Risk assessment of mandibular incisive canal perforation during dental implant surgery in the anterior edentulous mandible: a virtual implant placement study using cone beam computed tomography.

OBJECTIVE: The aim of this study was to evaluate the risk of mandibular incisive canal (MIC) perforation caused by implants placed on cone beam computed tomography (CBCT) images in the edentulous mandibular anterior region. STUDY DESIGN: A total of 1200 dental implants were virtually inserted on 150 eligible CBCT scans. The relationship of different implant sizes with the incidence of MIC perforation and the relationship between crest height and perforation were evaluated. RESULTS: A total of 1200 virtual implant applications were performed on 150 patients. In 87% of cases, MIC was identified. Perforation in 12 and 14 mm implants was significantly higher than in 8- and 10-mm implants (P < .05). Perforation was found to be statistically significantly higher in crest heights that were ≤20 mm than in crest heights >20 mm (P < .05). CONCLUSIONS: Our results showed high perforation rates in the 12- and 14-mm implants and crests heights that were ≤20 mm during implant surgery in the mandibular anterior edentulous region. Perforation of the MIC should be considered a complication of implant surgery in the mandibular anterior region; therefore, CBCT images should be evaluated before implant placement.

Retrospective Assessment of the Anatomy and Dimensions of Nasopalatine Canal with Cone-Beam Computed Tomography.

Objectives: The objective of this retrospective study was to evaluate the anatomy and morphology of the nasopalatine canal in axial, sagittal, and coronal sections with cone-beam computed tomography and to appraise the effect of gender, age, and dental status on the nasopalatine canal. Material and Methods: Overall 1000 patients with cone-beam computed tomography (CBCT) images were analysed retrospectively. The morphology of the nasopalatine canal (NPC) was classified according to sections. Its sizes were measured, and variations were evaluated. The variables obtained were statistically analysed. Results: It was observed that the most common NPC shape was the cylindrical type (47.1%) in sagittal sections, and the C-shaped canal (51.1%) in coronal sections. In the axial section, two Stenson foramen (45.2%) were observed most frequently, and the most common form was found as oval (60.7%). In sagittal sections, statistically significant differences were obtained between all morphometric measurements and shapes of the NPC except the angle of the canal. It was found that all morphometric measurements in sagittal and coronal sections were higher in men. Also, it was found that the NPC angle and NPC length decreased with tooth loss. Conclusions: The nasopalatine canal shows many variations, and its dimensions differ according to gender, age, and dental status. For this reason, before the surgical procedures are applied to the maxilla, it should be evaluated radiologically to prevent complications.

Risk Assessment of Lingual Plate Perforation in Anterior Edentulous Mandibular Region: A Virtual Implant Placement Study Using Cone-Beam Computed Tomography.

BACKGROUND: The aim of this study was to evaluate the prevalence of lingual cortical bone perforation caused by virtually placed implants on cone-beam computed tomography images in the edentulous mandibular canine region and determine the relationship between the morphological structure of the crest and the risk of perforation. METHODS: Eight hundred dental implants were virtually inserted on 100 qualified cone-beam computed tomography scans. Crests were divided into 4 groups according to the crest morphology as Type U, Type L, Type P, and Type C. The distance between the implant tip and lingual plate was measured using a digital caliper. Incidence of lingual plate perforation and proximity of the implant tip to the lingual plate were measured for 4 types of the alveolar crest. RESULTS: A total of 800 virtual implant applications were performed in 100 patients who met the inclusion criteria. The incidence of lingual plate perforation was found to be significantly higher in Type U crests than in the other types. It was also found to be statistically significantly higher in Type L crests than in Type P and Type C crests. When the relationship between implant length and perforation was evaluated, perforation in 14 mm implants was significantly higher than 8, 10, and 12 mm implants. CONCLUSIONS: According to the results of this study, it was determined that high rates of perforation occurred in the U and L type crests and 14 mm implants during implant surgery in the mandibular anterior edentulous region.