Applied Anatomy Of Immediate Implantation Of Maxillary

Objective The study of the anatomical characteristics of the normal adultmaxillary sinus and the relationship between maxillary sinus floor and posterior teethis explored through the measurement of the anatomy of maxilla and three-dimensionalreconstruction of CBCT, put forward methods to prevent the perforation of maxillarysinus floor, expand the dental implant of surgery indications and improve the successrate of dental implants, then provide a reliable technical support for clinical dentalimplants and teaching of oral anatomy.Materials and Methods1. There are16intact species of fresh adult mandible (32sides),8for female,8formale. At first, observing the number and location of maxillary sinus septa by movingthe roof of maxillary sinus. Then moving the frontal wall. In order to expose rootscompletely, stripping alveolar bones which are on surface of posterior teeth roots andinter-roots by dental grinding machine with direction in axial of teeth, measuring thedistance between root tip, alveolar ridge, root bifurcate and the floor of maxillarysinus with vernier caliper, and measuring the distance between root and root (rootneck, root middle, root tip), including interdental septa width and interradicular septawidth. Each measure was repeated three times, its mean was recorded.2. There are16intact species of fresh adult mandible (32sides),9for male,7forfemale. At first, observing the number and location of maxillary sinus septa bymoving the roof of maxillary sinus. Then moving the frontal wall. In order to measurethe distance between posterior root tip, alveolar ridge, root bifurcate and the floor ofmaxillary sinus, the alveolar height of roots’s (root neck, root middle, root tip) surfaceand the diatance between root bifurcate and buccal (palatal) alveolar process withvernier caliper. Each measure was repeated three times, its mean was recorded.3. There are CBCT image data on60(120sides) healthy adults,32for male,28forfemale. The distance which is between root tip of posterior teeth, alveolar ridge, root bifurcate and the floor of maxillary sinus, and which is between root and root (rootneck, root middle, root tip), including interdental septa width and interradicular septawidth were measured, we also measured the alveolar height that of roots (root neck,root middle, root tip)’s surface and the diatance between root bifurcate and buccal(palatal) alveolar process with three-dimensional reconstruction. Each measure wasrepeated three times, its mean was recorded. Comparison the image data to anatomy.4. Calculating the mean and standard deviation of all data with soft of SPSS18.0,then paired t-test the data of left and right, male and female.Results1. There are over50%(species for53.2%, images for53.4%)of maxillary sinus don’thave bone septa, and the bone septa often appear in the middle of maxillary sinusfloor (species for63.6%, images for61.9%), for the most probability of one(speciesfor25.0%, images for20.0%) or two (species for18.8%, images for23.3%).2. There are gender difference in the distance between alveolar ridge and the floor ofmaxillary sinus with posterior teeth of mandible, male’s larger than female’s. Thedistance between alveolar ridge and the floor of maxillary sinus from the firstpremolar[male of species for（22.58±3.18）mm，female（20.68±2.55）mm；maleof images fo（r22.19±3.64）mm，female（19.97±2.46）mm] to the first molar[maleof species for（13.08±4.09）mm，female（11.46±2.50）mm；male of images for（12.69±2.86）mm，female（11.32±2.16）mm] grows down, then grows up fromthe first molar to the third molar[male of species for（16.98±3.56）mm，female（13.74±3.81）mm；male of species for（16.27±4.02）mm，female（12.99±2.28）mm]. The distance between alveolar ridge and the floor of maxillary sinus of the firstmolar is the shortest.3. There are bilateral difference in the distance between root tip and the floor ofmaxillary sinus, right’s larger than left’s. The distance between root tip and the floor of maxillary sinus of the second premolar[left of species for（4.31±0.91）mm，right（4.63±0.89）mm；left of images for（4.28±0.83）mm，right（4.52±0.90）mm] is smaller than the first’s[left buccal root of species for（9.90±1.13）mm，right（10.68±1.15）mm，left palatal root（9.96±1.10）mm，right（10.89±1.17）mm；left buccal root of images for（9.68±1.07）mm，right（10.58±1.11）mm，left palatalroot（9.71±0.98）mm，right（10.81±1.12）mm；].4. The first molar’s[At root neck, buccal of mesiobuccal root in species for（2.46±0.31）mm，distobuccal（1.36±0.21）mm，palatal of palatal root（2.46±0.27）mm；at root middle, buccal of mesiobuccal root in species for（2.68±0.43）mm，distobuccal（1.88±0.27）mm，palatal of palatal root（2.72±0.45）mm；at root tip,buccal of mesiobuccal root in species for（3.12±0.41）mm，distobucca（l2.22±0.26）mm，palatal of palatal roo（t4.68±0.52）mm。At root neck, buccal of mesiobuccal rootin images for（2.29±0.34）mm，distobucca（l1.30±0.20）mm，palatal of palatal root（2.39±0.41）mm；at root middle, buccal of mesiobuccal root in species for（2.60±0.45）mm，distobuccal（1.81±0.28）mm，palatal of palatal root（2.69±0.47）mm；at root tip, buccal of mesiobuccal root in species for（3.06±0.39）mm，distobucca（l2.17±0.23）mm，palatal of palatal roo（t4.59±0.55）mm] alveolar heightof roots is the thinnest in maxillary posterior teeth, and the distance between root andpalatal alveolar process is far than which between root and buccal alveolar process.The height of alveolar process becomes thick from root neck to root middle and roottip.5. The interdental septa width of maxillary posterior teeth of palatal is larger thanbuccal besides width between the second molar and the third molar. The width ofinterdental septa becomes large from root neck to root middle and root tip. The firstmolar’s interradicular septa width is the largest in maxillary posterior teeth. At rootneck for species, the width between misobuccal root neck and disobuccal root neck is（2.06±0.30）mm, the width between misobuccal root and palatal root is（3.44±0.56）mm，the width between disisobuccal root and palatal root is（4.16±0.63）mm, for images, the width between misobuccal root neck and disobuccal root neck is（2.03±0.29）mm, the width between misobuccal root and palatal root is（3.31±0.55）mm，the width between disisobuccal root and palatal root is（4.03±0.62）mm.6. The distance between root bifurcate of maxillary posterior teeth and maxillary sinusfloor is over9mm, and palatal’s height of alveolar process is larger than buccal’s.Conclusion1.In order to prevent the floor of maxillary sinus from damaging by implant whenrestoration the maxillary posterior teeth with immediate implant, the length of implantcan’t over13mm for male, and can’t over12mm for female.2. In order to improve the stability of implant by raise the length of it, we can put theimplant palatal slightly according to teeth’s normal anatomical position whenimplanting the maxillary posterior teeth.