Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of the root position and angulation of maxillary premolars in alveolar bone using cone-beam computed tomography

  • Yun-Hoa, Jung (Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University) ;
  • Bong-Hae, Cho (Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University) ;
  • Jae-Joon, Hwang (Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University)
  • Received : 2022.07.10
  • Accepted : 2022.08.09
  • Published : 2022.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study investigated whether the relationship between the maxillary sinus and the root of the maxillary premolar is correlated with the root position and whether there is a difference in the long axis angle of premolars and the buccal bone thickness according to the sinus-root relationship and root position. Materials and Methods: Cone-beam computed tomographic images of 587 maxillary first premolars and 580 second premolars from 303 patients were retrospectively reviewed. The maxillary sinus floor-root relationship was classified into 4 types, and the root position in the alveolar bone was evaluated as buccal, middle, or palatal. The long axis angle of the maxillary premolars in the alveolar bone and the buccal bone thickness were measured. The correlation between these parameters was analyzed. Results: The maxillary sinus floor-root relationship showed a statistically significant correlation with the root position in the alveolar bone. Most maxillary first premolars were buccally located, and more than half of the second premolars had their roots in the middle. The long axis angle of the premolars was significantly larger in buccal-positioned teeth than in middle-positioned teeth, and the buccal bone was thinner. Conclusion: When the root of the maxillary premolar was separated from the sinus floor, the premolar was often located on the buccal side. Most of the maxillary first premolars had a thinner buccal bone and larger inclination than the second premolars. It is recommended to evaluate the root position, sagittal angle and buccal bone thickness using CBCT for implant treatment planning.

Keywords

Acknowledgement

This work was supported by a 2-Year Research Grant of Pusan National University.

References

  1. Kang SH, Kim BS, Kim Y. Proximity of posterior teeth to the maxillary sinus and buccal bone thickness: a biometric assessment using cone-beam computed tomography. J Endod 2015; 41: 1839-46. https://doi.org/10.1016/j.joen.2015.08.011
  2. Kim JH, Lee JG, Han DH, Kim HJ. Morphometric analysis of the anterior region of the maxillary bone for immediate implant placement using micro-CT. Clin Anat 2011; 24: 462-8. https://doi.org/10.1002/ca.21101
  3. Nishihara K, Yoshimine SI, Goto T, Ishihata K, Kume KI, Yoshimura T, et al. Topographic analysis of the maxillary premolars relative to the maxillary sinus and the alveolar bone using cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123: 606-12. https://doi.org/10.1016/j.oooo.2017.01.007
  4. Jung YH, Cho BH. Assessment of the relationship between the maxillary molars and adjacent structures using cone beam computed tomography. Imaging Sci Dent 2012; 42: 219-24. https://doi.org/10.5624/isd.2012.42.4.219
  5. Gu Y, Sun C, Wu D, Zhu Q, Leng D, Zhou Y. Evaluation of the relationship between maxillary posterior teeth and the maxillary sinus floor using cone-beam computed tomography. BMC Oral Health 2018; 18: 164.
  6. Razumova S, Brago A, Howijieh A, Manvelyan A, Barakat H, Baykulova M. Evaluation of the relationship between the maxillary sinus floor and the root apices of the maxillary posterior teeth using cone-beam computed tomographic scanning. J Conserv Dent 2019; 22: 139-43. https://doi.org/10.4103/JCD.JCD_530_18
  7. Yoshimine S, Nishihara K, Nozoe E, Yoshimine M, Nakamura N. Topographic analysis of maxillary premolars and molars and maxillary sinus using cone beam computed tomography. Implant Dent 2012; 21: 528-35. https://doi.org/10.1097/ID.0b013e31827464fc
  8. Sung CE, Cochran DL, Cheng WC, Mau LP, Huang PH, Fan WH, et al. Preoperative assessment of labial bone perforation for virtual immediate implant surgery in the maxillary esthetic zone: a computer simulation study. J Am Dent Assoc 2015; 146: 808-19. https://doi.org/10.1016/j.adaj.2015.04.007
  9. Petaibunlue S, Serichetaphongse P, Pimkhaokham A. Influence of the anterior arch shape and root position on root angulation in the maxillary esthetic area. Imaging Sci Dent 2019; 49: 123-30. https://doi.org/10.5624/isd.2019.49.2.123
  10. Lau SL, Chow J, Li W, Chow LK. Classification of maxillary central incisors-implications for immediate implant in the esthetic zone. J Oral Maxillofac Surg 2011; 69: 142-53. https://doi.org/10.1016/j.joms.2010.07.074
  11. Kan JY, Roe P, Rungcharassaeng K, Patel RD, Waki T, Lozada JL, et al. Classification of sagittal root position in relation to the anterior maxillary osseous housing for immediate implant placement: a cone beam computed tomography study. Int J Oral Maxillofac Implants 2011; 26: 873-6.
  12. Xu D, Wang Z, Sun L, Lin Z, Wan L, Li Y, et al. Classification of the root position of the maxillary central incisors and its clinical significance in immediate implant placement. Implant Dent 2016; 25: 520-4. https://doi.org/10.1097/ID.0000000000000438
  13. Chung SH, Park YS, Chung SH, Shon WJ. Determination of implant position for immediate implant placement in maxillary central incisors using palatal soft tissue landmarks. Int J Oral Maxillofac Implants 2014; 29: 627-33. https://doi.org/10.11607/jomi.2907
  14. Wang HM, Shen JW, Yu MF, Chen XY, Jiang QH, He FM. Analysis of facial bone wall dimensions and sagittal root position in the maxillary esthetic zone: a retrospective study using cone beam computed tomography. Int J Oral Maxillofac Implants 2014; 29: 1123-9. https://doi.org/10.11607/jomi.3348
  15. Hammerle CH, Araujo MG, Simion M, Osteology Consensus Group 2011. Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Implants Res 2012; 23 Suppl 5: 80-2. https://doi.org/10.1111/j.1600-0501.2011.02370.x
  16. Araujo MG, Silva CO, Misawa M, Sukekava F. Alveolar socket healing: what can we learn? Periodontol 2000 2015; 68: 122-34. https://doi.org/10.1111/prd.12082
  17. Tomasi C, Sanz M, Cecchinato D, Pjetursson B, Ferrus J, Lang NP, et al. Bone dimensional variations at implants placed in fresh extraction sockets: a multilevel multivariate analysis. Clin Oral Implants Res 2010; 21: 30-6. https://doi.org/10.1111/j.1600-0501.2009.01848.x
  18. Rossi F, Romanelli P, Ricci E, Marchetti C, Botticelli D. A cone beam tomographic evaluation of hard tissue alterations at immediate implants: a clinical prospective study. Int J Periodontics Restorative Dent 2013; 33: 815-23.
  19. Buser D, Chappuis V, Belser UC, Chen S. Implant placement post extraction in esthetic single tooth sites: when immediate, when early, when late? Periodontol 2000 2017; 73: 84-102. https://doi.org/10.1111/prd.12170
  20. Chappuis V, Engel O, Reyes M, Shahim K, Nolte LP, Buser D. Ridge alterations post-extraction in the esthetic zone: a 3D analysis with CBCT. J Dent Res 2013; 92 (12 Suppl): 195S-201S. https://doi.org/10.1177/0022034513506713
  21. Khoury J, Ghosn N, Mokbel N, Naaman N. Buccal bone thickness overlying maxillary anterior teeth: a clinical and radiographic prospective human study. Implant Dent 2016; 25: 525-31. https://doi.org/10.1097/ID.0000000000000427
  22. Wong J, Lee A, Zhang C. Diagnosis and management of apical fenestrations associated with endodontic diseases: a literature review. Eur Endod J 2021; 6: 25-33.
  23. Gupta R, Hasselgren G. Prevalence of odontogenic sinus tracts in patients referred for endodontic therapy. J Endod 2003; 29: 798-800. https://doi.org/10.1097/00004770-200312000-00003
  24. Januario AL, Duarte WR, Barriviera M, Mesti JC, Araujo MG, Lindhe J. Dimension of the facial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res 2011; 22: 1168-71.
  25. Fuentes R, Flores T, Navarro P, Salamanca C, Beltran V, Borie E. Assessment of buccal bone thickness of aesthetic maxillary region: a cone-beam computed tomography study. J Periodontal Implant Sci 2015; 45: 162-8.
  26. Farahamnd A, Sarlati F, Eslami S, Ghassemian M, Youssefi N, Jafarzadeh Esfahani B. Evaluation of impacting factors on facial bone thickness in the anterior maxillary region. J Craniofac Surg 2017; 28: 700-5. https://doi.org/10.1097/SCS.0000000000003643
  27. Gakonyo J, Mohamedali AJ, Mungure EK. Cone beam computed tomography assessment of the buccal bone thickness in anterior maxillary teeth: relevance to immediate implant placement. Int J Oral Maxillofac Implants 2018; 33: 880-7. https://doi.org/10.11607/jomi.6274
  28. Rojo-Sanchis J, Vina-Almunia J, Penarrocha-Oltra D, Penarrocha-Diago M. Facial alveolar bone width at the first and second maxillary premolars in healthy patients: a cone beam computed tomography study. J Oral Implantol 2017; 43: 261-5. https://doi.org/10.1563/aaid-joi-D-16-00195
  29. Hauman CH, Chandler NP, Tong DC. Endodontic implications of the maxillary sinus: a review. Int Endod J 2002; 35: 127-41. https://doi.org/10.1046/j.0143-2885.2001.00524.x
  30. Manor Y, Anavi Y, Gershonovitch R, Lorean A, Mijiritsky E. Complications and management of implants migrated into the maxillary sinus. Int J Periodontics Restorative Dent 2018; 38: e112-8. https://doi.org/10.11607/prd.3328
  31. Oberli K, Bornstein MM, von Arx T. Periapical surgery and the maxillary sinus: radiographic parameters for clinical outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: 848-53. https://doi.org/10.1016/j.tripleo.2006.09.017
  32. von Arx T, Fodich I, Bornstein MM. Proximity of premolar roots to maxillary sinus: a radiographic survey using cone-beam computed tomography. J Endod 2014; 40: 1541-8. https://doi.org/10.1016/j.joen.2014.06.022
  33. Jang JK, Kwak SW, Ha JH, Kim HC. Anatomical relationship of maxillary posterior teeth with the sinus floor and buccal cortex. J Oral Rehabil 2017; 44: 617-25. https://doi.org/10.1111/joor.12525
  34. Zhang S, Shi X, Liu H. Angulations of anterior teeth with reference to the alveolar bone measured by cbct in a chinese population. Implant Dent 2015; 24: 397-401. https://doi.org/10.1097/ID.0000000000000291
  35. Araujo MG, Sukekava F, Wennstrom JL, Lindhe J. Ridge alter-ations following implant placement in fresh extraction sockets: an experimental study in the dog. J Clin Periodontol 2005; 32: 645-52. https://doi.org/10.1111/j.1600-051X.2005.00726.x
  36. Rito-Macedo F, Barroso-Oliveira M, Paranhos LR, Rodrigues-Brum J, Pereira-Lima IF, Gomes-Franca FM, et al. Implant insertion angle and depth: peri-implant bone stress analysis by the finite element method. J Clin Exp Dent 2021; 13: e1167-73.
  37. Ferrus J, Cecchinato D, Pjetursson EB, Lang NP, Sanz M, Lindhe J. Factors influencing ridge alterations following immediate implant placement into extraction sockets. Clin Oral Implants Res 2010; 21: 22-9. https://doi.org/10.1111/j.1600-0501.2009.01825.x
  38. Vera C, De Kok IJ, Reinhold D, Limpiphipatanakorn P, Yap AK, Tyndall D, et al. Evaluation of buccal alveolar bone dimension of maxillary anterior and premolar teeth: a cone beam computed tomography investigation. Int J Oral Maxillofac Implants 2012; 27: 1514-9.