Clinical decision and related factors influencing implant direction in the esthetic area

doi:10.7518/hxkq.2023.2023151

Abstract

Abstract:

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.

Key words: implant in the esthetic area, prosthetic-driven implantology, direction of alveolar bone, implant direction

CLC Number:

R 783.4

Liu Yuting, Yuan Quan.. Clinical decision and related factors influencing implant direction in the esthetic area[J]. West China Journal of Stomatology, 2023, 41(5): 512-520.

Figures/Tables 6

Fig 1

Fig 2

Fig 3

Fig 4

Fig 5

Fig 6

References 50

1	Lim HC, Kang DU, Baek H, et al. Cone-beam computed tomographic analysis of the alveolar ridge profile and virtual implant placement for the anterior maxilla[J]. J Periodontal Implant Sci, 2019, 49(5): 299-309.
2	Tsigarida A, Toscano J, de Brito Bezerra B, et al. Buccal bone thickness of maxillary anterior teeth: a systematic review and meta-analysis[J]. J Clin Periodontol, 2020, 47(11): 1326-1343.
3	Omori Y, Lang NP, Botticelli D, et al. Biological and mechanical complications of angulated abutments connec-ted to fixed dental prostheses: a systematic review with meta-analysis[J]. J Oral Rehabil, 2020, 47(1): 101-111.
4	Garber DA, Belser UC. Restoration-driven implant pla-cement with restoration-generated site development[J]. Compend Contin Educ Dent, 1995, 16(8): 796, 798-802, 804.
5	Zhou Y, Si M, Liu Y, et al. Likelihood of needing facial bone augmentation in the anterior maxilla of Chinese Asians: a cone beam computed tomography virtual implant study[J]. Clin Implant Dent Relat Res, 2019, 21(3): 503-509.
6	Wu Q, Yang B, Gao S, et al. Apical U-shape splitting technique for undercut areas of the anterior alveolar ri-dge: a prospective non-randomized controlled study[J]. Int J Oral Maxillofac Surg, 2019, 48(3): 388-394.
7	Casar-Espinosa JC, Castillo-Oyagüe R, Serrera-Figallo MÁ, et al. Combination of straight and tilted implants for supporting screw-retained dental prostheses in atrophic posterior maxillae: a 2-year prospective study[J]. J Dent, 2017, 63: 85-93.
8	Cortés-Bretón Brinkmann J, García-Gil I, Pedregal P, et al. Long-term clinical behavior and complications of intentionally tilted dental implants compared with straight implants supporting fixed restorations: a systematic review and meta-analysis[J]. Biology (Basel), 2021, 10(6): 509.
9	宫苹. 牙缺失种植修复并发症与咬合[J]. 中华口腔医学杂志, 2018, 53(12): 800-804.
	Gong P. Role of occlusion in complications of implant rehabilitation[J]. Chin J Stomatol, 2018, 53(12): 800-804.
10	Ramanauskaite A, Sader R. Esthetic complications in implant dentistry[J]. Periodontol 2000, 2022, 88(1): 73-85.
11	Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations[J]. Int J Oral Maxillofac Implants, 2004, 19 Suppl: 43-61.
12	Buser D, Belser U, Wismeijer D.Implant therapy in the esthetic zone: single tooth replacements. The ITI treatment guide volume 1[M]. Berlin: Quintessence Publi-shing, 2007.
13	Rojas-Vizcaya F. Biological aspects as a rule for single implant placement. The 3A-2B rule: a clinical report[J]. J Prosthodont, 2013, 22(7): 575-580.
14	Testori T, Weinstein T, Scutellà F, et al. Implant placement in the esthetic area: criteria for positioning single and multiple implants[J]. Periodontol 2000, 2018, 77(1): 176-196.
15	Vera C, De Kok IJ, Reinhold D, et al. Evaluation of buccal alveolar bone dimension of maxillary anterior and premolar teeth: a cone beam computed tomography investigation[J]. Int J Oral Maxillofac Implants, 2012, 27(6): 1514-1519.
16	刘慧凤, 黄盛兴, 石磊, 等. 基于锥形束CT的上颌前牙区解剖形态学研究[J]. 口腔疾病防治, 2015, 23(6): 306-310.
	Liu HF, Huang SX, Shi L, et al. Anatomical morphology of maxillary anterior teeth—a study using cone beam computed tomography[J]. J Prev Treat Stomatol Dis, 2015, 23(6): 306-310.
17	陶荣, 蒙萌, 牛丽娜, 等. 300名正常上前牙牙根与牙槽窝位置关系的锥形束CT分析[J]. 中华口腔医学杂志, 2017, 52(10): 631-636.
	Tao R, Meng M, Niu LN, et al. Investigation of sagittal root position in relation to the anterior maxillary alveolar bone: a cone-beam CT study in 300 cases with normal occlusion[J]. Chin J Stomatol, 2017, 52(10): 631-636.
18	Evans CD, Chen ST. Esthetic outcomes of immediate implant placements[J]. Clin Oral Implants Res, 2008, 19(1): 73-80.
19	Le BT, Borzabadi-Farahani A, Pluemsakunthai W. Is buc-colingual angulation of maxillary anterior implants associated with the crestal labial soft tissue thickness[J]. Int J Oral Maxillofac Surg, 2014, 43(7): 874-878.
20	Monje A, Galindo-Moreno P, Tözüm TF, et al. Into the paradigm of local factors as contributors for peri-implant disease: short communication[J]. Int J Oral Maxillofac Implants, 2016, 31(2): 288-292.
21	Avila-Ortiz G, Elangovan S, Kramer KW, et al. Effect of alveolar ridge preservation after tooth extraction: a systematic review and meta-analysis[J]. J Dent Res, 2014, 93(10): 950-958.
22	Barootchi S, Tavelli L, Majzoub J, et al. Alveolar ridge preservation: complications and cost-effectiveness[J]. Periodontol 2000, 2022. doi: 10.1111/prd.12469 .
23	Slagter KW, Meijer HJA, Hentenaar DFM, et al. Immediate single-tooth implant placement with simultaneous bone augmentation versus delayed implant placement after alveolar ridge preservation in bony defect sites in the esthetic region: a 5-year randomized controlled trial[J]. J Periodontol, 2021, 92(12): 1738-1748.
24	Esfahrood ZR, Kadkhodazadeh M, Talebi Ardakani MR. Gingival biotype: a review[J]. Gen Dent, 2013, 61(4): 14-17.
25	Fischer KR, Künzlberger A, Donos N, et al. Gingival biotype revisited-novel classification and assessment tool[J]. Clin Oral Investig, 2018, 22(1): 443-448.
26	Lee SA, Kim AC, Prusa LA, et al. Characterization of dental anatomy and gingival biotype in Asian populations[J]. J Calif Dent Assoc, 2013, 41(1): 31-39.
27	Lee WZ, Ong MMA, Yeo AB. Gingival profiles in a select Asian cohort: a pilot study[J]. J Investig Clin Dent, 2018. doi: 10.1111/jicd.12269 .
28	Jung RE, Sailer I, Hämmerle CH, et al. In vitro color changes of soft tissues caused by restorative materials[J]. Int J Periodontics Restorative Dent, 2007, 27(3): 251-257.
29	Zucchelli G, Sharma P, Mounssif I. Esthetics in perio-dontics and implantology[J]. Periodontol 2000, 2018, 77(1): 7-18.
30	杜巧琳, 顾新华. 牙种植体形态结构设计的研究进展[J]. 口腔医学, 2021, 41(5): 475-480.
	Du QL, Gu XH. Progress of research on the morphological and structural design of dental implants[J]. Stomato-logy, 2021, 41(5): 475-480.
31	林野. 当代牙种植体设计进步与临床意义[J]. 华西口腔医学杂志, 2017, 35(1): 18-28.
	Lin Y. Current dental implant design and its clinical importance[J]. West China J Stomatol, 2017, 35(1): 18-28.
32	Karl M, Irastorza-Landa A. Does implant design affect primary stability in extraction sites[J]. Quintessence Int, 2017, 48(3): 219-224.
33	宿玉成. 口腔种植学[M]. 2版. 北京: 人民卫生出版社, 2014.
	Su YC. Implant dentistry[M]. 2nd ed. Beijing: People's Medical Publishing House, 2014.
34	Rajan M, Gunaseelan R. Fabrication of a cement-and sc-rew-retained implant prosthesis[J]. J Prosthet Dent, 2004, 92(6): 578-580.
35	Wittneben JG, Joda T, Weber HP, et al. Screw retained vs. cement retained implant-supported fixed dental prosthesis[J]. Periodontol 2000, 2017, 73(1): 141-151.
36	Lim G, Lin GH, Monje A, et al. Wound healing complications following guided bone regeneration for ridge augmentation: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2018, 33(1): 41-50.
37	Tay JRH, Lu XJ, Lai WMC, et al. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management[J]. Int J Implant Dent, 2020, 6(1): 76.
38	Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fe-nestrations: a systematic review[J]. Clin Oral Implants Res, 2009, 20(): 113-123.
39	Urban IA, Monje A. Guided bone regeneration in alveolar bone reconstruction[J]. Oral Maxillofac Surg Clin North Am, 2019, 31(2): 331-338.
40	Sato D, Kanazawa M, Kim YK, et al. Immediate loading of two freestanding implants placed by computer-guided flapless surgery supporting a mandibular overdenture wi-th magnetic attachments[J]. J Prosthodont Res, 2016, 60(1): 54-62.
41	D'haese J, Ackhurst J, Wismeijer D, et al. Current state of the art of computer-guided implant surgery[J]. Periodontol 2000, 2017, 73(1): 121-133.
42	Aydemir CA, Arısan V. Accuracy of dental implant placement via dynamic navigation or the freehand me-thod: a split-mouth randomized controlled clinical trial[J]. Clin Oral Implants Res, 2020, 31(3): 255-263.
43	Wismeijer D. Ridge augmentation procedures in implant patients. The ITI treatment guide volume 7[M]. Berlin: Quintessence Publishing, 2013.
44	Benic GI, Hämmerle CH. Horizontal bone augmentation by means of guided bone regeneration[J]. Periodontol 2000, 2014, 66(1): 13-40.
45	Lau SL, Chow J, Li W, et al. Classification of maxillary central incisors-implications for immediate implant in the esthetic zone[J]. J Oral Maxillofac Surg, 2011, 69(1): 142-153.
46	Chiapasco M, Casentini P. Horizontal bone-augmentation procedures in implant dentistry: prosthetically gui-ded regeneration[J]. Periodontol 2000, 2018, 77(1): 213-240.
47	Gluckman H, Pontes CC, Du Toit J. Radial plane tooth position and bone wall dimensions in the anterior maxilla: a CBCT classification for immediate implant placement[J]. J Prosthet Dent, 2018, 120(1): 50-56.
48	杨刚, 胡文杰, 曹洁, 等. 汉族青年人上颌前牙牙根位置及牙槽骨厚度的测量分析[J]. 中华口腔医学杂志, 2013, 48(12): 716-720.
	Yang G, Hu WJ, Cao J, et al. Measurement and analysis of maxillary anterior tooth root position and alveolar bone thickness in Han youth people[J]. Chin J Stomatol, 2013, 48(12): 716-720.
49	Andre A, Ogle OE. Vertical and horizontal augmentation of deficient maxilla and mandible for implant placement[J]. Dent Clin North Am, 2021, 65(1): 103-123.
50	Plonka AB, Urban IA, Wang HL. Decision tree for vertical ridge augmentation[J]. Int J Periodontics Restorative Dent, 2018, 38(2): 269-275.

[1]	Ma Liya, Chao Jiarui, Liu Fei, Mei Jiansong, Shen Jiefei.. A comparative study based on the mandibular movement track and the movement parameters of the virtual articulator in simulating occlusal adjustment [J]. West China Journal of Stomatology, 2023, 41(3): 254-259.
[2]	Yu Haiyang, Wu Jiacheng, Hu Nan.. Clinical decision making of implant guidance methods guided by new classification of surgical area mouth ope-ning [J]. West China Journal of Stomatology, 2023, 41(2): 134-139.
[3]	Wang Yingkai, Xie Chenyang, Zhang Yuqiang, Zhang Yameng, Fang Tinglu, Yu Haiyang.. Application of measurable surgical guides in immediate implant placement and immediate restoration [J]. West China Journal of Stomatology, 2022, 40(6): 731-739.
[4]	Yu Haiyang, Sun Manlin, Wang Zhongyi.. Clinical decision-making of anterior implant abutment [J]. West China Journal of Stomatology, 2022, 40(5): 504-512.
[5]	Lu Jiayi, Yu Jiayi, Xie Chenyang, Gao Jing, Yu Haiyang. Immediate precision of the digital osteotomy template in the digital stackable template: a clinical study [J]. West China Journal of Stomatology, 2021, 39(6): 732-738.
[6]	Wang Yanmei, Liu Xin, He Jiacai. Clinical application of integrated angulated screw channel abutment crown in implant-supported rehabilitation of aesthetic area [J]. West China Journal of Stomatology, 2021, 39(6): 712-717.
[7]	Zhang Jie, Zhu Songsong, Jiang Nan.. Effect of micro/nanoscaled Ti phosphate/Ti oxide hybrid coating on the osseointegration of Ti implants [J]. West China Journal of Stomatology, 2021, 39(5): 531-539.
[8]	Fan Zhen, Liu Yue, Wang Zuolin. Tilted implantation technique for edentulous patients [J]. West China Journal of Stomatology, 2021, 39(4): 377-385.
[9]	Wang Yanying, Gong Ping, Zhang Jian. Effects of different implant surface properties on the biological behavior of Schwann cells [J]. West China Journal of Stomatology, 2021, 39(3): 279-285.
[10]	Wu Jin, Liu Kun, Li Ming, Zhu Zhijun, Tang Chunbo. Clinical assessment of pterygoid and anterior implants in the atrophic edentulous maxilla: a retrospective study [J]. West China Journal of Stomatology, 2021, 39(3): 286-292.
[11]	Zhou Yongsheng, Sun Yuchun, Wang Yong. Clinical application and research progress of digital complete denture [J]. West China Journal of Stomatology, 2021, 39(1): 1-8.