Risk Assessment Of Lingual Plate Perforation In Posterior Mandibular Region During Implant Placement: Retrospective Study Using 3D Virtual Implant Placement Program

Year 2018, , 233 - 238, 01.12.2018

Murat Ulu , Furkan Cıcık Fahrettin Kalabalık , Keremcan Kuru Hüseyin Akçay , Şükrü Enhoş

https://doi.org/10.15311/selcukdentj.385564

Abstract

Background: The aim of this study was to determine the risk of
lingual perforation related with structure of the crest and evaluate the
prevalence of lingual perforation in virtually inserted dental implants to premolar
and molar area with the using of computer aided planning program on cone beam
computerized tomography (CBCT) images.

Material and Method: CBCT images of 543 patients from
the archives of Izmir Katip Çelebi University, Faculty of Dentistry were
scanned and 179 implants were virtually inserted on CBCT images of 107 patients
who met inclusion criteria using a virtual implant placement program (Simplant®).
Crests were classified according to sections as P, C and U types. Proximity of
lingual plate to implants, inserted 2 mm apart from inferior alveolar canal,
was evaluated.

Results: The majority of lingual perforations were seen in
U-type crests (% 87.5) and risk of perforation tends to increase after 8 mm of
length. Four (% 8.3)  perforations were
encountered in C-type crests and lingual perforation was seen in only two
(%4.2) patients in 14 mm length in P-type crests.

Conclusion: The results of this study once again demonstrated the
importance of CBCT in assessing the proximity of anatomical structures to the
area of osteotomy in implant applications. The measurement of the distance from
the alveolar crest to the mandibular canal is a routine pre-implant surgery
preparation. Mandibular anatomic structure should be assessed on sagittal plane,
if it’s not possible, examination with palpation of crest structure is
important in prevention of the pre-operative and post-operative complications.

Keywords: Mandible, Dental implant, Cone Beam Computerized
Tomography, Sublingual bleeding

Keywords

Mandible, Dental implant, Cone Beam Computerized Tomography, Sublingual bleeding

Posterior Mandibulada Dental İmplant Cerrahisi Sırasında Lingual Kemik Perforasyon Riskinin Değerlendirilmesi: 3 Boyutlu İmplant Planlama Programı Kullanılarak Yapılan Retrospektif Çalışma

Abstract

Amaç: Bu
çalışmanın amacı dişsiz mandibular molar ve premolar bölgelere bilgisayar
ortamında planlama programı kullanılarak konik ışınlı bilgisayarlı tomografi
(KIBT) görüntüleri üzerinde yerleştirilen implantların sebep olduğu lingual
perforasyon prevalansının değerlendirilmesi ve kretin morfolojik yapısı ile
lingual plakanın perforasyon riski arasındaki ilişkinin belirlenmesidir.

Gereç ve Yöntemler: İzmir
Katip Çelebi Üniversitesi Diş Hekimliği Fakültesi arşivindeki KIBT görüntüsü
alınmış hastalardan 543’ünün tomografi görüntüleri tarandı ve dahil edilme
kriterlerine uyan 107 hastanın görüntüleri üzerinde, Simplant^®
implant planlama programı kullanılarak 179 adet sanal implant yerleştirildi. Kretler
kesitlerine göre P tipi, C tipi ve U tipi olmak üzere 3 gruba ayrıldı.
Panoramik radyografide inferior alveolar kanala 2 mm uzaklıkta olacak şekilde
uzunlukları hesaplanan dental implantların lingual kemikle olan ilişkisi
değerlendirildi.

Bulgular: Lingualde
oluşan perforasyonların büyük çoğunluğu U tipi kretlerde (%87.5) görülürken,
perforasyon riskinin 8 mm uzunluktan sonra arttığı görülmüştür. C tipi
kretlerde dört (% 8.3) implantda perforasyona rastlanırken, P tipi kretlerde
14mm uzunlukta sadece iki (% 4.2) hastada lingual perforasyon görülmüştür.

Sonuçlar: Bu
çalışmanın sonuçları implant uygulamalarında, osteotomi yapılacak alanın
anatomik oluşumlara olan komşuluğunu değerlendirmede KIBT’nin değerini bir kez
daha ortaya koymaktadır. Alt çenede, implant cerrahisi öncesi kret tepesinden
mandibular kanala olan mesafenin ölçülmesi rutin yapılan bir hazırlıktır. Bunun
yanında sagittal düzlemde mandibulanın anatomik yapısının değerlendirilmesi bu
yapılamıyorsa ameliyat sırasında kret morfolojisinin palpasyonla muayenesi
ameliyat sırasında ve sonrasında gelişebilecek komplikasyonların önlenmesi
açısından önem arz etmektedir.

Anahtar Kelimeler: Alt
çene, Diş implantı, Konik ışınlı bilgisayarlı tomografi, Sublingual kanama.

Keywords

Alt çene, Diş implantı, Konik ışınlı bilgisayarlı tomografi, Sublingual kanama

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