Reabsorção óssea mandibular e sua relação com parâmetros objetivos e subjetivos de função mastigatória no desdentado total

Abstract

The physiological process of progressive bone resorption of the alveolar bone, which had a more sharply result in the mandible, is responsible for the instability of these prosthesis, resulting in difficulty in adaptation, impaired masticatory function, pain and complete patient dissatisfaction. Thus, the determination of atrophy of the rim has a direct influence on the choice of rehabilitative treatment of the total edentulous. Therefore, the objective of the studies were: i) to conduct a systematic literature review seeking for clinical or radiographic parameters that are used to quantify and determine the mandibular bone atrophy and ii) conduct a clinical study to measure the degree of mandibular bone atrophy in total edentulous patients and check if the level of bone resorption would affect the objective and subjective parameters of masticatory function. In order to achieve these, it was performed a systematic literature search in four databases. Articles were selected to determine a classification standard of bone atrophy and a way to quantify the residual alveolar ridge that could be clinically followed during the rehabilitation planning and the monitoring of these edentulous patients. The data collected in this first study guided the measurement and the classification of the alveolar ridge of the selected patients for the clinical study, which involved 23 patients rehabilitated with conventional complete dentures after 3 months of use. This sample was later submitted to the following reviews: radiographic measurement of the degree of bone atrophy to categorize 2 groups of mandibular edentulous, not atrophic and atrophic; retention and stability tests of the mandibular prosthesis; testing efficiency and masticatory performance by chewing Optocal test food; and evaluation of subjective chewing ability through the respective domains extracted from the questionnaires of impact on daily life (DIDL) and self-perceived oral health (GOHAI). Given the results of the two conducted studies, it can be concluded that: there is not a standard parameter to determine the bone atrophy of the mandible in edentulous patients. Regarding the clinical study there was no significant difference in performance and masticatory efficiency when the groups of patients were compared according the level of bone atrophy and severity of resorption. Additionally, the subjective evaluation of masticatory function of patients showed no exist a real perception of masticatory efficiency when this was objectively quantified.