Table 7 Four types of anatomical characteristics of maxillary anterior teeth for immediate implant according to the sagittal root angle with surrounding hard and soft tissue
Anatomical type | Angle | n | Index | Result | Significance | Implication for immediate implant design | Schematic map of implant(Bone level NC, Straumann; 3.3*12 mm) | |
|---|---|---|---|---|---|---|---|---|
Type I | < 0° | 9 | Coronary buccal bone and gingiva | Bone | < 1 mm | High risk of buccal bone wall defect when placing the implant | The implant could be place along the axis of tooth, while the palatal bone Under the CEJ should be noted to keep contact (> 1 mm at least) |
|
Gingiva | No correlation | / | ||||||
Coronary palatal bone | 1.5–1.7 mm | Relative thin for offering alternative bone | ||||||
Apical bone | Labial | 1.0–3.0 mm | Ensuring sufficient primary stability for immediate implant | |||||
Palatal | 2.0–4.0 mm | Relative thick for offering alternative bone | ||||||
Under apex bone along the tooth axis | 8.4 mm | To get enough primary stability | ||||||
Root diameters | No correlation | / | ||||||
Type II | 0°–10° | 125 | Coronary buccal bone and gingiva | Bone | 0.51–1.20 mm | High risk of buccal bone wall defect when placing the implant | The implant could be place along the axis of tooth, which was the best anatomic situation (not only the angle, but the surrounding bone) for immediate implantation |
|
Gingiva | No correlation | / | ||||||
Coronary palatal bone | 1.6–2.2 mm | Relative thick that could be used to adjust implant to proper position | ||||||
Apical bone | Labial | 1.0–3.0 mm | Ensuring sufficient primary stability for immediate implant | |||||
Palatal | 2.3–5.1 mm | Thick for offering alternative bone | ||||||
Under apex bone along the tooth axis | 9.9–10.1 mm | To get enough primary stability | ||||||
Root diameters | No correlation | / | ||||||
Type III | 10°–25° | 545 | Coronary buccal bone and gingiva | Bone | 0.50–1.03 mm | High risk of buccal bone wall defect when placing the implant | The implant was recommended to rotate palatally at the apical direction to protect the buccal bone wall around the apex. Intro-mouth adhesive of the crown and even angled implant base might be used during final restoration |
|
Gingiva | No correlation | / | ||||||
Coronary palatal bone | 1.7–3.1 mm | Adequate bone dimension that could be used to adjust implant to proper position | ||||||
Apical bone | Labial | 0.9–2.1 mm | < 1 mm usually indicates high risk of fenestration and perforation during implant placement | |||||
Palatal | 3.1–8.1 mm | / | ||||||
Under apex bone along the tooth axis | 6.4–9.4 mm | Abundant bone for getting enough primary stability | ||||||
Root diameters | No correlation | / | ||||||
Type IV | > 25° | 121 | Coronary buccal bone and gingiva | Bone | < 1 mm | High risk of buccal bone wall defect when placing the implant | The implant has to rotate palatally to protect the buccal bone wall. Angled implant base would be used during final restoration or immediate implant was not recommended on the consideration of long-term success |
|
Gingiva | No correlation | |||||||
Coronary palatal bone | 2.2–4.3 mm | Adequate bone dimension that could be used to adjust implant to proper position.Adequate bone dimension that could be used to adjust implant to proper position | ||||||
Apical bone | Labial | 0.8–1.4 mm | < 1 mm usually indicates high risk of fenestration and perforation during implant placement | |||||
Palatal | 4.4–10.3 mm | / | ||||||
Under apex bone along the tooth axis | 2.9–4.6 mm | High risk to get enough primary stability | ||||||
Root diameters | No correlation | / | ||||||
