Multiple Adjacent Dental Implant Placement In Anterior Aesthetic Region And Assessment Using Cone Beam Computed Tomography

Objective: To measured and analysed the multiple adjacent dental implant placement in anterior aesthetic region with cone beam computed tomography,providing some referential data for clinicians.Materails and methods : We select 50 cases according to the following inclusion criteria in patients who visited the stomatology center of Qingdao municipal hospital affiliated to Qingdao university from December 2017 to March 2018.We use the software of ICATVision to simulate the loss of multiple teeth in the aesthetic area and then the Invovo5 software was applied for the measurement and analysis of the ideal implantation site.The relevant data were extracted and analyzed by SPSS24.0.The measurement site is:the situation of two middle incisors loss,the midpoint of the palatal cemento-enamel junction in the lateral incisors and the center of the ideal implant in the maxillary central incisors.The situation of two anterior teeth missing including lateral incisors including four case.The first,the left maxillary lateral incisor and canine loss,the midpoint of the palatal cemento-enamel junction in the left maxillary central incisor and first premolar,and the center of the ideal implant in the left maxillary canine.The second,the left maxillary lateral incisor and central incisor loss,the midpoint of the palatal cemento-enamel junction in the left maxillary canine and the right maxillary central incisor,and the center of the ideal implant in the left maxillary centralincisor.The third,the right maxillary lateral incisor and canine loss,the midpoint of the palatal cemento-enamel junction in the right maxillary central incisor and first premolar,and the center of the ideal implant in the right maxillary canine.The fourth,the right maxillary lateral incisor and central incisor loss,the midpoint of the palatal cemento-enamel junction in the right maxillary canine and the left maxillary central incisor,and the center of the ideal implant in the right maxillary central incisor.The measured distance is the vertical distance between the midpoint of the adjacent tooth's cemento-enamel junction and the center of the ideal implant.Results : The measurement data are shown below,the situation of two middle incisors loss,the upper left incisor(4.24 ? 0.90mm),the upper right incisor(4.10 ? 0.86mm);Two anterior teeth missing including lateral incisors,the upper left canine(5.72 ? 0.72mm),the upper left incisor(5.10 ? 0.73mm),the upper right incisor(5.50 ? 0.77mm),the upper right canine(4.91 ? 0.97mm).According to gender classification,24 males(48%)and 26 females(52%)were male.Comparative analysis of the implantation sites of different genders in the absence of two middle incisors(independent sample T test).Shows different gender in the upper left incisor and the upper rightincisorwere significant differences(P < 0.05),the male maxillary central incisor,the upper left(3.77?0.79mm)?the upper right(3.74?0.79mm)lower than the women.Comparative analysis of the implantation sites of different genders in the loss ofanterior teeth missing including lateral incisors(independent sample T test).It can be seen that there is a significant difference between the different sexes on the upper left incisor(P < 0.05),and the mean value of the incidental incisor of the male in the upper left is 4.83 ? 0.78 mm,which is lower than that of the female on the upper left5.35?0.60 mm.There was no significant difference between the two sexes in the upper left and right upper incisors and the upper right canine(P>0.05).According to the shape of dental arch,there are three types of arch shape,including oval shape 31 cases(62.5%),square shape 19 cases(37.5%),and round shape 0 cases.Comparative analysis of the measurement of implantation site of different dental arch shapes in two middle incisors loss(independent sample T test).It can be seen that there are significantdifferences in the shape of different dental arch on the upper left and right upper incisors(P < 0.05).In the maxillary central incisor of oval shape,the mean value of the incised teeth was left 4.61?0.76 mm and right 4.35?0.77 mm higher than that in the shape of square left 3.62?0.78 mm and right 3.69?0.87 mm.Different dental arch shape including the two anterior teeth missing including lateral incisors of implant site measurement comparison analysis,(independent sample t-test),shows different dental arch shape maxillary central incisor in the left on significant differences(P < 0.05).The measuring mean of the oval shape on the upper left was 5.28?0.61 mm higher than the type of square 4.81?0.84 mm.There was no significant difference in the shape of the different dental arch in the rightmaxillary central incisor and the maxillary canines.Conclusion: The measure and analyze data can provide a theoretical basis for the implant site of immediate plant.It can be seen that in the absence of two middle incisor teeth,it is necessary to fully consider the difference between the gender and the shape of the dental arch,while the male is slightly more than the female with the palatal implant,and the oval shape is relative to the lateral palatal implant.In the absence of anterior teeth including lateral incisors,the difference of gender and arch shape should be taken into consideration when the implant site was incised in the left maxillary central incisor,and the other implant sites could refer to the mean value.