The influence of removable prosthodontic procedures and concepts on the esthetics of complete dentures

Dermatoglyphic assessment in subjects with different dental arch forms: an appraisal

Successful rehabilitation of edentulous individuals involves selection and arrangement of artificial teeth in accordance with the patient's original arch form. Various criteria exist for harmonious tooth arrangement but none is accepted universally. Finger and palm prints are unique to an individual and once formed in the sixth week of intra-uterine life, remain constant thereafter. Since dental arches are also formed during the same prenatal period, it is believed that the similar genetic factors may be involved in formation of dental arches and dermal patterns. This study was conducted to identify the association if any between type of dental arch forms and type of dermatoglyphic patterns. If specific dermal characteristics exist in individuals with specific dental arch forms, dermatoglyphic assessment of long standing edentulous subjects may help identify the patients preexisting dental arch form and thus aid in proper tooth arrangement. Ninety dentulous subjects were categorized into three groups on the basis of dental arch form (square, tapering or ovoid) and their finger and palm prints were recorded. The type of fingertip patterns, distribution of palmar patterns, Total Finger Ridge Count and angle atd were assessed. Subjects with square arches demonstrated a significantly high frequency of loops and a large atd angle with palmar patterns being most frequent in I3 region. Subjects with tapering arches showed a high frequency of whorls, a small atd angle and greatest distribution of palmar patterns in I4 region. In ovoid arched subjects, loops were the most common and palmar patterns were mostly observed in I4. Since distinctive dermal patterns were observed in subjects with different dental arch forms, it is believed that dermatoglyphics may be used as a reliable tool for identifying original arch form in edentulous patients.

A survey of dentulous and edentulous patient preference among different denture esthetic concepts

STATEMENT OF PROBLEM

Most esthetic preference research and anatomical average analysis come from dentulous populations. If edentulous patients have a different preference, application of this data during denture construction is problematic.

PURPOSE

The aim of this survey was to compare dentulous and edentulous respondent preference among three different denture esthetic concepts.

MATERIAL AND METHODS

A questionnaire and test booklet of standardized full-face digital photographs were used. It included three arrangements during maximum smile for six subjects. Dentulous and edentulous respondents were asked questions about their preference among the three randomly ordered concept photographs for each of the six subjects. A total of 167 dentulous and 269 edentulous questionnaires were analyzed descriptively and with Chi-squared tests to compare the esthetic preference of the respondents.

RESULTS

There was no statistically significant difference overall between dentulous and edentulous preference. Respondent preference varied significantly depending upon subject set and gender. Preference data compared closely to previous research.

CONCLUSION

Within the limitations of this survey, dentulous and edentulous respondent preference among the three esthetic concepts was not significantly different. Questionnaire respondents continued to frequently prefer appearances that are far from the anatomical average.

A Survey of Edentulous Patient Preference among Different Denture Esthetic Concepts

STATEMENT OF PROBLEM

Despite the fact that solutions to functional problems are available, successfully restoring the appearance of an edentulous patient remains a challenge.

PURPOSE

The aim of this survey was to determine if edentulous respondents could differentiate among three denture esthetic concepts and if there was an overall preference among the three.

MATERIALS AND METHODS

Six edentulous test subjects were selected based on age and smile criteria. One wax tooth arrangement was completed according to each of the three esthetic concepts for a total of three wax tooth arrangements per test subject. The three esthetic concepts followed were natural, supernormal, and denture look. Standardized full-face digital photographs were made of each arrangement (three) during maximum smile for each subject (six). These 18 photographs were included in a questionnaire. Respondents were asked questions about their preference among the three randomly ordered concept photographs for each of the six subjects. A total of 147 completed questionnaires were analyzed.

RESULTS

Ninety-six percent of respondents were able to differentiate among the three esthetic denture concepts. Natural tooth arrangements were preferred by 55% of the respondents, supernormal tooth arrangements were preferred by 19%, and the denture look arrangements were preferred by 26%.

CONCLUSION

Within the limitations of this survey, the questionnaire respondents differentiated between the three esthetic denture concepts. The tooth arrangement most closely resembling the anatomical average was selected by 55% of the respondents. Preference for a particular concept changed when responses to each test subject set were considered individually. Demographic factors do not significantly affect patient preference.

CLINICAL SIGNIFICANCE

Three esthetic concepts for complete denture construction have been differentiated. Questionnaire respondents preferred appearances that are far from the anatomical average 45% of the time.

Restoring dentate appearance: A literature review for modern complete denture esthetics

Despite the fact that solutions to functional and comfort problems are often available, successfully restoring the appearance of an edentulous patient remains a challenge. This review of the literature demonstrates the limited amount of useful evidence-based information available for restoration of dentate appearance in edentulous individuals. The English language peer-reviewed literature from 1880 to the present was reviewed. Articles were identified through previous literature reviews, an extensive hand search, and a search of MEDLINE using the key words esthetics and denture esthetics. Three main areas of information were found: published guidelines for achieving natural appearance, patient preference studies, and studies that have collected and analyzed anatomic norms.

Esthetics and the edentulous patient

Most individuals undergo some degree of psychological shock, depression, and loss of self-esteem after the loss of their teeth. Optimum success in the treatment of the edentulous patient can no longer be limited to the proper fit, function, speech, selection, and arrangement of teeth. In addition, today's dentists must use treatment strategies that include proper psychological management, caring, and recognition of the importance of the patient's perception of what is personally esthetic. This article addresses the esthetic considerations of this restorative challenge.