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| ORIGINAL ARTICLE |
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| Year : 2023 | Volume
: 15
| Issue : 1 | Page : 21-27 |
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A comparative evaluation of sagittal condylar guidance obtained by the protrusive interocclusal record and panoramic radiographic tracing in both dentulous and edentulous patients
Riju Das1, Tapan Kumar Giri2, Bishakha Kanrar3, Sugato Mukherjee4
1 Department of Prosthodontics, Burdwan Dental College and Hospital, Burdwan, West Bengal, India
2 Department of Prosthodontics and Crown and bridge, Dr. R Ahmed Dental College and Hospital, Kolkata, West Bengal, India
3 West Bengal University of Health Sciences, Kolkata, West Bengal, India
4 Department of Prosthodontics and Crown and Bridge Dr. R Ahmed Dental College and Hospital, Kolkata, West Bengal, India
| Date of Submission | 08-Jul-2021 |
| Date of Decision | 27-Oct-2021 |
| Date of Acceptance | 10-Nov-2021 |
| Date of Web Publication | 28-Dec-2022 |
Correspondence Address:
Riju Das
Department of Prosthodontics, Burdwan Dental College and Hospital, Burdwan, West Bengal
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jorr.jorr_51_21
Introduction: Successful prosthesis is made in harmony with the stomatognathic system. To fabricate a successful prosthesis the stomatognathic system must be simulated outside the patient's mouth in a mechanical device called articulator. For the aforesaid reason replication of sagittal condylar guidance outside the patients, the mouth is of utmost importance.
Aim of Study: To compare sagittal condylar guidance obtained by conventional method and panoramic radiographic tracing in both dentulous and edentulous patients. (1) To determine the condylar guidance on panoramic radiographs in dentate and edentulous subjects. (2) To determine the condylar guidance by the conventional clinical method in both dentate and edentulous patients. (3) To compare the values obtained from panoramic radiographs with the values obtained by conventional techniques. (4) To compare the right side condylar guidance values to the left.
Methodology: A total of 20 dentulous and 20 edentulous patients were selected and their sagittal condylar guidance is recorded firstly with conventional method and then with the tracing of orthopantomograph (OPG). Then, these values are compared with each other to find out any significant difference between these two methods.
Results: There is no significant difference in sagittal condylar guidance obtained from OPG and protrusive interocclusal record (PIR) method in dentulous and edentulous patients.
Conclusion: The radiographic method is a potential alternative to PIR method.
Keywords: Orthopantomograph, protrusive interocclusal record, sagittal condylar guidance
How to cite this article:
Das R, Giri TK, Kanrar B, Mukherjee S. A comparative evaluation of sagittal condylar guidance obtained by the protrusive interocclusal record and panoramic radiographic tracing in both dentulous and edentulous patients. J Oral Res Rev 2023;15:21-7 |
How to cite this URL:
Das R, Giri TK, Kanrar B, Mukherjee S. A comparative evaluation of sagittal condylar guidance obtained by the protrusive interocclusal record and panoramic radiographic tracing in both dentulous and edentulous patients. J Oral Res Rev [serial online] 2023 [cited 2023 May 30];15:21-7. Available from: https://www.jorr.org/text.asp?2023/15/1/21/365920 |
| Introduction | |  |
A dental prosthesis would be considered successful if it functions in harmony with the structures controlling the movement of the mandible.[1],[2],[3],[4],[5],[6] To fabricate a successful prosthesis, the mandibular movements must be simulated outside the patient's mouth in a mechanical device called articulator. The primary function of an articulator is to act as the patient in his absence.[7],[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18],[19]
Condylar guidance in articulator is an approximate duplication of the patient's condylar path which is essential to achieve harmonious occlusion in the patient's mouth.
Condylar guidance is the mandibular guidance generated by the condyle and articular disc traversing the contour of the glenoid fossae (GPT9).[19] It is duplicated in the articulator. It has two components:
- Sagittal condylar guidance
- Lateral condylar guidance.
Based on Christensen's finding, protrusive interocclusal records (PIRs) are used for recording sagittal condylar guidance [Figure 1], [Figure 2], [Figure 3], [Figure 4], while lateral condylar guidance can be obtained either from interocclusal records or calculated from Hanau's formula.
Despite accurate registration methods, sources of error can arise in laboratory procedures due to the instability of materials and changes during their chemical setting, hardening, or polymerization.[20],[21],[22] Errors may also arise due to variations in the movement of the jaw performed by the patient during protrusion. Values of condylar guidance obtained for a patient may vary from operator to operator or between articulators.[23] Accuracy of the graphic tracing is also affected by patient-related factors, stability of the record bases, and the ability of recording media to reproduce surface details.[12],[15]
A very early attempt to record condylar paths using radiographs was made by Boos in 1951. He used TMJ radiographs to determine the condylar guidance angle.
The introduction and development of rotational tomographic apparatus such as the rotograph (Blackman, 1960), panorex (Kumpala, 1961), and the OPG (Paatero, 1959a, 1959) have stimulated further research to find the ideal technique for radiography of the temporomandibular joint.
OPG is a very commonly used diagnostic tool in dentistry. Before treatment planning of complete denture or Full mouth rehabilitation.
The radiographic method is simpler as the angles can be directly evaluated on the radiograph and it helps the clinicians to overcome the shortcomings of the prosthetic method of determining condylar guidance.
Hence, the aim of this study is to compare the angle of sagittal condylar guidance obtained from PIRs and OPGs, in dentulous and edentulous patients, to determine whether there is a significant difference between the two methods.
| Methodology | | |
A study was performed to compare the sagittal condylar guidance, obtained by PIRs and by OPG for both dentulous and edentulous patients.
Twenty randomly selected dentulous patients and twenty randomly selected edentulous patients participated in the study. Written informed consents were obtained from the patients. OPGs of these patients were taken following the proper guidelines. The study was given clearance by the institutional ethics review committee and was completed over a period of 2 years.
Radiographic procedure for both dentate and edentulous patients
Criteria that were followed in radiographic technique are:
- Same operator
- Same radiographic machine
- Personal protection barrier
- Frankfort horizontal plane kept parallel to the floor of the mouth.
Exposure factors were maintained at 70 kVp and 10 mA.
The sagittal outlines of articular eminence and glenoid fossae were traced on a transparent acetate tracing sheet. The left and right orbitals and portions were identified and the Frankfort horizontal plane was constructed by joining the two landmarks on each side [Figure 5] and [Figure 6].
| Results and Statistical Analysis | | |
A prospective study was conducted in the department of prosthodontics and crown and bridge, Dr. R Ahmed Dental College and Hospital, to compare sagittal condylar guidance by two different methods measured in both dentulous and edentulous patients.
Statistical analysis was performed on all the values using the appropriate method, which is as follows.
Null hypothesis
There is no significant difference in condylar guide angle values obtained by OPG and by PIR and in between the left and right sides.
Alternate hypothesis
There is a significant difference in and condylar guide angle values obtained by OPG and by PIR and in between the left and right sides.
Statistical test used
Independent two-tailed t-test was used to compare the OPG and PIR and between left and right sides.
Comparison of the mean value of sagittal condylar guide angle of the right and left sides obtained by PIR was done and found that there was no significant difference between the two procedures (P = 0.81). Similarly, comparison of the right side was made and there was no significant difference too (P = 0.81).
Similarly, a comparison of the mean value of SCG angle of the left side, right side obtained by OPG was made (P = 0.76), (P = 0.81). No significant difference was found.
Comparison of the mean value of sagittal condylar guide angle of left side obtained by OPG and PIR was made t-test was performed and it was found that there was no significant difference between the two procedures (P = 0.76) comparison of the mean value of sagittal condylar guide angle of the dentulous patients with mean values of the left side, i.e., 32.55° (standard deviation of 5.45) with the mean value of right side, i.e., 32.85° (standard deviation of 6.50) obtained by OPG.[49],[50],[51]
Comparison of the mean value of sagittal condylar guide angle of the left side, i.e., 31.05° (standard deviation of 5.059) with the mean value of sagittal condylar guide angle of the right side, that is, 31.45° and (standard deviation of 4.438), obtained by PIR t-test was performed and it was found that there was no significant difference between the two procedures (P = 0.81)
Table 9 shows the comparison of the mean value of sagittal condylar guide angle of left side i.e., 32.55°, (standard deviation of 5.45) with the mean value of sagittal condylar guide angle of the right side, i.e., 32.85°, (standard deviation of 6.50), obtained by OPG.
Double-tailed t-test was performed, and it was found that there was no significant difference between the two sides (P = 0.87).
Comparison of the mean value of sagittal condylar guide angle of the left side, i.e., 30.05° (standard deviation of 6.026) with mean value of sagittal condylar guide angle of the right side, i.e., 30.50° (standard deviation of 3.723), Obtained by PIR.
Double-tailed t-test was performed and it was found that there was no significant difference between the two sides (P = 0.87).
Comparison of the mean value of sagittal condylar guide angle of the left side of dentulous patients, i.e., 31.60° (standard deviation of 6.2945) with the mean value of sagittal condylar guide angle of edentulous patients, i.e., 32.55° (standard deviation of 5.45), obtained by OPG.
The results show that there is no significant difference between protrusive condylar guidance obtained by OPG and PIR and in between right and left sides in both dentulous and edentulous patients.
| Discussion | | |
Accurate reading of the condylar guidance is not feasible because these instruments have a numerical scale with increments of 5°.[24],[25],[26],[27],[28],[29],[30] For precise readings of the condylar angle, this scale has to be customized with increments of 1°. Variation in sagittal condylar angle determination by PIR can also occur due to patient's difficulty to close precisely in protrusion, the degree of protrusion, deformation or compression of the interocclusal record, the quality of the record, due to cast tipping, which is caused by poor adaptation of the casts to the records, force applied by the operator on the record between the maxillary and mandibular member, the position at which the pressure is applied and the sensitivity of the adjustment mechanism.[11]
For edentulous patients, the accuracy of PIR varies with the dimensional stability of the bite registration material, the neuromuscular skill of the patients and the skill of the operators.[31],[32],[33],[34],[35]
A very early attempt was made to analyze the condylar path through radiographic examination by Boos in 1951.[60] Radiographically, the inclination of the temporal tubercle and the relative position of the condyle can be determined. Radiographic determination of the condylar guidance has been attempted from the temporomandibular joint (TMJ) transpharyngeal view described by Mc Queen. The angle of condylar guidance was determined by relating the sagittal condylar path inclination to the Camper's plane, that is, the plane joining the ala of the nose to the tragus. However, the reproducibility of these TMJ-specific views is questionable as the use of a reference plane which does not rely on stable bony landmarks can lead to the incorporation of errors.[52]
Condylar guidance on an articulator is adjusted utilizing either the patient's protrusive or lateral interocclusal registrations. The HANAU™ Wide-Vue Articulator, which has a fixed intercondylar distance, can be set using the protrusive interocclusal registration obtained from the patients and the condylar guidance can be measured in degrees relative to a plane of reference. Condylar guidance inclination determined by two methods can only be compared when measured in relation to the same plane of reference. In the present study, HANAU™ Spring Bow has been used, which relies on Frankfurt's horizontal plane as the plane of reference. The same plane is readily demonstrable on a panoramic radiograph by joining the porion and the orbitale, which are stable bony landmarks.[53],[54],[55]
For dentulous patients, within the age group of 20–40 years,[37],[38],[39],[40],[41],[42],[43],[44] having class I molar relation with no TMJ abnormalities were selected for this study. Patients with class II and class III molar relation were excluded from this study because cannot patients with class II jaw relation have to protrude too much to bring the anterior teeth edge to edge, whereas those with class III molar relation cannot protrude the mandible up to 5–6 mm. Hence, in this study, the sample size was kept homogenous as heterogeneity of the study population would result in errors. Oburg et al. reported that, TMJ size increases up to 20 years of age. Therefore, patients <20 years were not included in the study.[36]
Patients with TMJ disorders, previous orthodontic treatment were also excluded as they exhibit difficulty in mandibular movements, which in turn increases the chances of faulty records in both clinical and radiographic methods. Hence, in this study, the sample size was kept homogenous as heterogeneity of the study population would result in errors. Oburg et al. reported that, TMJ size increases up to 20 years of age. Therefore, patients <20 years were not included in the study.[36]
Patients with TMJ disorders, previous orthodontic treatment were also excluded as they exhibit difficulty in mandibular movements, which in turn increases the chances of faulty records in both clinical and radiographic methods.
Edentulous patients, with good ridge height, ridge shape, and class I ridge relation were included in the study as these factors increase the stability of the temporary denture base, which is of utmost importance for the clinical method of determining condylar guidance from PIR.
Patients with good neuromuscular control were chosen as they could follow the instructions properly during clinical procedures.
The temporary denture base which is of utmost importance for the clinical method of determining condylar guidance from PIR.
Patients with good neuromuscular control were chosen as they could follow the instructions properly during clinical procedures.
Gilboa et al. stated that the radiographic outline of the articular fossa and articular eminence provided an accurate representation of the equivalent outlines in 25 human skulls with a mean difference of 7° in inclination. The image of the articular eminences in a panoramic radiograph may be used to provide an indication of the degree of inclination of the articular eminence and may be of value as an aid in setting the condylar guidance in semi-adjustable articulators.[48]
Studies by Zamacona et al.,[45] Woelfel et al. found that sagittal condylar guidance may vary from 5° to 55°,[56] Hobo et al.,[57] Preti et al.,[58] and dos Santos et al.[59] found variations in condylar guidance angles ranging from 5 to 55°. The variations in condylar guidance by the interocclusal record method led many clinicians to use average condyle guide settings taken from mean published values 32.33°. In this study, sagittal condylar guide angle values also lied within these limits.
For dentulous patients, no significant difference was found between sagittal condylar guide angle obtained from PIR and by OPG separately for left side (P = 0.76) [Table 2] and Right side (P = 0.81) [Table 3].
For edentulous patients also no significant difference was found between OPG and PIR separately for both sides, (P-value for left. 096) [Table 7] and (P-value for right o. 16) [Table 8 and Diagram 1]. However, for dentulous patients mean value of sagittal condylar guide angle was found to be higher for the radiographic method than PIR by 0.45° for the right side and 0.55° for the left side.
Edentulous patients depicted difference in mean for the left side to be 2.50 and for the right side to be 2.30. The radiographic method showed higher values than PIR technique. The recording of sagittal condylar guidance in edentulous patients is more technique sensitive, chances of error are also high, it may lead to a higher difference in mean than dentulous patients.
Although for dentulous patients there was no significant difference between right and left sagittal condylar guide angle by both methods (P-value for OPG was 0.87 P value for PIR was 0.822) [Table 4], [Table 5] and [Diagram 2].
For edentulous patients too, there was no significant difference between left and right condylar guide angles obtained from OPG and PIR, respectively (P = 0.89 and 0.79) [Table 9], [Table 10] and [Diagram 3] and [Diagram 4].
Literature suggests that the right and left eminences seldom have exactly the same slants, contours, and declivities.[4] The average condyle path angle of the left condyle reported using a gnathograph was 35.11°, and that of the right condyle was 36.02°.[1] whereas, bilateral symmetry of the right and left sagittal condylar guidance angle of 31° on both sides has also been reported using PIRs.[13] Similarly, the present study showed a lesser mean difference of 0.49° between the right and left sides by the PIR method than 0.5° by the panoramic radiograph method.
Lundeen and Wirth recorded mandibular movements in plastic blocks and found that there was no significant difference in left and right sagittal condylar angle. Woelfel, et al.[56] also found no significant difference between the two sides.
However, there is some evidence in the literature contrary to the results obtained in this study. El-Gheriani and Winstanley[61] have reported significant variation between the left and right condylar guidance values.
The disagreement with results from el-Gheriani and Winstanley, on the other hand, maybe because all the patients in their study were those who were referred for treatment for TMJ disorders vis-a-vis healthy adults were employed in the present study.
The radiographic method was similar for both dentulous and edentulous patients. Therefore, right and left condylar guide angles of the dentulous and edentulous populations were compared in OPG and it was found that there was no significant difference between these two study groups (P-value for right side 0.6078 and P value for left side 0.6129) [Table 11], [Table 12] and [Diagram 5], [Diagram 6].
So an inference can be drawn from this result that in the adult population, condylar guidance does not change irrespective of the presence or absence of teeth.
Therefore, determining condylar guidance angle by panoramic radiograph is of value in programming the semi-adjustable articulator in both dentulous and edentulous patients with no TMJ abnormalities.
| Conclusion | | |
Within the limitations of the study, the following conclusions can be drawn:
- There is no significant difference in sagittal condylar guidance obtained from OPG and PIR methods in dentulous and edentulous patients.
- There is also no significant difference in sagittal condylar guidance on the left and right sides in both dentulous and edentulous patients.
- There is no significant difference in condylar guidance values between dentulous and edentulous patients.
Ethical clearance
The aforesaid study was approved by intitutional ethics committee of- Dr.R Ahmed Dental College and hospital. Approval No:15-2016-2019.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| Supplementary Material | | |
| Supplementary Material 1: RESULTS AND STATISTICAL ANALYSIS | | |
| Results and Statistical Analysis | | |
A prospective study was conducted in the department of prosthodontics and crown and bridge, Dr. R Ahmed Dental College and Hospital to compare sagittal condylar guidance by two different methods measured in both dentulous and edentulous subjects.
Statistical analysis was performed on all the values using appropriate method which is as follows:
Null hypothesis
There is no significant difference in condylar guide angle values obtained by orthopantomograph (OPG) and by protrusive interocclusal record (PIR) and in between left and right side.
Alternate hypothesis
There is a significant difference in and condylar guide angle values obtained by OPG and by PIR and in between left and right side.
Statistical test used
Independent two-tailed t-test was used to compare the OPG and PIR and between right and left side.
Level of significance
The level of significance was set at P < 0.05.
Decision criterion
We compare the P value with the level of significance if the P ≥ 0.05, we accept the null hypothesis.
If P < 0.05, we reject the null hypothesis and accept the alternate hypothesis.
The various formulae employed to perform the statistical analysis for the present study were
1. Mean
Arithmetic mean of a set of values is the ratio of their sum to the total number of values in the set. Thus, if there are a total of N numbers in a data set whose values are given by a group of x-values, then the arithmetic mean of these values, represented by “M,” can be found using this formula:
x_bar = (Σ xi)/n
2. Sample standard deviation
It is a measure of the spread (variability) of the scores in the sample on a given variable and is represented by:
s = sqrt[Σ(xi – x_bar) 2/(n – 1)]
The term “Σ (xi – x_bar)2” represents the sum of the squared deviations of the scores from the sample mean.
3. Double tailed t-test
4. P value
Total area greater than | t| and less than −|t | under t-curve with n − 1 degrees of freedom. If t is far enough from 0 on either side (the direction of H1), the P value will be small.
| Conclusion | | |
If P ≤ 0.05, we reject H0 with statistical significance. If P ≤ 0.01, we reject H0 with high statistical significance. If P > 0.05, we do not reject H.
Study population was divided into these groups:
I. Group I: Dentulous subjects
Group IA: Condylar guidance measured from OPG
A1: Left condylar guide angle
A2: Right condylar guide angle
Group IB: Condylar guidance measured from PIR
B1: Left condylar guide angle
B2: Right condylar guide angle
II. Group II: Edentulous subjects
Group IIC: Condylar guidance measured from OPG
C1: Left condylar guide angle
C2: Right condylar guide angle
Group IID: Condylar guidance measured from PIR
D1: Left condylar guide angle
D2: Right condylar guide angle.
| Tables Used in This Study | | |
Table 1 depicts the master chart of sagittal condylar guide angle obtained by OPG and PIR of the left and right side of dentulous subjects.
Table 2 shows difference in mean of sagittal condylar guidance of the right side of dentulous subjects.
Table 3 shows difference in mean of sagittal condylar guide angle of the left side of dentulous subjects.
Table 4 depicts difference in mean of sagittal condylar guide angle between left and right side from OPG for dentulous patients.
Table 5 shows difference in mean of sagittal condylar guide angle between left and right side from PIRs for dentulous patients.
Table 6 depicts master chart for comparison of sagittal condylar guide angle obtained by OPG and from PIR for edentulous subjects.
Table 7 depicts difference in mean for sagittal condylar guide angle of left side of edentulous subjects.
Table 8 shows difference in mean condylar guide angle obtained by OPG and PIRs of edentulous subjects of right side.
Table 9 shows comparative evaluation of sagittal condylar guide angle between left and right side for edentulous patients in OPG.
Table 10 shows comparative evaluation of sagittal condylar guidance obtained by PIR between left and right side.
Table 11 shows comparison of sagittal condylar guide angle of left side obtained by OPG between dentulous and edentulous patients.
Table 12 shows comparison of sagittal condylar guide angle of right side obtained by OPG between dentulous and edentulous patients.
| Diagram Used in This Statistical Analysis | | |
Diagram 1 shows difference in mean of condylar guidance of left and right side of dentulous patients obtained by PIR.
Diagram 2 shows comparison of mean between sagittal condylar guidance obtained by OPG and PIR in edentulous subjects of left side.
Diagram 3 shows comparison of sagittal CGA between left and right side obtained from OPG of edentulous patients.
Diagram 4 shows comparison of mean of CGA of left and right side obtained by PIR of edentulous patient.
Diagram 5 shows comparison of sagittal CGA of left side between dentulous and edentulous patients obtained from OPG.
Diagram 6 shows comparison between sagittal CGA of right side of dentulous and edentulous patients obtained by OPG.
Table 2 shows comparison of mean value of sagittal CGA of right side obtained by OPG, i.e., 31.85°, (standard deviation of 5.903) with the mean value of sagittal CGA obtained by PIR, i.e., 31.45° (standard deviation of 4.730).
t-test was performed and it was found that there was no significant difference between the two procedures (P = 0.81)
Table 3 shows comparison of mean value of sagittal CGA of left side obtained by OPG, i.e., 31.6° (standard deviation of 6.294) with mean value of sagittal CGA obtained by PIR, i.e, 31.05° (standard deviation of 5.09).
t-test was performed, and it was found that there was no significant difference between the two procedures (P = 0.76).
Table 4 shows comparison of mean value of sagittal CGA of the dentulous subjects with mean values of left side, i.e, 32.55° (standard deviation of 5.45) with mean value of right side, i.e., 32.85° (standard deviation of 6.50) obtained by OPG.
t-test was performed and it was found that there was no significant difference between the two sides (P = 0.89).
Table 5 shows comparison of mean value of sagittal CGA of left sideie, 31.05° (standard deviation of 5.059) with mean value of sagittal CGA of right side, that is, 31.45° and (standard deviation of 4.438), obtained by protrusive interocclusal record.
t-test was performed and it was found that there was no significant difference between the two procedures (P = 0.81)
Table 7 shows comparison of mean value of sagittal CGA of left side obtained by OPG ie, 32.55° (standard deviation of 5.48) With Mean value of sagittal CGA obtained by PIR, i.e., 30.05° (standard deviation of 3.66).
t-test was performed and it was found that there was no significant difference between the two procedures (P = 0.0960).
Table 8 shows comparison of mean value of sagittal CGA obtained by OPG, i.e., 32.85° (standard deviation of 6.538) with mean value of sagittal CGA obtained by PIR, i.e., 30.50° (standard deviation of 3.677) of right side.
t-test was performed and it was found that there was no significant difference between the two procedures (P = 0.16).
Table 9 shows comparison of mean value of sagittal CGA of left side ie, 32.55°,(standard deviation of 5.45) with the mean value of sagittal CGA of right side, i.e, 32.85°,(standard deviation of 6.50) obtained by OPG.
Double tailed t-test was performed, and it was found that there was no significant difference between the two sides (P = 0.87).
Table 10 shows comparison of mean value of sagittal CGA of left side, i.e., 30.05° (standard deviation of 6.026) with mean value of sagittal CGA of right side, i.e., 30.50° (standard deviation of 3.723), Obtained by PIR.
Double tailed t-test was performed and it was found that there was no significant difference between the two sides (P = 0.87).
Table 11 shows comparison of mean value of sagittal CGA of left side of dentulous patients, i.e., 31.60° (standard deviation of 6.2945) with mean value of sagittal CGA of edentulous patients, i.e., 32.55° (standard deviation of 5.45), obtained by OPG.
Double tailed t-test was performed and it was found that there was no significant difference between the two groups (P = 0.6129).
Table 12 shows comparison of mean value of sagittal condylar guide angle of right side of dentulous patients, i.e., 31.85° (standard deviation of 5.869) with mean value of sagittal CGA of edentulous patients, i.e., 32.85° (standard deviation of 6.34), obtained by OPG.
Double tailed t-test was performed and it was found that there was no significant difference between the two groups (P = 0.6129).
The results show that there is no significant difference between protrusive condylar guidance obtained by OPG and PIR and in between right and left side in both dentulous and edentulous patients.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
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