title: Risk assessment of inferior alveolar nerve injury for immediate implant placement in the posterior mandible: a virtual implant placement study.
abstract: OBJECTIVE
  To investigate the prevalence and morphological parameters of lingual concavity, and whether these factors are related to a higher risk of inferior alveolar nerve (IAN) injury when performing an immediate implant surgery in posterior mandible region.
  
  
  METHODS
  The CBCT images from 237 subjects (1008 teeth) were analysed the shape of the mandibles (C, P, U type), dimensional parameters of lingual concavity (angle, height, depth), and its relation to inferior alveolar canal (IAC) (A, B, C zone), RAC (distance from root apex to IAC) and probability of IAN injury. Multiple logistic regression modelling to determine the odds ratio of variables that made an important contribution to the probability of IAN injury and to adjust for confounding variables.
  
  
  RESULTS
  The U type ridge (46.7%) and the most concave point located at C zone (48.8%) are most prevalent in this region. The mandibular second molar presents highest risk for IAN injury than other tooth type (p<0.001), which were 3.82 times to occur IAN injury than the mandibular second premolar. The concave point located at A zone and B zone were 7.82 and 3.52 times than C zone to have IAN damage, respectively. The probability of IAN injury will reduce 26% for every 1mm increase in RAC (p<0.001).
  
  
  CONCLUSIONS
  The tooth type, morphological features of lingual concavities, and RAC are associated with risks of IAN injury during immediate implant placement.
  
  
  CONCLUSIONS
  Pre-surgical mapping of the IAC and identification of its proximity relative to the lingual concavity in the posterior mandible regions may avoid unpleasant complications, specifically when performing immediate implant procedures.
authors.affiliation: Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Ming-Hung
authors.initials: MH
authors.lastname: Lin
authors.affiliation: Department of Periodontics, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Lian-Ping
authors.initials: LP
authors.lastname: Mau
authors.affiliation: Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
authors.forename: David L
authors.initials: DL
authors.lastname: Cochran
authors.affiliation: Department of Oral Diagnosis and Pathology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yi-Shing
authors.initials: YS
authors.lastname: Shieh
authors.affiliation: Department of Dentistry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Po-Hsien
authors.initials: PH
authors.lastname: Huang
authors.affiliation: Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan. Electronic address: ndmcandy@ndmctsgh.edu.tw.
authors.forename: Ren-Yeong
authors.initials: RY
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019412:Anatomy, Cross-Sectional / Q000379:methods; D001641:Bicuspid / Q000000981:diagnostic imaging / Q000294:innervation; D002648:Child; D003198:Computer Simulation; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000294:innervation / Q000601:surgery*; D008340:Mandibular Nerve / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D008954:Models, Biological; D008963:Molar / Q000000981:diagnostic imaging / Q000294:innervation; D018570:Risk Assessment; D019227:Tooth Apex / Q000000981:diagnostic imaging / Q000294:innervation; D020390:Tooth Socket / Q000000981:diagnostic imaging / Q000294:innervation; D061221:Trigeminal Nerve Injuries / Q000209:etiology*; D014584:User-Computer Interface; D055815:Young Adult
chemical_list: D015921:Dental Implants
keywords: Cone beam computed tomography; Dental implants; Immediate placement; Inferior alveolar nerve; Mandible; Risk assessment