Maxilla vs. Mandible: A Multi-Dimensional Risk Scoring System for Dental Implant Planning
Abstract
Abstract Background Posterior maxillary and mandibular implant sites carry site-specific anatomical risk profiles that remain inconsistently quantified in pre-operative planning. We developed a multi-dimensional, cone-beam computed tomography (CBCT)-based risk scoring system for side-by-side comparison of residual bone quantity and anatomical risk factors between the two jaws. Methods A single-center retrospective cohort of 200 implant sites (100 maxillary, 100 mandibular; consecutively screened adults, both sexes, age 18–79) was analyzed. For each site, residual bone height and width, and jaw-specific anatomical risks (sinus pneumatization, septa, and membrane thickening in the maxilla; lingual undercut depth in the mandible) were scored and summed into a total site risk score (range 0–10). Intra-observer reliability was assessed at a 15-day interval using the intra-class correlation coefficient (ICC; single-rater, absolute-agreement, two-way random). Inter-group differences were tested using Welch's t-test or Mann–Whitney U; categorical comparisons used Fisher's exact test for sparse 2×2 tables (cell expectations ≤ 5) and chi-square otherwise. Results Total site risk was approximately two-fold higher in maxillary than in mandibular sites (mean 6.67 ± 2.58 vs 3.40 ± 0.92; p
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