Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment: a retrospective cross-sectional study

• Published in: Journal of stomatology, oral and maxillofacial surgery oral and maxillofacial surgery, 2023-12, Vol.124 (6), p.101634, Article 101634
• Main Authors: Huang, Zhuwei, Shi, Jiamin, Gao, Guangqi, Shi, Mengru, Gong, Zhuohong, Liu, Haiwen, Zeng, Peisheng, Chen, Shijie, Gan, Xuejing, Ding, Jianfeng, Wang, Yan, Chen, Zetao
• Format: Article
• Language: English
• Subjects: alveolar bone; apical palatal bone; immediate implant placement; maxillary incisor; quantitative study
• ISSN: 2468-7855; 2468-7855
• DOI: 10.1016/j.jormas.2023.101634

Apical palatal bone is important in immediate implant evaluation. Current consensus gives qualitative suggestions regarding it, limiting its clinical decision-making value. To quantify the apical palatal bone dimension in maxillary incisors and reveal its quantitative correlation with other implant-related hard tissue indices to give practical advice for pre-immediate implant evaluation and design. A retrospective analysis of immediate implant-related hard tissue indices in maxillary incisors obtained by cone beam computed tomography (CBCT) was conducted. Palatal bone thickness at the apex level (Apical-P) on the sagittal section was selected as a parameter reflecting the apical palatal bone. Its quantitative correlation with other immediate implant-related hard tissue indices was revealed. Clinical advice of pre-immediate implant assessment was given based on the quantitative classification of Apical-P and its other correlated immediate implant-related hard tissue indices. Apical-P positively correlated with cervical palatal bone, whole cervical buccal-palatal bone, sagittal root angle, and basal bone width indices. while negatively correlated with apical buccal bone, cervical buccal bone, and basal bone length indices. Six quantitative categories of Apical-P are proposed. Cases with Apical-P below 4 mm had an insufficient apical bone thickness to accommodate the implant placement, while Apical-P beyond 12 mm should be cautious about the severe implant inclination. Cases with Apical-P of 4-12 mm can generally achieve satisfying immediate implant outcomes via regulating the implant inclination. Quantification of the apical palatal bone index for maxillary incisor immediate implant assessment can be achieved, providing a quantitative guide for immediate implant placement in the maxillary incisor zone.