Age-related and functional changes of the bone base of the lower jaw occurring after complete edentulation
Bulgarian Medical Journal, 2023, 17(4), 41-46.
Y. Donkova1, A. Nenova-Nogalcheva2, D. Konstantinova1, D. Georgiev1
1 Department of Dental Material Science and Prosthetic Dental Medicine
2 Department of Oral Surgery, Faculty of Dental Medicine, Medical University ”Prof. Dr. Paraskev Stoyanov” – Varna
Abstract. Introduction: The correct planning and successful production of functionally suitable complete dentures is directly dependent on the knowledge and correct analysis of the anatomical landmarks in the prosthetic field, as well as on providing appropriate conditions for subsequent rehabilitation. It has been found that the degree of comfort in patients treated with complete dentures is directly dependent on the stability of the mandibular prosthesis. Aim: The purpose of the present study is to summarize and analyze some anatomical and morphological features of the lower jaw to ensure better conditions for prosthetics and a predictable prognosis from the treatment based on the available scientific literature. Material and Methods: In the period from October 2022 to February 2023, the electronic databases PubMed, Google Scholar, ScienceDirect and others were searched for the following key words: anatomical features, mandible, atrophy, residual bone. Papers in different languages were searched: English, German, French, Russian and Bulgarian language. The total number of accessible publications was 3685. By introducing the additional criterion – lower jaw, publication period after 2000, 1256 publications were selected. When additional filters – “review”, “clinical trial” and “full text”, were introduced, 50 publications were selected and analyzed. Results: A number of anatomical structures on an edentulous lower jaw undergo physiological and pathological changes. The most frequently commented on scientific databases is the volume of alveolar growth after complete tooth loss. Atrophic changes also occur at the articulating surfaces in the mandibular joint. The mandibular angle also undergoes change, etc. Knowing the degrees of atrophy of the lower edentulous jaw and the features of senile and functional changes allows planning of pre-prosthetic surgery and an appropriate postoperative period. It is used only in the presence of strict indications due to the occurrence of additional trauma and the need for a recovery period. Most often, soft tissue surgical correction includes excision of hypertrophied gingiva and mobile mucosa along the alveolar crest, correction of abnormal frenulum attachments (hypertrophic frenulum), vestibuloplasty to increase the attached gingiva in primary and secondary shallow vestibulum. Of the operative methods of pre-prosthetic surgical preparation on bone tissues, removal of sharp edges and exostoses on the alveolar crest, alveoloplasty, surgical modeling of the edentulous alveolar crest are most often applied. Sometimes reconstructive surgeries of the jawbone are also used, which include autoplasty or the use of bone substitutes. Conclusion: Knowing the anatomo-morphological features of a completely edentulous mandible and the interdisciplinary approach in patients with edentulous jaws makes the prognosis of prosthetic treatment good and predictable.
Key words: edentulous mandible, alveolar ridge atrophy, complete dentures, pre-prosthetic surgery
Address for correspondence: Yordanka Donkova, Faculty of Dental Medicine, MU ”Prof. Dr. Paraskev Stoyanov” 84 Tsar Osvoboditel Blvd., fl. 6, office 620, 9000 Varna, e-mail: daniddonkova@gmail.com