Reliability of fovea palatinea in determining the posterior palatal seal

Transcription

1 J Bagh Collg Dntistry Vol.21(1, 9 Rliability of fova Rliability of fova palatina in dtrmining th postrior palatal sal Yasmn T. AL Alousi, B.D.S, M.Sc. (1 ABSTRACT Background: Th prsnt study was carrid out to study th position of fova platina in rlation to postrior palatal sal (post dam in an Iraqi, population sampl, whthr in front, at or bhind, and gndr diffrntiations. Matrial and mthods: A clinical xamination was carrid out on patints with dntulous maxillary arch, attnding prosthtic Dpartmnt in th Collg of Dntistry, Baghdad Univrsity. Only 11 patints mt th study's critria. Each patint was xamind for th location of vibrating lin whthr in front, at or bhind th fova platina. Rsults: Th rsults showd that 5.9% of patints had thir vibrating lin at thir fova platina, 44.5% had it in front and 6.4% bhind. Thr wr highly significant diffrncs btwn; ag groups of patints, gndr distribution of patints, significant diffrncs btwn; ag group and gndr of patints, and non significant diffrncs btwn gndr and position of postrior palatal sal in rlation to fova palatina. Conclusion: Th study concludd that fova palatina is: A rliabl anatomical land mark that hlps in dtrmining th postrior palatal sal (post dam. Th majority of patints had thir vibrating lin at thir fova palatina Ky words: Postrior palatal sal, post dam, fova platina, vibrating lin. J Bagh Coll Dntistry 9; 21(1: INTRODUCTION Dtrmining th location of th postrior bordr of th maxillary dntur plays an important rol in its rtntion and patint comfort. Sinc th twntis of last cntury many authors havvaluatd tchniqus rlating to th location of th postrior bordr of th maxillary dntur. On of thasist and most practical mthods is using th anatomical land marks (fova palatina and hamulr notchs. (1 All authors agrd about th rlation btwn th vibrating lin and th postrior bordr of th maxillary dntur. (2-4 Th vibrating lin of th palat is th junction btwn th movabl and immovabl portion of th soft palat. (2,3 To dtrmin th location of th vibrating lin thr ar th fallowing tchniqus: 1. Phonation of th "ah" sound. (1,4 2. Th swallowing mthod. (5,6 3. Th nos blowing mthod. (4 Som anatomical structurs ar significant guids for locating th postrior bordr of th maxillary dntur. Ths guids includ th fova palatina which ar clos to th vibrating lin and ar always in soft tissu, making thm usful guids for th location of th dnturs postrior bordr (3,7. Th aim of this study is to invstigat th rliability of fova palatina for dtrmining th postrior bordr of th maxillary dntur. (1 Assistant lcturr, Dpartmnt of Prosthodontics, Collg of Dntistry, Baghdad Univrsity MATERIALS AND METHODS A clinical xamination of th palat of patints with dntulous maxillary arch, randomly slctd from patints at- tndring prosthtic Dpartmnt in th Collg of Dntistry Baghdad Univrsity. Th palat of ach patint was xamind for vidnc of pathological changs, for th visibility, numbr and location of th fova palatina, plus th visibility of th vibrating lin. From patints only 11 mt th study critria, 76 mal and 34 fmal of ag groups ranging from (-85 yars. Ths patints wr askd to opn wid and pronounc "ah" sound rptitivly; both th fova palatina and th vibrating lin wr markd with an indlibl pncil aftr drying th ara with gauz. Each patint was xamind by thr sniors indpndntly. If thy agrd to th position of th vibrating lin whthr in front, at or bhind th fova palatina. Thy will procd to th nxt patint if not thy will rpat thxamination until thir rsults coincid. Suitabl statistical mthods wr usd in ordr to analyz and assss th rsults using a computr through th SPSS program and Excl application, dscriptiv statistics and infrntial statistics. RESULTS Th following tabls and figurs involvd th rsults of many paramtrs invstigatd to valuat patints. Ths studid paramtrs involvd in this study will b rviwd and discussd as follows: Distribution of ag groups (Yar of patints: (Tabl and Figur 1 A total of 11 patints wr includd in th prsnt study. Data from tabl and figur 1 indicatd that th numbr and prcntag of Rstorativ Dntistry 41

2 J Bagh Collg Dntistry Vol.21(1, 9 Rliability of fova patints with ag groups (51-6 and 61-7 yars wr highr [44 ( % and 31 (28.2 %, rspctivly], than othr ag group (-5 yars was [19 (17.3 %], with highly significant diffrnc (P<.1. distribution of patints: (Tabl and Figur 2 Th rsults of tabl 2 proclaimd th mal prdominanc [ 76 (69.1% & 34 (3.9 %], with a mal to fmal ratio of 2.235:1 and highly significant diffrnc (P<.1. Rlationship btwn ag groups (Yar & of patints: (Tabl and Figur 3 Th statistical significant diffrnc (P<.5 btwn ag groups (Yars for both gndr, with mal high frqunt than fmal in must ag groups xcpt in (-5 yars [mal 8 (42.1% and 11 (57.9% for fmal]. Rlationship btwn & in front position of post dam: (Tabl and Figur 4 Tabl 4 rviwd that a non significanc diffrnc (P>.5 of rlationship btwn gndr of patints & in front position of post dam, which obsrvd th slightly lvatd in frquncy of ngativ than positiv in both gndr [ (Positiv 34, 44.7%, ( 42, 55.3% & (Positiv 15, 44.1%, ( 19, 55.9%] Rlationship btwn & at position of post dam: (Tabl and Figur 5 Th non significant diffrnc (P>.5 in tabl 5 btwn positiv & ngativ at position of post dam in mal [Positiv (36, 47.4% & (, 52.6] whil fmal [Positiv (18, 52.9% & (16, 47.1%]. Rlationship btwn & bhind position of post dam: (Tabl and Figur 6 Th ngativ bhind position of post dam wr incrasd in both gndr [ (7, 92.1% & (33, 97.1%] mor than positiv [ (6, 7.9% & (1, 2.9%], within th study (1 & thr wr a non significant diffrnc (P>.5. Rlationship btwn tst rsults: (Tabl and Figur 7 Gnrally, th bhind position of post dam was incrasd in ngativ rsult (13, 93.6% whil dcras positiv (7, 6.4%, with highly significant diffrnc (P<.1. Th positiv & ngativ rsult for in front & at position of post dam was similar [Positiv (49, 44.5%, ngativ (61, 55.5% & Positiv (56, 5.9%, ngativ (54, 49.1%, rspctivly], with non significant diffrnc (P>.5 for both tst. On othr hand, th comparison btwn in front & at position of post dam was non significant diffrnc (P>.5 but highly significant diffrnc (P<.1 whn compard bhind position of post dam with in front or at position of post dam. DISCUSSION In ordr to gain good rtntion of th maxillary complt dntur an adquat sal must b obtaind along th postrior bordr. (8 Th sal must b situatd in th rgion of comprssibl tissu just distal to th hard palat, but it must b antrior to th vibrating lin from which visibl movmnt of soft palat taks plac, and this is of grat importanc. (9 If th postrior bordr xtnds postriorly byond this vibrating lin, h sal will b brokn whn th soft palat riss during dglutition and spch, and th dntur will momntarily bcom loos and may drop, th patint is also likly to complain of nausa. If th postrior palatal bordr dos not rach this comprssibl ara, rtntion will b poor bcaus th sal will b infficint and again th patint may complain of nausa and thdg of th dntur may irritat th postrior third of th tongu as it will not bd into th tissu. (8 Postrior palatal sal (post dam: th sal at th postrior bordr of th maxillary dntur. (1 A similar study was carrid out by Ming Shh Chn. (11 1. A sampl of 72 patints wrxamind no ag groups or gndr distribution wr mntiond. 2. His study usd th nos blowing mthod (4, whil this study was basd on phonation of th "ah" sound, (1,4 for dtrmining th vibrating lin and th fova platina. 3. His study also masurd th distanc btwn th vibrating lin and fova platina, whil in this study w focusd on th position of th vibrating lin (in front, at or bhind th fova platina. 4. Th rsults of his study wr 25% of th sampl had thir vibrating lin laying dirctly on th fova palatina and 75% had thir vibrating lin postrior to thir fova platina and no patint had th vibrating lin lying antrior to thir fova palatina. H considrd th patints with vibrating lin that coincid with fova platina, to b postrior (bhind group in our study. H claimd bcaus of th width of th indlibl pncil lin which was approximatly.5m.m. (11 opposit to ths rsults. This study found that 44.5% had thir vibrating lin locatd in front of thir fova palatina, 49.1% had it at, and only 6.4% of th sampl had it bhind and ths rsults wr in agrmnt with th rsults obtaind by Ly (9 in which th fova palatina wr locatd, on th avrag 1.31mm. (Man of 1 subjcts antrior to th vibrating lin (17. Rstorativ Dntistry 42

3 J Bagh Collg Dntistry Vol.21(1, 9 Rliability of fova 5. H concludd that th fova platina ar unrliabl guids for locating th cntr portion of th postrior bordr of th maxillary dntur, whil in our study th rsults showd that fova palatina may b considrd as rliabl anatomical land mark. This was in agrmnt with th rsults of Ly (9, Fnn, t al. (8, Jons (12 and Bouchr, t al. (3. Th postrior bordr can b locatd with grat accuracy if it is possibl to s th two small pits (fova palatina on on ithr sid of th mid lin on th antrior part of soft palat (8. Anatomical landmarks that aid in th dtrmination of th vibrating lin ar th fova platina. (15. Th fova platina ar clos to th vibrating lin and ar always in soft tissu, which maks thm an idal guid for th location of th postrior bordr of th dntur (3. Tabl 1: Distribution of ag groups (Yar of patints. Ag groups N % (Yar valu Highly (P< l 11 1 Prcntag % of patints Ag groups (Yar Figur 1: Distribution of ag groups (Yar of patints. Tabl 2: distribution of patints. Binomial tst ( z-tst N % valu l Highly (P<.1 Prcntag % of patints Figur 2: distribution of patints. Tabl 3: Rlationship btwn ag groups (Yar & of patints. Kruskal Wallis tst l ( Ag groups (Yar N % N % N % N % N % 1 1 N l % Prcntag % of patints valu Ag groups (Yar (P<.5 Figur 3: Rlationship btwn ag groups (Yar & gndr of patints. Rstorativ Dntistry 43

4 J Bagh Collg Dntistry Vol.21(1, 9 Rliability of fova Tabl 4: Rlationship btwn gndr & in front position of post dam. in front valu N % Fmal N % l N % (P>.5 Prcntag % of at Positiv Figur 5: Rlationship btwn & at position of post dam. Prcntag % of in front Positiv Figur 4: Rlationship btwn & in front position of post dam. Tabl 6: Rlationship btwn & bhind position of post dam. Bhind valu N % Fmal N % N l % (P>.5 Tabl 5: Rlationship btwn & at position of post dam. At valu N % Fmal N % N l % (P>.5 Prcntag % of bhind Positiv Figur 6: Rlationship btwn & bhind position of post dam. Rstorativ Dntistry 44

5 J Bagh Collg Dntistry Vol.21(1, 9 Rliability of fova Tabl 7: Rlationship btwn tst rsults. Tsts rsults Fridman tst ( Tsts Positiv valu in N front % (P>.5 At N % (P>.5 N 7 13 Highly bhind. % (P<.1 in front Vs At.495 (P>.5 in front Vs bhind. Highly (P<.1 At Vs bhind. Highly (P<.1 Prcntag % of tsts rsults Positiv in front At bhind Tsts REFERENCES 1. Ellingr CW, Rayson JH, Trry JM, Rahn AO. Synopsis of complt dnturs. La and Fbigr Philadlphia P31, Magr ME. Th importanc of th postrior bordr ara in th construction of full uppr dntur. Dnt Pract 197; : Bouchr CO, Hicky JC, Zarb CA. Prosthodontic tratmnt for dntulous patints, d 9 St. Louis Th C.V. Mosby Co. pp 118-,128, 134-7,1-1, Hart wll Jr CM, Rahn AO. Syllabus of complt Dnturs, d2. Philadlphia, 1974, La. and Fbigr, pp 13-14, -41, , 177, Sabt EM. A nw approach for dtrmining th postrior limit of th uppr dntur for post damming. Egypt Dnt J 1972; 18: Lvll WL, Zach GA. Th postrior limit of xtnsion for a complt maxillary dntur. J Acad Gn Dnt 1973; 21: Kudyba P. An approach to achiv a post palatal sal. JNJ Dnt Soc 197; 41: Fnn HRB, Liddlow KP, Gimson AB. Clinical dntal prosthsis, d. Staplss prss limitd P177, Ly TL. Th significanc of th fova palatini in complt dntur prosthodontics. J Prostht Dnt 1975; 33: Glossary of prosthodontic trms. J Prostht Dnt 1987; 58: 717, Ming Shh Chn. Rliability of th fova palatina for dtrmining th postrior bordr of th maxillary dntur. J Prostht Dnt 198; 43: Jons HS. Improving th palatal sal complt uppr dnturs. Dnt Surv 1975; 51: 54. Figur 7: Rlationship btwn tst rsults. Rstorativ Dntistry 45