Influential Factors in Buccal and Lingual Plate Perforation around Dental Implants Using Cone-Beam Computed Tomography

This study determined the influential factors in buccal and lingual plate perforation around dental implants using cone-beam computed tomography (CBCT). In this retrospective, cross-sectional study, CBCT scans of dental implants taken for purposes not related to this study from 2017 to 2018 were retrieved from the archives of a private dental clinic. Demographic information, implant site, length, diameter, shape, and angulation, buccal and lingual plate thickness, buccolingual diameter of bone, and presence of crestal bone resorption were all assessed on CBCT scans. Data were analyzed using chi-squared, Mann-Whitney, Kruskal-Wallis, and independent t-tests. Of 604 implants, 88 had caused bone perforation in 41 females (46.6%) and 47 males (53.4%) with a mean age of 54.97 ± 13.99 years; 83% of perforations were in the maxilla; 55.7% of implants causing perforation were cylindrical and 44.3% were conical. The mean length and diameter of implants was 11.78 ± 1.91 mm, and 4.49 ± 0.76 mm, respectively; 38.9% of perforations were in the buccal and 18.2% in the lingual plate, and 42% were in the apical region. Crestal bone loss was noted in 58% of perforation cases. The mean angular deviation of implants was 19.13 ± 12.41°. Implant length and diameter had a significant association with the occurrence of perforation in the mandible (P < 0.05). Perforations had a higher frequency in the posterior maxilla, and mainly in the apical region. The buccal plate was thin in the anterior maxilla, with minimum thickness in the apical region. Lingual plate perforation had the highest frequency in the mandible.