Some problems such as dental pain, periodontal disease, dental caries, and expensive dental therapies can be solved with tooth extraction. These therapies may cause edentulism, which unfortunately may represent the beginning of various new problems. Edentulism can essentially influence general and oral health and at the same time affect overall quality of life [
Panoramic radiographs have wide, complementary clinical radiological applications in dentistry. Alhaija stated that panoramic radiographs are a useful tool for the measurement of GA [
Panoramic radiographs had been selected from Gaziantep University Dentistry Faculty Orthodontic and Prosthodontic Departments Archives. Seventy-two panoramic radiographs of the following three groups of subjects were evaluated: Group I (completely edentulous group), 24 subjects (mean age 69.7 years old; all older than 50 years); Group II, (old dentate group), 24 subjects (mean age 62.2 years old; all older than 50 years); Group III (young dentate group), 24 subjects (mean age 18.8 years old; range, 16–21 years old) (Table
Descriptive statistics (subject number, sex, and mean age) of study groups.
Groups | Number of |
Sex |
Mean |
---|---|---|---|
I | 24 | 13/11 | 69.70 ± 8.10 |
II | 24 | 17/7 | 62.20 |
III | 24 | 15/9 | 18.83 |
The radiographs were taken with the same digital machine (Sirona, XG 3, Munchen, Germany). The criteria for selection of patients radiographs were that they had to be of high quality and sharpness, and all radiographs had to be taken using the same apparatus by the same technician. In addition to these criteria, the condylar area, the posterior border of the ramus, and the lower border of the mandible had to be clearly readable on the left part of panoramic radiograph to define skeletal landmarks. Each panoramic radiograph was traced on acetate with a 0.5 mm mechanical pencil and by the same investigator (B.A.) as follows (Figure Gonial Angle (GA): it was traced between the imaginary tangential line along the posterior border of the mandibular ramus and the inferior border of the mandible [ Condylar Height (CH): the line was drawn perpendicular to the ramus tangent line at the level of the most lateral image of the condyle. Another line was drawn perpendicular to the ramus tangent line at the level of the most superior image of the condyle. CH was the perpendicular distance between the lines [ Ramus Height (RH): the line was drawn perpendicular to the ramus tangent line at the level of the most lateral image of the ramus. RH was the distance between the lines [ Antegonial Notch Depth (AND): it was measured as the distance along a perpendicular line from the deepest point of the antegonial notch concavity to a line parallel to the inferior cortical border of the mandible [ Ramal Notch Depth (RND): it was defined as the distance along a perpendicular line from the deepest point of the ramus notch concavity [
Measuring method used for the gonial angle, ramus height, condylar height, antegonial notch depth, and ramal notch depth on panoramic radiograph.
Statistical analysis was performed with SPSS statistics for Windows Version 16 (SPSS, Chicago, IL, USA). Descriptive statistics, including the mean, standard deviation, median, and minimum and maximum values, were calculated for each of the three groups (Table
Significant differences were found only in RH among the three groups (
Comparison of variables with Kruskal-Wallis test related to groups.
Variables | Group I |
Group II |
Group III |
|
---|---|---|---|---|
Gonial Angle (°) | 124.12 ± 7.75 | 120.39 ± 6.79 | 121.95 ± 6.69 | 0.182 |
Condylar Height (mm) | 9.81 ± 1.94 | 7.64 ± 1.41 | 8.36 ± 1.60 | 0.186 |
Ramus Height (mm) | 48.95 ± 6.37 | 53.17 ± 6.04 | 50.08 ± 5.87 |
|
Antegonial Notch Depth (mm) | 2.12 ± 1.36 | 2.32 ± 2.08 | 1.51 ± 1.12 | 0.196 |
Ramal Notch Depth (mm) | 3.72 ± 1.15 | 3.97 ± 1.22 | 3.30 ± 1.09 | 0.137 |
Mean ramus height values, standard deviations, and Mann-Whitney
Variable | Number of |
Groups | Mean (Sd) |
Mann-Whitney |
---|---|---|---|---|
24 | I | 48.95 |
A | |
Ramus Height | 24 | II | 53.17 |
B |
24 | III | 50.08 |
AB |
Different capital letters indicate that ramus height values are significantly different at
In this study, five mandibular morphological and anatomical parameters, including one angular and four linear ones, were measured [
Many studies have demonstrated that the GA widens in edentulous subjects; conversely, researchers have reported nonwidening of the GA in edentulous subjects [
No significant difference was found in CH between groups. However, the completely edentulous group showed higher mean values of CH. According to this result, we can say that there was no relationship between dentition and CH. This condition may have occurred because condylar height measurement in panoramic radiographs is controversial. Türp et al. studied the asymmetry of the condylar area and ramus heights on panoramic radiographs; after comparison with direct measurements from skulls, they found a low correlation between measurements [
Depending on age, sex, and dental condition of patients, mandibles with edentulism show many morphological and anatomical differences. According to our results, RH values showed significant differences between groups (
AND was affected by many factors, including muscle functions, osteoporotic and osteopenic conditions, and mandibular growth rotation. Dutra et al. reported that AND was significantly decreased in subjects with normal bone mass compared to osteopenic and osteoporotic patients [
According to our results, there were no significant results between the young dentate group, old dentate group, and completely edentulous group. RND measurement was identified as the distance along a perpendicular line from the deepest point of the ramus notch concavity [
This study has limitations, such as the predicted growth pattern of the mandible, gender mismatch, and skeletal classifications of the participants. However, this study is important in the fact that it shows the effects of different dental states and age conditions on mandibular morphology.
In conclusion, RH was affected by edentulism, although the only significant difference was found between the edentulous and old dentate groups. Edentulism may have a potential to decrease RH. According to the results, edentulism may affect GA, AND, and RND, and the deepness of notches may become larger with age. The comparison of different ages allow us to predict the mandibular morphological parameters before edentulous state.
The authors declare that there is no conflict of interests regarding the publication of this paper.