Statistical Investigation of the Standard Height of Occlusal Rim Blocks among Patients Attending Makerere University Dental Hospital, Kampala, Uganda

Abstract

Edentulous patients desire to reinstate oral function and aesthetics in the most comfortable state and to regain their self-esteem. Due to racial anatomic differences, there is a need to ascertain the standard height of Occlusal Rim Blocks (ORBs) for edentulous patients in Uganda. This study was aimed at statistical investigation of the standard height of ORBs among patients attending Makerere University Dental Hospital, Kampala, Uganda. This was a cross-sectional quantitative study that comprised 240 pairs of wax ORBs requested by clinicians for patients in need of complete dentures. Consecutive sampling was used to select the ORBs. The height of the anterior and posterior portions of the maxillary and mandibular ORBs were recorded using a pair of pliers and a flexible ruler, and data were entered into Excel and exported into STATA software version 15 for analysis. The mean height for the anterior portion of maxillary ORBs was 19.4 mm and for the posterior, 17.4 mm after adjustment while the mean height for the mandibular counterparts was 16.4 mm and 16.0 mm, respectively. There was a statistically significant difference between the mean height of ORB before and after adjustments and between the newly established and internationally accepted standard height of ORB. There was no significant sex difference in the mean height of ORBs. Overall, the mean height of ORBs for the Ugandan population was significantly shorter than the internationally accepted standard height. Keywords: Bite registration, Complete denture, Dental hospital, Edentulous patients, Height, Occlusal rim blocks

Evaluation of the Suitability of The Established Standard Height of Occlusal Rim Blocks Among the Dental Clinicians in Makerere University Dental Hospital In Uganda

“…The present study highlighted a trend where the height of ORB in the Ugandan setting often falls below international standards. This is in line with other studies [24,25,26,8,16] where most heights range from as low as 17 mm for the upper anterior to 15-16 mm for the mandibular anterior. Similarly, Gupta [27] emphasizes the significance of considering each case independently, aligning with the principle of patient-centered care.…”

“…Dental clinicians attending to edentulous patients carried out an oral examination took the primary and secondary impressions of the patient's arches and sent them to the prosthetic dental laboratory for the technologist to fabricate the ORBs. The dental technologists fabricated two pairs of ORBs: one, the gold standard based on the internationally accepted heights (22 and 18 mm for anterior and posterior maxillary arch, respectively; 18 and 18 mm for anterior and posterior mandibular arch, respectively) [17], while the second one was made based on the newly estimated height (19.4 and 17.4 mm for anterior and posterior maxillary arch, respectively; 16.4 and 16.0 mm for anterior and posterior mandibular arch, respectively [16]. The clinicians carried out bite registration on the patients using both pairs of ORBs to achieve a freeway space of 2-4 mm.…”

“…In Turkey, Yanikoglu [14] found that out of the 45 edentulous patients, the mean distance from the depth of the maxillary mucobuccal/vestibule to the tip of the buccal tubercle of the maxillary and mandibular posterior teeth was 17.2 mm and 16.4 mm, respectively, and Stananought and Newton [15] suggested 20 mm for the anterior upper jaw and 18 mm for the anterior lower jaw. In Uganda, Nono et al [16] on 240 pairs of ORBs, found the mean height for anterior maxillary and mandibular to be 19.4 and 16.4 mm, respectively, while for posterior maxillary and mandibular, 17.4 and 16.0 mm, respectively. Different height measurements of ORBs are reported from studies in different countries including Uganda.…”

“…However, there is no readily available published literature about their suitability. Therefore, the purpose of the present study was to evaluate the suitability of the established standard height of ORBs previously recorded in Ugandan patients [16] among dental clinicians in Makerere University Dental Hospital in Uganda.…”

Exploring lived experiences on the usage of removable complete dentures among edentulous patients attending Makerere University Dental Hospital, Kampala, Uganda

“…The Uganda National Oral Health Policy [ 21 ] recommended the fabrication of conventional RCDs for the rehabilitation of edentulous patients using internationally accepted standards which include both clinical and laboratory procedures involving taking preliminary and final impressions, recording jaw relations using occlusal rim block (ORB), trial fitting of the wax denture, conversion of wax into the acrylic denture, and delivery or insertion of final RCD [ 22 , 23 ]. However, the ORBs produced by this recommendation are not suitable for Ugandan patients [ 24 ], hence could be contributing to the post-insertion complaints associated with removable complete dentures [ 25 ]. These complaints include lack of retention and stability during function, pain or discomfort, accumulation of food under the denture, altered speech, unsatisfactory appearance, and gagging [ 26 , 27 ].…”