The Study Of Anatomy Elements Related To Immediate Implant In Maxillary Central Incisor Area By CBCT

Background: Currently,more and more people pay attention to the total time of implant therapy,the size of the wound and the aesthetic effect,the idea of modern implant prosthesis is simply,instantly and aestheticslly.This is put forward to higher requirements and challenges of Oral Implantology technology,and C lassic delayed implant treatment cycle is long,bone tissue physiological absorption causes a loss of bone mass,the graft has bring difficulty and soft tissue aesthetics risk.The immediate flapless implant replacement is a technology that the implants implanted directly after tooth extraction.It does not damage the gingival tissue,preserve the blood supply of the blood supply of the alveolar ridge,maintain the original gingival contour and shape.The doctors and the patients are willing to accept the operation method to reduce the patient's injury and pain,shorten the operation time,.Aesthetic area,however,what anatomy elements is suitable for the immediate flapless implant replacement and what conditions suitable for the immediate implant replacement is no clear indication.So the study will provides the theory basis for clinicians.Objective: Establish a new classification of alveo lar bone anatomy in maxillary incisor area by Cone Bone Computer Tomogrhpy(CBC T),so clinicians could according to it when they make a treatment plan related to immediate implant.Methods: CBCT scans were screened to include 110 subjects which were obtained from the x-ray department of Hua Xi Dental Hospital of Si C huan university in October 2015 between 1 and 31.There were 49 males and 61 females,with an age range of 18–69 years old,a total of 110 left maxillary incisors were selected(If left maxillary incisors were not in conformity with the conditions,we would selected the right tooth).we used the software to analysis the integrity of the bone wall in buccal side.The classification and statistics were made at the cross sectional views in the middle of the maxillary left central incisor,include the following contents:Frist,the position relationship of the root axis and the concave point.Second,the position relationship of the intersection which intersect by the root axis and the palate bone wall.Third,the width of the bone in the alveolar crest of faciolingual.Fourth,bone height between root apex and the nasal floor.Fifth,the distance from the concave point to the root apex.Results: Frist,the position's ratio of the intersection which intersect by the root axis and the cleft palate bone wall with root apex account for 97.3%which below the root apex.The ratio of the root axis parallel with the palate bone wall account for 2.7%.Second,the concave point in the labial of the root axis account for 45.5%,on the root axis account for 35.5%,in the lingual of the root axis account for 19.0%?Third,the bone height between root apex and the nasal floor which cannot attach 5mm account for 0.05%.Fourth,the average width of the bone in the alveolar crest of faciolingual is 7.5mm..Fifth,the average width of the bone in the alveolar of the concave point is 10.15 mm.Sixth,the distance from the concave point to the root tip more than 5mm only 15.5%.Seventh,the tooth have a integrity labial bone wall account for 76.4%.Conclusion: 1.The position of the intersection below the root apex account for 97.3%,the drill won't penetrate from the palatal bone wall if you put the axis of implant parallel with the root axis in these case,and the palatal bone wall will wider when the depth increase.2.The ratio of the root axis parallel with the palate bone wall account for 2.7%,the drill will penetrate from the palatal bone wall if drill the hole partial palatal side.3.The bone height between root apex and the nasal floor which cannot attach 5mm account for 0.05%,the information we can get from this is that most of case have enough bone height during the immediate implant surgery.4.The average width of the bone in the alveolar crest of faciolingual is 7.5mm.,the alveolar bone is wide enough for the implant have enough bone in the buccal side and lingual side.5.The new classification is :1,have a integrity labial bone wall,Type1,the concave point in the labial of the root axis,easy case,fit to do flapless immediate implant.Type2,the concave point on the root axis.The risk of the implant out of the alveoar bone is increase.Type3,the concave point in the lingual of the root axis,the ratio of the implant out of the alveoar bone is very high,advise operater do not do the flapless operation with this kind of case,probably,the implant will not acquire the initial stability in the case which have a big sunken in the labial of the alveoar bone.2,Do not have a integrity labial bone wall,this kind of case must not do the flapless operation:Type1,the concave point in the of the root axis,easy case,fit to do the immediate implant.Type2,the concave point on the root axis.The risk of the implant out of the alveoar bone is increase.Type3,the concave point in the lingual of the root axis,the ratio of the implant out of the alveoar bone is very high,Probably,the implant will not acquire the initial stability in the case which have a big sunken in the labial of the alveoar bone.