Assessment and Comparison of the Condylar Guidance by Protrusive Interocclusal Records and Panoramic Radiographic Imaging in Edentulous and Dentulous Individuals

Abstract

Aim: To compare the condylar guidance angle obtained by extraoral Gothic arch tracing, protrusive interocclusal records (IORs), and orthopantomogram (OPG) in completely edentulous and dentulous subjects. Materials and methods:A total of 30 edentulous and 30 dentulous subjects were selected. Conventional steps in the fabrication of complete denture with balanced occlusion were carried out. Extraoral Gothic arch tracing records were obtained from each subject. Protrusive IORs were used to program the Hanau Wide-Vue semiadjustable articulator, to obtain the sagittal condylar guidance angle. The sagittal condylar guidance was determined in 60 subjects by protrusive IORs and facebow transfer. The sagittal outline of the articular eminence and glenoid fossa was traced in panoramic radiographs. The sagittal condylar path inclination was constructed by joining the heights of curvature in the glenoid fossa and the corresponding articular eminence. This was then related to the constructed Frankfurt horizontal plane to determine the radiographic angle of sagittal condylar guidance.Results: There was statistically significant difference between the sagittal condylar guidance values obtained using extraoral Gothic arch tracing and OPG method (p 0.0237) in edentulous subjects. Statistically significant values were obtained using protrusive records and OPG method (p 0.0237) in dentulous subjects. Conclusion:The use of OPG to set condylar guidance on the articulator should be taken into consideration for both dentulous and edentulous subjects. Clinical significance:In clinical practice, the use of IORs following Gothic arch tracing for the programming of semiadjustable articulator may be associated with manual errors. To minimize the errors and to obtain more accurate sagittal condylar guidance values, the use of OPG along with IORs should be considered for programming of the semiadjustable articulator.

Accuracy of radiographic and protrusive occlusal record methods in determining condylar guidance angles: a systematic review and meta-analysis

“…Typically, 26 studies were conducted in India, 1,7,11,13,14,19,20,[23][24][25][26][27]29,30,32,[34][35][36][37][38][39][40][41][42][43][44] two each in Iran 8,28 and Saudi Arabia 22,33 and one each in Nepal, 21 Korea 31 and Poland. 9 In total, 20 studies included were conducted among dentate patients having a total sample size of 595 and age ranged from 18-43 years 1,19,20,21,25,27,30,32,34,[37][38][39][40]42,44 while 15 studies included were conducted among edentulous patients having a total sample size of 277 and age ranged from 35-75 years. [7][8][9]11,…”

“…9 In total, 20 studies included were conducted among dentate patients having a total sample size of 595 and age ranged from 18-43 years 1,19,20,21,25,27,30,32,34,[37][38][39][40]42,44 while 15 studies included were conducted among edentulous patients having a total sample size of 277 and age ranged from 35-75 years. [7][8][9]11,13,14,19,20,[22][23][24]26,28,29,31,33,35,36,41,43 The ethical approval was obtained in 25 studies 1,9,11,13,14,[19][20][21][22][23][24][25][26][30]…”

“…[7][8][9]11,13,14,19,20,[22][23][24]26,28,29,31,33,35,36,41,43 The ethical approval was obtained in 25 studies 1,9,11,13,14,[19][20][21][22][23][24][25][26][30][31][32][33][34][35][36]38,[40][41][42][43] while informed consent was obtained in only 20 studies. 8,9,11,[20][21][22][23][...…”

“…The brands and the models of the articulator, OPG, CBCT, CT scan, LC and TMJ tomogram varied according to the studies. Radiographically the HCG angle was measured using OPG 1,7-9,14, [19][20][21][22][23][26][27][28][30][31][32][34][35][36][37][38][39][40]42 in 24 studies, seven studies recorded HCG angle with CBCT, 8,11,25,31,33,35,43 five studies used LC 1,23,24,29,41 and one study each recorded HCG angle with CT scan 13 and TMJ tomogram. 44 For all of the included studies, the orientation jaw relation was registered utilising face-bow and was transferred on to the semi-adjustable articulator employing mounting jig or extra oral gothic arch tracers, and the protrusive interocclusal record was obtained by instructing the subject to protrude the mandible forward by 6mm.…”

“…The condylar guidance angle was measured between the Frankfort's horizontal plane and the line formed along the posterior slope of articular eminence (AE), connecting the most concave (highest) point on the glenoid fossa and the most convex (lowest) point on the apical portion of AE in all the included studies. The right and left HCG angle was calculated separately for both the dentate and edentulous patients in all the included studies except for studies Amin et al, 20 Jerath S et al, 25 Katiyar et al 26 and Paul et al 1 cumulative value of right and left angle is mentioned.…”