4 However, when a failing maxillary central incisor is to be replaced, the proximity of the incisive canal can become a limiting factor5,6 that precludes immediate implant placement. There- fore, it is imperative that the central incisor–incisive canal (CI-IC) relationship is accurately identified during diagnosis and treatment planning. Due to its accuracy7–11 and relatively low effective dose of ionizing radiation,12 the use of cone beam computed tomography (CBCT) during treatment planning for implant placement has increased. Because the diagnostic features of CBCT can be customized, it is important that the data are properly reconstructed to provide an accurate diagnosis. The purpose of this study was to determine the CI-IC relationship by compar- ing the visibility of the incisive canal on two-dimensional (2D) sagittal images of the central incisors acquired from two CBCT reconstruction modalities. The clini- cal implications are also discussed. 181 VOLUME 2 • NUMBER 3 • FALL 2012 © 2012 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER. KAN ET AL MATERIALS AND METHODS Communications in Medicine) file and opened using a proprietary software Patient selection viewer (i-CAT Vision, Imaging Sciences International). This retrospective study was approved In the axial view, an open polygon by the Institutional Review Board of was created using 11 mapping points. Loma Linda University and was con- From this radiographic mapping, a pan- ducted at the Center for Prosthodontics oramic view and a series of 2D cross- and Implant Dentistry, Loma Linda Uni- sectional images were created along versity School of Dentistry, Loma Linda, the open polygon. The reconstructed California. Treatment records and CBCT 2D cross-sectional (sagittal) images of images of patients who received treat- the maxillary central incisors were used ment from May 2006 to November 2009 to evaluate the CI-IC relationship. In this were reviewed. To be included in this study, two reconstruction modalities study, the patients must (1) be at least were used: 18 years of age, (2) have both central incisors, (3) have stable posterior oc- 1. Manufacturer’s recommended meth- clusal support, and (4) show no clinical od (MRM): Nine mapping points or radiographic evidence of alterations were evenly distributed on the alveo- to the anterior maxilla (surgical altera- lar housings or, in their absence, on tion and/or trauma). the residual ridge, following its con- tour in a curvilinear fashion (Figs 1a Data reconstruction and and 1b). image acquisition 2. Modified method (MM): Five anterior mapping points were adjusted to All CBCT scans were performed us- create a line tangential to the ante- ing the i-CAT system (Classic i-CAT, rior maxillary arch form at the midline Imaging Sciences International). Fol- and parallel to the facial surface of lowing the primary reconstruction, the the central incisors (Figs 2a and 2b). volumetric data were opened using the 2D orthogonal multiplanar reformatting Data collection viewer for the secondary reconstruc- tion. The image was rotated so that the The visibility of the incisive canal on palatal plane (the line joining the an- nine reconstructed 2D sagittal images terior and posterior nasal spines) was of each maxillary central incisor (mid- parallel to the horizontal and vertical dle of the tooth [Mid] and 0.8, 1.6, and reference lines in the sagittal and axial 2.4 mm mesial [M] and distal [D] to views, respectively. In the coronal view, Mid) using both CBCT modalities were the image was rotated so that the verti- recorded and compared. The visibility cal line bisecting the facial structures of the incisive canal was classified as was perpendicular to the horizontal invisible, partially visible, or completely reference line. The data were exported visible. Descriptive statistics were used as a DICOM (Digital Imaging and to analyze the data. 182 THE AMERICAN JOURNAL OF ESTHETIC DENTISTRY © 2012 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER. KAN ET AL Axial slice position: 66.40 b Figs 1a and 1b (a) Axial view with the open polygon tool bisecting the alveolar process; (b) sagittal view a of the failing tooth using the MRM. Axial slice position: 66.40 b Figs 2a and 2b (a) Axial view with the open polygon tool parallel to the facial surface of the maxillary central incisors; (b) sagittal view of a the failing tooth using the MM. 183 VOLUME 2 • NUMBER 3 • FALL 2012 © 2012 BY QUINTESSENCE PUBLISHING CO, INC. PRINTING OF THIS DOCUMENT IS RESTRICTED TO PERSONAL USE ONLY. NO PART MAY BE REPRODUCED OR TRANSMITTED IN ANY FORM WITHOUT WRITTEN PERMISSION FROM THE PUBLISHER. KAN ET AL IV IV PV PV CV CV 100 100 1.7 1.7 6.7 16.7 16.7 20.0 23.3 28.4 30.0 30.0 40.0 75 53.4 75 35.0 46.7 35.0 33.3 76.7 36.7 38.3 85.0 91.7 50 50 50.0 38.3 78.3 68.3 41.6 58.3 25 48.3 38.3 25 50.0 33.3 40.0 20.0 21.7 11.7 20.0 8.3 6.6 11.7 0 3.3 3.3 1.7 0 2.4D 1.6D 0.8D Mid 0.8M 1.6M 2.4M 2.4D 1.6D 0.8D Mid 0.8M 1.6M 2.4M Fig 3 Percentage distribution of incisive canal Fig 4 Percentage distribution of incisive canal visibility on the maxillary right central incisor visibility on the maxillary left central incisor sagittal images using the MRM. IV = invisible; sagittal images using the MRM. IV = invisible; PV = partially visible; CV = completely visible. PV = partially visible; CV = completely visible. IV IV PV PV CV CV 100 100 3.3 8.3 1.7 11.7 10.0 1.7 6.7 31.7 33.3 25.0 75 51.7 75 38.3 40.0 75.0 50 50 100 100 100 100 96.7 91.7 36.7 90.0 73.3 66.7 35.0 25 48.3 25 55.0 30.0 20.0 13.3 0 5.0 0 2.4D 1.6D 0.8D Mid 0.8M 1.6M 2.4M 2.4D 1.6D 0.8D Mid 0.8M 1.6M 2.4M Fig 5 Percentage distribution of incisive canal Fig 6 Percentage distribution of incisive canal visibility on the maxillary right central incisor visibility on the maxillary left central incisor sagittal images using the MM. IV = invisible; sagittal images using the MM. IV = invisible; PV = partially visible; CV = completely visible. PV = partially visible; CV = completely visible. RESULTS sagittal images are presented in Figs 3 to 6. The visibility of the incisive canal A total of 60 patients (30 men and was significantly greater at all locations 30 women) with a mean age of 57.9 (2.4 mm D to 2.4 mm M) when using years (range: 19 to 83 years) were in- the MRM (Figs 3 and 4) as opposed to cluded in this study.
Recommended publications
  • Tooth Size Proportions Useful in Early Diagnosis
    #63 Ortho-Tain, Inc. 1-800-541-6612 Tooth Size Proportions Useful In Early Diagnosis As the permanent incisors begin to erupt starting with the lower central, it becomes helpful to predict the sizes of the other upper and lower adult incisors to determine the required space necessary for straightness. Although there are variations in the mesio-distal widths of the teeth in any individual when proportions are used, the sizes of the unerupted permanent teeth can at least be fairly accurately pre-determined from the mesio-distal measurements obtained from the measurements of already erupted permanent teeth. As the mandibular permanent central breaks tissue, a mesio-distal measurement of the tooth is taken. The size of the lower adult lateral is obtained by adding 0.5 mm.. to the lower central size (see a). (a) Width of lower lateral = m-d width of lower central + 0.5 mm. The sizes of the upper incisors then become important as well. The upper permanent central is 3.25 mm.. wider than the lower central (see b). (b) Size of upper central = m-d width of lower central + 3.25 mm. The size of the upper lateral is 2.0 mm. smaller mesio-distally than the maxillary central (see c), and 1.25 mm. larger than the lower central (see d). (c) Size of upper lateral = m-d width of upper central - 2.0 mm. (d) Size of upper lateral = m-d width of lower central + 1.25 mm. The combined mesio-distal widths of the lower four adult incisors are four times the width of the mandibular central plus 1.0 mm.
    [Show full text]
  • An Impacted Primary Lateral Incisor As a Cause of Delayed Erupt,On
    Animpacted primary lateral incisoras a causeof delayed erupt,onof a permanenttooth: case report TimothyW. Adams, DDS rolonged impaction of primary incisors is un- process, but this condition has not been reported to usual. There have been only two such cases affect the primary anterior teeth. 6 Partial impaction p reportedin the dental literature. 1.2 Bothcases in- of primary, permanent, or supernumeraryteeth in the volved maxillary primary incisors and the etiology may area of an alveolar cleft does occur.4 Other syndromes have been accidental trauma in both. Luxationinjuries are associated with cyst formation and impaction of in the primary dentition are commondue to the resil- multiple secondary or supernumeraryteeth (cleidoc- ient nature of the bone surrounding these teeth, and ranial dysplacia, Gardner syndrome)? However, completeintrusion of erupted primary incisors into the Andreasen4 states that in cleidocranial dysostosis, the alveolar process occasionally occurs.3 However,even primary teeth, because of their superficial position, whena traumatic condition remains undiagnosed, in- nearly always erupt spontaneously. truded primary incisors don’t usually remain impacted This case emphasizes the importance of a thorough but re-erupt within a 2- to 4-moperiod following the dental history and radiographic examin children with injury? Belostokyet al.1 describeda case in whicha 10o missing teeth? Prolonged impaction of the maxillary month-oldfemale child fell, and a maxillary primary primaryleft lateral incisor wasassociated with eruption central incisor presumed"lost" had apparently been in- delay, ectopic eruption, and an apparent dilaceration of truded throughthe buccal cortical plate whereit could the root of the maxillaryleft permanentlateral incisor. not re-erupt.
    [Show full text]
  • Morphological Characteristics of the Pre- Columbian Dentition I. Shovel
    Morphological Characteristics of the Pre­ Columbian Dentition I. Shovel-Shaped Incisors, Carabelli's Cusp, and Protostylid DANNY R. SAWYER, D .D.S. Department of Pathology, Medical College of Virginia, Health Sciences Division of Virginia Commonwealth University, Richmond, Virginia MARVIN J . ALLISON, PH.D. Clinical Professor of Pathology , Medical College of Virginia, Health Sciences Division of Virginia Commonwealth University, Richmond, Virginia RICHARD P. ELZA Y, D.D.S., M.S.D. Chairman and Professor, Department of Oral Pathology, Medical College of Virginia, Health Sciences Division of Virginia Commonwealth University, Richmond. Virginia ALEJANDRO PEZZIA, PH.D. Curator, Regional Museum oflea, lea, Peru This Peruvian-American cooperative study of logic characteristics of the shovel-shaped incisor (Fig paleopathology of the pre-Columbian Peruvian cul­ I), Carabelli's cusp (Fig 2 ), and protostylid (Figs 3A, tures of Southern Peru began in 1971. The purpose of 38, and 3C). this study is to evaluate the medical and dental health A major aspect of any study of the human denti­ status of these cultures which date from 600 BC to tion is the recognition and assessment of morphological the Spanish conquest. While several authors such as variations. The shovel-shape is one such character­ Leigh,1 Moodie,2 Stewart,3 and Goaz and Miller4 istic and is manifested by the prominence of the me­ have studied the dental morphology of Northern Pe­ sial and distal ridges which enclose a central fossa on ruvians, the paleodontology and oral paleopathology the lingual surface of incisor teeth. Shovel-shaped of the Southern Peruvians has not been recorded. incisors are seen with greater frequency among the This paper reports dental findings on the morpho- maxillary incisors and only occasionally among the mandibular incisors.
    [Show full text]
  • Hypomineralisation Or Hypoplasia?
    Hypomineralisation or hypoplasia? IN BRIEF Provides general dental practitioners with an overview of the background and aetiology of enamel hypomineralisation and hypoplasia Outlines the different characteristics and clinical variabilities between hypomineralisation and hypoplasia Provides an understanding of how to diagnose hypomineralisation and hypoplasia and guide management ABSTRACT Enamel hypomineralisation is a qualitative defect, with reduced mineralisation resulting in discoloured enamel in a tooth of normal shape and size. Because the enamel is weaker, teeth can undergo post eruptive breakdown, resulting in missing enamel. Enamel hypoplasia is a quantitative defect of the enamel presenting as pits, grooves, missing enamel or smaller teeth. It can sometimes be difficult to differentiate between the two. In this review paper, we aim to explain the importance of differentiating between the two conditions, and how to manage patients presenting with enamel defects. HOW DOES ENAMEL FORM? Enamel is produced by specialised end-differentiated cells known as ameloblasts.1 The formation of enamel can be separated into initial stages which involve secretion of matrix proteins such as amelogenin, ameloblastin and enamelin, and later stages of mineralization and maturation.1 Tooth enamel is unique due to its high mineral content. It is composed of highly organised, tightly packed hydroxyapatite crystallites that comprise 87% of its volume and 95% of its weight, with the remainder comprising of organic matrix and water.1 This pattern of organisation and mineralisation gives enamel its significant physical properties, making it the hardest tissue in the body.1 Developmental defects of enamel are not uncommon, both in the primary and permanent dentitions.1 Environmental and/or genetic factors that interfere with tooth formation are thought to be responsible for both hypomineralisation and hypoplasia.1,2 If a disturbance occurs during the secretion phase, the enamel defect is called hypoplasia.
    [Show full text]
  • CHAPTER 5Morphology of Permanent Molars
    CHAPTER Morphology of Permanent Molars Topics5 covered within the four sections of this chapter B. Type traits of maxillary molars from the lingual include the following: view I. Overview of molars C. Type traits of maxillary molars from the A. General description of molars proximal views B. Functions of molars D. Type traits of maxillary molars from the C. Class traits for molars occlusal view D. Arch traits that differentiate maxillary from IV. Maxillary and mandibular third molar type traits mandibular molars A. Type traits of all third molars (different from II. Type traits that differentiate mandibular second first and second molars) molars from mandibular first molars B. Size and shape of third molars A. Type traits of mandibular molars from the buc- C. Similarities and differences of third molar cal view crowns compared with first and second molars B. Type traits of mandibular molars from the in the same arch lingual view D. Similarities and differences of third molar roots C. Type traits of mandibular molars from the compared with first and second molars in the proximal views same arch D. Type traits of mandibular molars from the V. Interesting variations and ethnic differences in occlusal view molars III. Type traits that differentiate maxillary second molars from maxillary first molars A. Type traits of the maxillary first and second molars from the buccal view hroughout this chapter, “Appendix” followed Also, remember that statistics obtained from by a number and letter (e.g., Appendix 7a) is Dr. Woelfel’s original research on teeth have been used used within the text to denote reference to to draw conclusions throughout this chapter and are the page (number 7) and item (letter a) being referenced with superscript letters like this (dataA) that Treferred to on that appendix page.
    [Show full text]
  • Microstructure of Primary Tooth Dentin
    Scientific Article Microstructure of primary tooth dentin David A. Sumikawa, DDS, MS Grayson W. Marshall, DDS, MPH, PhD Lauren Gee, MPH Sally J. Marshall, PhD Dr. Sumikawa is in private pediatric dental practice in Honolulu, Hawaii. Dr. G. Marshall is Professor and Chair, Division of Biomaterials and Bioengineering, Ms. Gee is with the Department of Epidemiology and Biostatistics, and Dr. Sally Marshall is Professor and Vice-Chair for Research, Department of Restorative Dentistry, University of California, San Francisco, California. Abstract Purpose: This study was performed to determine variations in Restoration of primary teeth, particularly anterior teeth, is dentin microstructure from primary anterior teeth at specific ar- often difficult because of their small size, thinness of enamel, eas and depths in relation to the dentin enamal junction, (DEJ). enamel morphology, pulpal anatomy, and rapid spread and Methods: Ten freshly extracted, non-carious primary maxil- extent of decay.4 lary anterior teeth were sectioned to provide two 1.0 mm x 1.0 Dentin bond strength comparisons between primary and mm matchsticks extending from the DEJ to the pulp chamber— permanent teeth have shown mixed results. Salama and Tao5 one each from the central and distal regions of each tooth. Slices found lower bond strength to primary dentin, Bordin-Aykroyd were prepared at distances of 0.15, 0.8, and 1.45 mm from the et al.1 found higher bond strengths, while others.6,7 found no DEJ. Following polishing, each slice was examined in a wet scan- significant differences. ning election microscope, (SEM) and tubule density, tubular Tubule diameters and tubule numerical density increase diameter, and peritubular width were determined at nine grid from the dentinoenamel junction (DEJ), towards the pulp, with locations.
    [Show full text]
  • Hibernation Is Recorded in Lower Incisors of Recent and Fossil Ground Squirrels (Spermophilus)
    Journal of Mammalogy, 86(2):323–332, 2005 HIBERNATION IS RECORDED IN LOWER INCISORS OF RECENT AND FOSSIL GROUND SQUIRRELS (SPERMOPHILUS) H. THOMAS GOODWIN,* GAIL R. MICHENER,DANIEL GONZALEZ, AND CAROLINE E. RINALDI Biology Department, Andrews University, Berrien Springs, MI 49104, USA (HTG, DG) Department of Biological Sciences, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada (GRM) Department of Basic Medical Science, University of Missouri School of Medicine, Kansas City, MO 64108, USA (CER) Incremental dentin and associated enamel, features visible on the surface of lower incisors, were characterized for 3 species of ground squirrels (Spermophilus): Pleistocene and Recent S. elegans, Recent S. richardsonii, and Recent S. parryii. A hibernation mark was evident in incisor dentin and enamel, most characteristically as a sleeve of enamel terminating basally adjacent to medially depressed dentin with indistinct and often very fine increments. This mark was absent in juveniles but present in older animals of both sexes for at least 6 weeks after hibernation, eventually being lost through growth and wear of the incisor. Temporal association with hibernation was confirmed from specimens of S. richardsonii with known dates of hibernation. Parturition and onset of lactation were usually associated with reduction in thickness of dentin increments but could not be recognized unambiguously. Combining wear stage of cheek teeth with the presence and location of the hibernation mark allowed placement of many specimens into age and season categories at time of death (young of year, early-season adults, and late-season adults). Examination of lower incisors of Pleistocene S. elegans from Porcupine Cave in central Colorado showed that hibernation was recorded in fossils and confirmed the utility of event-anchored incremental dentin in elucidating taphonomic questions.
    [Show full text]
  • Maxillary All-On-Four® Surgery: a Review of Intraoperative Surgical Principles and Implant Placement Strategies
    Maxillary All-on-Four® Surgery: A Review of Intraoperative Surgical Principles and Implant Placement Strategies David K. Sylvester II, DDS Assistant Clinical Professor, Department of Oral & Maxillofacial Surgery, University of Oklahoma Health Sciences Center Private Practice, ClearChoice Dental Implant Center, St. Louis, Mo. Ole T. Jensen DDS, MS Adjunct Professor, University of Utah School of Dentistry Thomas D. Berry, DDS, MD Private Practice, ClearChoice Dental Implant Center, Atlanta, Ga. John Pappas, DDS Private Practice, ClearChoice Dental Implant Center, St. Louis, Mo. residual bone. Advocates for additive treatment BACKGROUND attempt to procure the bone volume necessary for implant support through horizontal and vertical augmentation techniques. Graftless Implant rehabilitation of full-arch maxillary approaches seek to offer full-arch implant edentulism has undergone significant changes support through creative utilization of angled since the concept of osseointegration was first implants in existing native bone. introduced. Controversy over the ideal number of implants, axial versus angled implant Biomechanical analysis of the masticatory placement, and grafting versus graftless system repeatedly demonstrated that the treatment modalities have been subjects of greatest bite forces are located in the posterior continuous debate and evolution. Implant jaws. Anatomic limitations of bone availability supported full-arch rehabilitation of the maxilla due to atrophy and sinus pneumatization make was originally thought to be more difficult than maxillary posterior implant placement its mandibular counterpart due to lower overall challenging. The resulting controversy with bone density. regards to full-arch rehabilitation was whether prostheses with long distal cantilevers could be The foundation for any implant supported full- tolerated. If tilting posterior implants could arch rehabilitation is the underlying bone.
    [Show full text]
  • WIB Identify Age from Bone (PDF)
    Activity: Can You Identify the Age? Background Skeletons are good age markers because teeth and bones mature at fairly predictable rates. How Teeth Reveal Age Baby teeth, also called milk or deciduous teeth, start erupting at about six months, beginning with the central incisors in the lower jaw (mandible). Each tooth type - incisors, canines, premolars, molars - erupts on a predictable schedule. The incisor teeth are any of the four anterior teeth in each jaw, used for cutting and gnawing. The canine teeth are the four sharp-pointed teeth next to the incisors. The premolar teeth are one of eight bicuspid teeth located in pairs on each side of the upper and lower jaws behind the canines and in front of the molars. The molar teeth are the teeth with a broad crown used to grind food, located behind the premolars. Permanent teeth begin to replace deciduous teeth at about six years of age and finish erupting by about 21 years of age. Figure 1. Human teeth. X-rays provide views of the unerupted permanent (Source: Gray's teeth and tooth roots still within the bone. The crown Anatomy)For toddler to of a tooth forms first, followed by the root. Scientists age 21, teeth are the most estimate age by comparing the stage of tooth accurate age indicators. formation in the X-rays and bone with known dental Like many other growth standards. mammals, humans have two sets of teeth - "baby" teeth and permanent teeth. Below are three X-rays showing dental development: Figure 2 is the jaw of a four- to five-year old child.
    [Show full text]
  • The All-On-Four Implant Therapy Protocol in the Management of Edentulous Chinese Patients
    The All-on-Four Implant Therapy Protocol in the Management of Edentulous Chinese Patients Ping Di, MDa/Ye Lin, MDb/Jian-hui Li, MDc/Jia Luo, MDd/Li-xin Qiu, MDc/Bo Chen, MDe/Hong-yan Cuif Purpose: To evaluate the outcome and special characteristics of immediate implant rehabilitation using the All-on-Four treatment concept in completely or potentially completely edentulous Chinese patients. Materials and Methods: A convenience sample consisted of 69 consecutive patients (37 men, 32 women; mean age: 56.7 years) treated with immediate implant placement and full-arch prosthodontic provisional prostheses between April 2008 and December 2011. Of 344 implants (192 mandibular, 152 maxillary), 240 implants were placed in fresh extraction sites. The remaining 104 implants were placed in healed sites. Implants were immediately loaded with a fixed full-arch provisional prosthesis. Implant survival rate, marginal bone loss, abutment selection, complications, and subjective patient responses were recorded during follow-up. Results: Implant survival rate was 96.2% at 33.7 months of mean follow-up (range: 12 to 56 months). A statistically significantly higher implant survival rate was found in the mandible (99.0% vs 92.8%) (P < .05). No significant difference existed between survival rates for implants placed in postextraction sites and healed sites (P > .05). Peri-implant marginal bone loss around upright implants and tilted implants was 0.7 ± 0.2 mm and 0.8 ± 0.4 mm, respectively. All patients reported satisfactory treatment outcomes. Conclusions: The modified All-on-Four treatment concept provides predictably favorable outcomes in completely or potentially completely edentulous patients and is well suited to the sociodemographic needs of Chinese patients.
    [Show full text]
  • All-On-Four Concept in Implant Dentistry: a Literature Review
    Journal of Dentistry and Oral Care Medicine Volume 3 | Issue 2 ISSN: 2454-3276 Review Article Open Access All-On-Four Concept in Implant Dentistry: A Literature Review Durkan R1 and Oyar P*2 1Department of Prosthodontics, Faculty of Dentistry, Afyon Kocatepe University, Afyonkarahisar, Turkey 2Health Services Vocational High School, Department of Dental Prostheses Technology, Hacettepe University, An- kara, Turkey *Corresponding author: Oyar P, DDS, Ph.D., Associate Professor, Health Services Vocational High School, Department of Dental Prostheses Technology, Hacettepe University, D-Blok, 3. Kat, 06100 Sihhiye, Ankara, Turkey, E-mail: [email protected] Citation: Durkan R, Oyar P (2017) All-On-Four Concept in Implant Dentistry: A Literature Review. J Dent Oral Care Med 3(2): 205. doi: 10.15744/2454-3276.3.205. doi: 10.15744/2454-3276.3.205 Received Date: August 9, 2017 Accepted Date: September 20, 2017 Published Date: September 22, 2017 Abstract The implant technology developed as the all-on-four concept is offered as an alternative to conventional implant applications. In the all-on-four technique, 4 implants are placed in the interforaminal region in the mandible and in the pre-maxillary region in total edentulism cases. This application is based on the placement of two of these implants to the anterior region so as to be perpendicular to the occlusal plane, and on the placement of two implants to the posterior region so as to be inclined 30-45o. These implants are ensured to function by making immediate fixed complete denture over them. The patient is administered with permanent fixed full arch restoration 3 months later.
    [Show full text]
  • Solitary Maxillary Central Incisor: Clinical Report
    PEDIATRICDENTISTRY/Copyright ©1985 by TheAmerican Academy of Pediatric Dentistry Volume7 Number2 CLINICAL Solitary maxillary central incisor: clinical report Phillip R. Parker, DDS William F. Vann, Jr., DMD,MS, PhD In 1976 Rappaport et al. introduced the term Mon- nancy which occurred after an unsuccessful bilateral osuperocentroincisivodontic dwarfism to describe pa- tubal ligation. During pregnancy the mother took tients who exhibit a solitary maxillary central incisor conjugated estrogens a to induce menses for approx- in both dentitions in conjunction with growth retar- imately 6 of the first 8 weeks. Conjugated estrogens dation.1 The frequency of congenitally missing max- and their use during early pregnancy are known to illary primary central incisors has not been reported, be associated with congenital abnormalities. Diaze- b but the frequency of congenitally missing maxillary pam was taken early in the pregnancy for back-re- permanent central incisors is rare and is reported to lated muscle spasms. Several studies have suggested be2 less than 1%. an increased risk of congenital malformations asso- Reports describing a solitary maxillary central in- ciated with minor tranquilizers taken during the first cisor have appeared in the literature since 1958.3 In trimester of pregnancy.~ The first trimester was com- some patients this syndrome has been linked to known plicated further by sporadic vaginal bleeding and growth hormone deficiency with concomitant short cramping. stature and in other individuals it has been linked to An extra digit on both the right hand and foot were short stature for which the precise etiology is un- present at birth. Both extra digits were removed by known.
    [Show full text]