Prevalence of horizontal alveolar changes in edentulous patients: a retrospective tomographic study

Abstract Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.

Morphology and morphometry of the human sublingual glands in mouth floor enlargements of edentulous patients

Asymptomatic mouth floor enlargements may be observed in edentulous patients. These masses, which protrude from the mouth floor, may complicate the fitting of dentures and require surgery. Whether this "entity" may be considered an anatomical variation of the mouth floor or represent specific alterations in the sublingual gland is not known. Objective: The aim of this work is to investigate the morphological and morphometric aspects of the sublingual glands of edentulous patients with mouth floor enlargements and compare the glands of these patients with the sublingual glands of human cadavers. Material and Methods: Microscopic evaluation was performed on human sublingual glands from edentulous patients with mouth floor enlargements (n=20) and edentulous cadavers (n=20). The patients and cadavers were of similar ages. The data were compared using Mann-Whitney U, Fisher's exact and Student's t tests (p<0.05). Results: Acinar atrophy, duct-like structures, mononuclear infiltrates, replacement of parenchyma with fibrous/adipose tissue, mucous extravasation and oncocytosis were similar between the groups (p>0.05). Only the variables "autolysis" and "congested blood vessels" presented statistical difference between groups (p=0.014; p=0.043). The morphometric study revealed that the volume densities of acini, ducts, stroma and adipose tissue were similar between the groups (p>0.05). CONCLUSION: The microscopic characteristics of the sublingual glands in mouth floor enlargements in edentulous patients correspond to characteristics associated with the normal aging process. The glands are not pathological and represent an age-related alteration that occurs with or without the presence of the mouth floor enlargements. .

Dimensión vertical en edentados: relación con síntomas referidos / Vertical dimension on edentulous patient: relationship with symptoms reported

La dimensión vertical es una medida aproximada de las relaciones fisiológicas intermaxilares. Su obtención es un proceso sensible y metódico que produce efectos craneofaciales colaterales cuando es erróneamente lograda. Los conceptos individualistas de su obtención deben ser cambiados e interiorizados de una manera colectiva debido a la complejidad de la dinámica masticatoria que exige una perspectiva más amplia de esta noción. La correspondencia entre la dimensión vertical y lo funcional-disfuncional cráneo-cervical es innegable y va mas allá de una relación exclusivamente dental. Esta revisión busca situar al lector en una realidad estomatognática y no solo odontológica, que exige mayores esfuerzos y un cambio de perspectiva en la conceptualización de la importancia de la dimensión vertical en el normal funcionamiento del sistema estomatognático y de estructuras vecinas en el paciente edentado.

Vertical dimension is an approximate measure of the physiological inter-maxillary relations. Its register is a sensitive and methodical process with craniofacial side effects when wrongly achieved. Single concepts for vertical dimension register should be changed and understood in a collective manner. The complexity of the masticatory dynamics requires a broader view of this notion. The correspondence between the vertical dimension and the functional-dysfunctional cranio-cervical relations is undeniable and goes beyond an exclusively dental relation. This review seeks to place the reader in a stomatognathic functional perspective, which requires greater efforts of the prosthodontics operator. Normal functioning of the stomatognathic system and surrounding structures in the edentulous patient depends on the conceptualization about the importance of vertical inter-maxillary relations.

Estudio de la localización del foramen mentoniano en mandíbulas maceradas con diferentes grados de edentulismo / Study of the localization of the mental foramen in macerated mandibles with different degree of edentulism

El estudio de la localización del foramen mentoniano se realiza estableciendo su posición por medio de la inspección y palpación de estructuras vecinas relacionadas. Se sabe de la importancia de ese elemento, ya que de él emerge un paquete neurovascular. La correcta determinación de su localización viene a facilitar actividades clínicas tales como la realización de anestesias, implantes, cirugías, así como también, la colocación de prótesis. Fueron analizadas en este trabajo, tres grupos de mandíbulas maceradas: 53 dentadas (presencia de dientes o de sus alvéolos), 55 desdentadas posterior e 62 desdentadas (con reabsorción de todo el proceso alveolar), sumando 170 piezas. En estas mandíbulas fueron realizadas mediciones del foramen mentoniano así como la distancia a estructuras vecinas, con el objetivo de predecir la localización de este foramen. Las estructuras anatómicas vecinas usadas como referencia fueron: base de la mandíbula, pogonion (punto craneométrico) y reborde alveolar. Fue realizado un análisis estadístico en cada grupo, comparándolos posteriormente. Se observaron diferencias entre los tres grupos, debido a la presencia o ausencia de los dientes, relacionado a la mayor o menor cantidad de hueso presente y, así, modificando la localización del foramen mentoniano cuando es medido desde el reborde alveolar; llegando en algunos casos a obtenerse valor cero en la medición, por la reabsorción ósea. En consecuencia, el foramen mentoniano se encontraba más próximo del reborde alveolar en las mandíbulas desdentadas, seguidas por las desdentadas posterior, y de éstas, por las dentadas.

The study of the mental foramen localization has the aim to establish its position through the inspection and touching related to the surrounded structures. Taking notice of the importance of this structure, since from it emerges a neurovascular bundle the correct determination of its localization facilitates the clinical activities such as the realization of anesthesia, implants, surgeries, as well as the placement of prosthesis. In this work three groups of macerated mandibles were used: 53 dentate (presence of teeth or their alveolus), 55 posterior edentulous and 62 edentulous (with reapsortion of all the alveolar process), totalizing 170 specimens. These mandibles were used to do mensurations of the mental foramen until their surrounding structures, with the aim of determining the localization of this foramen. The surrounding anatomic structures used as a reference were: the basis of the mandible, pogonion (craniometric point) and alveolar edge. The statistical analyses in each group were done, comparing among them later. There were observed differences between the three groups, due to the presence or not of the teeth meaning less or high quantity of the bone and, in this way, modifying the localization of the mental foramen when mensurated up to the alveolar edge, in some cases we could obtain a zero value of this distance, such was the osseous reabsorption. Therefore the mental foramen was localized closer of alveolar edge in the edentulous mandibles, followed by posterior edentulous and these, by the dentate.

A study to determine whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion by unbiased observers: a pilot study.

CONTEXT: By convention, the posterior palatal seal area is located on the palate between the anterior and posterior vibrating lines. However, there are opposing views on whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion. AIMS: The study was carried out to determine whether the anterior and posterior vibrating lines can be distinguished as two separate lines of flexion by unbiased observers. A second part of the study was formulated to evaluate whether the palpatory method correlated with the nose-blowing method in locating the anterior line of flexion. MATERIALS AND METHODS: Twenty-three dental undergraduate clinical students were selected as observers. Twenty-three edentulous patients were randomly selected. The students were asked to record the anterior and posterior vibrating line on one patient each using two differently colored marking pencils. Also, the anterior vibrating line was marked by the palpatory method (using T burnisher) using a third colored marking pencil. The marked lines were then transferred onto the previously made impression of modeling plastic. RESULTS: Of the 23 recorders used in the study, 19 could locate separate anterior and posterior lines of flexion. In 4 cases, the anterior and posterior lines of flexion coincided and were not distinct. In 20 cases, the palpatory method produced a line anterior to the line located by the Valsalva maneuver. CONCLUSIONS: The anterior and posterior vibrating lines could be located by the undergraduate students as two separate lines of flexion when the appropriate action was elicited for each of them; and the palpatory method produced a line slightly anterior to the anterior vibrating line located by the Valsalva maneuver.

Tumefaçöes do soalho bucal relacionadas às glândulas sublinguais em desdentados parciais e totais: estudos clínico e microscópico / Mouth floor enlargement related to the sublingual gland in edentulous and partially edentulous: clinical and microscopical studies

A tumefaçäo do soalho bucal relacionada à glândula sublingual é uma entidade que tem sido pouco enfatizada na literatura e foi descrita inicialmente por Campos, em 1996, como uma hiperplasia da glândula sublingual. Ocorre em pacientes com perda de dentes posteriores inferiores e pode causar problemas na adaptaçäo de próteses totais ou parciais inferiores. O objetivo deste trabalho foi definir as principais alteraçöes microscópicas e a epidemiologia das tumefaçöes do soalho bucal. Foram removidas 24 glândulas sublinguais de 19 pacientes, 15 do gênero feminino e quatro do masculino, com idade variando de 48 a 74 anos e média de 57 anos. A indicaçäo para cirurgia foi o traumatismo sobre a regiäo no soalho bucal ou para possibilitar a adaptaçäo de próteses. O material obtido foi corado com H.E., Tricrômico de Mallory e P.A.S. Das 24 glândulas sublinguais removidas, seis foram consideradas microscopicamente normais, apesar do aspecto clínico alterado. Nas 18 glândulas alteradas, observamos as seguintes alteraçöes: 1) Atrofia acinar e aumento no número de ductos e formaçöes ductiformes. 2) Fibrose intersticial e retençäo de muco intraductal em 17 casos. 3) Discreto infiltrado mononuclear e diminuiçäo do tecido linfóide em 16 casos. 4) Infiltraçäo de tecido adiposo em 15 casos. 5) Oncocitose em cinco glândulas. Ocorrem principalmente em mulheres após a quarta década de vida, sempre associadas com ausência de dentes posteriores inferiores. Sugerimos que as tumefaçöes do soalho bucal em desdentados parciais ou totais sejam consideradas entidade nosológica

Contribuiçäo para o estudo das variaçöes da profundidade da fossa mandibular humana, face a ausência total dos dentes permanentes / Contribution to the study of variation of the depth of the human jaw cavity face of total absence of the permanent teeth

Adotando-se um método morfométrico tridimensional de mensuraçäo, os autores estudaram a profundidade da fossa mandibular humana em 120 crânios secos de brasileiros, adultos, tendo como fonte de variaçäo principal, a ausência total dos dentes com acentuada reabsorçäo das apófises alveolares da maxila e da mandíbula. Constataram que näo existem diferenças estatisticamente significantes na profundidade da fossa mandibular em crânios de indivíduos desdentados totais ao comparar com crânios de indivíduos parcialmente desdentados. Somente quanto ao fator sexo foi encontrada uma variaçäo. A profundidade da fossa mandibular nos indivíduos do sexo masculino é maior que no sexo feminino

Registro da relaçäo central no desdentado total, utilizando os métodos com o "jig" de Lucia e o guiado näo forçado / Registration of the centric relation in the edentulous patients, using \"jig\" and guided methods

Foi feito um estudo comparativo entre os métodos do "jig" e guiado näo forçado para a determinaçäo da relaçäo central em pacientes desdentados totais. Foram utilizados 40 pacientes, observando-se o seguinte critério para a seleçäo: - desdentados bimaxilares; - pacientes com fibromucosa resiliente; - livre movimentaçäo mandibular; - pacientes que näo apresentavam quaisquer sintomas de disfunçäo temporomandibular. Para a determinaçäo da relaçäo central pelo método do "jig", confeccionou-se o "jig" com resina acrílica incolor autopolimerizável sobre os seis dentes anteriores, previamente montados no plano de cera superior. Para a determinaçäo da relaçäo central pelo método guiado näo forçado, utilizou-se um dispositivo composto de um pino inscritor colocado no plano de cera superior e placa de registro montada no plano de cera inferior...

Relaçäo central em desdentados totais: estudo comparativo entre os métodos do "jig" e intra-oral / Centric relation in edentulous patients: comparative study between \"jig\" and intra-oral methods

Foi realizado um estudo comparativo entre os métodos intra-oral e do "jig" para a determinaçäo da relaçäo central em pacientes desdentados totais. Foram utilizados 30 pacientes, observando-se o seguinte critério para a seleçäo: - desdentados bimaxilares; - pacientes com fibromucosa resiliente; - livre movimentaçäo mandibular; - pacientes que näo apresentavam quaisquer sintomas de disfunçäo temporomandibular. Para determinaçäo da relaçäo central pelo método intra-oral, utilizou-se um dispositivo, composto de uma pua ou pino inscritor e placas para o registro, o pino era colocado na placa de cera superior, enquanto que a placa era colocada no plano de cera inferior. Para determinaçäo da relaçäo central pelo método do "jig", foi confeccionado o "jig" com resina acrílica incolor autopolimerizável, sobre os seis dentes anteriores, previamente montados no plano de cera superior...