International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 13 , ISSUE 2 ( April-June, 2023 ) > List of Articles


Categorization of Extremely Resorbed Mandibular Edentulous Ridges and Formulation of Edentulous Stock Trays Conforming to Different Resorbed Ridge Forms: An Observational Study

Neha Verma, Komal Sehgal, Puneet Sahore, Manisha Khanna

Keywords : Angle of retromolar pad, Edentulous mandibular arch, Edentulous stock trays, Laboratory research, Lingual flange, Resorbed residual ridges

Citation Information : Verma N, Sehgal K, Sahore P, Khanna M. Categorization of Extremely Resorbed Mandibular Edentulous Ridges and Formulation of Edentulous Stock Trays Conforming to Different Resorbed Ridge Forms: An Observational Study. Int J Prosthodont Restor Dent 2023; 13 (2):70-75.

DOI: 10.5005/jp-journals-10019-1400

License: CC BY-NC 4.0

Published Online: 28-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Purpose: Commercially available stock trays do not usually fit the arch form and are relatively flat in dimensions, leading to a compromised impression and prosthesis. So, the purpose of this study was to categorize resorbed mandibular ridges according to arch width and sulcus depth and formulation of stock tray design conforming to different resorbed ridge forms. Materials and methods: Measurements on master casts of completely edentulous resorbed ridges (n = 280) were done using a digital vernier caliper. Cluster analysis of means of anterior and posterior arch width and posterior alveololingual sulcus (ALS) depth was done to categorize the extremely resorbed residual ridges for the formulation of conforming stock trays. Cluster analysis formulated three categories. Category 1 had a mean anterior arch width of 23 mm, posterior arch width of 50 mm, and posterior ALS depth of 5.5 mm. Respective dimensions in category 2 were 31, 58, and 12 mm, and in category 3 were 27, 55, and 8.7 mm. Means of arch length, ridge width, sulcus depth, and retromolar pad (RMP) angle were used to modify tray flange dimensions. One-way analysis of variance (ANOVA) for K-means and multiple Tukey honestly significant difference (HSD) tests were applied for validation of clusters/categories. Results: Significant p-values in one-way ANOVA for K-means cluster (p < 0.001) and multiple Tukey HSD test (p < 0.001) validated categorization of extremely resorbed mandibular residual ridges in the study. Mean values of other parameters were used to modify the tray flanges. The 135° angle of the RMP with residual resorbed ridge was suggested to be incorporated in trays to accommodate higher angles too. Conclusion: Use of the formulated stock trays, will improve their adaptation to the resorbed mandibular edentulous ridges and hence the primary impression making, which will provide a strong foundation for a successful final complete denture in such patients.

  1. AL-Jamoor CA, Kalid Ali F, Faith J. The prevalence of lower alveolar flat ridge among completely edentulous patients in Sulaimani. Sulaimani Dent J 2015;2(1):53–56. DOI: 10.17656/sdj.10038
  2. Ferro KJ, Morgano SM, Driscoll CF, et al. The Glossary of Prosthodontic Terms Ed 9. J Prosthet Dent. 2017;117(5S).
  3. Winkler S. Essentials of Complete Denture Prosthodontics Ed 3. Year Book Medical Pub; 1988.
  4. Pietrokovski J. The bony residual ridge in man. J Prosthet Dent 1975;34(4):456–462. DOI: 10.1016/0022-3913(75)90166-3
  5. Parkinson CF. Similarities in resorption patterns of maxillary and mandibular ridges. J Prosthet Dent 1978;39(6):598–602. DOI: 10.1016/s0022-3913(78)80066-3
  6. 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
  7. Jayaram B, Shenoy KK. Analysis of mandibular ridge resorption in completely edentulous patients using digital panoramic radiography. J Dent Med Sci 2017;16(8):66–73. DOI: 10.9790/0853-1608016673
  8. 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
  9. Zarb GA, Hobkirk J, Eckert S, et al. Prosthodontic treatment for edentulous patients: complete dentures and implant-supported prostheses. Elsevier Health Sciences Ed 13; 2013.
  10. Edwards LF, Boucher CO. Anatomy of the mouth in relation to complete dentures. J Am Dent Assoc 1942;29(3):331–345. DOI: 10.14219/jada.archive.1942.0019
  11. Levin B. Current concepts of lingual flange design. J Prosthet Dent 1981;45(3):242–252. DOI: 10.1016/0022-3913(81)90384-x
  12. Rasaie V, Abduo J, Hashemi S. Accuracy of intraoral scanners for recording the denture bearing areas: a systematic review. J Prosthodont 2021;30(6):520–539. DOI: 10.1111/jopr.13345
  13. Wang C, Shi YF, Xie PJ, et al. Accuracy of digital complete dentures: a systematic review of in vitro studies. J Prosthet Dent 2021;125(2):249–256. DOI: 10.1016/j.prosdent.2020.01.004
  14. Romalee W, Kettratad M, Trang TTN, et al. Evaluation of the potential denture covering area in buccal shelf with intraoral scanner. J Dent Sci 2022;17(3):1335–1341. DOI: 10.1016/j.jds.2022.04.010
  15. Jamjoom FZ, Aldghim A, Aldibasi O, et al. Impact of intraoral scanner, scanning strategy, and scanned arch on the scan accuracy of edentulous arches: an in vitro study. J Prosthet Dent 2023:S0022–3913(23)00069-0. DOI: 10.1016/j.prosdent.2023.01.027
  16. Preiskel HW. The posterior lingual extension of complete lower dentures. J Prosthet Dent 1968;19(5):452–459. DOI 10.1016/0022-3913(68)90059-0
  17. 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
  18. Wiland L. Evaluating the size of dentulous stock trays. J Prosthet Dent 1971;25(3):317–322. DOI: 10.1016/0022-3913(71)90193-4
  19. Winkler S. Making edentulous impression; Essentials of complete denture prosthodontics, 2nd edition; AITBS publication; 2012:pg no. 88-5.
  20. Bomberg TJ, Hatch RA, Hoffman W Jr. Impression material thickness in stock and custom tray. J Prosthet Dent 1985;54(2):170–172. DOI: 10.1016/0022-3913(85)90278-1
  21. Ahmed ZM. Clinical measurements of the dimensions of the dental arches and its application on construction of dental prosthesis. Al-Rafidain Dent J 2006;6(1):88–97. DOI: 10.33899/rden.2006.42394
  22. Pietrokovski J, Starinsky R, Arensburg B, et al. Morphologic characteristics of bony edentulous jaws. J Prosthodont 2007;16(2):141–147. DOI: 10.1111/j.1532-849X.2007.00165.x
  23. Ryu M, Nakamura M, Izumisawa T, et al. Morphological investigation of residual ridge in Japanese edentulous elderly for fabrication of edentulous stock tray. Bull Tokyo Dent Coll 2019;60(3):185–192. DOI: 10.2209/tdcpublication.2018-0066
  24. Haines RW, Barrett SG. The structure of the mouth in the mandibular molar region. J Prosthet Dent 1959;9(6):962–974. DOI: 10.1016/0022-3913(59)90156-8
  25. Dathan P, Nair C, Jayakumar A, et al. The validity of retromolar pad as an intraoral landmark in the fabrication of complete dentures - a short review. Acta Scientific Dental Sciences 2021;5:48–51. DOI: 10.31080/ASDS.2021.05.1167
  26. Sharma A, Deep A, Siwach A, et al. Assessment and evaluation of anatomic variations of retromolar pad: a cross sectional study. J Clin Diagn Res 2016;10(5):ZC143–ZC145. DOI: 10.7860/JCDR/2016/19551.7880
  27. Sotokawa T. Measurements of distances between anatomic landmarks on casts for edentulous patients-trays fitting to edentulous alveolus ridges. Nihon Hotetsu Shikagakkaishi 2019;37:469–79.
  28. McGarry TJ, Nimmo A, Skiba JF, et al. Classification system for complete edentulism. The American College of Prosthodontics. J Prosthodont 1999;8(1):27–39. DOI: 10.1111/j.1532-849x.1999.tb00005.x
  29. Tarigan T, Nasution ID. Alveolar arch shapes and its relation to complete denture retention. J Syiah Kuala Dent ociety. 2021;5:30–36. DOI: 10.24815/jds.v5i1.18426
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.