Selecting maxillary anterior tooth width by measuring certain facial dimensions in the Kurdish population

Correlation between different points on the face and the width of maxillary anterior teeth

Statement of problem

There is currently no consensus on the relationship between maxillary anterior teeth and different facial anthropometric measurements. Additionally, whether these relationships vary by age and sex remains unreported.

Purpose

This clinical study aimed to investigate the relationship between the intercanine distance (ICaD) and intercanthal distance (ICD), interpupillary distance (IPD), interalar width (IAW), and intercommissural width (ICW), and to compare whether these relationships differ between different age and sex populations.

Material and methods

Participants (n = 409) were enrolled according to the inclusion criteria, and their standardized digital images were taken to measure facial and oral segments through an image processing program. The differences between ICaD and four facial measurements and the sexual differences for all measurements were compared using the 1-sample t-test. The differences among different age groups for all measurements were compared using the one-way analysis of variance (ANOVA) test, and a least significant difference (LSD) test was used for multiple comparisons. The association between ICaD and the four facial measurements was evaluated using Pearson correlation analysis. The correlation between ICaD and four facial measurements was evaluated using linear regression. Differences in regression equations among the subgroups were evaluated through subgroup regression analysis and the significance test of the difference between the two regression coefficients. Tests of significance were two-sided, with alpha level of 0.05. The reliability of the results was evaluated by calculating intraclass correlation coefficients.

Results

The ICD, IPD, ICW, and IAW significantly differed from the ICaD in both sexes (P < 0.01). All measurements were significantly greater in men than in women (P < 0.01). The differences among the age groups were statistically significant for all measurements except IPD (P < 0.05). A significant positive correlation was found between all facial measurements (r = 0.258 [ICD], r = 0.334 [IPD], r = 0.389 [ICW], and r = 0.393 [IAW]) and the ICaD in both sexes. The highest correlation was found between ICW(r = 0.345) and ICAD in men and IAW (r = 0.285) and ICAD in women. Except for the 20-29 and 50-59 age groups, the mathematical equations of ICaD and facial anthropometric measurements differed among the other age groups and sexes.

Conclusions

ICD, IPD, ICW, and IAW cannot be directly used to determine ICaD in both sexes. Nevertheless, when observed from the frontal aspect, by the use of digital images, all facial measurements correlated to the intercanine distance, with a high probability. The mathematical formulae combined with facial anthropological measurements can help ensure the combined width of the six maxillary anterior teeth, but the effects of sex and age differences should be considered.

Correlation Between Maxillary Anterior Teeth and Common Facial Measurements

Background

The symmetry between maxillary anterior teeth and the face holds significant importance. This study assessed and analyzed the relationship between facial parameters and anterior teeth in the maxillary arch of male and female subjects. Specifically, individual width and combined width (CW) measurements of the maxillary anterior teeth were investigated.

Methods

This study involved a total of 150 dentate Yemeni subjects (74 men and 76 women), whose ages ranged from 18 years old to 30 years old. A maxillary cast was created, and two digital photographs of the face of each subject were taken and analyzed. Digital calipers and AutoCAD were used to gather measurement data of the dental parameters (intercanthal distance [ICD], interpupillary distance [IPD], interalar width [IAW], intercommissural width [ICW], and bizygomatic width [BZW]) and facial parameters (profile distance).

Results

Significant correlations were found for the following: IPD and width of six maxillary anterior teeth of each of the study subjects; ICD and their central incisors; and BZW and their canine width measurements. In contrast, IAW and ICW were not correlated with all tooth measurements. Linear regression findings showed that the CW measurement of the four incisors was significantly correlated with all facial parameter measurements, excluding the ICW and IAW in females and the IAW, ICW, and profile distance in males.

Conclusion

The IPD and ICD of males and females may be used to determine their CW measurements. The BZW and IPD of males can be used to take precise anthropological measurements of the width of the central canines and incisors. Meanwhile, the IPD distance of females can be used to assess the central and lateral incisor widths.

Evaluation of the parameters related to the golden ratio in the teeth of individuals from different countries: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Golden proportion, golden percentage, and recurring esthetic dental (RED) proportion are parameters used in esthetic dentistry. However, a meta-analysis of studies evaluating these parameters in individuals from different countries is lacking.

PURPOSE

The purpose of this systematic review and meta-analysis was to determine and compare the golden ratio, golden percentage, and RED ratio values as seen in the maxillary anterior teeth of individuals from different countries.

MATERIAL AND METHODS

A systematic search was performed using PubMed/Medline, Google Scholar, and Web of Science to identify English and non-English language articles reporting the golden proportion, golden percentage, and RED proportion. The titles, full text, and abstracts were scanned by 2 investigators independently to identify articles that fulfilled the inclusion criteria. Using a meta-analysis software program, data extracted from each selected study were statistically combined using the random-effects model. Weighted mean differences, 95% confidence intervals, and heterogeneity were calculated for each measurement.

RESULTS

The search protocol resulted in a total of 752 articles, but only 26 articles fulfilling the inclusion criteria were included in the meta-analysis. While the sample size varied between 46 and 384 in the 26 analyzed studies, a total of 3786 individuals from 12 countries were evaluated. No similarity was found using the esthetic parameters determined in the populations to which the meta-analysis was applied.

CONCLUSIONS

Mathematical formulas did not provide consistent results that would allow for their use as a standardized guide for creating natural looking smiles. Rather, dental esthetic ratios should be set based on the racial and ethnic character of a population.

Two-dimensional facial measurements for anterior tooth selection in complete denture treatment

Purpose

Anterior tooth selection is one of the most challenging parts in determining tooth dimensions and critical to the aesthetic aspect of the complete denture treatment. However, the methods for anterior tooth size selection using facial measurements are still controversial. This study aimed to investigate the relationship between dental measurements and facial measurements, and to establish the anterior tooth size prediction equation using facial dimensions in the Thai population for the complete denture treatment.

Materials & methods

One hundred and twenty-five Thai participants (53 men and 72 women) aged 18-35 years old with Angle class I occlusion, did not currently undergo orthodontic treatment, had normal alignment on the maxillary anterior teeth, no attrition, abrasion, proximal restoration or prosthesis were investigated. One frontal facial photograph and one dental photograph of each participant were made using an image analyzing program (ImageJ version 1.53b) to measure the six horizontal facial distances, five vertical facial distances and three dental distances as 2D facial and dental measurements. Pearson correlation and multiple linear regression analysis were performed.

Results

The difference of facial and dental measurements between men and women were statistically significant (P < .001). Interpupillary width, interlateral canthal width, intercommissural width and bizygomatic width were correlated to dental measurements in both sexes. Intermedial canthal width and lip thickness were correlated to dental measurements in women. Face length and lateral canthus to lower border of face were correlated to dental measurements in men. Prediction equations of each dental measurement were established using only horizontal facial dimension and using both horizontal and vertical facial dimensions.

Conclusions

Facial and dental dimensions are sex-dependent. Facial measurements can be applied in a regression equation to predict dental measurements. Adding vertical dimensions of facial measurements to the prediction equations of anterior tooth size selection results in a higher R squared to 0.444. This finding can be used as a tool for anterior tooth size selection in the complete denture treatment.

Analysis of the Facial Measurements and Dental Arch Dimensions for the Construction of Dental Prostheses among Adult Yemenis

AIM

To investigate the dental arch dimension (width, length, and height) and facial measurements including inner-canthal width (ICW), bizygomatic width (BZW), inter-alar width (IAW), and mouth width (MW), and to assess the correlation between these facial measurements and dental arch width (canine width [CW], inter-first premolar width [I1PW], and inter-first molar width [I1MW]), to establish a preliminary reference for artificial teeth selection in Yemeni adult.

MATERIALS AND METHODS

The study included 80 individuals (40 males and 40 females) with symmetrical faces and normal class I occlusion ranging in age from 20 to 35. Maxillary and mandibular stone casts were made for each individual. The dimensions of dental casts and facial measurements, including ICW, BZW, IAW, and MW, were assessed using a digital caliper. The collected data were analyzed by using the SPSS software program. The descriptive statistics for each measurement were made. Differences between males and females were tested using an independent-sample t-test with p-values below 0.05 considered significant. Pearson correlation coefficient between facial measurements and dental arch width was also done.

RESULTS

Most dental arch dimensions and facial measurements exhibited larger mean values in the male than in the female group, with the greatest significant difference in the maxillary dental arch width and the lowest in mandibular dental arch length. A highly significant correlation is observed between ICW and maxillary canine width (CW) (r = 0.318, p = 0.004). In contrast, no significant correlation between dental arch width and BZW, IAW, and MW is shown.

CONCLUSIONS

Within this study's limitations, the ICW can determine the ideal dimension of the artificial teeth in the anterior maxillary arch. While the other facial parameters, including BZW, IAW, and MW, cannot be used for artificial teeth selection in Yemeni populations.

CLINICAL SIGNIFICANCE

The findings of this study established a reference database of facial measurements and their correlation to dental arch and teeth width in Yemeni populations. So, it can be implemented in artificial teeth and dental prostheses design and construction.

Evaluation of influence factors on the width, length, and width to length ratio of the maxillary central incisor: A systematic review and meta-analysis

OBJECTIVES

The aim of this study was to analyze whether symmetry of left and right sides, gender, measuring method, and ethnicity have influences on width (W), length (L), and width to length ratio (W/L) of the maxillary central incisor (MCI) and provide a reference for dental treatment planning in the esthetic zone.

MATERIALS AND METHODS

An electronic search was conduct of the dental literature. Studies reporting data about measurements were included. Data were extracted and analyzed for the differences between left and right, male and female, different measuring methods, and ethnicities by Review Manager and Stata statistical software.

RESULTS

Seventeen studies were included. There were no differences between measurement of the left and right groups, perceived and actual measuring groups. However, differences were found between genders in MCI's W and L but no difference in W/L. Differences were also found between Asians and Caucasian subjects in MCI's W, L, and W/L.

CONCLUSIONS

The results of this meta-analysis suggest that symmetry of left and right sides and measuring method do not influence MCI dimension. Gender and ethnicity are found as influence factors for MCI dimension. We believe these findings can be helpful for dentists to decide and design the dimensions of the restorations for maxillary anterior teeth in clinical practices.

CLINICAL SIGNIFICANCE

In the process of designing maxillary anterior teeth for implantation, the contralateral MCI can be helpful to create a symmetrical esthetic restoration. For patients with maxillary anterior tooth loss or diastemas, dentists should divide the left and right space equally and keep the MCI contact area aligned with the midline. Dentists should take face size and gender into consideration when making treatment plans for the MCI. Facial parameters as well as the size ratios of the previous teeth can be evaluated and may influence the size and shape of the teeth. When measuring anterior teeth or facial dimensions for esthetic evaluation, the recommended method is to measure the perceived sizes of a facial view image created by a digital camera. Slight discrepancies may exist between the actual and measured values due to the curvature of the arch and the angle in which the photograph was taken.

Relationship between different points on the face and the width of maxillary central teeth in a Turkish population

STATEMENT OF PROBLEM

Dentists may have difficulty determining the appropriate widths of the maxillary central incisors (CW) when restoring teeth for patients with edentulism. Anthropological measurements can help.

PURPOSE

The purpose of this observational study was to evaluate the relationship between different anthropological distances on the face and the CW in a young Turkish population.

MATERIAL AND METHODS

A total of 210 Turkish dental students without dental and facial deformities participated in this study. Two different digital photographs of their face (relaxed and smiling) were taken. The intercommissural width (ICW), intermedial canthus width (MCW), interlateral canthus width (LCW), interpupillary width (IPW), interalar width (IAW), and CW were measured. The t test, Pearson correlation analysis, and multiple linear regression analysis were performed to determine the relationship between facial measurements and CW (α=.05).

RESULTS

A significant correlation was found between facial measurements (r=0.516[ICW], r=-0.534[IAW], r=-0.639[MCW], r=-0.599[LCW], and r=-0.683[IPW]) and CW in both sexes. All facial measurements, except ICW and IPW in women and MCW in men, had a significant effect on CW according to the multiple linear regression analysis.

CONCLUSIONS

IAW and LCW can be used to determine CW in both sexes. The ICW and IPW can be specific anthropological measurements for men, and the MCW can be a specific anthropological measurement for women to determine CW.

Correlation between Interalar Distance and Mesiodistal Width of Maxillary Anterior Teeth in Thrissur, Kerala, Indian Population

Aims and Objectives:

The aim of this study was to assess the validity of interalar distance as an aid in maxillary anterior teeth selection in Thrissur, Kerala, Indian population. The study also evaluated whether interalar distance and maxillary anterior teeth undergo any changes as age increases in this population and whether there is a gender difference in these parameters in this population.

Materials and Methods:

A study was planned on 1200 participants in Thrissur Municipal Corporation area, Kerala, India, with the aim of checking the validity of interalar distance as a successful aid in maxillary anterior teeth selection. The collected data were analyzed using SPSS version 21.0. Mean standard deviation and 95% confidence intervals were estimated. Student's t-test was used for comparison between gender and two age groups such as 18–25 and 40–50 years. One-way ANOVA analysis was done for combined effects.

Results:

The study showed that there is a high statistical significance between the interalar distance and the mesiodistal width of six maxillary anterior teeth in females (P < 0.01) and no significance in males.

Conclusion:

The study concluded that, within the population evaluated, there was a high significant correlation between interalar distance and the mesiodistal width of six maxillary anterior teeth in both males and females. Both interalar distance and mesiodistal width of maxillary anterior teeth showed a significant increase in size as age increases. There was a significant increase in size difference for males compared to females in relation to interalar distance and not for mesiodistal width of maxillary anterior teeth.

Analysis of the golden proportion and width/height ratios of maxillary anterior teeth in Arab and Kurdish populations

STATEMENT OF PROBLEM

Dentists providing anterior restorations are guided by the principles of anatomic tooth dimension. Dental biometrics should consider ethnicity to produce a more comprehensive evaluation.

PURPOSE

The purpose of this clinical study was to analyze the anatomic crowns of maxillary central incisors (CI), lateral incisors (LI), and canines (C) with respect to the golden proportion (GP) and width/height (W/H) ratio in Kurdish and Arab populations.

MATERIAL AND METHODS

Maxillary gypsum casts were obtained from 100 participants (50 from a Kurdish and 50 from an Arab population). Standardized digital photographs of each cast were recorded. The apparent and actual anterior tooth dimensions were determined by ImageJ software for the calculation of the GP and W/H ratio. Data were statistically analyzed using ANOVA to investigate ethnic, sex, and arch side differences. The chi-square test was used to explore the GP, and the 1-sample t test was used to test the ideal W/H ratio (α=.05).

RESULTS

The GP was found in both the Kurdish and Arab groups in the LI/CI mean (0.62, 0.63), but not in the C/LI mean (0.69, 0.73). No difference due to sex was detected in the LI/CI in either ethnic group, but Kurdish men had significantly larger C/LI than women (0.73, 0.66, P=.006) and larger right-side LI/CI than left (0.63, 0.60, P=.049). The W/H ratio was higher than the predicted ideal ratio of 80% (range, 88% to 90%). The LI W/H ratio in Arabs was significantly larger than in Kurds (90.3% versus 82.7%, respectively; P<.001).

CONCLUSIONS

The GP was found to exist between the apparent widths of maxillary anterior teeth LI/CI for the both populations in both men and women but not for C/LI. No ideal ratio was detected for the W/H ratios. Specific population characteristics must be taken into consideration, especially when applying the proportions to Kurdish individuals.

Evaluation of the Current Techniques and Introduction of a Novel Approach for Estimating Maxillary Anterior Teeth Dimensions

INTRODUCTION

Several techniques and methods have been proposed to estimate the anterior teeth dimensions in edentulous patients. However, this procedure remains challenging especially when preextraction records are not available. Therefore, the purpose of this study is to evaluate some of the existing extraoral and intraoral methods for estimation of anterior tooth dimensions and to propose a novel method for estimation of central incisor width (CIW) and length (CIL) for Saudi population.

MATERIALS AND METHODS

Extraoral and intraoral measurements were recorded for a total of 236 subjects. Descriptive statistical analysis and Pearson's correlation tests were performed. Association was evaluated between combined anterior teeth width (CATW) and interalar width (IAW), intercommisural width (ICoW) and interhamular notch distance (IHND) plus 10 mm. Evaluation of the linear relationship between central incisor length (CIL) with facial height (FH) and CIW with bizygomatic width (BZW) was also performed.

RESULTS

Significant correlation was found between the CATW and ICoW and IAW (p-values <0.0001); however, no correlation was found relative to IHND plus 10 mm (p-value = 0.456). Further, no correlation was found between the FH and right CIL and BZW and right CIW (p-values = 0.255 and 0.822). The means of CIL, CIW, incisive papillae-fovea palatinae (IP-FP), and IHND were used to estimate the central incisor dimensions: CIL = FP-IP distance/4.45, CIW = IHND/4.49.

CONCLUSION

It was concluded that the ICoW and IAW measurements are the only predictable methods to estimate the initial reference value for CATW. A proposed intraoral approach was hypothesized for estimation of CIW and CIL for the given population.

CLINICAL SIGNIFICANCE

Based on the results of the study, ICoW and IAW measurements can be useful in estimating the initial reference value for CATW, while the proposed novel approach using specific palatal dimensions can be used for estimating the width and length of central incisors. These methods are crucial to obtain esthetic treatment results within the parameters of the given population.