Radiographic Examination of Alveolar Ridge Resorption in Relation to Age in Kennedy Class II Edentulism

Abstract

Purpose: After the loss of teeth, alveolar bone begins to resorb due to disappearance of the stimulus being applied by the teeth to the alveolar bone. This situation is termed as residual ridge resorption. The aim of this study is to determine the amount of alveolar bone resorption occured in the maxilla and mandible of the patients having Kennedy Class II edentulousness and the distribution of it according to age groups. Material and Methods: The study was carried out on the panoramic radiographs of 122 individuals (60 mandible, 62 maxilla). Vertical measurements were made at 10 sites (central incisors, first premolars and molars at the left and right of both jaws). The difference of the measurements according to the group and demographic variables was analyzed with the independent groups independent-t and one-way ANOVA tests. Also, dentate and edentulous measurements according to the group and demographic characteristics in the group interaction was analyzed with the repeated ANOVA test. Results: When the edentulous regions were considered, the vertical height values of the mandible were lower than maxilla. Also, statistically significant difference was detected in the maxillar premolar region of the edentulous regions. According to gender, womens’ vertical height results were found to be lower than men and the vertical heights of the 6-12 months group were higher than 12-24 months group. Conclusions: According to these results, we think that the patient should be directed to implant rehabilitation in order to prevent bone loss, especially in edentulous patients in the maxillary premolar region.

Keywords

• Alveolar Resorption
• Alveolar Bone Loss
• Panoramic Radiography
• Anatomy

References

1. Atwood DA. Some clinical factors related to rate of resorption of residual ridges. J Prosthet Dent. 1962;12(3):441–450. doi:10.1016/0022-3913(62)90125-7.
2. Bodic F, Hamel L, Lerouxel E, Baslé MF, Chappard D. Bone loss and teeth. Joint Bone Spine. 2005;72(3):215–221. doi:10.1016/j.jbspin.2004.03.007.
3. Kingsmill V. Post-extraction remodeling of the adult mandible. Crit Rev Oral Biol Med. 1999;10(3):384–404. doi:10.1177/10454411990100030801.
4. Kondo T, Kanayama K, Egusa H, Nishimura I. Current perspectives of residual ridge resorption: pathological activation of oral barrier osteoclasts. J Prosthodont Res. 2023;67(1):12–22. doi:10.2186/jpr.JPR_D_21_00333.
5. Springe B, Slaidina A, Soboleva U, Lejnieks A. Bone mineral density and mandibular residual ridge resorption. Int J Prosthodont. 2014;27(3):270–276. doi:10.11607/ijp.3283.
6. Al AlSheikh H, AlZain S, Shaik JP, Bhogoju S, Warsy A, Parine NR. Two novel SNPs in genes involved in immune response and their association with mandibular residual ridge resorption. Saudi J Biol Sci. 2020;27(3):846–852. doi:10.1016/j.sjbs.2020.01.016.
7. Atwood DA. Some clinical factors related to rate of resorption of residual ridges. J Prosthet Dent. 2001;86(2):119–125. doi:10.1067/mpr.2001.117609.
8. Canger EM, Çelenk P. Radiographic evaluation of alveolar ridge heights of dentate and edentulous patients. Gerodontology. 2012;29(1):17–23. doi:10.1111/j.1741-2358.2010.00391.x.

9. Sawai DS, Joshi A, Mishra G, Mansoor MA, Kumar U, Suharwardy GA. Evaluation of correlation between residual ridge resorption and diabetes mellitus. J Pharm Bioallied Sci. 2024;16(Suppl 1):S915. doi:10.4103/jpbs.jpbs_1097_23.
10. Gerken U, Esser F, Möhlhenrich SC, Bartella AK, Hölzle F, Fischer H, et al. Objective computerised assessment of residual ridge resorption in the human maxilla and maxillary sinus pneumatisation. Clin Oral Invest. 2020;24:3223–3235. doi:10.1007/s00784-020-03196-6.
11. Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J Prosthet Dent. 1972;27(2):120–132. doi:10.1016/0022-3913(72)90188-6.
12. Reich KM, Huber CD, Lippnig WR, Ulm C, Watzek G, Tangl S. Atrophy of the residual alveolar ridge following tooth loss in a historical population. Oral Dis. 2011;17(1):33–44. doi:10.1111/j.1601-0825.2010.01699.x.
13. Cawood J, Howell R. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232–236. doi:10.1016/S0901-5027(88)80047-X.
14. Chu TMG, Liu SSY, Babler WJ. In: Craniofacial biology, orthodontics, and implants. Elsevier; 2014. p. 225–242. doi:10.1016/B978-0-12-416015-6.00011-3.
15. Packota G, Hoover J, Neufeld B. A study of the height of intact alveolar bone on panoramic radiographs of adult patients. J Prosthet Dent. 1988;60(4):504–509. doi:10.1016/0022-3913(88)90258-2.
16. Unal Erzurumlu Z, Celenk P. A radiological evaluation of the effects of edentulousness on the temporomandibular joint. J Oral Rehabil. 2020;47(3):319–324. doi:10.1111/joor.12910.
17. Wilding R, Levin I, Pepper R. The use of panoramic radiographs to measure alveolar bone areas. J Oral Rehabil. 1987;14(6):557–567. doi:10.1111/j.1365-2842.1987.tb00752.x.
18. Xie Q, Wolf J, Ainamo A. Quantitative assessment of vertical heights of maxillary and mandibular bones in panoramic radiographs of elderly dentate and edentulous subjects. Acta Odontol Scand. 1997;55(3):155–161. doi:10.3109/00016359709115409.
19. Wical KE, Swoope CC. Studies of residual ridge resorption. Part I. Use of panoramic radiographs for evaluation and classification of mandibular resorption. J Prosthet Dent. 1974;32(1):7–12. doi:10.1016/0022-3913(74)90093-6.
20. Närhi TO, Ettinger RL, Lam EW. Radiographic findings, ridge resorption, and subjective complaints of complete denture patients. Int J Prosthodont. 1997;10(2):183–189.
21. Ozan O, Orhan K, Aksoy S, Icen M, Bilecenoglu B, Sakul BU. The effect of removable partial dentures on alveolar bone resorption: A retrospective study with cone-beam computed tomography. J Prosthodont. 2013;22(1):42–48. doi:10.1111/j.1532-849X.2012.00877.x.
22. DeCarlo LT. On the meaning and use of kurtosis. Psychological Methods. 1997;2(3):292. doi:10.1037/1082-989X.2.3.292.
23. Groeneveld RA, Meeden G. Measuring skewness and kurtosis. Statistician. 1984;33(4):391–399. doi:10.2307/2987742. Hopkins KD, Weeks DL. Tests for normality and measures of skewness and kurtosis: Their place in research reporting. Educ Psychol Meas. 1990;50(4):717–729. doi:10.1177/00131644905004001.
24. Moors JJA. The meaning of kurtosis: Darlington reexamined. Statistician. 1986;40(4):283–284. doi:10.2307/2987742. Klemetti E. A review of residual ridge resorption and bone density. J Prosthet Dent. 1996;75(5):512–514. doi:10.1016/S0022-3913(96)90455-2.
25. Alsaggaf A, Fenlon MR. A case-control study to investigate the effects of denture wear on residual alveolar ridge resorption in edentulous patients. J Dent. 2020;98:103373. doi:10.1016/j.jdent.2020.103373.
26. Pietrokovski J, Harfin J, Levy F. The influence of age and denture wear on the size of edentulous structures. Gerodontology. 2003;20(2):100–105. doi:10.1111/j.1741-2358.2003.00100.x.
27. Alajbeg IZ, Valentic-Peruzovic M, Alajbeg I, Illes D, Celebic A. The influence of dental status on masticatory muscle activity in elderly patients. Int J Prosthodont. 2005;18(4):333–338.
28. Alajbeg IZ, Valentic-Peruzovic M, Alajbeg I, Cifrek M. The influence of age and dental status on elevator and depressor muscle activity. J Oral Rehabil. 2006;33(2):94–101. doi:10.1111/j.1365-2842.2006.01541.x.
29. Panchbhai AS. Quantitative estimation of vertical heights of maxillary and mandibular jawbones in elderly dentate and edentulous subjects. Spec Care Dentist. 2013;33(2):62–69. doi:10.1111/j.1754-4505.2012.00301.x.
30. Kurt MH, Yilmaz S, Evli C, Karahan S. Comparative evaluation of trabecular bone structures of bruxist and non-bruxist individuals with bone apposition in the mandible angle region by fractal analysis. J Oral Rehabil. 2023;50(5):360–369. doi:10.1111/joor.13435.
31. Wyatt CC. The effect of prosthodontic treatment on alveolar bone loss: A review of the literature. J Prosthet Dent. 1998;80(3):362–366. doi:10.1016/S0022-3913(98)70138-6.
32. Atwood DA, Coy WA. Clinical, cephalometric, and densitometric study of reduction of residual ridges. J Prosthet Dent. 1971;26(3):280–295. doi:10.1016/0022-3913(71)90070-9.
33. Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012;23:1–21. doi:10.1111/j.1600-0501.2011.02375.x.
34. Huumonen S, Haikola B, Oikarinen K, Söderholm A, Remes-Lyly T, Sipilä K. Residual ridge resorption, lower denture stability and subjective complaints among edentulous individuals. J Oral Rehabil. 2012;39(5):384–390. doi:10.1111/j.1365-2842.2011.02284.x.
35. Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restor Dent. 2003;23(4):313–323.
36. Tanaka M, Yamashita-Mikami E, Akazawa K, Yoshizawa M, Arai Y, Ejiri S. Trabecular bone microstructure and mineral density in human residual ridge at various intervals over a long period after tooth extraction. Clin Implant Dent Relat Res. 2018;20(3):375–383. doi:10.1111/cid.12591.