Professional Documents
Culture Documents
by N
ht
pyrig
No Co
t fo
rP
ub
lica
tio
n
te
ss e n c e
Width/Length
n
The Importance of
Ratios of Maxillary Anterior Permanent Teeth in Esthetic Rehabilitation
fo r
224
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
ot
CASE REPORT
fo r
Abstract
The aim of this study was to investigate the
ot
Q ui
by N
ht
DUARTE ET ALopyrig
No C
t fo
rP
ub
lica
tio
n
te
ss e n c e
225
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
CASE REPORT
Q ui
by N
ht
pyrig
No Co
t fo
rP
ub
lica
tio
n
te
Method and materials ss e nc e
ot
fo r
One of the most challenging tasks in esnious distribution of teeth shapes, sizes,
a pleasant smile.
(GC
Fujirock
EP).
The
widest
Fig 1
226
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
Fig 2
fo r
Table 1
Width (mm)
Length (mm)
W/L ratio
Central incisors
34
8.14 (0.56)
9.57 (0.60)
0.85 (0.09)
Lateral incisors
34
6.54 (0.54)
8.38 (1.01)
0.79 (0.10)
Canines
34
7.52 (0.74)
9.08 (0.88)
0.83 (0.10)
7.4 (0.9)
9.01 (0.97)
0.82 (0.10)
Total
102
ot
Q ui
by N
ht
DUARTE ET ALopyrig
No C
t fo
rP
ub
lica
tio
n
Mean (SD) widths, lengths, and W/L ratios of maxillary anterior teeth t e s
se nc e
Table 2
Multiple comparisons of maxillary anterior W/L ratios*
Results
Subset 1
a
Subset 2
Lateral incisors
34
.790
Canines
34
.834a,b
.834b
Central incisors
34
.853b
.064
.423
cally significant differences in each category: width (P < .0001), length (P < .0001), and
ratios
of
maxillary
anterior
teeth
(Table 2). Two statistically significant subsets of W/L ratios were found. Maxillary
central incisor width corresponded to 85%
of the length, resulting in the largest W/L ratio of the three maxillary anterior teeth. The
Fig 3
Fig 4
Case 1
A 45-year-old male patient presented for
treatment because he was dissatisfied with
his smile. The clinical exam revealed
porcelain-fused-to-metal crowns (maxillary
left central and lateral incisors) and allceramic crowns (maxillary right central and
lateral incisors) that showed inappropriate
width/length ratios (Fig 3). The old crowns
227
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
CASE REPORT
Q ui
by N
ht
pyrig
No Co
t fo
rP
ub
lica
tio
n
te
ss e n c e
fo r
Fig 6
transmission.
a
Fig 7
Fig 8
a
Fig 9
228
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
ot
Fig 5
fo r
ot
Q ui
by N
ht
DUARTE ET ALopyrig
No C
t fo
rP
ub
lica
tio
n
te
ss e n c e
Fig 10
Soft tissues after removal of the provisionals. (a) The first retraction cord was packed in. (b) Second re-
sue complex.
3,10
The wax-
traoral
adjustments
of
the
provisional
patients expectations.
229
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
CASE REPORT
Q ui
by N
ht
pyrig
No Co
t fo
rP
ub
lica
tio
n
te
ss e n c e
fo r
d
Fig 11
ot
(a to c) Final impressions showing adequate soft tissue deflection. (d to f) A Geller master cast was
Fig 12
(a and b)
Examples of modified
anterior
teeth
individual
tooth
proportions depends
on the space availb
230
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
fo r
Fig 13
ot
Q ui
by N
ht
DUARTE ET ALopyrig
No C
t fo
rP
ub
lica
tio
n
te
ss e n c e
a
Fig 14
(a to c) Final restorations were fabricated using the following W/L ratios: central incisors = 85% and
Case 2
maxillary teeth.13 After 1.5 years of treatment, some deficiencies in the soft tissue
Fig 15
Fig 16
papillae.
231
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
CASE REPORT
Q ui
by N
ht
pyrig
No Co
t fo
rP
ub
lica
tio
n
te
ss e n c e
fo r
17
ot
Fig
slight
to
over-
a
Fig 18
b
(a) Gingival view of the porcelain-fused-to-metal crowns before the mini-wings were fabricated.
(b) Delicate mini-wings were produced to close the interproximal black triangles.
14,15
However,
alongside
the
defined
ITP
were
also
restorations.
However,
the
interdental
space available was larger than the required mean width of the individual teeth.
Discussion
Minor rotation of the maxillary central incisors (Fig 17) associated with slight inter-
232
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
fo r
Fig 19
ot
Q ui
by N
ht
DUARTE ET ALopyrig
No C
t fo
rP
ub
lica
tio
n
te
ss e n c e
dentition.
3,4,6
In addition, the
233
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008
CASE REPORT
Q ui
by N
ht
pyrig
No Co
t fo
rP
ub
lica
tio
n
te
ss e n c e
ot
fo r
Conclusions
sions are reproduced in an anterior reharior esthetics and a more natural appear-
er dimensions.
Acknowledgments
The authors thank Dr Bernard Tandler for editorial assistance.
References
1. Rufenacht C. Fundamentals of
Esthetics. Chicago: Quintessence, 1990.
2. Brisman AS. Esthetics: A comparison of dentists and
patients concepts. J Am Dent
Assoc 1980;100:345352.
3. Sterrett JD, Oliver T, Robinson
F, Fortson W, Knaak B, Russell
CM. Width/length ratios of normal clinical crowns of the
maxillary anterior dentition in
man. J Clin Periodontol 1999;
26:153157.
4. Magne P, Gallucci GO, Belser
UC. Anatomic crown width/
length ratios of unworn and
worn maxillary teeth in white
subjects. J Prosthet Dent 2003;
89:453461.
5. Wolfart S, Thormann H, Freitag
S, Kern M. Assessment of dental appearance following
changes in incisor proportions.
Eur J Oral Sci 2005;113:
159165.
6. Chu SJ. Range and mean distribution frequency of individual tooth width of maxillary
anterior dentition. Pract Proced
Aesthet Dent 2007;19:209215.
7. Davis BK. Dental aesthetics
and the aging patient. Facial
Plast Surg 2006;22:154160.
234
THE EUROPEAN JOURNAL OF ESTHETIC DENTISTRY
VOLUME 3 NUMBER 3 AUTUMN 2008