Does the sagittal root position of maxillary anterior teeth affect the decision making on immediate implants in the anterior maxilla? A CBCT-based study.

Background: Immediate implant placement in the maxillary esthetic zone is a challenging and demanding task. To achieve favorable results, proper case selection and treatment planning are necessary. Variables like the sagittal root position (SRP) and the labial bone thickness (LBT) of maxillary anterior teeth are of paramount importance for predictable outcomes.

Objectives: The aim of the present study was to evaluate the SRP and LBT of maxillary anterior teeth in the context of immediate implant placement by using cone-beam computed tomography (CBCT) in a sample of the Pakistani population.

Material and methods: A cross-sectional study was conducted using the CBCT scans of patients. The SRP of each tooth (maxillary canine to canine) was evaluated in the sagittal section of a CBCT scan according to the classification by Kan et al. The LBT of each tooth was measured perpendicularly to the long axis of tooth at 3 sites: at the alveolar crest (P1); 2 mm from the alveolar crest (P2); and 4 mm from the alveolar crest (P3). Descriptive statistics were reported for SRP and LBT. The χ2 test was employed to assess any association between the variables.

Results: Class I SRP was the most prevalent (n = 196, 81.7%), while Class III was the least frequent (n = 1, 0.4%). The association between the tooth type and SRP was statistically non-significant (p = 0.510).

Conclusions: In the evaluated sample of the Pakistani population, the most frequent type of the SRP of maxillary anterior teeth was Class I, which is most favorable for immediate implant placement. Furthermore, the labial bone in the maxillary esthetic zone was found to be mostly thin - LBT was within the range of 0.5-0.9 mm - which makes immediate implant placement in the anterior maxilla a challenge. The results of the present study could serve as a guide for clinicians in terms of appropriate patient selection for immediate implant placement in the maxillary esthetic zone.