Cephalometric evaluation of the changes in patients wearing complete dentures: a 20-year study.

The purpose of this continuing longitudinal investigation was to study the changes on the craniofacial complex in complete denture wearers; herein are reported the 20-year findings. At the onset of the study complete dentures were made for 64 persons. Two dentures techniques were employed: a complex method of construction and a simplified method. At the start of the project the patients' ages ranged from 30 to 60 years (average age 53 years) and all had been edentulous for at least 1 year (range 1 to 30 years). Lateral cephalometric radiographs were made immediately after initial placement of the dentures and during subsequent years (1, 2, 3, 4, 5, 7, 10, 15, and 20). The same cephalostat was used throughout and all films were exposed with the teeth in centric occlusion. Thirty-four subjects presented for the 20-year follow-up. Of this number, the radiographs of 24 subjects (14 women and 10 men; average age 65.5 years [range 50-83 years]) (12 complex denture wearers; 12 simplified technique denture wearers) were used in this report (10 had denture alterations over the 20-year period that excluded them). The 20-year observations corroborate earlier findings. There is a loss of the vertical dimension of occlusion as viewed from the right profile, and the mandible rotates in a counterclockwise fashion resulting in an increase in relative prognathism. The maxillary alveolus was stable, the mandibular alveolus resorbed, and the dentures rotated counterclockwise and shifted slightly forward. The observed changes were not significantly affected by the sex of the patient or by the denture technique employed.