Evaluation of mandibular first molar teeth in the context of immediate implant placement using Cone Beam Computed Tomography

Main Article Content

Raif Alan
Javid Isayev


Objective: During the immediate dental implant (IMI) procedure in the mandibular posterior region, some limitations caused by anatomical structures that may affect the success of implant treatment and increase the risk of complications may be encountered. Socket size, distance from root apices to the inferior alveolar canal (IAC), and lingual concavity are some of the critical conditions. This study aimed to examine the alveolar bone of mandibular first molars using cone beam computed tomography (CBCT) and to evaluate its prevalence on a subpopulation basis.

Material and Methods: A total of 153 mandibular first molar teeth in 100 patients who met the evaluation criteria were evaluated for cross-sectional classification of the alveolar bone, distance from root apices to IAC, and socket size using CBCT scans.

Results: In this study, which included 42 females and 58 males, the age range was 19-70 years (38.13±13.74 years). Of the 153 mandibular first molars analyzed, 53.6% were on the left, while 46.4% were on the right. The distances from the apices of the roots to the IAC were the least in females (p<0.05) and U-type ridges. It was also found that this distance was positively correlated with age. The mean crestal socket width measured in the current study was suitable for choosing a dental implant with an appropriate diameter for IMI surgery.

Conclusion: Cross-sectional analysis of the relevant regions before surgery is important for IMI placement. This will allow clinicians to take precautions against possible complications.


Download data is not yet available.

Article Details

How to Cite
Alan, R., & Isayev, J. (2023). Evaluation of mandibular first molar teeth in the context of immediate implant placement using Cone Beam Computed Tomography . Medical Science and Discovery, 10(5), 308–312. https://doi.org/10.36472/msd.v10i5.945
Research Article
Received 2023-05-05
Accepted 2023-05-13
Published 2023-05-15


Chan HL, Brooks SL, Fu JH, Yeh CY, Rudek I, Wang HL. Cross-sectional analysis of the mandibular lingual concavity using cone beam computed tomography. Clin Oral Implants Res. 2011;22(2):201-6.

Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, Ohman A. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg Suppl. 1977;16:1-132.

Padhye NM, Shirsekar VU, Bhatavadekar NB. Three-Dimensional Alveolar Bone Assessment of Mandibular First Molars with Implications for Immediate Implant Placement. Int J Periodontics Restorative Dent. 2020;40(4):e163-7.

Sayed AJ, Shaikh SS, Shaikh SY, Hussain MA. Inter radicular bone dimensions in primary stability of immediate molar implants - A cone beam computed tomography retrospective analysis. Saudi Dent J. 2021;33(8):1091-7.

Zhou Y, Jiang T, Qian M, Zhang X, Wang J, Shi B, Xia H, Cheng X, Wang Y. Roles of bone scintigraphy and resonance frequency analysis in evaluating osseointegration of endosseous implant. Biomaterials. 2008;29(4):461-74.

Sayed AJ, Shaikh SS, Shaikh SY, Hussain MA, Tareen SUK, Awinashe V. Influence of Inter-Radicular Septal Bone Quantity in Primary Stability of Immediate Molar Implants with Different Length and Diameter Placed in Mandibular Region. A Cone-Beam Computed Tomography-Based Simulated Implant Study. J Pharm Bioallied Sci. 2021;13(Suppl 1):S484-91.

Greenstein G, Cavallaro J, Tarnow D. Practical application of anatomy for the dental implant surgeon. J Periodontol. 2008;79(10):1833-46.

Smith RB, Tarnow DP, Sarnachiaro G. Immediate Placement of Dental Implants in Molar Extraction Sockets: An 11-Year Retrospective Analysis. Compend Contin Educ Dent. 2019;40(3):166-70.

Wang TY, Kuo PJ, Fu E, Kuo HY, Nie-Shiuh Chang N, Fu MW, Shen EC, Chiu HC. Risks of angled implant placement on posterior mandible buccal/lingual plated perforation: A virtual immediate implant placement study using CBCT. J Dent Sci. 2019;14(3):234-40.

Yoon TY, Patel M, Michaud RA, Manibo AM. Cone Beam Computerized Tomography Analysis of the Posterior and Anterior Mandibular Lingual Concavity for Dental Implant Patients. J Oral Implantol. 2017;43(1):12-8.

Tomasi C, Sanz M, Cecchinato D, Pjetursson B, Ferrus J, Lang NP, Lindhe J. Bone dimensional variations at implants placed in fresh extraction sockets: a multilevel multivariate analysis. Clin Oral Implants Res. 2010;21(1):30-6.

Zadik Y, Sandler V, Bechor R, Salehrabi R. Analysis of factors related to extraction of endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(5):e31-5.

McCaul LK, Jenkins WM, Kay EJ. The reasons for the extraction of various tooth types in Scotland: a 15-year follow up. J Dent. 2001;29(6):401-7.

Hamouda NI, Mourad SI, El-Kenawy MH, Maria OM. Immediate implant placement into fresh extraction socket in the mandibular molar sites: a preliminary study of a modified insertion technique. Clin Implant Dent Relat Res. 2015;17(Suppl 1):e107-16.

Shareef RA, Chaturvedi S, Suleman G, Elmahdi AE, Elagib MFA. Analysis of Tooth Extraction Causes and Patterns. Open Access Maced J Med Sci. 2020;8(D):36-41.

de Pablo OV, Estevez R, Péix Sánchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod. 2010;36(12):1919-31.

Chen ST, Wilson TG Jr, Hämmerle CH. Immediate or early placement of implants following tooth extraction: review of biologic basis, clinical procedures, and outcomes. Int J Oral Maxillofac Implants. 2004;19:12-25.

Smith RB, Tarnow DP. Classification of molar extraction sites for immediate dental implant placement: technical note. Int J Oral Maxillofac Implants. 2013;28(3):911-6.

Kawashima Y, Sakai O, Shosho D, Kaneda T, Gohel A. Proximity of the Mandibular Canal to Teeth and Cortical Bone. J Endod. 2016;42(2):221-4.

Bürklein S, Grund C, Schäfer E. Relationship between Root Apices and the Mandibular Canal: A Cone-beam Computed Tomographic Analysis in a German Population. J Endod. 2015;41(10):1696-700.

Kovisto T, Ahmad M, Bowles WR. Proximity of the mandibular canal to the tooth apex. J Endod. 2011;37(3):311-5.

Schmittbuhl M, Le Minor JM, Schaaf A, Mangin P. The human mandible in lateral view: elliptical fourier descriptors of the outline and their morphological analysis. Ann Anat. 2002;184(2):199-207.

Srivastava S, Alharbi HM, Alharbi A.S, Soliman M, Eldwakhly E, Abdelhafeez MM. Assessment of the Proximity of the Inferior Alveolar Canal with the Mandibular Root Apices and Cortical Plates-A Retrospective Cone Beam Computed Tomographic Analysis. J Pers Med. 2022;12:1784.

Swasty D, Lee JS, Huang JC, Maki K, Gansky SA, Hatcher D, Miller AJ. Anthropometric analysis of the human mandibular cortical bone as assessed by cone-beam computed tomography. J Oral Maxillofac Surg. 2009;67(3):491-500.

Gupta G, Gupta DK, Gupta N, Gupta P, Rana KS. Immediate Placement, Immediate Loading of Single Implant in Fresh Extraction Socket. Contemp Clin Dent. 2019;10(2):389-93.

Schropp L, Kostopoulos L, Wenzel A. Bone healing following immediate versus delayed placement of titanium implants into extraction sockets: a prospective clinical study. Int J Oral Maxillofac Implants. 2003;18(2):189-99.

Sammartino G, Marenzi G, Citarella R, Ciccarelli R, Wang HL. Analysis of the occlusal stress transmitted to the inferior alveolar nerve by an osseointegrated threaded fixture. J Periodontol. 2008;79(9):1735-44.

Ketabi M, Deporter D, Atenafu EG. A Systematic Review of Outcomes Following Immediate Molar Implant Placement Based on Recently Published Studies. Clin Implant Dent Relat Res. 2016;18(6):1084-94.

Ragucci GM, Elnayef B, Criado-Cámara E, Del Amo FS, Hernández-Alfaro F. Immediate implant placement in molar extraction sockets: a systematic review and meta-analysis. Int J Implant Dent. 2020;6(1):40.

Deporter D, Khoshkhounejad AA, Khoshkhounejad N, Ketabi M. A new classification of peri implant gaps based on gap location (A case series of 210 immediate implants). Dent Res J (Isfahan). 2021;18:29.

Rosa AC, da Rosa JC, Dias Pereira LA, Francischone CE, Sotto-Maior BS. Guidelines for Selecting the Implant Diameter During Immediate Implant Placement of a Fresh Extraction Socket: A Case Series. Int J Periodontics Restorative Dent. 2016;36(3):401-7.

Chan HL, Benavides E, Yeh CY, Fu JH, Rudek IE, Wang HL. Risk assessment of lingual plate perforation in posterior mandibular region: a virtual implant placement study using cone-beam computed tomography. J Periodontol. 2011;82(1):129-35.

Chrcanovic BR, de Carvalho Machado V, Gjelvold B. Immediate implant placement in the posterior mandible: A cone beam computed tomography study. Quintessence Int. 2016;47(6):505-14.

Chen H, Wang W, Gu X. Three-dimensional alveolar bone assessment of mandibular molars for immediate implant placement: a virtual implant placement study. BMC Oral Health 2021;21:478.

Ho JY, Ngeow WC, Lim D, Wong CS. Anatomic considerations for immediate implant placement in the mandibular molar region: a cross-sectional study using cone-beam computed tomography. Folia Morphol (Warsz). 2022;81(3):732-8.

Lin MH, Mau LP, Cochran DL, Shieh YS, Huang PH, Huang RY. Risk assessment of inferior alveolar nerve injury for immediate implant placement in the posterior mandible: a virtual implant placement study. J Dent. 2014;42(3):263-70.

Tufekcioglu S, Delilbasi C, Gurler G, Dilaver E, Ozer N. Is 2 mm a safe distance from the inferior alveolar canal to avoid neurosensory complications in implant surgery? Niger J Clin Pract. 2017;20(3):274-7.