CLINICAL EVALUATION OF RESIDUAL RIDGE IN MAXILLARY

ARCH OPPOSING TWO IMPLANT SUPPORTED MANDIBULAR

OVERDENTURE: AN IN VIVO STUDY

BY

DR. GIBY M. MARKOSE

(Batch 2017)

Dissertation submitted to
Dr. Bhim Rao Ambedkar University, Agra
In partial fulfilment of the requirement for the degree of
MASTER OF DENTAL SURGERY
In the speciality of
PROSTHODONTICS AND IMPLANTOLOGY

Under the guidance of

Dr. AJAY GUPTA
(Professor and Head)

DEPARTMENT OF PROSTHODONTICS AND IMPLANTOLOGY

D.J. COLLEGE OF DENTAL SCIENCES AND RESEARCH
Niwari Road, Modinagar - 201204
 Dr. Bhim Rao Ambedkar University, Agra, Uttar Pradesh

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation titled CLINICAL EVALUATION OF RESIDUAL

RIDGE IN MAXILLARY ARCH OPPOSING TWO IMPLANT SUPPORTED

MANDIBULAR OVERDENTURE: AN IN VIVO STUDY is a bonafide and genuine

research work carried out by me under the supervision and guidance of Dr. AJAY GUPTA,

Professor and head, Department of PROSTHODONTICS &IMPLANTOLOGY, D.J. College

of Dental Sciences & Research, Modinagar, Uttar Pradesh.

Date: Signature of the Candidate

Place: Modinagar

Dr. GIBY M. MARKOSE

POST GRADUATE STUDENT
 CERTIFICATE BY THE GUIDE

This is to certify that the dissertation titled” CLINICAL EVALUATION OF RESIDUAL

RIDGE IN MAXILLARY ARCH OPPOSING TWO IMPLANT SUPPORTED

MANDIBULAR OVERDENTURE: AN IN VIVO STUDY” being submitted by Dr.

GIBY M. MARKOSE in partial fulfillment of the requirements for the award of the degree

of MASTER OF DENTAL SURGERY in the specialty of PROSTHODONTICS AND

IMPLANTOLOGY, is a bonafide research work carried out by her under my direct

guidance and supervision and to my satisfaction.

Signature of the Guide

Date:
Place: Modinagar
Prof, Dr. AJAY GUPTA
BDS, MDS Professor and Head
Department of Prosthodontics
D.J. College of Dental Sciences
And Research, Modinagar.
 CERTIFICATE BY THE CO-GUIDE

This is to certify that the dissertation titled “CLINICAL EVALUATION OF RESIDUAL

RIDGE IN MAXILLARY ARCH OPPOSING TWO IMPLANT SUPPORTED
MANDIBULAR OVERDENTURE: AN IN VIVO STUDY” being submitted by Dr.
ANITA TIWARI in partial fulfillment of the requirements for the award of the degree of
MASTER OF DENTAL SURGERY in the specialty of PROSTHODONTICS AND
IMPLANTOLOGY, is a bonafide research work carried out by her under our direct
guidance and supervision and to our satisfaction.

CO-GUIDE

Dr. Leena Tomer

BDS, MDS Professor
Department of Prosthodontics
D.J. College of Dental Sciences
And Research, Modinagar.

Dr. Vijay Prakash Dr. Gagan Khanna

BDS, MDS Professor BDS, MDS Professor
Department of Prosthodontics Department of Prosthodontics
D.J. College of Dental Sciences D.J. College of Dental Sciences
And Research, Modinagar. And Research, Modinagar.

Date:

Place: Modinagar
 ENDORSEMENT BY THE HEAD OF THE DEPARTMENT
AND PRINCIPAL OF THE INSTITUTION

This is to certify that the dissertation titled “CLINICAL EVALUATION OF RESIDUAL

RIDGE IN MAXILLARY ARCH OPPOSING TWO IMPLANT SUPPORTED
MANDIBULAR OVERDENTURE: AN IN VIVO STUDY”is a bonafide research work
done by Dr. GIBY M. MARKOSE under the guidance of

Dr. AJAY GUPTA, Professor and Head, Department of PROSTHODONTICS

&IMPLANTOLOGY,D.J. College of Dental Sciences and Research, Modinagar, Uttar
Pradesh.

Seal & Signature of the Head Seal & Signature of the Principal

Prof. Dr. AJAY GUPTA Prof. Dr. Reena R Kumar

B.D.S. M.D.S B.D.S., M.D.S.
Professor and Head Principal & Dean
Department of Prosthodontics D.J. College of Dental Sciences and
D.J. College of Dental Sciences and Research, Modinagar,
Research, Modinagar, Distt – Ghaziabad
Distt - Ghaziabad

Date: Date:
Place: Modinagar Place: Modinagar
 COPYRIGHT

DECLARATION BY THE CANDIDATE

I hereby declare that Dr. BHIM RAO AMBEDKAR UNIVERSITY, AGRA, UTTAR
PRADESH shall have the rights to preserve, use and disseminate this dissertation in print or
electronic format for academic/research purpose.

Date: Dr. GIBY M. MARKOSE

Place: Modinagar POST GRADUATE STUDENT

© Dr. Bhim Rao Ambedkar University, Agra, Uttar Pradesh, India

LEAD KINDLY LIGHT
 Acknowledgement

I am grateful to Almighty god for showering me with blessings and love that have provided
me with inspiration throughout my life & thankful for the inspiration and strength which was
very essential for me to finish this work.

I seize this opportunity to express my gratitude to all those who stood by me through the
years of my Post Graduate training programme and helped in the successful completion of
this dissertation. The list is long, but I cherish each contribution to my development.

It gives me great pleasure to express my deep sense of gratitude towards my respected

teacher &Dr. Ajay Gupta Professor& Head of the Department of Prosthodontics &
Implantology, D. J. College of Dental Sciences & Research, Modinagar for his able guidance,
inspiration and continuous encouragement at every stage given to me throughout the work. I
thank for his ceaseless encouragement, precious advice, thoughtful criticism and time and
attention during busy schedule. It’s a dream to have a teacher who believes in you, who tugs
and pushes and leads you to next plateau, sometimes poking you with a sharp stick called
“truth” He has been instrumental in installing the will and courage, and extended all his skills
and guidance towards the successful completion of this work.

It is a matter of great honour for me to acknowledge the invaluable guidance rendered to me

by my guide Dr. Leena Tomer Professor , Department of Prosthodontics & Implantology,
D. J. College of Dental Sciences & Research, Modinagar , for her constructive suggestion,
overwhelming encouragement invaluable clinical tips and expert guidance during this
dissertation. She demonstrates that scholars have a responsibility to use the privileges of
academia to imagine and create a better world. Her attention to detail and perseverance has
given this the face of perfection. The constant enthusiasm that she included in me is not only
limited to this work, but will take me a long way in life. Without her inspiration, ever helping
attitude, innovative ideas, constructive criticism and immaculate scrutiny, this work would
not have been possible. I would here like to thank her for her endless and dedicated
professionalism towards the project and also for making me more knowledgeable. It was a
great privilege to be her student and learn all that I could from vast pool of her knowledge.
With utmost sincerity and deep sense of appreciation I thank my beloved teacher, Dr. (Prof)
Reena R Kumar B.D.S., M.D.S. Principal, D.J. College of Dental Sciences and Research,
Modinagar, for the permission, help and guidance during conductance of my dissertation.

I am sincerely thankful to Dr. GaganKhanna, Professor D.J. College of Dental Sciences and
Research, Modinagar for his able and unwavering support, comprehensive outlook, tireless
efforts and relentless help all throughout the study. I shall always try in every small way to be
like the epitome of goodness as you are. I shall always be grateful for all that you have
imbibed in me.

I am sincerely thankful to my Co Guides Dr. Vijay Prakash Gupta, Professor, D.J. College
of Dental Sciences and Research, Modinagar, for their encyclopedic knowledge & their
cooperation and help during my dissertation work.

A great deal to thanks goes to my seniors Dr. Nikhil, Dr. Satvik, Dr. Sumit, Dr. Sidarth,
Dr. Uruvashi, Dr. Neha, Dr. Puneet, Dr. Waseem, Dr. Anita, Dr. Gitanjali for their
constant support and encouragement to me and always being on my side, boosting my
confidence to do hard and diligent work,

I am grateful to my seniors Dr. Precily and Dr. Gautam for their help and support
throughout my work.

My special thanks and credit to my colleagues Dr. Mohit, Dr. Arti, Dr. Sumasri, Dr.
Srimukhi

I also convey my thanks to my juniors Dr. Nithin, Dr.Awaise, Dr. Kunal, Dr. Arjun, Dr.
Soniya, Dr. Anjali, Dr. Aiswarya, Dr. John, Dr. Nazreen, Dr. Mandeep, Dr. Veenuka,
Dr. Pavan who rendered selfless help of any kind whenever it was needed.

I bow my head in gratitude to my parents, Mr. M .K Thampy and Mrs. Vimala Thomas
whose unforgettable sacrifices and choicest blessings provided me the opportunity to be
educated and who patiently bore my absence at home. My deep regards to them for their
innumerable sacrifices and motivation.

I would like to give my heartfelt thanks to my friend Cyril Abraham, Dr. Denny Thomas,
Mr. Samanth, Dr. Ashvin and Mrs. Jessin, Dr. Fyjo, Dr. Mithun, Dr. Premchinth
through all the highs and lows I have faced during the completion of my dissertation.
I express my gratitude thanks to my brother Er. Gify M. Markose for creating a safe space
where I could dig deep into the muck and find the gems of my existence.

I am grateful to my loving wife Dr. Susan Zachariah for their constant support and
encouragement to me and always being on my side, boosting my confidence to do hard and
diligent work.

I would like to acknowledge the support of Mr.Manoj Kumar lab technician of our
department

And last but not the least I would also like to thank to Gaurav Jain,M/s Jain Photostat,
Modinagar.

In the end,I thank all those people who in some way or the other have helped me to complete
this thesis successful.

Dr. Giby M.Markose

 TABLE OF CONTENTS

S NO. TITLE PAGE NO.

1 INTRODUCTION 1-5

2 AIM AND OBJECTIVES 6

3 REVIEW OF LITERATURE 7-24

4 MATERIALS AND METHODS 25-44

5 CASE SERIES 45-50

6 RESULTS AND OBSERVATIONS 51-59

7 DISCUSSION 60-63

8 CONCLUSION 64

9 BIBLIOGRAPHY 65-72

10 ANNEXURES 73-93

i) FORM 1-5
ii) CASE HISTORY PROFORMA
iii) CONSENT FORM
 LIST OF FIGURES

S NO. TITLE PAGE NO.

1. GENTIAN VIOLET MARKS AT BILATERAL 34

CANINE REGION IN LOWER DENTURE

2. MARKS TRANSFERRED INTRA-ORALLY 34

3. INCISION AND BONE WIDTH GAUGE 35

4. OSTEOTOMY PREPARATION WITH PILOT 36

DRILL

5. USE OF A RATCHET WRENCH 37

6. BOTH IMPLANTS IN PLACE 37

7. SUTURES GIVEN 37

8. ARMAMENTARIUM FOR MAKING COMPLETE 41

DENTURE

9. AUTOCLAVE 41

10. IMPLANT SURGICAL KIT 42

11. ARMAMENTARIUM FOR IMPLANT PLACEMENT 42

12. SURGICAL DRILLS 43

13. RATCHET 43

14. HANAU ARTICULATOR AND FACE BOW 44

 LIST OF TABLES

SR. NO. TOPIC PAGE NO.

TABLE 1 MATERIALS USED FOR COMPLETE DENTURE 26

FABRICATION

TABLE 2 MAXILLARY ALVEOLAR BONE RESORPTION 51

BALANCED

TABLE 3 MAXILLARY ALVEOLAR BONE RESORPTION 52

NON BALANCED

TABLE 4 ANTERIOR RESORPTION 56

TABLE -5 POSTERIOR RESORPTION 57

TABLE -6 BLEEDING INDEX 58

TABLE -7 PATIENT SATISFACTION 59

 LIST OF GRAPHS

SR. NO. TOPIC PAGE NO.

1 Graphical representation denotes Anterior resorption of 2 56

groups (balanced and non balanced) at a regular intervals
of 3 months (0, 3, 6 months) and results showing no
significant difference between 2 groups.

2 Graphical representation denotes posterior resorption of 2 57

groups (balanced and non balanced) at a regular intervals
of 3 months (0, 3, 6 months) and results showing no
significant difference between 2 groups.

3 Graphical representation denotes bleeding index of 2 58

groups (balanced and non balanced) at a regular intervals
of 3 months (0, 3, 6 months) and results showing significant
difference between 2 groups.

4 Graphical representation denotes Patient satisfaction of 2 59

groups (balanced and non balanced) at a regular intervals
of 3 months (0, 3, 6 months) and results showing no
significant difference between 2 groups.