Pre-surgical socket analysis for immediate implant placement

TL;DR

This study analyzes bone dimensions in the upper anterior teeth to assess the feasibility of immediate dental implants after tooth extraction.

Contribution

The study provides new insights into socket dimensions and bone characteristics affecting immediate implant placement in different teeth and age groups.

Findings

Bone attachment levels and cortical thickness are lower in women compared to men across all analyzed teeth.

Canines show the greatest reduction in bone measurements and are the most complex for immediate implant placement.

Older patients have a higher percentage of unfavorable sockets for immediate implants.

Abstract

Traditional protocols for implant surgery suggest a healing period of 2-3 months from dental extraction to implant placement. Based on all the volumetric modifications produced by that approach, there are authors who advocate for immediate implantology. The aim of the present study was to determine the prevalence of different sockets, and the dimensions of the bone around the upper anterior incisors and canines, to determine the predictability of immediate implants in our population.

This is an observational, cross-sectional study based on cone-beam computed tomography images of the anterior maxila of patients attending the Odontological Hospital of the University of Barcelona (OHUB) and requesting for implant treatment. Different measurements were performed on every analyzed tooth, and also they were categorized by using the main dental sockets classifications.

Bone attachment levels and cortical thickness are lower in women compared to men in all three types of teeth (the difference in the bone attachment levels ranges from 4.68%-8.63% and in the bone thickness goes from 0.02-0.58mm). Bone attachment level gradually reduces with age. The reductions observed in all the measurements are higher in the case of canines, compared with the other teeth. The differences from patients <45 years old and patients between 55-64 years old are 13.58±14.55mm in the case of central incisors, 10.04±5.52 in the case of lateral incisors and 22.39±13.65mm in the case of canines.

According to our results, the canines are the teeth with the greatest complexity when it comes to immediate implantology treatments. Furthermore, that kind of treatment is more complex as age increases, since we observed a gradual percentage of unfavourable sockets in older patients.

Key words:Bone attachment, cortical bone height, cortical thickness, bone resorption, type of socket, immediate implants.

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