Axiograph and the Panoramic Radiographic Imaging Technique, an Alternative to Conventional Technique to Record Condylar Guidance

Abstract

Introduction: The documentation of the maxillomandibular relationship and the recording values of condylar guidance is the most critical, yet essential step in fabrication of complete denture prosthesis and it also helps in diagnosing, treatment planning, and fabrication of the balanced complete denture prosthesis that aids in enhancing the aesthetics, and maintenance of the stomatognathic system. Various techniques are available to record the condylar guidance; One of them being axiographic technique and panoramic radiograph followed by programming the semi adjustable articulators. Aim: The aim of the present study was to evaluate and compare the condylar guidance using the conventional technique the gothic arch tracing with that of axiographic technique and the panoramic radiographs. Materials and Methods: The observational study with the clinical set up was carried out over a period between October 2018- March 2019. Twenty completely edentulous patients were selected for the study. The comparative evaluation of axiographic tracing technique, panoramic radiographic technique and the extraoral gothic arch tracing technique was conducted. The horizontal condylar guidance values obtained with these techniques were assessed. The data obtained was statistically analysed using Karl Pearson correlation test to determine the correlation between the values obtained from all the three techniques on the right side and the left side of the subjects. Paired t-test and Bonferroni Post-Hoc test were used to compare the extraoral gothic arch tracing values and Orthopantomogram values and axiographic tracing values on right side and left side of the subjects. Results: A statistically significant correlation was observed between the extraoral Gothic arch tracing technique and the panoramic radiographic technique on right (r=0.047, p-value 0.04) and left sides (r=0.55, p-value 0.01) of the subjects. The axiographic tracing showed lower values when compared with gothic arch tracing technique and the panoramic radiographic technique. (95%CI of difference was -0.49 lower). Significant differences were obtained on comparison between all three techniques on right (p-value<0.001) and left sides.(p-value 0.008). On pairwise comparison of right sides between Extraoral gothic arch Tracing and Axiographic tracing (p-value<0.001) and between axiographic tracing and Orthopantomographic tracing (p-value<0.001), were significant, while pairwise comparison on left side between Orthopantomogram and Axiographic tracings (p-value 0.01) was significant. Conclusion: The panoramic radiographic images can be used as an alternative method to that of conventional gothic arch tracing technique to obtain the condylar guidance values. The values obtained using axiographic tracings method was comparatively lower. Thus, the values obtained from axiographic technique should be used with caution or the values needs to be compared to gold standard techniques to further analyse the accuracy of the values that can be used as a valuable aid in setting the condylar guidance in semi-adjustable articulators.