Retrospective examination of the relationship of dental implants in the maxilla and mandibular with surrounding anatomical structures in cone-beam computed tomography

Chewing, speech, aesthetic, phonetic and psychological problems occur in individuals with complete or partial missing teeth. Dental implants are seen as a more successful option than traditional treatments in solving these problems. In dental implant applications, attention should be paid to the characteristics of the bone in the area where the implant will be applied. These features are the quantity, quality, density of the bone and its relationship with the surrounding anatomical structures and formations. The aim of this study is to examine the dental implants made in the maxilla and mandible on cone-beam computed tomography (CBCT) images and to evaluate their relationship with the surrounding anatomical structures according to the margin of safety. In this study, images taken with Planmeca three-dimensional Mid (ProMax, Helsinki, Finland) CBCT device between 2017-2021 in the tomography archive of Gaziantep University Faculty of Dentistry, Department of Oral and Maxillofacial Radiology were used. CBCT images of a total of 802 implants, 450 of which were in the mandible and 352 in the maxilla, in 250 (110 men, 140 women) patients aged 22-91 years were evaluated by typing their relationship with the surrounding anatomical structures in multiplanar planes. In the maxilla, type 1 implant was mostly seen with the maxillary sinus with a rate of 26.1%, type 2 implant with the nasal cavity and maxillary sinus with 7.7%, and type 3 implant with the nasal cavity with a rate of 29.0%. Type 1 implant in the mandibula was observed with the mental foramen at a maximum rate of 12%. When examined according to gender, no statistically significant difference was found between the maxillary and mandibular anatomical formations and typing (p > 0.05). The mean age of the patients with type 1 relationship with the nasal cavity floor is higher than the mean age of the patients with type 2 relationship, and this difference is statistically significant (p < 0.05). A statistically significant difference was found between the mean age of the cases with no relationship with the lingual foramen and the mean age of the cases with type 3 relationship with the lingual foramen (p < 0.05). In conclusion, type 1 implant was most frequently detected with the maxillary sinus in the maxilla and the mental foramen in the mandible. The mean age of the type 1 cases associated with the nasal cavity in the maxilla and the mandibular incisive canal in the mandible was found to be significantly higher than the mean age of the implant cases without relationship. Implant planning with CBCT is recommended to prevent the risk of permanent nerve damage and rhinosinusitis that may result in anesthesia or dysesthesia in implants to be made in the nasal cavity and mandibular incisive canal region in advanced ages.