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A classification of maxillary premolar sockets in relation to the osseous housing for immediate implant placementPetroche, Maria Fernanda, DMD 13 August 2021 (has links)
The aim of this study was to establish a classification system for use in immediate implant placement by examining fresh extraction sockets in maxillary premolars and evaluation of the varying morphologies using CBCT imaging. Selection criteria included dentulous patients ages 15-85 that had CBCT imaging taken for varying treatment. A total of 400 maxillary premolars were classified by their root morphology as Type I (two-rooted premolar with interradicular bone), II (fused roots with mesiodistal alveolar constriction) or III (single blunted root with no interradicular bone). The internal root angle was measured for all Type 1 maxillary first premolars (n=40), as well as the interradicular septal bone height. A Type 1 premolar socket is present in 32% of the sampled maxillary first and second premolars. Type 2 socket was present in 22% of premolars, and type 3 socket was present in 46% of premolars. The average internal angle formed between the long axis of the crown versus the long axis of the palatal root was 11.46 ± 4.35° (range 4° to 20.7°). The average interradicular septal bone height was of 6.9 ± 1.6 mm (range 3.28 to 9.61). Type I root form had the highest incidence at maxillary first premolars sites and has the most alveolar bone available, thus having a higher probability for primary stability. The type III root form is most common in the maxillary second premolar site and has the least amount of alveolar support for immediate implant placement. The angulation and alveolar bone support provided by the palatal root in Type I root form maxillary first premolar sites may provide stability for an immediate implant at an appropriate prosthetic position.
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