Abstract：
The biaxial nature of the anterior maxilla poses a surgical and restorative challenge in implant dentistry. The present study sought to investigate the apical socket perforation rate (ASPR) from a simulated uniaxial implant placement and to determine the effect of implant length and diameter on ASPR when a uniaxial implant was placed compared with the orientation of the pre-existing dual-axis implant.
Cone beam computed tomography (CBCT) scans from the database of three private practices were searched for patients who received dual-axis implants within the esthetic zone in immediate tooth replacement therapy. A uniaxial implant was virtually placed using the pre-existing screw access channel of the dual-axis implant as a reference. The closest length and diameter were selected for the simulated implant. ASPR by the uniaxial implant was recorded. In addition, the affordable maximum length of a corresponding uniaxial implant that would avoid apical socket perforation was measured.
Eighty-one patients with a total of 101 dual-axis dental implants were selected for analysis. A simulated virtual surgical planning with uniaxial implants revealed high ASPR (48.51%). When the length of the uniaxial implant was reduced to 11 and 9 mm, ASPR was decreased to 41.58% and 20.79%, respectively.
Dual-axis implant design effectively evades anatomical challenges in the anterior maxilla (esthetic zone). Considering the current evidence, efforts should be made to carefully consider the angular disparity between the extraction socket-alveolus complex and the future restorative emergence so that a harmonious biologic-esthetic result may be more predictably and consistently obtained.
Cone beam computed tomography (CBCT) scans from the database of three private practices were searched for patients who received dual-axis implants within the esthetic zone in immediate tooth replacement therapy. A uniaxial implant was virtually placed using the pre-existing screw access channel of the dual-axis implant as a reference. The closest length and diameter were selected for the simulated implant. ASPR by the uniaxial implant was recorded. In addition, the affordable maximum length of a corresponding uniaxial implant that would avoid apical socket perforation was measured.
Eighty-one patients with a total of 101 dual-axis dental implants were selected for analysis. A simulated virtual surgical planning with uniaxial implants revealed high ASPR (48.51%). When the length of the uniaxial implant was reduced to 11 and 9 mm, ASPR was decreased to 41.58% and 20.79%, respectively.
Dual-axis implant design effectively evades anatomical challenges in the anterior maxilla (esthetic zone). Considering the current evidence, efforts should be made to carefully consider the angular disparity between the extraction socket-alveolus complex and the future restorative emergence so that a harmonious biologic-esthetic result may be more predictably and consistently obtained.
摘要：
目的：前上颌骨的双轴性质在种植牙科中提出了手术和修复的挑战。本研究旨在研究模拟单轴植入物放置的根尖窝穿孔率（ASPR），并确定与现有双轴植入物的方向相比，单轴植入物放置时植入物长度和直径对ASPR的影响。
方法：从三个私人诊所的数据库中搜索锥形束计算机断层扫描（CBCT）扫描，以寻找在立即进行牙齿置换治疗时在美学区域内接受双轴植入物的患者。使用双轴植入物的预先存在的螺钉进入通道作为参考，实际上放置了单轴植入物。为模拟植入物选择最接近的长度和直径。记录单轴植入物的ASPR。此外,测量了相应的单轴植入物的可承受的最大长度，该植入物可以避免根尖窝穿孔。
结果：选择81名患者，共101个双轴牙种植体进行分析。具有单轴植入物的模拟虚拟手术计划显示出高ASPR（48.51％）。当单轴植入物的长度减少到11和9毫米时，ASPR分别降至41.58%和20.79%,分别。
结论：双轴植入物设计有效地避免了前上颌骨（美学区）的解剖学挑战。考虑到目前的证据,应努力仔细考虑拔牙窝-肺泡复合体与未来的修复性出现之间的角度差异，以便可以更可预测和一致地获得和谐的生物美学结果。
方法：从三个私人诊所的数据库中搜索锥形束计算机断层扫描（CBCT）扫描，以寻找在立即进行牙齿置换治疗时在美学区域内接受双轴植入物的患者。
结果：选择81名患者，共101个双轴牙种植体进行分析。
结论：双轴植入物设计有效地避免了前上颌骨（美学区）的解剖学挑战。
