Root morphology and angulation analysis of mandibular first molar for the planning of immediate implants. A cross-sectional study using CBCT


Submitted: 22 April 2023
Accepted: 27 September 2023
Published: 27 September 2023
Abstract Views: 290
PDF: 220
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Introduction The placement of immediate implants has considerable advantages over conventional implant placement. Drilling prior to extraction of the tooth favors stabilization through the interradicular septum, which simplifies obtaining a correct three-dimensional position and good primary stability. But not in all cases the root morphology and angulation allow the use of the interradicular osteotomy for immediate molar implants.

Aim To analyze the root morphology and angulation of the first lower molar using CBCT and determine anatomical criteria for the placement of an immediate dental implant in the presence of the interradicular septum.  

Materials and methods CBCTs of 91 first molars were analyzed. Coronal and axial sections were made to measure the interradicular septum thickness, the angulation of the roots in relation to the occlusal plane and the distance of the apex from the mesial root and distal to the inferior alveolar nerve canal.  

Results The interradicular distance of the first lower molar at the apical level was 3.79 ± 1.18 mm, and at the medium level it was 3.70 ± 0.95 mm, these measurements corresponding to the thickness of the interradicular septum at the apical and mid-level, respectively. The distance from the apex of the mesial root to the canal of the inferior dental nerve was 4.30 ± 1.97 mm and the apex of the distal root was 4.00 ± 1.87 mm. The angle of the mesial root in relation to the occlusal plane was 101.68 ± 5.84 ° and the distal root of 105.23 ± 7.19.

Conclusion The thickness of the interradicular septum in most of the cases does not allow to stable the implant into it. To achieve apical anchorage, it is necessary to have a distance from the apices to the inferior alveolar nerve to be able to perform drilling without injuring the nerve. Root angulation complicate interradicular technique, in those situation extraction prior osteotomy is recommended


Míchel Baltazar, C., Garza Salinas, B. R., Rodríguez Franco, N. I., Martínez Sandoval, G., Martínez González, G. I., Bustamanete Whitney, A. E., & Baltazar-Ruiz, A. (2023). Root morphology and angulation analysis of mandibular first molar for the planning of immediate implants. A cross-sectional study using CBCT. Journal of Osseointegration, 15(4), 233–237. https://doi.org/10.23805/JO.2023.543

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