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.

Assessment of Bone Dimensions in the Anterior Maxilla: A Cone Beam Computed Tomography Study.

PURPOSE: To evaluate labial and palatal bone thickness at the maxillary anterior teeth as well as distance from cemento-enamel junction (CEJ) to bone crest using cone beam computed tomography (CBCT). MATERIALS AND METHODS: Measurements were obtained for maxillary anterior teeth of 120 subject CBCT volumes including thickness of labial and palatal plates of bone (coronal, middle, and apical thirds), and distance between CEJ and alveolar bone crest mid-labially, mesially, and distally. RESULTS: The mean value of bone thickness at coronal, middle, and apical thirds of the labial side for central incisor roots were respectively: 0.73, 0.69, 0.60 (mm), for lateral incisors: 0.70, 0.61, 0.49 (mm), and for canines: 0.74, 0.53, 040 (mm). The thickness of palatal bone was significantly larger. The mean distance between CEJ and mid-labial bone crest for all sites was 2.16 mm. CONCLUSION: Labial bone thickness is thin in the vast majority of maxillary anterior teeth. Use of CBCT facilitates planning for immediate implant placement and is helpful in the decision-making process when further bone augmentation is needed.

Antibiotics prescribing practices in oral implantology among jordanian dentists. A cross sectional, observational study.

BACKGROUND: In oral implantology, there is no consensus on the most appropriate regimen for antibiotics prescribing, the decision to prescribe antibiotic is usually based on procedure, patient and clinician related factors. The aim of this study was to investigate the rationale of antibiotic prescribing among Jordanian clinicians who practice oral implantology. FINDINGS: The target sample for the study was the 250 Jordan Dental Implant Group members. A five page questionnaire contained 41 questions, both closed and open questions were used to collect data. Statistical analysis was performed using SPSS Windows 16.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were generated.The response rate was (70.4%) 176/250. Mean age was 37.2 yrs, 49.4% always prescribe antibiotics mainly oral amoxicillin and amoxicillin with clavulinic acid. Antibiotics prescribing increased with flap raising, multiple implants and sinus or bone augmentation. Patient medical condition, periodontitis and oral hygiene were the most important clinical factors in antibiotic prescribing, non-clinical factors were; reading scientific materials, courses and lectures, knowledge gained during training, and the effectiveness and previous experience with the drug. CONCLUSIONS: Wide variations in antibiotics types, routes, dose and duration of administration were found. Recommendations on antibiotic prescribing are needed to prevent antibiotic overprescribing and misuse.