Restoring Severely Atrophic Edentulous Ridge of Mandible Using Self-Expanding Tissue Expander-A Case Report.

This report describes the use of Self Inflating Tissue Expanders (SITEs) to rehabilitate severely atrophic edentulous mandibular ridges, enabling successful bone grafting and implant placement. The treatment resulted in stable and complication-free implants over a seven-year follow-up, demonstrating SITEs' effectiveness in providing sufficient bone volume and soft tissue coverage for dental implants.

Single crown restorations supported by 6-mm implants in the resorbed posterior mandible: A 10-year prospective case series.

PURPOSE: To assess marginal bone level changes, implant and restoration survival, condition of the peri-implant mucosa, and the patient's satisfaction with the single restoration supported by a 6-mm long implant in the posterior mandible after 10 years in function. MATERIALS AND METHODS: Twenty-one consecutive patients missing premolars or molars in the posterior mandible, with a bone volume consisting of a width of at least 6 mm and an estimated height of 8 mm between the top of the ridge and alveolar nerve, were included. Each patient received one or more 6-mm implants. After 3 months, the implants were restored with custom-made titanium abutments and cemented zirconia-based porcelain crowns. The clinical examination and radiograph data were assessed at restoration placement and after 12, 60, and 120 months. The patients answered a questionnaire to score their satisfaction before treatment and after 12, 60, and 120 months with the restoration in function. RESULTS: A total of 31 implants were placed. Implant survival was 100%. The 10-year mean marginal bone loss was 0.18 mm (SE: 0.08). The plaque, calculus, gingiva, and bleeding indices scores were low as was the mean pocket probing depth. The patients' satisfaction was high. CONCLUSION: The 10-year follow-up data of this limited case series study reveal that 6-mm dental implants inserted in the resorbed posterior mandible provide a solid basis for single tooth restorations.

Bone formation in large/moderate gap after immediate implantation in response to different treatments: a pre-clinical study in the canine posterior mandible.

OBJECTIVES: This study aims to investigate different treatments on new bone formation around immediate implants in the canine posterior mandible with varying sized mesial-distal gap. MATERIALS AND METHODS: The 4th premolar and the 1st molar of six Labrador dogs were extracted from the mandible, and 4 dental implants were placed 1 mm below the level of the buccal bone crest. Moderate/large mesial-distal gaps between the implants and the sockets were treated with one of four methods and divided into the following groups: (1) the blank group, (2) the collagen membrane (CM) group, (3) the deproteinized bovine bone mineral (DBBM) group, and (4) the DBBM + CM group. Sequential fluorescent labeling was performed at 4, 8, and 10 weeks after the operation. After 12 weeks, the dogs were euthanized, and specimens were collected for micro-CT scanning and histological analysis. RESULTS: The survival rate of immediate implant was 100%. Micro-CT showed significant differences in bone mineral density (BMD) and bone volume fraction (BVF) among groups (P = 0.040, P = 0.009); other indicators were not significantly different among groups. Histological analysis showed the proportion of new bone formation and bone-to-implant contact were not significantly different among groups. No significant difference in bone reduction height around dental implant among four groups and varied mesial-distal gap size. CONCLUSION: Owing to the restricted sample size, this pilot study lacks conclusive findings. Within the limitation, this study demonstrated that although DBBM significantly increase BMD and BVF, the use of DBBM/CM didn't significantly improve bone formation and healing in extraction sockets around the implants in both moderate and large mesial-distal gap. CLINICAL RELEVANCE: The use of deproteinized bovine bone in conjunction with collagen is a common practice in immediate implantation procedures in the posterior mandible. However, there is a lack of conclusive evidence regarding the timing and circumstances under which they should be employed.

Ameloblastic fibro­odontoma in the posterior mandible: A case report.

Ameloblastic fibro-odontoma (AFO) is a rare, slow-growing neoplastic lesion classified as a benign, epithelial odontogenic mesenchymal tumor. This tumor exhibits histological features characteristic of both ameloblastic fibromas and complex odontomas. The clinical manifestation of AFO is typically characterized by the asymptomatic enlargement of the jawbones. Radiographically, it presents as a distinct radiolucent region, indicating the presence of radiopaque substances with varying degrees of irregularities in size and morphology. Standard therapeutic intervention involves enucleation. Despite its benign nature, AFO can cause significant morbidity if left untreated. Therefore, prompt diagnosis and appropriate management are essential to ensure optimal patient outcomes. The present study describes the case (clinical presentation and management) of an 18-year-old male patient with an AFO lesion located in the posterior mandible. This particular case was treated with conservative measures involving surgical enucleation along with the extraction of the impacted tooth and the curettage of residual bone.

Ameloblastic Fibro-Odontoma of the Posterior Mandible: A Rare Pathological Entity.

Ameloblastic fibro-odontoma (AFO) is a rare, slow-growing neoplastic lesion classified as a benign, epithelial mixed odontogenic tumor with odontogenic mesenchyme. This tumor demonstrates the histological features characteristic of both ameloblastic fibromas and complex odontomas. The clinical manifestation of AFO is typically characterized by asymptomatic enlargement of the jawbones. Radiographically, it presents as a distinct radiolucent region, indicating the presence of radiopaque substances with varying degrees of irregularities in size and morphology. Standard therapeutic intervention involves enucleation. Despite its benign nature, AFO can cause significant morbidity if left untreated. Therefore, prompt diagnosis and appropriate management are essential to ensure optimal patient outcomes. The following case report details the clinical presentation and management of an 18-year-old male with an AFO lesion located in the posterior mandible. This particular case was treated with conservative measures involving surgical enucleation.

Management of Posterior Mandibular Bone Cavitation for Dental Implant Placement: A Case Series of 5-24 Years of Follow-Up.

Focal osteo-cavitation in the posterior mandible is a condition that clinicians do not know well. Inadvertent implant placement in such areas may result in nerve damage due to abrupt drill penetration and implant displacement in the medullary space. In the present case series, focal osteo-cavitation was managed with the following procedures: (1) undersized drilling, (2) gentle trabecular curettage, (3) bone substitute material grafting in the cavity, and (4) long healing period for osseointegration. In all cases, a sudden loss of drilling pressure immediately after passing through the thin cortical layer revealed focal osteo-cavitation. Following undersized drilling and gentle trabecular curettage, the bone substitute material was packed into the cavity with care not to press the inferior alveolar canal. Implant placement was subsequently performed. Despite a lack of primary implant stability in 3 of 4 cases, all implants were successfully osseointegrated after 6-9 months. Over 5-24 years, all implants functioned well.

Vertical ridge augmentation of atrophic posterior mandible with corticocancellous onlay symphysis graft versus sandwich technique: clinical and radiographic analysis.

Alveolar ridge augmentation of atrophic posterior mandibular ridge represents a challenge in oral and maxillofacial surgery to restore aesthetic and function. The aim of the study was to compare the clinical and radiographic outcomes of bone formation in atrophic posterior mandibles augmented using onlay symphysis cortico-cancellous bone block with that augmented using sandwich bone augmentation technique (Inlay). Twelve patients were selected with missing mandibular posterior teeth. CBCT were done for all patients preoperatively to assess the residual bone height, ranged between 5 and 7 mm from the inferior alveolar nerve with adequate sufficient alveolar ridge width more than 4 mm. Patients required bone augmentation procedure with autologous onlay chin graft (group I) versus those used as inlay sandwich technique (group II). Clinical and radiographic analysis were done to analyses the newly formed bone and bone height. Percent of change in bone height was also calculated and revealed that group I was higher than group II, however, statistically insignificant differences between the two groups were found regarding the percentage of newly formed bone. Vertical ridge augmentation procedures using onlay chin graft took lesser time than the interpositional grafting with fixation technique, however, both techniques are promising for vertical ridge augmentation.

Comparison Between the Bone Lid Technique and the Traditional Technique in Surgical Treatment of the Posterior Mandibular Lesions: A Randomized Controlled Trial.

Introduction Cystic lesions of the jaws and the impacted teeth are two of the most common cases that require surgical intervention in oral and maxillofacial surgery; however, surgeons also frequently use a traditional technique that involves the removal of the buccal bone plate. This study was conducted to compare the clinical and radiologic outcomes of the bone lid technique and the traditional technique. Methods This randomized controlled trial included 20 patients who were randomly divided into two groups (n = 10 each): the T group, in which the lesions were accessed using the traditional technique with classical rotating instruments, and the BL group, in which the lesions were accessed with the bone lid technique performed using a piezoelectric device, with repositioning of the buccal bone plate. Operative time, pain, edema, inferior alveolar nerve injury, and bone defect healing were measured during clinical and radiological follow-ups at 24 h, 72 h, one week, one month, and six months after the surgery. Results Normal soft tissue and bone healing were observed in all cases except one case in the BL group. The T group had a shorter mean operative time than the BL group. In terms of pain, edema, and inferior alveolar nerve injury, the groups did not differ statistically significantly. The percentage of bone defect healing was significantly greater in the BL group than in the T group after six months of follow-up. Conclusion The bone lid technique performed using a piezoelectric device was effective and safe for managing lesions in the posterior mandibular region and was not associated with increased postoperative complications. The disadvantages of this technique include a longer operative time and the need for fixation tools in some cases. In contrast, this technique outperforms the traditional technique in terms of reducing bone loss and improving the healing of bone defects.

Dynamic navigation system-guided trans-inferior alveolar nerve implant placement in the atrophic posterior mandible: A case report.

BACKGROUND: In atrophic posterior mandibular areas, where the bone height superior to the inferior alveolar nerve (IAN) is less than 6 mm, short implants are not applicable. Conventional alternatives such as IAN transposition and various alveolar bone augmentation approaches are technically demanding and prone to complications. CASE SUMMARY: Computer-guided dynamic navigation implantation improves the accuracy, predictability, and safety of implant placement. This case report presents a dynamic navigation system-guided trans-IAN implant placement technique, which can successfully treat a posterior mandibular dentition defect when the bone height is only 4.5 mm. The implant was inserted into the buccal side of the IAN and was 1.7 mm away from the IAN. The implantation deviations were controlled within a satisfying range, and the long-term restoration outcome was stable. CONCLUSION: Dynamic navigation system-guided trans-IAN implant placement might be a recommended technique for patients with extremely insufficient residual bone height and sufficient bone width in the posterior mandibular area.

Evaluation of the survival rate of short implants placed in the posterior atrophic mandible: 5-year clinical study.

OBJECTIVE: The aim of the study was to assess the long-term prognosis of short implants (5 to 6 mm) placed in the posterior region of the atrophic mandible. METHOD AND MATERIALS: The study included 81 patients with severe vertical atrophy of the bone in the posterior region. The patients had 248 short implants (5 to 6 mm) implants placed in the mandibular posterior region and 256 implants with length greater than 10 mm in the mandibular anterior region. Analysis of implant and prosthesis failures, cumulative survival rate, and marginal bone loss was determined at 1 year and 5 years of follow-up (58 ± 7 months). RESULTS: Mean marginal bone loss after 1 year of prosthetic loading was 0.74 mm for short implants and 0.72 mm for implants with length greater than 10 mm; after 5 years of prosthetic loading this was 1.27 mm for short implants and 1.31 mm for implants with length greater than 10 mm. Of 248 short implants (5 to 6 mm), six failed: four due to peri-implantitis and two due to lack of osseointegration (early rejection). Of 256 implants with length greater than 10 mm, five failed: three due to peri-implantitis and two due to lack of osseointegration (early rejection). On average, over the observation period (58 ± 7 months), the 5-year cumulative implant survival rate was 97.8% in short implants, and 98.1% in longer implants; the prosthesis cumulative survival rate was 98.2%. CONCLUSIONS: Based on the results, it was concluded that the prognosis of the use of short implants for prosthetics in the posterior resorbed mandible can be considered favorable and reasonable.

3D vertical alveolar crest augmentation in the posterior mandible using the tunnel technique: A 10-year clinical study.

PURPOSE: To evaluate the short- and long-term outcomes of vertical 3D bone augmentation in the posterior mandible, performed using the split bone block technique with a tunnel technique. MATERIALS AND METHODS: Patients were treated for vertical and horizontal alveolar bone defects without simultaneous implant placement and followed up for at least 10 years postoperatively. Autogenous bone blocks were harvested from the mandibular retromolar area following the MicroSaw protocol (Dentsply Sirona, Charlotte, NC, USA). The harvested bone blocks were split longitudinally according to the split bone block technique and grafted in 3D form using a tunnel technique. Implants were inserted and exposed after 3 months and prosthetic restoration was performed. RESULTS: A total of 117 consecutively treated patients with 128 grafted sites in 3D form were enrolled in the present study and followed up over a period of up to 17 years. The 10-year results were collected with a total patient dropout rate of 24.13%. Minimal late graft exposure was documented postoperatively for 4 to 8 weeks on the lingual site in two cases but did not influence the outcome. Infection of the grafted area occurred in one other case, leading to loss of the grafted bone. The postoperative mean vertical bone gain was 7.6 ± 3.1 mm and the mean bone width achieved after surgery was 8.1 ± 1.6 mm. A total of 287 implants were inserted 3 months after the augmentation procedure. The maximum vertical bone resorption, which was calculated around implants, was 0.66 ± 0.38 mm after 1 year, 0.72 ± 0.31 mm after 5 years and 0.75 ± 0.43 mm after 10 years. Furthermore, five implants were lost during this time, due to peri-implantitis and chronic pain. After 10 years, the mean vertical bone gain was stable at 6.72 ± 2.26 mm and the resorption rate was 11.4%. CONCLUSIONS: The short- and long-term results of the present study confirm the predictability of using mandibular bone blocks according to the split bone block technique for 3D bone reconstruction in the posterior mandible.

Potential Circumferential Bone Engagement following Tooth Extraction in the Posterior Mandible: Computed Tomography Assessment.

Background and Objectives: Immediate implant placement (IIP) is a popular surgical procedure with a 94.9-98.4% survival rate and 97.8-100% success rate. In the posterior mandible, it poses a risk of injury to adjacent anatomical structures if the implant engages apical bone. This study sought to assess the implant dimensions that allow for circumferential bone engagement at each position in the posterior mandible without additional apical drilling. Materials and Methods: An observational, cross-sectional study design was used. The pre-extraction cone beam computed tomography scans of 100 candidates for IIP were analyzed. Measurements of each root of the posterior mandibular second premolar, first molar, and second molar were taken from three aspects: buccolingual, mesiodistal, and vertical. Two-sided p values < 0.05 were considered statistically significant. Results: A total of 478 mandibular teeth and 781 roots were assessed. Based on Straumann® BLX/BLT implant-drilling protocols, predicted rates of radiological circumferential engagement (RCE) were 96% for implants 5 mm in diameter in the second premolar root position; 94% for implants 4.0-4.2 mm in diameter in the first molar root position; and 99% for implants 4.5-4.8 mm in diameter in the second molar root position. Corresponding rates of achieving an available implant length (AIL) of 10 mm were 99%, 90%, and 86%. Patients <40 years old were at higher risk of lower RCE and lower AIL (p < 0.005) than older patients for all roots measured. Conclusions: The high primary stability prediction rates based on the calculation of RCE and AIL support the use of IIPs without further apical drilling in the posterior mandible in most cases.

Dynamic Navigated "Sandwich" Technique: A Novel Surgical Approach for Safe Osteotomies in the Rehabilitation of an Atrophic Posterior Mandible: A Case Report.

A 56-year-old female patient with vertical atrophy of the right posterior mandible was treated adopting an interpositional bone block approach using a cancellous heterologous bone block. Osteotomies of the patient's mandible were performed with the help of dynamic computer-assisted surgery using virtual anatomical patient information obtained from a cone beam computed tomography (CBCT). The use of the dynamic computer-assisted surgery allowed authors to perform the horizontal osteotomy line as planned preoperatively on the CBCT virtual reconstruction, trying to minimize the risks of the inlay technique. No neurological complications were observed after surgery. The inlay technique could benefit from the aid of dynamic navigation technologies in posterior atrophic mandibles, increasing the reproducibility of the technique. A likely safer method for performing osteotomies with the "sandwich" technique in the posterior atrophic mandible is reported.

Computed Tomography for the Assessment of the Potential Risk After Implant Placement in Fresh Extraction Sites in the Posterior Mandible.

Immediate implant placement (IIP) is considered a reliable procedure, with survival rates of 94.9%-98.4%. Nevertheless, in the posterior mandible, it poses a high risk of damage to anatomic structures. The aim of this study was to determine the risk of anatomic structures injury associated with IIP in the posterior mandible based on apical primary stability, respecting a safe distance from the inferior alveolar nerve and lingual plate, and to evaluate the influence of different factors on those risks. Pre-extraction cone beam computed tomography scans of 100 patients were retrospectively analyzed. Measurements were taken from tooth apices to lingual plate and to mandibular canal. Values of <4 mm of the former and <6 mm of the latter were categorized as considerable risk. Values of <2 mm at both measurements were considered high risk. Two-sided P < .05 was considered statistically significant. Mean root-to-alveolar canal distance was 7.6 ± 2.7 mm in the first molar, 6.5 ± 3mm in the second premolar, and 5.4 ± 3 mm in the second molar (P < .005). The mean distance to the outer lingual cortex was 3.9 ± 2.1 mm in the first molar and 3.2 ± 0.1 mm in the second molar. Thus, second molars were at higher risk of inferior alveolar nerve injury and lingual plate perforation during IIP. Background factors associated with higher IIP risk were female sex and age < 40 years. In the mandible, the anatomic risk posed by IIP is greatest for second molars and lowest for first molars. Several background factors affect the distances between root apices and the mandibular canal.

Split-crest technique with inlay bone block grafts for narrow posterior mandibles: a retrospective clinical study with a 3-year follow-up.

The use of the split-crest technique (SCT) and bone block grafts provides benefits to horizontal bone augmentation. However, no information is currently available to evaluate the clinical effects of SCT combined with inlay bone block grafts on soft and hard tissues of the narrow posterior mandibles. In this study, 56 healthy patients underwent SCT to augment the alveolar ridge width. Implant placement was performed 3 months after SCT, and the implants were restored 3 months after placement. A planned follow-up was performed to analyze various clinical features, including X-ray radiographs, alveolar ridge width, and keratinized mucosal width, after SCT to evaluate the success of the procedure. The incisions healed well in all patients. The average initial alveolar ridge width was 2.78 ± 0.56 mm, which increased to 6.67 ± 0.60 mm after SCT. Three months later, this width declined slightly to 6.19 ± 0.48 mm. The average initial keratinized mucosal width was 2.83 ± 0.66 mm, which increased to 6.00 ± 0.71 mm 3 months later. Both at 3 months and 1 year after the procedure, vertical bone loss at the buccal sites was 1.32 ± 0.56 mm and 1.94 ± 0.54 mm, respectively. Survival rates of the implants were 100% after 3 years. SCT with inlay bone block grafts was successfully applied to narrow posterior mandibles with efficient augmentation of soft and hard tissue widths. The findings of this study aim to identify future beneficial applications of SCT.

Key factors influencing short implant success.

AIM: This systematic article reviews the literature on the confounding parameters that affect short implant survival in order to establish specific surgical and prosthetic protocols that create an optimal biomechanical scenario and ensure implant longevity. MATERIALS AND METHODS: The available literature was screened for randomized clinical trials and prospective cohort and retrospective studies, published up to February 20, 2020, on the prognosis of short-length implants placed in posterior jaws. Studies evaluating the 5-year clinical performance of short dental implants (5 mm or 6 mm) in fixed rehabilitations of partially edentulous posterior jaws were included. RESULTS: Eleven studies were selected after assessment of inclusion and exclusion criteria, of which 8 were RCTs, 2 were prospective studies, and 1 was a retrospective study. After 5 years in function, 22 short (12 in maxilla and 10 in mandible) and 10 standard (2 in maxilla and 8 in mandible) implants were lost, resulting in high survival rates independent of implant length or location. More biological complications were found in standard implants especially those placed in augmented posterior mandibles (135 complications compared to 48 in short mandibular implants). Splinted prostheses were associated with less technical complications (15 out of 53 complications affecting short implants). CONCLUSION: The findings of this review showed that, when used correctly, short implants achieve predictable and promising long-term outcomes, provided they are placed following a comprehensive surgical and prosthetic protocol, based on the different biomechanical parameters essential to optimize long-term prognosis. CLINICAL SIGNIFICANCE: The use of short implants in clinical practice has considerably increased in a wide variety of cases, given that they offer several advantages for both patient and practitioner. Recent literature shows that, when specific criteria are respected, new generations of short implants present high, long-term survival rates. This review is designed to provide a thorough understanding of the surgical and prosthetic protocols that create an optimal biomechanical scenario for short implants and improve their prognosis.

Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series.

PURPOSE: To present the application of custom-made 3D-printed subperiosteal implants for fixed prosthetic restoration of the atrophic posterior mandible of elderly patients. METHODS: Between January 2017 and June 2018, all partially edentulous patients aged over 65 years, with two or more missing teeth in the posterior atrophic mandible, and who did not want to undergo bone regenerative procedures, were included in this study. These patients were rehabilitated with custom-made subperiosteal implants, designed from cone beam computed tomography (CBCT) and fabricated in titanium by means of direct metal laser sintering (DMLS). The outcome measures were fit and stability of the implants at placement, duration of the intervention, implant survival, and early and late complications. All patients were followed for 1 year after surgery. RESULTS: Ten patients (four males, six females; mean age 69.6, SD ± 2.8, median 69, 95% CI 67.9-71.6) were included in the study. The fit of the implants was satisfactory, with a mean rating of 7 out of 10 (SD ± 1.6, median 7, 95% CI 6-8). Only two implants had insufficient fit, because of the presence of scattering in the CBCT; however, they were adapted to the sites during the interventions. The mean duration of the intervention was 44.3 min (SD ± 19.4, median 37, 95% CI 32.3-56.3). At the one-year follow-up, no implants were lost (survival rate 100%). One implant presented immediate postoperative complications with pain, discomfort and swelling, and two patients experienced late complications, having their provisional restorations fractured during the temporisation phase. All these complications were minor in nature, but the final complication rate amounted to 30% (three of ten patients). CONCLUSIONS: Although this study has limits (small patient sample and short follow-up), DMLS has proven to be an effective method for fabricating accurate subperiosteal implants, with high survival rates. This may represent an alternative treatment procedure in elderly patients with a severely atrophic posterior mandible, since it allows avoidance of regenerative bone therapies. Further studies are needed to confirm these outcomes.

Odontogenic Tumors.

Odontogenic tumors are a group of neoplastic growths that originate from the tissues responsible for tooth formation and the periodontal apparatus of the jaw. Odontogenic tumors usually present as radiolucent defect, which makes diagnosis somewhat confusing while differentiating them from cysts. Although cystic lesions are surrounded by sclerotic borders, few odontogenic tumors share similar features. This article reviews clinical concepts of several odontogenic tumors that occur in the proximity or in association with teeth and not merely focusing on relatively common conditions.

Morphometric predictors of lingual undercut depth in the posterior mandible and their relevance to immediate dental implant insertion: recommendations for CBCT / Predictores morfométricos de la profundidad de la «undecurt¼ lingual en la parte posterior de la mandíbula y su relevancia para la inserción inmediata de implantes dentales: recomendaciones para la CBCT

Deep lingual undercut (LU) is commonly encountered in the posterior mandible, and is considered a risk factor in dental implants. In this study we investigated the value of data extracted from OPGs in predicting LU depth. Such predictors might be valuable in reducing the chance of lingual plate perforation (LPP) by recommending CBCTs prior to dental implant insertion when deep LU is anticipated We aimed at assessing the following variables as potential predictors of LU depth: 1) alveolar process height (measured on OPGs), 2) alveolar process width (measured on CBCTs), and 3) the distance from apical region of dental alveoli to superior margin of IAN canal (measured on OPGs). 128 CBCTs and corresponding OPGs of posterior mandibles of 128 patients (70 females, 58 males; age range=18-87 years, mean age=45.8 years, SD=17.0 years) were used. Only dentate sites of lower first (LM1) and second molars (LM2) were considered. Four predictors of LU depth were found, the strongest was the ratio between alveolar process width (which could be assessed clinically) and alveolar process height as measured on OPGs (r=.454 at LM1 site, r=.592 at LM2 site). Predictors derived from OPG measurements might be valuable in anticipating LU depth and might be more valuable when combined with alveolar process width (which might be assessed clinically). We recommend considering the suggested predictors in assessing the need of CBCT prior to immediate dental implant insertion in posterior mandible.

El socavado lingual profundo (SLU) se encuentra comúnmente en la porción posterior de la mandíbula y es considerado un factor de riesgo en los implantes dentales. En este estudio, investigamos el valor de los datos extraídos de los OPG para predecir la profundidad del SLU. Dichos predictores podrían ser valiosos para reducir la posibilidad de perforación de la placa lingual (PPL) recomendando CBCT antes de la inserción del implante dental cuando se anticipa un SLU. El objetivo consistió en evaluar las siguientes variables como posibles predictores de profundidad de SLU: 1) altura del proceso alveolar (medida en OPG), 2) ancho del proceso alveolar (medido en CBCT) y 3) la distancia desde la región apical de los alvéolos dentales al margen superior del canal IAN (medido en OPG). Se utilizaron 128 CBCT y las OPG correspondientes de mandíbulas de 128 pacientes (70 mujeres, 58 hombres; rango de edad = 18-87 años, edad media = 45,8 años, SD = 17,0 años). Sólo se consideraron los sitios dentados de los primeros molares inferiores (LM1) y los segundos molares inferiores (LM2). Se encontraron cuatro predictores de profundidad de SLU, el más fuerte fue la relación entre el ancho del proceso alveolar (que podría evaluarse clínicamente) y la altura del proceso alveolar medida en OPG (r = 0,454 en el sitio LM1, r = 0,592 en el sitio LM2). Los predictores derivados de las mediciones de OPG podrían ser valiosos para anticipar la profundidad de SLU y podrían ser más valiosos cuando se combinan con el ancho del proceso alveolar (que podría evaluarse clínicamente). Recomendamos considerar los factores predictivos sugeridos para evaluar la necesidad de CBCT antes de la inserción inmediata del implante dental en la porción posterior de la mandíbula.