3 years ago

A wide mesio-distal gap in sites of congenitally missing maxillary lateral incisors is related to a thin alveolar ridge

Michael H. Bertl, Verena Schulze Grotthoff, Kristina Bertl, Andreas Stavropoulos, Christian Ulm, André Gahleitner, Patrick Heimel
Objectives To evaluate (i) a possible correlation between the mesio-distal gap width and the alveolar ridge (AR) dimensions in patients missing the maxillary lateral incisor (I2) either due to agenesis or loss and (ii) the possibility of straightforward implant placement based on simulation. Methods The bucco-palatal width, area, and height of the AR at the position of I2, and the mesio-distal gap width between the central incisor and the canine, were assessed in maxillary CT scans of three groups: Patients with (i) agenesis of I2 (TA; n = 40); (ii) I2 regularly erupted but extracted (TL; n = 24); (iii) I2 regularly erupted and in situ (C; n = 40). Further, the possibility of straightforward placement of an implant 3 or 3.5 mm in diameter ×10 mm in length, with 1 mm distance from the buccal and palatal plate of the alveolar ridge was simulated and compared to the actual treatment delivered. Results Bucco-palatal width and area of the AR at I2 and the adjacent teeth was significantly reduced in TA compared to TL and C. Further, in TA, but not TL, an increasing mesio-distal gap width between the central incisor and canine resulted in a significantly reduced bucco-palatal width of the edentulous AR. This impeded a simulated straightforward implant placement in >50% of the cases in TA, even with a reduced implant diameter. Conclusions In patients congenitally missing I2, an increased mesio-distal gap width correlates significantly with reduced edentulous AR dimensions. A mesio-distal gap of >6 mm was associated with thin bucco-palatal alveolar ridges, precluding straightforward implant placement in 60–80% of the cases.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/clr.12915

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