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The Use of a New Safe Angle Concept for Immediate Implant Placement in the Anterior Maxilla: A Cross-sectional Cone Beam Computed Tomography Study.
PURPOSE: The current cross-sectional study aims to introduce a new method for the labiopalatal positioning and angulation of immediately placed dental implants in the anterior maxilla with relation to the type of abutment used (straight/angled abutment).
MATERIAL AND METHODS: Cone beam computed tomography scans from the database of a private practice were searched for patients who received immediate implants in anterior maxilla. After superimposition of the initial and post-operative scans, incisal/root angle (IRA), incisal/implant angle (IIA) and the difference between both angles were measured. Furthermore, assessment of whether the implant position would be lying within the safe angle or not. Age, gender, tooth/implant site and type of prosthetic abutment (straight/angled) were retrieved from patients' records.
RESULTS: Seventy-four patients with a total of 95 immediate implants were selected for analysis. In regard to the type of abutment, 76 (80%) were straight, while 19 abutments (20%) were angled. Regardless of abutment type, 72 implants (75.8%) lay within the safe angle while 23 implants (24.2%) did not lie within the safe angle. All 19 implants with angled abutments were not lying within the safe angle. There was a statistically significant association between type of abutment, IRA, difference between IIA and IRA, gender and lying within the safe angle (P-value <0.001, OR = 19, P-value <0.001, Effect size = 0.904, P-value <0.001, Effect size = 1.209 and P-value <0.001, OR = 2.995 respectively). There was no statistically significant association between IIA, site or age and lying within the safe angle (P-value = 0.757, Effect size = 0.063, P-value = 0.200, Effect size = 0.184 and P-value = 0.387 Effect size = 0.208, respectively). There was a statistically significant association between IRA, difference between IIA and IRA and type of abutment (P-value = 0.001, Effect size = 0.762, P-value <0.001, Effect size = 1.056, respectively).
CONCLUSIONS: The Safe Angle Concept can be used as a reliable planning tool to choose the correct IIP position in the anterior maxilla. Applying the safe angle concept will decrease the use of angled abutment for prosthetic correction.
MATERIAL AND METHODS: Cone beam computed tomography scans from the database of a private practice were searched for patients who received immediate implants in anterior maxilla. After superimposition of the initial and post-operative scans, incisal/root angle (IRA), incisal/implant angle (IIA) and the difference between both angles were measured. Furthermore, assessment of whether the implant position would be lying within the safe angle or not. Age, gender, tooth/implant site and type of prosthetic abutment (straight/angled) were retrieved from patients' records.
RESULTS: Seventy-four patients with a total of 95 immediate implants were selected for analysis. In regard to the type of abutment, 76 (80%) were straight, while 19 abutments (20%) were angled. Regardless of abutment type, 72 implants (75.8%) lay within the safe angle while 23 implants (24.2%) did not lie within the safe angle. All 19 implants with angled abutments were not lying within the safe angle. There was a statistically significant association between type of abutment, IRA, difference between IIA and IRA, gender and lying within the safe angle (P-value <0.001, OR = 19, P-value <0.001, Effect size = 0.904, P-value <0.001, Effect size = 1.209 and P-value <0.001, OR = 2.995 respectively). There was no statistically significant association between IIA, site or age and lying within the safe angle (P-value = 0.757, Effect size = 0.063, P-value = 0.200, Effect size = 0.184 and P-value = 0.387 Effect size = 0.208, respectively). There was a statistically significant association between IRA, difference between IIA and IRA and type of abutment (P-value = 0.001, Effect size = 0.762, P-value <0.001, Effect size = 1.056, respectively).
CONCLUSIONS: The Safe Angle Concept can be used as a reliable planning tool to choose the correct IIP position in the anterior maxilla. Applying the safe angle concept will decrease the use of angled abutment for prosthetic correction.
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