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Classification system on the selection of number of implants and superstructure design on the basis available vertical restorative space and interforaminal distance for implant supported mandibular overdenture

View Article: PubMed Central - PubMed

ABSTRACT

Purpose:: The rehabilitation of the edentulous mandible is a challenge due to various limiting factors, of which the available vertical restorative space (AVRS) has been well understood in the literature. However, other anatomic variations such as arch form, arch size, and also the interforaminal distance (IFD) (due to the presence of mandibular nerve) are influential in the selection of size and position of implants, and thereby the prosthetic design.

Materials and method:: In the present study, 30 edentulous patients from a group of 300 edentulous patients, representing all the three jaw relations (Class I, II, and III) were evaluated for designing a classification that could help in a comprehensive treatment plan for the edentulous mandible. Dental panoramic radiographs of each individual with a trial or final prosthesis were made. The horizontal IFD and AVRS values were calculated.

Results:: One-way analysis of variance followed by post-hoc test (multiple comparison) and Bonferroni method having P < 0.05 as significant value showed an overall mean of 38.9 mm for horizontal distance and 13.69 mm for the AVRS in 30 edentulous patients.

Conclusion:: The results showed that in the majority of cases (90%) there is insufficient space to place a bar attachment supported by five implants for mandibular overdentures. This suggests that a universal treatment plan cannot be followed due to varying anatomic factors. Hence, it becomes imperative to have a set of clinical guidelines based on the AVRS and IFD, for the selection of implant number and type of attachment. The article proposes a simple classification system based on the AVRS and IFD for establishing guidelines in the treatment planning of the edentulous mandible, to aid in selection of implant size, number, and position along with the associated prosthetic design.

No MeSH data available.


Related in: MedlinePlus

Digital orthopantomography of a patient, where yellow arrow indicates the gutta-percha marked over the mandibular denture teeth, black arrow representing the calibrated interforaminal distance, and red arrow shows the calibrated vertical space (from crest of alveolar ridge to occlusal plane)
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Figure 4: Digital orthopantomography of a patient, where yellow arrow indicates the gutta-percha marked over the mandibular denture teeth, black arrow representing the calibrated interforaminal distance, and red arrow shows the calibrated vertical space (from crest of alveolar ridge to occlusal plane)

Mentions: The horizontal distance (IFD) and vertical space values i.e., from the crest of mandibular residual alveolar ridge to the proposed occlusal plane were calculated with the help of a two-dimensional digitized measuring tool provided in Vista software (Vistascan Combi+, Model no. D74321, Biegheim Bissingen, 2007) [Figure 4], the radiographic errors were standardized. Values were then computed and statistically analyzed. Jaw relation and type of mandibular arch form was analyzed and recorded. Descriptive statistics was calculated for each group. The results were subjected to one-way analysis of variance (ANOVA) and two-way ANOVA statistical analysis with a significance level of P < 0.05.


Classification system on the selection of number of implants and superstructure design on the basis available vertical restorative space and interforaminal distance for implant supported mandibular overdenture
Digital orthopantomography of a patient, where yellow arrow indicates the gutta-percha marked over the mandibular denture teeth, black arrow representing the calibrated interforaminal distance, and red arrow shows the calibrated vertical space (from crest of alveolar ridge to occlusal plane)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837775&req=5

Figure 4: Digital orthopantomography of a patient, where yellow arrow indicates the gutta-percha marked over the mandibular denture teeth, black arrow representing the calibrated interforaminal distance, and red arrow shows the calibrated vertical space (from crest of alveolar ridge to occlusal plane)
Mentions: The horizontal distance (IFD) and vertical space values i.e., from the crest of mandibular residual alveolar ridge to the proposed occlusal plane were calculated with the help of a two-dimensional digitized measuring tool provided in Vista software (Vistascan Combi+, Model no. D74321, Biegheim Bissingen, 2007) [Figure 4], the radiographic errors were standardized. Values were then computed and statistically analyzed. Jaw relation and type of mandibular arch form was analyzed and recorded. Descriptive statistics was calculated for each group. The results were subjected to one-way analysis of variance (ANOVA) and two-way ANOVA statistical analysis with a significance level of P < 0.05.

View Article: PubMed Central - PubMed

ABSTRACT

Purpose:: The rehabilitation of the edentulous mandible is a challenge due to various limiting factors, of which the available vertical restorative space (AVRS) has been well understood in the literature. However, other anatomic variations such as arch form, arch size, and also the interforaminal distance (IFD) (due to the presence of mandibular nerve) are influential in the selection of size and position of implants, and thereby the prosthetic design.

Materials and method:: In the present study, 30 edentulous patients from a group of 300 edentulous patients, representing all the three jaw relations (Class I, II, and III) were evaluated for designing a classification that could help in a comprehensive treatment plan for the edentulous mandible. Dental panoramic radiographs of each individual with a trial or final prosthesis were made. The horizontal IFD and AVRS values were calculated.

Results:: One-way analysis of variance followed by post-hoc test (multiple comparison) and Bonferroni method having P &lt; 0.05 as significant value showed an overall mean of 38.9 mm for horizontal distance and 13.69 mm for the AVRS in 30 edentulous patients.

Conclusion:: The results showed that in the majority of cases (90%) there is insufficient space to place a bar attachment supported by five implants for mandibular overdentures. This suggests that a universal treatment plan cannot be followed due to varying anatomic factors. Hence, it becomes imperative to have a set of clinical guidelines based on the AVRS and IFD, for the selection of implant number and type of attachment. The article proposes a simple classification system based on the AVRS and IFD for establishing guidelines in the treatment planning of the edentulous mandible, to aid in selection of implant size, number, and position along with the associated prosthetic design.

No MeSH data available.


Related in: MedlinePlus