Hjerppe Jenni, Lehmijoki Miikka, Suomalainen Anni, Stoor Patricia
J Oral Implantol. 2025 Jul 15;51(3):283-288. doi: 10.1563/aaid-joi-D-24-00185.
Replacing congenitally missing teeth can be challenging due to anatomical limitations. This retrospective radiographic study aimed to evaluate (1) the dimensions of the alveolar ridge in congenitally missing maxillary lateral incisor sites and (2) whether straightforward implant placement and placement in a prosthetically ideal position was possible. CBCT images of the maxillary alveolar ridge were measured at 3, 8, and 13 mm from the planned crown margin in a labio-palatal and mesio-distal dimension. Virtual implant planning was completed in 3D planning software to evaluate whether the straightforward placement of a 3-mm wide and 10-mm long implant (with 1.5 mm safety distance to neighboring teeth; 1 mm bone wall on the buccal and palatal aspect of the implant) was possible in a prosthetically driven position. Twenty-three patients with 39 missing maxillary lateral incisors were analyzed. The mean (SD) of the alveolar ridge labio-palatal width was varying, 4.6 mm (1.3) at 3 mm, 5.6 mm (1.2) at 8 mm, and 7.8 mm (1.9) at 13 mm. Radiologically straightforward implant placement was possible in 56.4% (n = 22) of the sites. In 5 sites (22.7%) where straightforward implant placement was possible, the implants could be planned in a prosthetically driven position. According to patient records, straightforward implant placement was performed in 33.3% (n = 13) of the cases, 5 of them in prosthetically driven position. In congenitally missing maxillary lateral incisor sites, the alveolar ridge width is limited in the labio-palatal direction and might affect the possibility of straightforward and prosthetically driven implant placement.
由于解剖学限制,替换先天性缺失牙具有挑战性。这项回顾性影像学研究旨在评估:(1)先天性缺失上颌侧切牙部位的牙槽嵴尺寸;(2)能否直接植入种植体并将其置于修复理想位置。在上颌牙槽嵴的CBCT图像上,于距计划牙冠边缘3、8和13毫米处测量其唇腭向和近远中向尺寸。利用三维规划软件完成虚拟种植体规划,以评估能否在修复驱动位置直接植入一枚宽3毫米、长10毫米的种植体(与相邻牙保持1.5毫米安全距离;种植体颊侧和腭侧有1毫米骨壁)。对23例共39颗上颌侧切牙缺失患者进行了分析。牙槽嵴唇腭向宽度的平均值(标准差)各不相同,在3毫米处为4.6毫米(1.3),8毫米处为5.6毫米(1.2),13毫米处为7.8毫米(1.9)。56.4%(n = 22)的部位在放射学上可直接植入种植体。在5个(22.7%)可直接植入种植体的部位,种植体可规划于修复驱动位置。根据患者记录,33.3%(n = 13)的病例进行了直接种植体植入,其中5例处于修复驱动位置。在先天性缺失上颌侧切牙部位,牙槽嵴宽度在唇腭向受限,可能会影响直接和修复驱动种植体植入的可能性。