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Anatomical considerations
This document discusses important anatomical structures to consider when placing dental implants, including the inferior alveolar canal, mental foramen, incisive foramen, maxillary sinus, and interdental spaces. It recommends using cross-sectional imaging to assess bone dimensions and distances from structures like the inferior alveolar canal. Shorter implants may be used when vertical bone is compromised. Safety zones of 1-2mm from structures like the mental foramen are advised. The size and location of the incisive papilla must also be determined for maxillary anterior implants.
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Anatomical considerations
- 1. Member A.O.I.A Fellow I.C.O.I Scientificconsultant of sybron implant solutions Manager of implant direct company
- 4. 1) Inferior alveolar canal 2) Mental foramen 3) Incisive Foramen 4) Maxillary sinus 5) Nasal cavity 6) Interdental space (neighboring teeth) 7) Bone width (bucco-lingual) 8) Mylohyoid ridge
- 7. For implantsthat are to be placed in the mandible, the distance from the edentulous alveolar crest to the upper border of the inferior alveolar canal should be assessed from cross-sectional tomographic radiographs.
- 8. The safetyzone between the tip of the implant and the border of the canal should be at least 1-2 mm. Patients with compromised vertical bone dimension can sometimes be treated by placing multiple shorter implants of optimal width followed by splinting the prosthetic crowns together during the restorative phase of therapy.
- 10. The positionof the mental formen should be identified and located when implant surgeries in the premolar and molar areas of the mandible are performed. In some situations a loop of the nerve can be found to extend mesially.
- 11. In onereport the anterior loop of the mental neurovascular bundle extended mesially from 1.1 - 3.3 mm and a safety zone of 4 mm was recommended to avoid damaging the nerve during implant placement (Kuzmanovic et al.2003)
- 13. When placingan implant in the anterior part of the maxilla the size and location of the incisive papilla need to be determined. In addition, it must be established if there is enough bone in the area to place an implant or if the area needs to be grafted.
- 20. Anatomic concavitiesare frequently found on the lingual side of the mandible. It is important to avoid perforating the lingual plate during preparation of the implant site since perforations in this location can result in extensive and even life-threatening bleeding (Bruggenkate et al. 1993)
- 21. A safeway of performing surgery in this area is to reflect a lingual flap at least to a level corresponding to the length of the implant to be placed.