Background:
Immediate implant placement is becoming a widely accepted treatment option after tooth extraction in the maxillary anterior esthetic zone in recent years. To achieve successful long-term clinical and esthetic outcomes, it is essential to make comprehensive treatment planning and to follow several established clinical guidelines. The sagittal root position in relation to its associated labial and palatal cortical plates affects the bone volume available for implant engagement after tooth extraction. Since the primary implant stability is crucial for implant success, it is highly recommended to predetermine the socket morphology before tooth extraction with the cone beam computed tomography (CBCT) image. Classification of different sagittal root positions can be also used as one of the indicators of the feasibility of immediate implant placement and as a communication tool with patients and dental colleagues.
Aim/Hypothesis:
The aim of this study was to investigate and classify the sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates in Taiwanese population using CBCT. A comparison was also made between our study and Kan’s study (Kan et al. 2011) to see whether there are differences between western and Taiwanese populations regarding the frequency of each classification.
Material and Methods:
CBCT images were reviewed using ImplantMax software (Saturn, Taiwan) on 100 patients (51 men, 49 women; mean age, 48.6 years), who received treatment in our dental clinic between March 2009 and November 2013 and fulfilled the inclusion criteria. The sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates was evaluated with the cross-sectional image made at the midpoint of the tooth parallel to its long axis and was classified as Class I, II, III, or IV according to Kan’s classification. For Class I, the root is positioned against the labial cortical plate; for Class II, the root is centered in the middle of the alveolus without engaging either side of the cortical plates at its apical third; for Class III, the root is positioned against the palatal cortical plate; for Class IV, at least two thirds of the root is engaging both sides of the cortical plates. The frequency distribution was grouped according to the sagittal root position (Class I, II, III, and IV) and different tooth positions (central incisors, lateral incisors, and canines) and was analyzed using descriptive statistics.
Results:
In the 600 samples of maxillary anterior teeth, the frequencies of each class of the sagittal root position were 93.8%, 1.5%, 0%, and 4.7% for Class I, II, III, and IV, respectively. While Class I was the most common for all tooth position, none of teeth in this study was classified as Class III. Class IV was mainly found on lateral incisors (24 out of 28 teeth, 85.7%). Canines were the least variant tooth position and were almost exclusively classified as Class I (198 out of 200 teeth, 99%). Compared with Kan’s study, the tendency of the frequency distribution was the same, that the Class I was the predominant class, followed by Class IV, Class II, and the Class III was the rarest. However, the percentage of Class I in our study was about 13% higher than in Kan’s study, while the other classes were relatively uncommon in Taiwanese population.
Conclusions and clinical implications:
CBCT is a useful tool to evaluate the probable complexity of surgical and prosthetic procedures of implant therapy. The CBCT image of the sagittal root position provides information of socket morphology after tooth extraction in the anterior maxilla and thus assists in treatment planning of immediate implant placement. However, a certain class of the sagittal root position is not definitely indicative of a certain treatment strategy. The classification system could be further optimized.
Background:
Immediate implant placement is becoming a widely accepted treatment option after tooth extraction in the maxillary anterior esthetic zone in recent years. To achieve successful long-term clinical and esthetic outcomes, it is essential to make comprehensive treatment planning and to follow several established clinical guidelines. The sagittal root position in relation to its associated labial and palatal cortical plates affects the bone volume available for implant engagement after tooth extraction. Since the primary implant stability is crucial for implant success, it is highly recommended to predetermine the socket morphology before tooth extraction with the cone beam computed tomography (CBCT) image. Classification of different sagittal root positions can be also used as one of the indicators of the feasibility of immediate implant placement and as a communication tool with patients and dental colleagues.
Aim/Hypothesis:
The aim of this study was to investigate and classify the sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates in Taiwanese population using CBCT. A comparison was also made between our study and Kan’s study (Kan et al. 2011) to see whether there are differences between western and Taiwanese populations regarding the frequency of each classification.
Material and Methods:
CBCT images were reviewed using ImplantMax software (Saturn, Taiwan) on 100 patients (51 men, 49 women; mean age, 48.6 years), who received treatment in our dental clinic between March 2009 and November 2013 and fulfilled the inclusion criteria. The sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates was evaluated with the cross-sectional image made at the midpoint of the tooth parallel to its long axis and was classified as Class I, II, III, or IV according to Kan’s classification. For Class I, the root is positioned against the labial cortical plate; for Class II, the root is centered in the middle of the alveolus without engaging either side of the cortical plates at its apical third; for Class III, the root is positioned against the palatal cortical plate; for Class IV, at least two thirds of the root is engaging both sides of the cortical plates. The frequency distribution was grouped according to the sagittal root position (Class I, II, III, and IV) and different tooth positions (central incisors, lateral incisors, and canines) and was analyzed using descriptive statistics.
Results:
In the 600 samples of maxillary anterior teeth, the frequencies of each class of the sagittal root position were 93.8%, 1.5%, 0%, and 4.7% for Class I, II, III, and IV, respectively. While Class I was the most common for all tooth position, none of teeth in this study was classified as Class III. Class IV was mainly found on lateral incisors (24 out of 28 teeth, 85.7%). Canines were the least variant tooth position and were almost exclusively classified as Class I (198 out of 200 teeth, 99%). Compared with Kan’s study, the tendency of the frequency distribution was the same, that the Class I was the predominant class, followed by Class IV, Class II, and the Class III was the rarest. However, the percentage of Class I in our study was about 13% higher than in Kan’s study, while the other classes were relatively uncommon in Taiwanese population.
Conclusions and clinical implications:
CBCT is a useful tool to evaluate the probable complexity of surgical and prosthetic procedures of implant therapy. The CBCT image of the sagittal root position provides information of socket morphology after tooth extraction in the anterior maxilla and thus assists in treatment planning of immediate implant placement. However, a certain class of the sagittal root position is not definitely indicative of a certain treatment strategy. The classification system could be further optimized.
Background:
Immediate implant placement is becoming a widely accepted treatment option after tooth extraction in the maxillary anterior esthetic zone in recent years. To achieve successful long-term clinical and esthetic outcomes, it is essential to make comprehensive treatment planning and to follow several established clinical guidelines. The sagittal root position in relation to its associated labial and palatal cortical plates affects the bone volume available for implant engagement after tooth extraction. Since the primary implant stability is crucial for implant success, it is highly recommended to predetermine the socket morphology before tooth extraction with the cone beam computed tomography (CBCT) image. Classification of different sagittal root positions can be also used as one of the indicators of the feasibility of immediate implant placement and as a communication tool with patients and dental colleagues.
Aim/Hypothesis:
The aim of this study was to investigate and classify the sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates in Taiwanese population using CBCT. A comparison was also made between our study and Kan’s study (Kan et al. 2011) to see whether there are differences between western and Taiwanese populations regarding the frequency of each classification.
Material and Methods:
CBCT images were reviewed using ImplantMax software (Saturn, Taiwan) on 100 patients (51 men, 49 women; mean age, 48.6 years), who received treatment in our dental clinic between March 2009 and November 2013 and fulfilled the inclusion criteria. The sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates was evaluated with the cross-sectional image made at the midpoint of the tooth parallel to its long axis and was classified as Class I, II, III, or IV according to Kan’s classification. For Class I, the root is positioned against the labial cortical plate; for Class II, the root is centered in the middle of the alveolus without engaging either side of the cortical plates at its apical third; for Class III, the root is positioned against the palatal cortical plate; for Class IV, at least two thirds of the root is engaging both sides of the cortical plates. The frequency distribution was grouped according to the sagittal root position (Class I, II, III, and IV) and different tooth positions (central incisors, lateral incisors, and canines) and was analyzed using descriptive statistics.
Results:
In the 600 samples of maxillary anterior teeth, the frequencies of each class of the sagittal root position were 93.8%, 1.5%, 0%, and 4.7% for Class I, II, III, and IV, respectively. While Class I was the most common for all tooth position, none of teeth in this study was classified as Class III. Class IV was mainly found on lateral incisors (24 out of 28 teeth, 85.7%). Canines were the least variant tooth position and were almost exclusively classified as Class I (198 out of 200 teeth, 99%). Compared with Kan’s study, the tendency of the frequency distribution was the same, that the Class I was the predominant class, followed by Class IV, Class II, and the Class III was the rarest. However, the percentage of Class I in our study was about 13% higher than in Kan’s study, while the other classes were relatively uncommon in Taiwanese population.
Conclusions and clinical implications:
CBCT is a useful tool to evaluate the probable complexity of surgical and prosthetic procedures of implant therapy. The CBCT image of the sagittal root position provides information of socket morphology after tooth extraction in the anterior maxilla and thus assists in treatment planning of immediate implant placement. However, a certain class of the sagittal root position is not definitely indicative of a certain treatment strategy. The classification system could be further optimized.
Background:
Immediate implant placement is becoming a widely accepted treatment option after tooth extraction in the maxillary anterior esthetic zone in recent years. To achieve successful long-term clinical and esthetic outcomes, it is essential to make comprehensive treatment planning and to follow several established clinical guidelines. The sagittal root position in relation to its associated labial and palatal cortical plates affects the bone volume available for implant engagement after tooth extraction. Since the primary implant stability is crucial for implant success, it is highly recommended to predetermine the socket morphology before tooth extraction with the cone beam computed tomography (CBCT) image. Classification of different sagittal root positions can be also used as one of the indicators of the feasibility of immediate implant placement and as a communication tool with patients and dental colleagues.
Aim/Hypothesis:
The aim of this study was to investigate and classify the sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates in Taiwanese population using CBCT. A comparison was also made between our study and Kan’s study (Kan et al. 2011) to see whether there are differences between western and Taiwanese populations regarding the frequency of each classification.
Material and Methods:
CBCT images were reviewed using ImplantMax software (Saturn, Taiwan) on 100 patients (51 men, 49 women; mean age, 48.6 years), who received treatment in our dental clinic between March 2009 and November 2013 and fulfilled the inclusion criteria. The sagittal root position of the maxillary anterior teeth in relation to its labial and palatal cortical plates was evaluated with the cross-sectional image made at the midpoint of the tooth parallel to its long axis and was classified as Class I, II, III, or IV according to Kan’s classification. For Class I, the root is positioned against the labial cortical plate; for Class II, the root is centered in the middle of the alveolus without engaging either side of the cortical plates at its apical third; for Class III, the root is positioned against the palatal cortical plate; for Class IV, at least two thirds of the root is engaging both sides of the cortical plates. The frequency distribution was grouped according to the sagittal root position (Class I, II, III, and IV) and different tooth positions (central incisors, lateral incisors, and canines) and was analyzed using descriptive statistics.
Results:
In the 600 samples of maxillary anterior teeth, the frequencies of each class of the sagittal root position were 93.8%, 1.5%, 0%, and 4.7% for Class I, II, III, and IV, respectively. While Class I was the most common for all tooth position, none of teeth in this study was classified as Class III. Class IV was mainly found on lateral incisors (24 out of 28 teeth, 85.7%). Canines were the least variant tooth position and were almost exclusively classified as Class I (198 out of 200 teeth, 99%). Compared with Kan’s study, the tendency of the frequency distribution was the same, that the Class I was the predominant class, followed by Class IV, Class II, and the Class III was the rarest. However, the percentage of Class I in our study was about 13% higher than in Kan’s study, while the other classes were relatively uncommon in Taiwanese population.
Conclusions and clinical implications:
CBCT is a useful tool to evaluate the probable complexity of surgical and prosthetic procedures of implant therapy. The CBCT image of the sagittal root position provides information of socket morphology after tooth extraction in the anterior maxilla and thus assists in treatment planning of immediate implant placement. However, a certain class of the sagittal root position is not definitely indicative of a certain treatment strategy. The classification system could be further optimized.