Department of Oral Rehabilitation, Medical College of Georgia, School of Dentistry, Medical College of Georgia, Augusta, GA 30912-1260, USA.
J Prosthet Dent. 2011 Jan;105(1):44-50. doi: 10.1016/S0022-3913(10)60190-4.
When making complete dentures, clinicians may have difficulty with selection of properly sized denture teeth.
The purpose of this study was to determine if there are specific measurements made on an edentulous cast that could be useful to clinicians for selection of proper maxillary anterior denture tooth width.
Following Institutional Review Board approval, measurements were made on 50 maxillary and mandibular sets of complete denture casts and their marked and contoured occlusion rims and record bases consecutively submitted to a dental laboratory. The following 6 measurements were recorded for each set of casts: left mid-maxillary to right mid-maxillary, representing the distance between the respective residual ridge crest points adjacent to each canine eminence; left retromolar pad to right retromolar pad; incisive papilla to left hamular notch; incisive papilla to right hamular notch; left hamular notch to right hamular notch; and incisive papilla to vibrating line. These measurements were statistically compared with the control, the canine-to-canine distance as marked on the contoured maxillary occlusion rim to indicate the relaxed commissures. The casts were also classified as small, medium or large based upon the tooth width specified by the commercial mold guide for their respective canine-to-canine control measurement. The estimation bias was determined for each of the 6 measurements, and for those measurements for which the bias was significantly different from zero, a bias-correction was applied. St. Laurent's coefficient was used to describe the agreement between each (bias-corrected) measurement and the canine-to-canine control. A commercial guide was used to determine the accuracy of each of the 6 bias-corrected measurements in classifying denture teeth width as small, medium or large as compared to the same classification using the canine-to-canine control.
The bias-corrected measurement from the left hamular notch mark to the right hamular notch mark, obtained by adding 10 mm, exhibited the greatest degree of agreement with the control. This measurement was also the only one of the 6 that correctly classified more than 50% of both the medium and large casts. None of the 6 measurements classified more than 30% of the small casts correctly.
Of the 6 measurements considered here, the bias-corrected measurement from left hamular notch mark to right hamular notch mark was preferred for selecting denture teeth width.
当制作全口义齿时,临床医生可能难以选择合适尺寸的义齿。
本研究旨在确定在上颌无牙颌模型上进行哪些特定测量,以便临床医生选择合适的上颌前牙义齿宽度。
经机构审查委员会批准,连续向牙科实验室提交 50 套上颌和下颌全口义齿模型及其标记和成型的牙合架和记录基托。记录了每副模型的以下 6 个测量值:左侧中切牙到右侧中切牙,代表相邻每颗尖牙的牙槽嵴顶点之间的距离;左侧磨牙后垫到右侧磨牙后垫;切牙乳头到左侧钩状突切迹;切牙乳头到右侧钩状突切迹;左侧钩状突切迹到右侧钩状突切迹;切牙乳头到震颤线。将这些测量值与对照值(标记在成型上颌牙合架上的尖牙到尖牙距离,指示放松的颌间距离)进行统计学比较。根据各自的商业模具指南中规定的尖牙到尖牙控制测量值,将模型分为小、中、大。对于偏倚明显不为零的 6 个测量值,确定了估计偏倚。采用圣洛朗系数描述每个(偏倚校正后)测量值与对照值(尖牙到尖牙控制测量值)之间的一致性。使用商业指南确定每个偏倚校正后的测量值在将义齿牙宽分类为小、中或大方面的准确性,与使用尖牙到尖牙控制值进行的相同分类相比。
校正偏倚后,从左侧钩状突标记到右侧钩状突标记的测量值增加了 10mm,与对照值的一致性最大。该测量值也是 6 个测量值中唯一正确分类了超过 50%的中型和大型模型的测量值。没有一个测量值正确分类了超过 30%的小型模型。
在考虑的 6 个测量值中,从左侧钩状突标记到右侧钩状突标记的校正偏倚测量值更适合选择义齿牙宽。