Characterization of the anterior maxillary region for immediate implant placement: A radiographic cross-sectional study.

Abstract

Statement of problem: Information regarding the influence of local phenotypical features in the context of immediate implant placement (IIP) in the anterior maxillary region is sparse.

Purpose: The purpose of this clinical study was to characterize key phenotypical and anatomical characteristics of the anterior maxilla related to the feasibility of virtual IIP.

Material and methods: Cone beam computed tomography (CBCT) scans acquired from adult participants were used for virtual implant placement and to measure periodontal phenotypical dimensions (buccal and palatal gingival (GT) and bone thickness (BT)), the buccal gap (BG) at different apico-coronal levels, and anatomical variables nasopalatine canal and ramifications, nasal cavity, maxillary sinus). The study sample was comprised of 330 maxillary anterior teeth. Two different immediate implant modalities were examined: cingulum emergence plan (CEP) and incisal edge emergence plan (IEP).

Results: A total of 660 implants were virtually placed. The mean periodontal phenotypical dimensions showed variability between and within individuals depending on the apico-coronal level, tooth type, and implant placement modality. Immediate implant feasibility was 90.1% and 93.6% for the CEP and IEP groups, respectively, and was influenced by tooth type and anatomical variables. BG distance was generally greater at the coronal aspect and in the CEP. Thick bone and gingiva (≥1 mm) were observed in 15.2% and 89.3% of the sites, respectively. A minimum of 2 mm of apical bone availability to achieve primary stability was observed in 88.8% and 91.2% of the sites in the CEP and IEP groups, respectively.

Conclusions: This study highlights the variability in periodontal phenotypical and local anatomical features at anterior maxillary sites. These observations underscore the importance of recognizing such variations that should be identified and considered during the planning and execution of therapy.