Evaluation of Total and Partial Edentulous Jaws Using Panoramic Radiography

Abstract

Aim: Panoramic radiography is a diagnostic modality for providing a view of the entire maxillofacial region and used as an initial screening tool to examine partially and completely edentulous jaws in pretreatment assessment. Material-method:This study included digital panoramic images of 321 partially and totally edentulous patients. The images were evaluated for positive radiographic findings including presence of retained root fragments, impacted teeth, radiolucencies, radiopacities, proximity of the mental foramen and maxillary sinus to the residual alveolar ridge. Results: Totally 538 edentulous jaws were examined in 321 individuals (51.1 % females, 48.9 % males) mean aged 57.3 (standard deviation=11.5). The rate of completely edentulous jaws was 29 % (n=156) and the rate of partially edentulous jaws was 71 %. Prevalence of one or more positive radiographic findings was found to be 51 %. Of the radiographic findings, 49.4 % was in females and 50.6 % in males. The most frequent finding was retained root fragments (15.6 %), followed by location of the maxillary sinus close to the alveolar crest (10.6 %), radioopacities (9.3 %), impacted teeth (8 %), location of the mental foramen on the crest (6.8 %) and radiolucencies (1.2 %). Conclusion: Prevalence of positive radiographic findings was found to be relatively high in clinically healthy looking edentulous patients in this study. This result confirmed that pretreatment panoramic examination is necessary to detect pathologies and requirement of any dental procedure for a successful prosthodontic rehabilitation. Key words: Panoramic radiography, edentulous patients, radiographic evaluation ÖZET Amaç: Panoramik radyografi tüm maksillofasiyal bölgenin görülmesine olanak sağlayan bir diagnostik yöntemdir ve parsiyel ve tam dişsiz çenelerin tedavi öncesi değerlendirmesinde ilk inceleme yöntemi olarak kullanılır. Gereç ve yöntem: Bu çalışmada 321 parsiyel ve total dişsiz hastanın dijital panoramik görüntüsü incelendi. Görüntüler, kök artıkları, gömülü dişler, radyolusensiler, radyoopasiteler, mental foramen ve maksiller sinüsün alveolar kret tepesine yakınlığı gibi pozitif radyografik bulgular yönünden değerlendirildi. Bulgular: Yaş ortalaması 57.3 (standart sapma=11.5) olan 321 (% 51.1 kadın, % 48.9 erkek) hastada toplam 538 dişsiz çene incelendi. Total dişsiz çenelerin oranı % 29 (n=156) ve parsiyel dişsiz çenelerin oranı i% 71'di. Bir veya daha fazla pozitif radyografik bulguların görülme sıklığı, % 51 olarak bulundu. Bunların % 49.4'ü kadın, % 50.6'sı erkeklerdeydi. En fazla görülen bulgu artık köklerdi (% 15.6), bunu maksiller sinüsün alveolar krete yakınlığı (% 10.6), radyoopasiteler (% 9.3), gömülü dişler (% 8), mental foramenin alveolar krete yakınlığı (% 6.8) ve radyolusensiler (% 1.2) takip etmekteydi. Sonuç: Bu çalışmada klinik olarak sağlıklı görünen dişsiz hastalardaki pozitif radyografik bulguların görülme sıklığı, göreceli olarak yüksek bulundu. Bu sonuç başarılı bir prostodontik tedavi için herhangi bir işlemin gerekliliğini ve patolojilerin b...

Analysis of digital panoramic imaging findings of completely edentulous patients applying for prosthetic treatment

“…One of the most important indications of panoramic radiography is to evaluate the jaws and surrounding tissues before prosthetic applications. However, there are different opinions regarding the use of panoramic radiography in complete denture patients (2,12,15). Some of the studies in the literature opposed routine panoramic radiography before prosthetic application, arguing that most of the detected positive radiographic findings did not affect the treatment (5,9).…”

“…Some of the studies in the literature opposed routine panoramic radiography before prosthetic application, arguing that most of the detected positive radiographic findings did not affect the treatment (5,9). However, many researchers have emphasized that it is critical to evaluate all patients in this group with panoramic radiography before treatment (2,12,15). The high rate of positive radiographic findings obtained in our study indicates the importance of examination with panoramic radiography before the prosthetic procedures to be applied in complete edentulous patients.…”

“…The studies in which panoramic radiographic images of completely edentulous patients were examined, the rates of positive radiographic findings ranged from 32-68.3% (2,5,(7)(8)(9)11,12,15). Proportional differences may be due to factors such as the examination of different structures/ pathologies, the experience/expertise of the dentist, and the increased image quality of the devices that develop in time (12). The rate of positive radiographic findings in our study was found to be quite high compared to other studies.…”

“…In the study of Köse et al (11), which is one of the studies reporting the locations of the impacted teeth, they reported that the majority of the impacted teeth (88%) were observed in the maxilla. Peker et al (12) reported that the impacted teeth were seen most frequently in the mandibular molar region. While the rates determined in our study were found to be compatible with these studies, the positions of the impacted teeth were not concentrated in a certain region.…”

“…The most important advantage of panoramic radiography is that, a general evaluation of both jaws and adjacent anatomical structures can be made thanks to a single radiographic image obtained in a short time and with low dose radiation (3,(8)(9)(10). In panoramic radiographic examinations performed in completely edentulous patients, apart from pathologies, many anatomical and structural conditions that may affect prosthetic treatment, such as the route of the mandibular canal, the position of the mental foramen and maxillary sinuses, and bone resorption level (2,3,11,12). Since the area that can be examined is large, the presence of soft tissue calcifications (STCs) such as calcified carotid artery atheroma, sialolith, and tonsillolith, which are both dental and medically important, can be determined (13,14).…”