Use of panoramic radiographs for evaluation of maxillary and mandibular residual ridge resorption: In vitro study

Priyanka Tiwari

Abstract

Oral Health Meet 2018: Use of panoramic radiographs for evaluation of maxillary and mandibular residual ridge resorption: In vitro study - Priyanka Tiwari - Dental Surgeon (Prosthodontist), Malaysia.   Priyanka Tiwari Dental surgeon (Prostodontist), Malaysia   Abstract INTRODUCTION: Ridge resorption is the major reason of mandibular complete denture losing its stability and retention. The location of the mental foramen can be identified easily on panoramic radiographs, and radiographic examinations are considered an important component of Prosthodontics diagnostic and treatment planning. Also, the location of maxillary landmark is important to known how much resorption is there. Aim: To determine the average ratio of bone height with nearest constant anatomical landmarks in maxilla and in mandible. OBJECTIVE To find out the association between radiographic findings & prosthodontics, such as measurements of the amount of resorption and the variation in the treatment planning of edentulous patients. Methods: In this study OPG machine- Kodak C 8000 and Software to calculate the distance- Screen calipers v2.1 is used. 100 patients OPG was taken in this study. Major inclusion parameters included were presence of mandibular premolars and molars, minimal ridge resorption and clear radiographic landmarks visible on the OPG. After which the landmarks and specific structures were marked on the OPG. Then measurement was done for distance ???c???, ???a???, ???x???, ???y???, ???z???. Lastly, the calculations from measurements were done to calculate the ratio of c/a, to calculate the ratio of x/y, to calculate the ratio of x/z. Result: The descriptive statistics was done. The C/a ratio mean is 2.71  0.31. The X/Y ratio mean is 1.49  0.34 and the X/Z ratio mean is 1.51 0.24. Conclusion: This ratio can be assessed in edentulous patients and then their further treatment plan can be decided according to the ratio. The implant placement can be assessed by using the measurements in this study. KEYWORDS- Average alveolar bone, panoramic radiograph, mental foramen, mandibular ridge, zygomatic process, maxillary ridge. Residual ridge resorption is an incessant, dynamic, irreversible, and impairing sickness, and it has likely multifactorial starting point. Bone misfortune fluctuates from patient to understanding, however increasingly critical changes happen in the mandibular curve. Tallgren and Atwood and Coy found that the mean proportion of front maxillary to foremost mandibular (remaining edge decrease [RRR]) was 1:4. This is on the grounds that mandibular edge bears higher useful powers transmitted through the false teeth than the maxillary edge due to its littler region and less profitable state of the lower basal seat. Remaining edge resorption, particularly in the mandible, may influence dental replacement dependability and maintenance. Net resorption of the edentulous mandibular alveolar procedure over some undefined time frame bringing about extreme loss of the dental replacement bearing edge and for the most part the overlying slim and atrophic mucosa over it makes it progressively hard to withstand the masticatory load. The mucosa gets encroached between the sharp edge and the dental replacement bringing about extreme agony and distress to the patient. The troubles experienced in such patients during capacity can be decreased with the utilization of either embeds or strong dental replacement liners. In spite of the fact that inserts have been accounted for as profoundly powerful, they are not a feasible answer for every edentulous patient due to negative hidden bone, important clinical, mental, and monetary requirements. Then again, treatment with the strong dental replacement liners has just not many restrictions, being the nonsurgical application technique, and have low treatment cost. The adaptability, strength, and the stun sponginess of the tough dental replacement liner materials help in sway decrease and appropriation of masticatory burden to the edge. MATERIALS AND METHODS This clinical examination was completed in the Department of Prosthodontics, CDER, All India Institute of Medical Sciences, New Delhi after endorsement from institutional morals board of trustees (IESC/T-255/01.06.2012). An absolute number of 28 totally edentulous patients inside the age gathering of 45–60 years following the consideration measures; edentulous patients throughout the previous a half year, having class I jaw connection, all around created edges with firm mucosa and no past dental replacement experience were chosen to partake in the examination. Quiet enduring with any fundamental issue which may impact bone digestion and having class II or class III jaw relationship were prohibited. Members were altogether educated about the entire method, need of follow-up visits, radiographs required, and composed educated assent was gotten. The example size was determined dependent on writing review as two gatherings, equal, rehashed measures with resorption as the essential result variable estimated at a half year's and a year's postdenture addition. Remembering the likelihood to have dropouts and to accomplish 90% force with perceptible distinction at 95% certainty span, 14 members were joined up with every one of the two gatherings according to defined (male/female) square randomization which depended on PC created numbers given by the analyst. RESULTS A total of 28 (14 male/14 female) participants with mean age of 53.93 ± 4.25 years were rehabilitated with maxillary and mandibular complete dentures. The mean mandibular bone height from radiopaque markers at five different points in the right posterior, anterior and left posterior regions to a reference plane in mandible was measured in both groups over a period of 12 months. The mean change in bone height in right posterior, anterior and left posterior region in control group from baseline to 12 months was 1.4 ± 0.14 mm (4.9%), 1.4 ± 0.2 mm (5.2%), and 1.7 ± 0.05 mm (5.9%) respectively and in experimental group, this was 0.7 ± 0.08 mm (2.3%), 0.6 ± 0.06 mm (2.5%), and 0.9 ± 0.08 mm (3.2%), respectively. Results showed decrease in bone height at all time intervals in both groups, and the change was statistically significant (P < 0.05).