Criteria for the classification of the interradicular septum shape in maxillary molars with clinical importance for prosthetic-driven immediate implant placement

[J. Z. Milanović]

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Uvod. Kako interradikularni septum predstavlja idealno mesto za imedijatnu ugradnju implanata u regiji maksilarnih molara posmatrano sa protetskog aspekta, cilj studije bio je ispitati morfometrijske karakteristike i definisati kriterijume za klasifikakciju oblika interradikularnog septuma. Materijal i metode. Analizirano je 173 CBCT snimka iz baze snimaka Zavoda za stomatologiju Fakulteta medicinskih nauka. Analiza je obuhvatila ispitivanje koronalnog (širina i visina septuma, interradikularni furkacioni ugao, visina kosti od baze septuma do poda maksilarnog sinusa, visinu kosti od vrha septuma do baze maksilarnog sinusa i definisanje oblika interradikularnog septuma) i aksijalnog preseka (površina interradikularnog septuma i analiza odnosa površine implanta i interradikularnog septuma. Rezultati. Prateći algoritam zasnovan na vizuelnoj identifikaciji oblika iterradikularnog septuma opisani su oblik strele, broda, kapi, palatinalne i bukalne konvergencije. Najučestaliji je oblik strele, dok je oblik kapi najmanje frekventan. Najistaknutija širina za ugradnju implanata primećena je kod oblika palatinalne konvergencije, dok je kriterijume za visinu zadovoljio oblik bukalne konvergencije. Analiza aksijalnih prikaza pokazala je da je površina septuma potrebna za ugradnju implanta bila najistaknutija kod oblika palatinalne konvergencije za prvi i oblik čamca za drugi maksilarni molar. Zaključak. Rezultati ove studije pokazali su značaj CBCT dijagnostike u analizi regiona posteriorne maksile. Klasifikacija oblika interradikularnog septuma može biti vrlo korisna u postizanju bržeg i preciznijeg planiranja intervencija ovog regiona.

Introduction. As the interradicular septum represents an ideal place for immediate implant placement in maxillary molars region from the prosthetic view, the aim of this study was to examine morphometric characteristics and to define criteria for the interradicular septum shape classification. Materials and methods. 173 CBCT scans from a radiological database from Department of Dentistry Faculty of medical sciences, were analyzed. Analysis included coronal (septum width and height, interradicular furcation angle, distance between septum base and sinus floor, distance between interradicular furcation and the sinus floor) and axial plane (interradicular septum surface area and the relationship between the implant surface and the interradicular septum). Results. Following the algorithm based on the visual shape identification we described the following shapes: arrow, boat, drop, palatal and buccal convergence. The arrow shape was the most frequent while drop shape was the least frequent. The most prominent width for the implantation was observed in the palatal convergence shape, while the buccal convergence shape showed the highest height for both molars. The analysis of the axial planes showed that the interradicular septum surface required was the most prominent in the palatal convergence shape for the first and boat shape for the second maxillary molar. Conclusion. The results of this study showed the advantages of CBCT diagnostics in the morphometric analysis of the posterior maxilla region. Interradicular septum shape classification may be very useful in achieving faster and more precise planning for interventions in this region.

interradikularni septum, imedijatna ugradnja implanata, protetski vođena implantološka terapija, CBCT

Interradicular septum, Immediate implant placement, Prosthetic-driven implant therapy, Cone-beam computed tomography (CBCT)

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