Panoramic radiographic examination of edentulous mouths

Panoramic radiographs often are the first method used to screen edentulous patients before complete denture therapy. However, routine radiographic examination of edentulous patients is being questioned because of the cumulative effects and cost of radiation exposure. The purpose of this study was to determine the frequency and location of significant radiographic findings in edentulous jaws.

Panoramic radiographs from 338 patients were included in the survey (183 men, 155 women; 676 edentulous arches). The radiographs were evaluated by 1 oral radiology specialist for the following clinically significant radiographic findings: retained root fragments, impacted teeth, radiolucencies associated with cysts, radiopacities associated with localized sclerotic bone formation, location of the mental foramen on the crest, and location of the maxillary sinus close to the crest of the ridge. The data were analyzed using descriptive statistics.

Radiographic findings were found in 47.6% (56.5% women, 43.5% men) of the edentulous patients. Fifty-two subjects (29 women, 23 men) had 67 submucosal or intrabony root remains, 50 of which were located in the maxilla. The most frequent finding was retained root fragment, followed by radiopacities. Impacted teeth were found in 11 women and 10 men. In 15 patients the mental foramen was situated at the top of the residual ridge. Of these patients, 13 were women and 2 were men. In 29 patients (14 women, 15 men) the maxillary sinus was close to the crest of the ridge. Six patients (3 women, 3 men) had a bilateral maxillary sinus close to the crest of the ridge. The other 23 patients had a unilateral maxillary sinus close to the crest of the ridge, and except for in 2 men, all were in the left side of the maxilla.

Routine panoramic examination of the jaws is necessary to detect impacted teeth, retained root fragments, and other radiographic findings that may require treatment before construction of complete dentures.