Investigation of anatomical variations in the jaws and their relationship with dental implants in cone beam computed tomography images

Objective: The aim of this retrospective study is to determine which anatomical structure and/or variation causes implant penetration by retrospectively examining the relationship of anatomical structures and variations in the jaws with implants in CBCT images. Due to insufficient and limited research on this subject, it is aimed to emphasize the importance of imaging methods and anatomical knowledge in implant planning by drawing attention to the related anatomical structures and contributing to the literature on the prevalence of implant penetration determined in the anatomical structures examined in this study. Method: Of the 3600 CBCT images taken in our clinic for various reasons, 181 patients and 717 implants were included in the study. Implant penetrations associated with anatomical structures and variations appearing in the jaws in these images were investigated. Non-variative structures; maxillary sinus, mandibular canal, nasopalatine canal and nasal cavity: Variations; maxillary sinus variations, nasopalatine canal variations, canalis sinosus, mandibular canal variations, mandibular incisive canal, lingual foramen and canal, lateral lingual foramen (LLF) and accessory mental foramen (AMF) and those with implant penetration from these structures were recorded. The determined data were statistically analyzed by recording according to gender, age groups and distribution regions in the jaws. Results: Anatomical variations-implant penetration were statistically higher in anterior mandible (p<0.001). The prevalence of mandibular incisive canal among anatomical variations was 43.1%. Among the non-variative anatomical structures, the maxillary sinus was found to be the structure with the most implant penetration. The penetration of implant-anatomical variation was found to be statistically significantly higher in males (9.5%) than females (5.1%) (p=0.024). Conclusion: The mandibular incisive canal and anterior mandible appear to be the most risky region in terms of anatomical variation and implant penetration. Considering the limitations of the studies in the literature, studies on the prevalence of implant penetration of anatomical variations in different populations and large patient groups should continue. Key words: Anatomic variation,CBCT, implant, mandibular incisiv canal