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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

Analysis of the degree of jaw bone atrophy by 2D imaging for the purposes of prosthetic treatment in edentulous patients

Yordanka Donkova, Desislava Konstantinova, Anna Nenova-Nogalcheva, Delyan Georgiev


Introduction: The facial and jaw changes that occur in completely edentulous patients require a precise analysis and evaluation in three planes due to the complex and volumetric structure of the human head. The greater the atrophy of the edentulous jaw, the more pronounced the soft tissue features become. Planning the treatment for such patients requires restoring facial aesthetics and the function of the masticatory apparatus.

Aim: The aim of this study is to analyze the vertical bone loss in edentulous upper and lower jaws for the purposes of prosthetic rehabilitation, using 2D imaging measurements.

Materials and Methods: A total of 36 panoramic radiographs of edentulous patients were examined. Radiographic criteria for selection included the absence of obvious facial asymmetry, clearly visible anatomical structures, and no history of surgery or fractures. Measurements were made using reference lines drawn through anatomical landmarks on standardized panoramic radiographs. Each panoramic radiograph was processed with the Romexis® Viewer 4.6.2.R (Planmeca) software. After calibrating the software, the respective reference lines were determined, and measurements were taken. Statistical analysis was performed using the SPSS v. 20.0 software for Windows. The following analyses were used: comparative analysis; correlation analysis—Pearson’s coefficient; graphical and tabular methods for visualizing the results. A significance level of p < 0.05 was adopted with a 95% confidence interval.

Results: From the obtained results, no significant difference was observed in the height of the alveolar bone between men and women in both jaws (p < 0.05). A moderate inverse relationship was observed between age and the height of the alveolar bone in the molar region of the lower jaw (p = 0.01, r = -0.423)—the height of the alveolar bone decreases with advancing age. The exceptions are the premolar areas on the left and right, where a decrease in the height of the alveolar ridge is not recorded (r = 0.40).

Conclusion: The atrophy of the alveolar bone and the establishment of anatomical landmarks on the prosthetic field using panoramic radiography have crucial diagnostic importance in planning functionally suitable dentures.

In the present study, the height of the alveolar bone in completely edentulous patients was measured. A statistically insignificant difference was determined between the heights of the upper and lower jaws concerning the gender of the subjects. Only in the premolar region of the lower jaw in women was a greater height observed.

Regarding the distribution by age groups - in the range of 81–90 years, the greatest atrophy of the alveolar ridges was recorded. An inverse relationship was identified between the age indicators and the height of the alveolar bone—as one indicator increased, the other decreased.


atrophic changes, panoramic radiography (OPG), edentulous patients

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