Measurement of maximum vertical space between teeth as a factor in digital guide design for dental implant placement in angle class I and class II population
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PURPPOSE: The objective of this research was to measure MVS between the central incisors and the posterior areas to evaluate whether computer designed guides can be used. MATERIALS AND METHODS: A total of 150 adult subjects (aged 22−78) were included. The population was further stratified by race, sex and Angle Classification. The examiner measured the maximum vertical space (MVS) at six specific sites. Measurements were repeated twice at each site. In addition overbite and ovejet were measured at the central incisor position. The pilot drill/guide appliance combination space requirement was tested with each category of MVS measurement. RESULTS: (i) there was a race effect, with African American having a greater maximum vertical space measurement than Caucasian and Asian respectively (P < 0.0001); (ii) there was a also gender effect, with males having a greater maximum vertical space measurement than females(P < 0.0001); (iii) there was an inverse association with overjet on central incisors and first premolars, with less overjet subjects having a greater maximum vertical space measurement (P < 0.05). We found that overall only 76% of the female cohort in our sample satisfied this space requirement of Nobel Guide (45mm) at the central incisor position. SUMMARY: Using the Nobel computer guided surgery minimum dimension requirement of 45mm, our findings suggest that first premolar or second molar implants could not be placed in our sample of dentulous patients, while a central incisor implant could be placed in 76%-100% of subjects depending on gender and race factors.
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