| Objectives:Due to the special anatomic structure and high aesthetic risk of the upper anterior region,performing immediate implant surgery in this region has always been a difficult dental implantation problem.Implant implants should be guided by biomechanics,Otherwise,aesthetic problems such as lip bone wall absorption,secondary gingival recession,and abutment exposure may occur.Therefore,it is extremely important to understand the shape of the alveolar process and the anatomy of the root before surgery.Cone beam computed tomography?CBCT?can provide accurate 3D anatomical information of the maxillofacial region compared with curved tomography,and provides a novel platform for the diagnosis and treatment of oral diseases,which is the guarantee of the success of implant surgery.In this study,CBCT was used to measure and analyze the anatomy of the normal maxillary anterior teeth,and to provide a reference for immediate pre-implant evaluation,surgical implement,and selection of prosthetic solutions,with a view to reducing surgical,prosthetic and aesthetic complications.Materials and methods:From October 1st 2016 to October 1st 2018,100 patients were selected for CBCT shooting in the Department of Stomatology,Department of Stomatology,Affiliated Hospital of Dalian Medical University,and 45 of them were male and 55 were female.They were measured and analyzed with CDV Viewer.Software to measure dental anatomy data of central incisor?ce?,lateral incisor?la?,and canine?ca?:tooth length?A?,root length?B?,root neck 1/3 width?C?,1/3 width in the root?D?;anatomical data of alveolar process:width of alveolar process top?E?,middle alveolar process width?F?,alveolar process base width?G?,labial neck bone mass?H?,Root Bone Mass?I?,Hip Neck Bone Mass?J?,Hip Root Bone Mass?K?,Denture?M?,Lip Cortical Bone Depression?R?,Nasal Sacral Tube diameter?V?;relationship between tooth and alveolar process:the long axis of the tooth forms an angle with the long axis of the alveolar process?L?,the distance from the apex to the base of the nose?N?,the distance from the alveolar crest to the CEJ?O?,the tooth Angle of trough process and nasal floor?P?,sagittal classification of roots?Q?,width of anterior nasal and iliac canal coronal bone?W?,width of anterior nasal and iliac canal root?X?,dental axis Nasal canal angle?Y?;Simulated implantation:whether immediate implantation?S?,screw retention?T?,whether root-oriented simulation implant?U?,are measured using SPSS 23.0 Statistical analysis was performed to analyze the differences in gender and tooth position.Finally,the correlation between the measurement items was analyzed,and age was used as a risk factor to explore its impact on immediate implant.Results:1.Upper anterior teeth anatomy data:1.1 The ce/la/ca tooth lengths were:22.68±1.94 mm,21.99±1.60 mm,and25.62±2.10 mm.1.2 The lengths of ce/la/ca roots were 12.52±1.65 mm,13.10±1.31 mm,and 16.61±1.82 mm.1.3 The 1/3 width of ce/la/ca root neck was 6.75±0.48 mm,6.32±0.56 mm,7.77±0.73mm.1.4 The 1/3 width of ce/la/ca roots were 4.93±0.47 mm,4.97±0.60 mm,and5.97±1.10 mm.There is a significant difference in A/B/C/D between ce/la/ca?P<0.05?;there is a significant difference in A/B/C/D between genders?P<0.05?.2.Anterior alveolar process anatomy data:2.1 The widths of the ce/la/ca alveolar processes were:8.20±0.79 mm,7.67±0.79 mm,9.48±0.95 mm.2.2 The widths of the ce/la/ca alveolar processes were:8.84±1.70 mm,7.44±1.68 mm,and 10.03±1.97 mm.2.3 The widths of ce/la/ca alveolar protrusions were 11.00±2.33 mm,9.63±2.52 mm,and 13.64±3.03 mm.2.4 ce/la/ca lip neck bone mass was 0.84±0.37 mm,0.81±0.53 mm,0.86±0.56 mm;ce/la/ca lip neck bone mass>2mm occurred at a rate of 1%,4%,3%.2.5 The ce/la/ca labial root bone mass was 1.33±0.78 mm,1.47±0.83 mm,and1.35±1.01 mm.2.6 The ce/la/ca sacroiliac neck bone mass were 1.13±0.78 mm,0.81±0.40 mm,and1.06±0.41 mm.2.7 ce/la/ca sacral root bone mass were:7.51±1.62 mm,5.97±1.54 mm,8.68±1.85mm,ce/la/ca sacral root bone mass were less than 5mm and the incidence rates were 6%,24%,3%.2.8 The depth of ce/la/ca sockets are:9.70±1.89 mm,10.12±1.59 mm,13.61±1.92mm.2.9 The depth of ce/la/ca labial cortical bone depressions were 1.99±0.93 mm,2.53±0.89 mm,and 1.11±0.82 mm.2.10 The diameter of the nasal canal tube was 3.14±0.88 mm.There is a significant difference between ce/la/ca in E/F/G/J/K/M/R?P<0.05?;between genders E/(F[ce],F[la])/G[ce]/H[ce]/I[ce]/J[ca]/(K[ce],K[la])have significant differences?P<0.05?.There are significant differences in the above data.In the data,men are greater than women,The incidence of ce/la/ca lip-side neck bone mass>2 mm accounted for 1%,4%,3%,and ce/la/ca palatine side root bone mass K<5 mm accounted for 6%,24%,3%.3.Anatomy data of the relationship between tooth and alveolar process:3.1 The angles between the long axis of the ce/la/ca tooth and the long axis of the alveolar process were:15.56±7.13°,17.70±7.95°,17.43±7.22°.3.2 The distances from the apex to the nasal floor of ce/la/ca were 12.14±8.05 mm,11.73±3.15 mm,7.92±3.78 mm.3.3 The distance from the ce/la/ca alveolar crest to the CEJ are:2.81±1.28 mm,2.99±0.97 mm,3.00±1.11 mm.3.4 The angles between the ce/la/ca alveolar process and the nasal floor were126.5±7.34°,125.46±6.26°,and 118.15±6.17°.3.5 The types of cetoid and teeth?,?,?,and?are 77.50%,15.50%,1.00%,and 6.00%,respectively.The types of gingival and?,?,?,and?to teeth are:63.50%,10.50%,2.00%,24.00%;the ratio of ca.alveolar process to teeth?,?,?,?are:90.50%,5.50%,0.00%,4.00%.3.6 Anterior nasal and iliac canal coronal bone width:2.29±0.86 mm.3.7 Anterior nasal and iliac canal root square bone width:4.26±1.30 mm.3.8 Angle between dental axis and nasal tube:3.06±9.79°.There is a significant difference in L/N/P/Q between ce/la/ca?P<0.05?,and a significant difference in L/N/O[ca]/P[ce]between genders?P<0.05?,above There were significant differences in the data for men over women.4.Simulation implants4.1 ca cannot be implanted immediately:16.0%.4.2 The ratios of ce/la/ca screw retention are:75%,49%,74%.4.3 The ce/la/ca root-direction simulated implantation penetration rates were:74%,63.50%,and 80.50%.ce/la/ca showed a significant difference in T/U?P<0.05?;male and female showed a significant difference in T[la]/U[la]?P<0.05?,male la can be screwed The bit ratio is higher than that of females,and the penetration rate of laminar laminar bone implantation in females is higher than that in males.5.Correlation studies R,H,X[ce]screen relevant factors.Linear regression analysis shows that the regression equations are:R=3.604-0.187F+0.015Y;H=0.251-0.257D+0.227E;X[ce]=2.491+0.806W-0.032Y.T and U screen relevant factors and conduct unconditional logistic regression analysis to conclude that increasing F,H,and Y values are favorable factors for screw retention,and decreasing K and O values are favorable factors for screw retention;L values increase Large is the risk factor for root penetration to the lip.Decreasing G,I,J,Y values are risk factors for root penetration to the lip.The effects of aging on F,I,L,N,O,U,V,and Y were statistically significant?P<0.05?,and aging was negatively correlated with F,I,and Y,and related to L,N,O,and U and V are positively correlated.Conclusions1.The labial bone wall of the maxillary anterior teeth area is thin,and the anatomical structure around different tooth positions have different characteristics.The anatomical evaluation of the area by CBCT before implanting has important clinical value.Gender differences and aging changes also affect the anatomy of the jaw in the anterior teeth area,which should be considered immediately before implant.2.The apical region of the central incisor has sufficient bone mass.Immediate implant is easy to obtain initial stability,but attention should be paid to the size and morphological changes of the nasal canal.The bone plate in the lateral incisor area is the thinnest and is a high-risk area for immediate implantation.It is prone to complications such as insufficient initial stability and perforation of the labial bone wall.The roots of canines are thick and long,often resulting in insufficient bone mass from the apex to the base of the nose,affecting the initial stability of the implant.3.Immediately before the maxillary anterior implant,the following anatomical factors should be evaluated:the depth of the labial bone depression,the thickness of the labial bone wall,the width of the root and square bone of the anterior wall of the nasal canal,the width of the middle alveolar process,and the bone volume of the neck,Bone mass at the palatal root,distance from alveolar ridge top to CEJ,base width of alveolar process,bone mass at the labial root,bone mass at the palatal neck,long axis of the teeth and long axis of the alveolar process,dental axis and nose Sacral tube angled and so on.4.Factors influencing the choice of restoration retention methods include:the width of the middle of the alveolar process,the bone mass of the labial neck,the bone mass of the palatal root,the distance from the alveolar crest to the CEJ,and the angle between the dental axis and the nasal canal.5.The influencing factors of implant lip and palatal implant angle include:the width of the alveolar base,the bone mass of the labial root,the bone of the iliac neck,the angle between the long axis of the alveolar process and the long axis of the alveolar process,the dental axis and the nasal cavity Angled. |
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