Sains Malaysiana 50(4)(2021): 1047-1056

http://doi.org/10.17576/jsm-2021-5004-15

Risk Associated with Immediate Implant at Mandibular Canine and Premolars: A Cone Beam Computed Tomography (CBCT) Study

(Risiko Berkaitan dengan Implan Segera pada Gigi Taring dan Geraham: Kajian Tomografi Berkomputer Pancaran Kon)

KIRTHIGA RAMESWARAN, AMINAH MOHD SHARIFF & DANIEL LIM*

Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Federal Territory, Malaysia

Received: 17 March 2020/Accepted: 6 September 2020

ABSTRACT

With the evolution of implant dentistry, immediate implantation remains a challenge especially in achieving a good primary stability with avoidance of complications such as nerve injuries and lingual perforations. This study was aimed to determine the risks of nerve injury and lingual perforation following virtual implant placement at mandibular canines, mandibular first premolars and mandibular second premolars using cone beam computed tomography (CBCT) scans. From the total of 771 CBCT scans screened, 100 CBCT scans were included. Measurements were made based on the cross-section of the study teeth, that were mandibular canine, first premolar and second premolar, to obtain the distance between root apex and nerve canal as well as risk of nerve injury. A virtual implant was then placed at each site to assess the risk of lingual perforation. Generally, the distance between root apex and nerve was less than 6 mm and the highest risk of nerve injury was observed at second premolar (79.6%) followed by first premolar (45.3%) and canine (23.4%). Risk of lingual perforation following immediate implant placement was between 0.7-1.5%. The risk of nerve injury was considerably high due to insufficient root apex to nerve canal distance while the risk of lingual perforation was low.

Keywords: Complications; cone beam computed tomography; dental implant; mandible

ABSTRAK

Dengan perkembangan dalam implan pergigian, pengimplanan serta-merta masih merupakan satu cabaran terutamanya dalam mencapai kestabilan primer yang baik di samping mengelakkan komplikasi seperti kecederaan saraf dan perforasi lingual. Penyelidikan ini adalah bertujuan untuk menentukan risiko kecederaan saraf dan perforasi lingual berikutan perletakan implan maya pada gigi taring, gigi geraham kecil pertama dan kedua rahang bawah dengan menggunakan imbasan tomografi berkomputer pancaran kon (CBCT). Daripada 771 imbasan CBCT yang disaring, 100 imbasan CBCT telah dimasukkan dalam penyelidikan ini. Bagi memperoleh jarak antara apeks akar gigi dan kanal saraf, ukuran telah dilakukan pada keratan rentas imbasan CBCT gigi taring, geraham kecil pertama dan kedua rahang bawah. Satu implan maya kemudiannya diletakkan pada kedudukan setiap gigi tersebut untuk menilai risiko perforasi lingual. Secara umumnya, jarak di antara apeks akar dan kanal saraf adalah kurang daripada 6 mm dan risiko kecederaan saraf adalah paling tinggi pada kedudukan geraham kecil kedua (79.6%) diikuti geraham kecil pertama (45.3%) dan geraham kecil kedua (23.4%). Risiko perforasi lingual berikutan implan serta-merta adalah antara 0.7-1.5%. Risiko kecederaan saraf adalah agak tinggi memandangkan kekurangan jarak antara apeks akar gigi dan kanal akar, manakala risiko perforasi lingual adalah rendah.

Kata kunci: Implan pergigian; komplikasi; rahang bawah; tomografi berkomputer pancaran kon

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*Corresponding author; email: daniel_khlim@um.edu.my