Suthar Jignasha, Mathur Somil, Upadhyay Snehal, Taduri Thanmai
Department of Prosthodontics, Crown and Bridgework and Oral Implantology, Faculty of Dental Science, Dharmsinh Desai University, Nadiad, Gujarat, India.
J Indian Prosthodont Soc. 2025 Jul 1;25(3):244-250. doi: 10.4103/jips.jips_33_25. Epub 2025 Jul 16.
To validate the CBCT classification for immediate implant placement (IIP) given by Howard Gluckman in the local population of Gujarat, India, and additionally evaluate the available bone beyond the tooth apex for IIP in the direction of proposed osteotomy.
Cross-sectional Observational study.
A total of 103 cone beam computed tomography (CBCT) scans involving the six maxillary anterior teeth were scrutinized in the radial plane. Each CBCT was divided into six slices (n = 618), which were classified according to Gluckman's classification, followed by making the osteotomy lines. Six measurements (L, W1, W2, W3, W4, and W5) were made from root to nasal floor. Bone length (L) was measured in the direction of proposed osteotomy, whereas the bone width was measured at five different points along the proposed osteotomy.
Chi-square p value, One-way ANOVA and Post hoc Tukey test.
As per Gluckman's classification, it was found that class I showed the highest bone width with the lowest bone length, whereas Class V showed the lowest bone width. The highest bone length was observed in Class IV. The prevalence of different radial root position (RRP) starting from class I to class V was 1%, 75%, 15%, 16%, and 3%, respectively.
A distinct correlation was found between the anterior root position and the available bone between the root tip and the nasal floor as per Gluckman's classification.
This study helps in the radiographic evaluation of available bone around the roots of maxillary anterior teeth, which is a critical determining factor for treatment planning in IIP cases. A deep knowledge of RRP, bone morphology, and available alveolar bone beyond the apex provides useful perception to the clinician to plan surgical and grafting procedures to achieve primary stability. This will also help the clinicians to visualize the final prosthetic outcome with respect to the position of access hole.
验证霍华德·格鲁克曼（Howard Gluckman）给出的用于印度古吉拉特邦当地人群即刻种植（IIP）的锥形束计算机断层扫描（CBCT）分类，并额外评估在拟行截骨术方向上IIP时根尖以外的可用骨量。
横断面观察性研究。
在径向平面仔细检查了总共103例涉及上颌六颗前牙的锥形束计算机断层扫描（CBCT）。将每个CBCT分成六个切片（n = 618），根据格鲁克曼分类法进行分类，然后绘制截骨线。从牙根到鼻底进行六项测量（L、W1、W2、W3、W4和W5）。骨长度（L）在拟行截骨术的方向上测量，而骨宽度在拟行截骨术的五个不同点测量。
卡方p值、单因素方差分析和事后Tukey检验。
根据格鲁克曼分类法，发现I类显示出最高的骨宽度和最低的骨长度，而V类显示出最低的骨宽度。IV类观察到最高的骨长度。从I类到V类不同径向牙根位置（RRP）的患病率分别为1%、75%、15%、16%和3%。
根据格鲁克曼分类法，发现前牙根位置与根尖和鼻底之间的可用骨量之间存在明显相关性。
本研究有助于对上颌前牙牙根周围可用骨进行影像学评估，这是IIP病例治疗计划的关键决定因素。对RRP、骨形态以及根尖以外可用牙槽骨的深入了解，为临床医生规划手术和植骨程序以实现初期稳定性提供了有用的认识。这也将帮助临床医生根据进入孔的位置可视化最终的修复效果。
