Attokaran George, Shenoy Kamalakanth
Professor Department of Prosthodontics, PSM College of Dental Science and Research, Thrissur, Kerala, India, Phone: +919846123660 e-mail:
Department of Prosthodontics, Yenepoya Dental College Yenepoya University, Derlakatte, Mangaluru, Karnataka,India.
J Contemp Dent Pract. 2016 May 1;17(5):382-7. doi: 10.5005/jp-journals-10024-1859.
Selecting and replacing missing teeth to natural proportions and esthetic preference of a patient in the absence of pre-extraction records is a very challenging task. Although facial analysis and proportions are well discussed in many populations, none exists for the Thrissur, Kerala, population. A prosthodontic rehabilitation for Kerala patients relying on other racial norms may result in dissonant facial proportions. Therefore, the purpose of this study was (1) to evaluate the validity of innercanthal distance as a guide in determining the mesiodistal dimension of six maxillary anterior teeth in a selected Malayalee population in the Thrissur Municipal Corporation area; (2) to check whether innercanthal distance undergoes dynamic changes over time as a result of aging; and (3) to evaluate whether there is a gender difference in the analyzed mean facial and dental proportions in this population.
The study was conducted on 1,200 subjects in the Thrissur Municipal Corporation area. From five wards, 240 subjects were selected, out of which 120 were from the 18 to 25 years age group and 120 from the 40 to 50 years age group. Sixty males and females were selected from each group. The innercanthal distance was measured using a Digital Vernier Caliper, and alginate impressions were made to evaluate the size of maxillary anteriors. The data was analyzed statistically.
The study showed that there is a high statistical significance between the innercanthal distance and the mesiodistal width of six maxillary anterior teeth in females (p < 0.01) and no significance in males. There was also dynamic changes in the innercanthal dimension and the mesiodistal width of maxillary anteriors with increase in age (p < 0.001). The difference in the mean of innercanthal distance between the genders was highly statistically significant, but no significance was found between the genders in the mesiodistal width of maxillary anteriors.
Within the population evaluated, there was a high statistical significance in females between the innercanthal distance and the mesiodistal width of six maxillary anterior teeth, but not for males. Innercanthal dimension was found to undergo dynamic changes as age increases in both males and females, and it was much higher in males than in females. There was no statistical significance in the comparative evaluation of mesiodistal width of maxillary anteriors of males and females in the study.
Teeth selection is a critical step in determining the outcome of successful prosthodontic treatment. No definite guidelines for the selection of maxillary anterior teeth pertaining to the Thrissur, Kerala, population exist. A prosthodontic rehabilitation of Thrissur, Kerala, patients relying on other racial norms will result in dissonant facial proportions. In selecting maxillary anterior teeth, the knowledge of racial norms will help specify certain esthetic and functional modifications in treatment plans, which might be specific to each group. Therefore, there remains an unquestionable need for a scientific and reliable method for maxillary anterior teeth selection, which can be applied on this group of Indian population.
在没有拔牙前记录的情况下，根据患者的自然比例和美学偏好来选择和替换缺失牙是一项极具挑战性的任务。尽管面部分析和比例在许多人群中已有充分讨论，但喀拉拉邦特里苏尔人群尚无相关研究。依赖其他种族标准为喀拉拉邦患者进行口腔修复可能会导致面部比例不协调。因此，本研究的目的是：（1）评估内眦间距作为确定特里苏尔市辖区选定马拉雅拉姆人群中六颗上颌前牙近远中尺寸指南的有效性；（2）检查内眦间距是否会因年龄增长而随时间发生动态变化；（3）评估该人群中分析的平均面部和牙齿比例是否存在性别差异。
本研究在特里苏尔市辖区的1200名受试者中进行。从五个病房中选取240名受试者，其中120名来自18至25岁年龄组，120名来自40至50岁年龄组。每组选取60名男性和女性。使用数字游标卡尺测量内眦间距，并制取藻酸盐印模以评估上颌前牙的大小。对数据进行统计学分析。
研究表明，女性内眦间距与六颗上颌前牙的近远中宽度之间存在高度统计学意义（p < 0.01），而男性则无统计学意义。随着年龄增长，内眦尺寸和上颌前牙的近远中宽度也有动态变化（p < 0.001）。两性之间内眦间距平均值的差异具有高度统计学意义，但在上颌前牙近远中宽度方面两性之间无统计学意义。
在所评估的人群中，女性内眦间距与六颗上颌前牙的近远中宽度之间存在高度统计学意义，男性则不然。发现内眦尺寸在男性和女性中均随年龄增长而发生动态变化，且男性的内眦尺寸远高于女性。在本研究中，男性和女性上颌前牙近远中宽度的比较评估无统计学意义。
牙齿选择是决定口腔修复治疗成功结果的关键步骤。对于喀拉拉邦特里苏尔人群，尚无确定的上颌前牙选择指南。依赖其他种族标准为喀拉拉邦特里苏尔患者进行口腔修复会导致面部比例不协调。在选择上颌前牙时，了解种族标准将有助于在治疗计划中明确某些美学和功能方面的调整，这些调整可能因群体而异。因此，对于这组印度人群，仍然迫切需要一种科学可靠的上颌前牙选择方法。
