The continuing

ridges

reduction

in complete

mixed-longitudinal

of the residual

denture
study

wearers:
covering

Antje Tallgren,
L.D.S., Odont.Dr.*
The Royal Dental College, Copenhagen,

alvealar

A
25 years

Denmark

1 he effect of the wearing

of complete
dentures on facial morphology
has been
the object of a series of longitudinal
studies by the present author.l-*
The resorption
of the residual alveolar ridges during a seven-year period of denture wear was found
to have caused a pronounced
reduction
of the pre-extraction
morphologic
face
height
and an accompanying
although
less marked
reduction
in the rest fact
height.2 In subjects provided
with complete upper and partial lower free-end dentures, the decrease in facial height was, on the average, only half that noted in
the complete
denture
group. The adaptive changes in the rest face height to the
alterations
in the morphologic
face height have been confirmed
in several other
studies.5-10
A study of the morphologic
changes in the facial skeleton during seven years
of complete
denture wear3 revealed that the decrease in facial height was mainly
due to a pronounced
reduction
of the mandibular
ridge and a consequent
forwardupward
rotation
of the mandible.
The change in mandibular
position was accompanied by a marked increase in mandibular
prognathism,
i.e., a forward positioning
of the chin in relation
to the upper part of the face. The reduction
of the residual
alveolar ridges was most rapid during
the first year of denture wear.* This is in
accordance
with
findings
by other
authors
for various
categories
of denture
wearers.11-15 Despite the marked alveolar bone loss and resultant
alterations
in jaw
relationship,
no dimensional
changes were found in the cranial base, the upper part
of the face, or the basal parts of the mandible.
Nor was there any evidence of
remodelling
changes in the gonial process.3
This
study
was supported
by a United
States
Public
Health
DE-02858
from
the National
Institute
of Dental
Research,
National
Bethesda,
Md., and by the Danish
Medical
Research
Council.
Presented
before
the Greater
New York
Academy
of Prosthodontics,
*Research
Lecturer
in

120

Associate,
Prosthetics,

Institute
University

of Orthodontics,
Royal
of Turku,
Finland.

Dental

Service
research
grant
Institutes
of Health,

College,

New

York,

N. Y.

Copenhagen,

and

Reduction

of

ridges

in denture

wearers

121

A study of the positional

changes of the complete dentures due to the alveolar
resorption*
revealed particularly
marked changes of the lower denture.
In addition
to a pronounced
settling on the basal seat, the lower denture displayed also a forward slide on the residual
ridge. The upward
rotation
of the mandible
and the
forward
slide of the lower denture led to a reduction
in the horizontal
overlap, and
in some patients, even to a horizontal
overlap of the lower teeth over the upper ones.
The resorption
of the residual ridges and the changes in jaw and occlusal relationships
showed great individual
variation.
Analysis of the relationship
between
morphologic
characteristics
of the facial skeleton and the anterior bone loss during
seven years of denture wearlG revealed a marked association between the mandibular
shape and the resorption,
especially of the lower ridge.
In order to investigate
the continuing
reduction
of the residual ridges during
protracted
wearing
of dentures, a cephalometric
radiographic
follow-up
study was
made of two groups of complete denture wearers-those
with 15 and those with
25 years experience
with denture wear. Furthermore,
the individual
variations
in
mandibular
bone loss were subjected to closer analysis.
MATERIAL
AND
Samples
studied

METHODS

The two groups studied consisted of subjects who had been provided with complete maxillary
and mandibular
dentures at the Institute
of Dentistry,
University
of Helsinki.
The first sample (Group A) comprised
nine subjects from a sample of
11 complete
denture
wearers, previously
followed
during
seven years of denture
wear.2, 3 The nine subjects (seven women and two men) were examined
after a
total of 13.5 years of denture wear, and six of these also after a total of 15 years of
denture wear. The mean age of the nine subjects who were examined
after 13.5
years was 63.7 years (range 33 to 76 years). The reductions
of the sample were in
two instances due to death, one subject had moved to another area of the country
and was not able to attend, and two subjects did not respond to repeated attempts
at follow-up.
The second sample (Group C) consisted of 20 subjects from a previous sample
of 45 subjects, who at the initial examination1
had been wearing complete dentures
for ten years. These 20 subjects, all women, were re-examined
15 years after the
first examination,
that is, after a total of 25 years of denture wear. The mean age
of the subjects at the 25 year stage was 72.1 years (range 59 to 88 years). The reduction of the initial sample was in 11 instances due to death, four subjects could not
be traced, six subjects did not respond to repeated attempts at follow-up,
and four
subjects were unable to attend due to illness or old age.
Prosthetic

treatment

Details regarding
the prosthetic
treatment
have been given in a previous pub1ication.l
In both groups, the treatment
undertaken
was of the conventional
type,
the dentures being constructed
tw? to four months after extraction.
In Group C,
all dentures were made of vulcanite;
in Group A, the dentures were made of acrylic
resin. In both groups the dentures were provided with porcelain
teeth (cusp angulation about 15 degrees) .

122

J. Prosthet.
February,

Tallgren

Dent.
1972

Fig. 1. Measurements of alveolar resorption. The anterior height of the upper and lower
alveolar ridges at two stages of observation (a and b). The difference a - b represents the
reduction in height of the alveolar ridges between the stages of observation. The shaded area
represents the area of resorption.
Fig. 2. The shape of the mandibular
base in terms of the P-angle and the gonial angle
(RL-ML) .
For the subjects in
first seven years of
6), the dentures
year controls, and
control.
In Group C, seven
Fig. 7) were still using
of the dentures having
acrylic resin had been
aminations.
the
Fig.
13.5
year

Radiographic

Group A no rebasing of the dentures had been done during

denture wearing.
For subjects Nos. 17, 31, 32 and 53 (see
were remade or rebased between
the seven-year and the
for subject No. 2, the dentures were rebased after the 13.5
of the 20 subjects (Nos. 4, 7, 12, 19, 29, 43, and 45-see
their 25-year-old
vulcanite
dentures without
any corrections
been made. For the remaining
13 subjects, new dentures of
made during the period between
the two radiographic
ex-

procedure

The standardized
radiographic
cephalometric
procedure
for obtaining
the profile head films has been accounted
for in previous publications.l,
2 The film series
of each subject obtained
in the present follow-up
study consisted of two or three
radiographs
made in the rest position
of the mandible
and one radiograph
made
with the teeth in occlusion.
The rest position exposures were made both with and
without
the dentures in the mouth.
The enlargement
of the structures
in the median
plane was the same as in
previous recordings
(6.6 per cent) . No corrections
have been made for this enlargement.
Measurements
The variables studied
ridges and the anterior
mandible
was measured
angle, RL-ML
(Fig. 2).
the reader is referred to
ment is given below.

were the reduction

in anterior
height of the bony alveolar
resorption
areas (Fig. 1). Furthermore,
the shape of the
in terms of the P-angle
(LindegHrd17)
and the gonial
For details regarding
measurements
and method
errors
a previous article. 3 A brief survey of methods of measure-

Reduction
ANTERIOR

HEIGHT
mm
30 -

HEIGHT

of

ridges

OF ALVEOLAR

in denture

wearers

123

RIDGES

MANDIBLE

RoUPC
7
MAXILLA

GROUP

BE AlJzlyr.

lY%.

1yrs.

10yrs.

13syrs.

25yrs.

Fig. 3. The mean reduction

in anterior
height
of the bony alveolar
ridges in 9 subjects
of
Group
A during
13.5 years of complete
denture
wearing
(3 years: n = 6), and in Group
C
between
the 10 year and 25 year stages of denture
wearing
(n = 20). The diagram
is based
on the mean
height
of the residual
alveolar
ridges
at the different
stages of observation.
BE = Before extraction.
AI = After insertion.

All measurements
were obtained
from the rest position films without
dentures,
the other films from the same series being used as an additional
check of bony
contours and of measuring
points. The linear and angular measurements
were made
directly on the films according
to the method of Bjork and So10w.~~ The measurements of the resorption
areas (Fig. 1) were made on contour tracings by planimeter,
the mean of three .registrations
of each area bein g used in the subsequent analysis.
The statistical
methods
used in the present study have been reported
elsewhere.3 lG Examination
of the relationship
between
pairs of variables was performed graphically
and by calculation
of correlation
coefficients. The 5 and 1 per
cent significance
limits for the correlation
coefficients for the sample size of 20 are
0.44 and 0.56. All calculations
were carried out at NEUCC,
the Northern
Europe
University
Computing
Centre in Copenhagen.
RESULTS
Reduction

in height

of the alveolar

ridges

The mean reduction

in anterior height of the bony alveolar ridges in Groups A
and C is shown in Table I and Fig. 3. The mean rate of reduction
in the two
samples is given in Table I and is presented graphically
in Figs. 4 and 5. The mean

124

J. Prosthet.
February,

Tallgren
MEAN

RATE

OF REDUCTION

OF ALVEOLAR

Dent.
1972

RIDGES

mmtyear

MAXILLA

El

0
EEAlhlyr.

7yrs.

3yrs.

Fig. 4. The mean

rate
alveolar
ridges
(mm/year)
AI = After
insertion.

of

Table I. Mean reduction

alveolar ridges in Group
(BE, before extraction;

GROUP

13.5yc5.

10yrs.

reduction
in Groups

GROUP

in anterior
A and C.

15yrs.

height

25yrs.

of

the

and mean rate of reduction

in anterior
A and Group C during the total period
AI, after insertion)

Group

No.

Difference,
mand.-max.

Mandible
1

IF

mandibular

height of the bony

of observation

(mm.)
Maxilla

and

Based on Table I. BE = Before extraction.

Reduction
Observation
period
(yr.)

maxillary

Rate

of reduction
(mndyr.)

Maxilla

Mandible

jY

A:

BE-AI
AIS
S-1
AI-1
1-3
3-7
AI-7
7-13.5
AI-13.5
13.5-15
Group

11
11
11
11
7
7
11
9
9
6

1.27*
0.50**
0.23
0.73*(
0.21
0.86
1.73s
0.39
2.22***
0.08

1.68
0.50
0.41
0.75
0.39
0.85
0.98
0.33
1.09
0.20

1.41*
1.14***
1.27***
2.41***
2.21***
2.71***
6.55***
1.44***
7.72**
0.33

1.63
0.67
0.72
0.89
0.91
1.11
2.52
0.58
2.88
0.26

0.14
0.64*
1.04**
1.68Y
2.00X
1.85**
4.82***
1.05**
5.50**
0.25

5.08
1 .oo
0.46
0.73
0.11
0.22
0.25
0.06

5.64
2.28
2.54
2.41
1.11
0.68
0.94
0.22

0.05

0.22

20

0.75***

0.53

3.00***

1.53

2.25***

0.05

0.20

C:

lo-25
*Denotes
**Denotes
***Denotes

the 5 per
the 1 per

cent level
cent

level

of significance.
of significance.

the 0.1 per cent level

of significance.

Volume
Number

27
2

Reduction
MEAN

RATE

of

OF REDUCTION

ridges

OFALVEOLAR

in denture

wearers

125

RIDGES

mm/year

MANDIBLE

GROUP

(!J

GROUP

0
EEAlhlyr.

3yrs.

7yrs.

10yrs.

13.5yrs.15yrs.

Fig. 5. See legend

for Fig.

zsyrs.

4.

changes reported
below are all significant
at least at the 5 per cent level if not
otherwise
stated.
Regarding
the previously
reported
reduction
of the alveolar ridges in Group
A during
seven years of denture
wear, it should be noted that during
the preinsertion
period
no significant
difference
between
the maxillary
and mandibular
reduction
was found. Owing
to a marked reduction
of the lower ridge but only
slight reduction
of the upper ridge during
the subsequent
years of denture wear,
the relationship
between
the mandibular
and maxillary
reduction
gradually
increased to approximately
4: 1 at the seven-year stage.4
The present follow-up
study revealed a continuing
reduction
of the residual
ridges. In Group A the mean decrease in anterior
height of the lower ridge between the seven-year and 13.5 year controls was 1.4 mm. and that of the upper
ridge was 0.4 mm. In three of the nine subjects no further reduction
of the upper
ridge was observed during
this period, while the lower ridge was reduced in all
subjects. The mean decrease in mandibular
height during the total period of 13.5
years was 7.7 mm. and the maxillary
reduction
was 2.2 mm. Of the six subjects
examined
at the 15 year stage of denture wear, four subjects showed a further
reduction
of the lower ridge, while only one subject displayed
reduction
of the
upper ridge.
In Group C the mean reduction
in anterior height of the lower residual ridge
between the 10 year and 25 year stages of denture wear was 3 mm. and that of
the upper ridge was 0.8 mm. Regarding
the individual
results, all subjects displayed reduction
of the lower ridge, while in three subjects no reduction
of the
upper ridge was found.

126

J. Prosthet.
February,

Tdgren

A 53

A51

A2

A 38

Dent.
1972

Al7

63

A31

A32

5cm

Fig. 6. Individual
tracings
of the anterior
bone loss of the lower ridge during
13.5 years of
complete
denture
wearing
(Group
A). The tracings
show the bony contour
of the anterior
residual
ridge at the stage of insertion
of the dentures,
at the 1 year,
7 year and 13.5 year
stages of observation.
Sequence
according
to magnitude
of bone loss at the 7 year stage Subjects Nos. A53 and A2 are men.

Table II. Resorption

areas in the anterior
Groups A and C (AI after insertion)

Group
A
C

region

of the bony

alveolar

Maxilla
(mm.l)

Observation
period
(yr.)

No.

AI-13.5
IO-25

9
20

Min.
10.3
0.0

1 Max.
47.7
22.3

ridges

in

Mandible
(mm.2)

5F

27.84
6.40

Min.

12.74
5.17

( Max.

20.3
3.7

120.0
55.3

58.59
23.93

s
36.89
13.61

The mean rates of reduction

for the upper and for the lower ridge during the
follow-up
periods were of the same magnitude
in the two samples (Table
I, Figs.
4 and 5). As also seen in Fig. 3, the mean curves for the respective maxillary
and
mandibular
reduction
run parallel.
Judging
from the mean alveolar reduction
in
the two samples studied, the average reduction
in anterior
height of the lower
ridge during
a 25 year period of complete
denture
wear would amount
to some
9 to 10 mm. and the reduction
of the upper ridge to some 2.5 to 3 mm.
Individual
The
samples
the

variation
magnitude
of denture

anterior

region

The anterior
shown in Fig. 6.
stage of insertion
stages of denture
denture

noticeable.

wearing

in alveolar

bone

of alveolar resorption
wearers. The means
of

the

residual

ridges

bone loss of the lower

The tracings show the
of the dentures, at the
wearing.
The marked
and

the

gradual

loss
showed great individual
variation
and variabilities
for the resorbed
are

given

in

ridge in the
bony contour
one-year, the
alveolar bone

decrease

in

the

Table

in both
areas in

II.

nine subjects of Group A is

of the residual ridge at the
seven-year, and the 13.5 year
loss during the first year of
rate

of

resorption

is

clearly

Reduction

0c 0
29

of

ridges

Cl9

c LO

c0

C23

c3

c 15

c7

in denture

C32

c42

C6

c 33

5 cm

wearers

127

C4

Cl&

CL3

c Ll

Fig. 7. Individual tracings of the anterior bone loss of the lower ridge between the 10 year
and 25 year stages of complete denture wear (Group C, women). Sequence according to
magnitude of bone loss.
Regarding
the shape of the individual
resorption
areas, each subject displayed
more or less the same resorption
pattern throughout
the period of denture wear.
In some subjects a flat pattern with mainly vertical bone loss was noted, while
other subjects displayed a more sharp
pattern with marked horizontal
bone loss.
The anterior
mandibular
bone loss in the 20 subjects of Group C between the
10 and 25 year stages of denture
wear is shown in Fig. 7. Like the findings in
Group A, the magnitude
and pattern of resorption
showed great individual
variation. Analysis of the relationship
between the anterior
mandibular
bone loss and
the shape of the mandible
(Figs. 8 and 9) revealed a marked positive correlation
with the P-angle (r = 0.75)
and a marked negative correlation
(-0.63)
with
the gonial angle (RL-ML)
. A p renounced
mandibular
bone loss thus was seen
in subjects with a marked mandibular
base bend (a large p-angle and a small gonial
angle), while a less marked resorption
was seen in subjects with a flattened
mandibular
base (a small P-angle and a large gonial angle) . No association
was observed between the mandibular
bone loss and the height of the lower ridge at the
10 year stage (r = -0.01).
**Significant

at the 1 per cent level.

120

,I. lrosthet.
February,

Tallgren

Dent.
1972

mm21

.
.

.
.

.
.

.
.

l
.

20

2L

-L

MANDIBULAR

Fig. 8. Diagram
illustrating
anterior
bone loss of the
denture
wear (r = 0.75**).

the
lower

-__
26

SHAPE

32 degrees

iJ3 -ANGLE)

relationship
between
ridge
between
the

the mandibular
shape (P-angle)
and the
10 year and 25 year stages of complete

.
.

.
.
l

.
.

.
.

.
.

.
.

,i-----------LL
11L 116

122

MANDIBULAR

Fig. 9. Diagram
illustrating
the relationship
anterior
bone loss of the lower
ridge
between
denture
wear
(r = -0.63**).

126

SHAPE

130

(RL

between
the
the 10 year

13L

J
degree t5

- ML)

gonial
angle
and 25 year

(RL-ML)
stages

and the
of complete

V&me
Number

27
2

Reduction

P-angle
RL-ML

23.5
132.5

p-angle
RL-ML

30.0
116.5

of

ridges

5cm

in denture

129

wearers

P-angle
RL-ML

23.0
133.5

P-angle
RL-ML

30.5113.5

Fig. 10. Tracings of four complete denture wearers (Group C) illustrating the relationship
between the mandibular shape and the anterior bone loss of the lower ridge. Subjects Nos.
C7 and C29 with a flattened mandibular base displayed small mandibular bone loss, while
subjects Nos. Cl2 and C41 with a marked mandibular base bend displayed large mandibular
bone loss. The marked difference between the mandibular and maxillary resorption is also seen.
The relationship
observed between
the mandibular
resorption
and the shape
of the mandible
is further illustrated
by the tracings (Fig. 10) of two subjects with
a small mandibular
resorption
and of two subjects with a pronounced
resorption.
The marked difference between the mandibular
and the maxillary
bone loss is also
seen. It may be noted that subjects Nos. 7, 29, and 12 still used their original
25-year-old
dentures without
any corrections
having been made, while for subject
No. 41 new dentures had been made at the 14 year stage of denture wearing.

DISCUSSION
The present follow-up
study of two groups of complete denture wearers to the
15 year and 25 year stages of denture wear revealed a continuing
reduction
of the
residual ridges, particularly
marked on the lower ridge. In both samples, the mean
reduction
in anterior
height of the lower ridge during
the follow-up
periods was
about four times greater than that of the upper. The same relationship
between
the mandibular
and maxillary
reduction
was previously
observed at the seven-year
stage of denture
wear.3, *
The difference
between the jaws in alveolar reduction
increased gradually
dur-

130

Tallgren

J. Prosthet.
February:

Dent.
1972

ing the first years of denture

wear. This would seem to indicate
that the lower
ridge is more likely to respond to the various functional
forces transmitted
through
the dentures than the upper ridge. The most likely reason for this is in the smaller
area and less advantageous
shape of the lower basal seat. In regard to the less
marked
resorption
of the upper ridge, the resistance offered by the hard palate
to the influence of the dentures on the alveolar ridge may play an important
part.
The reduction
of the residual ridges during the protracted
wearing
of dentures
was slight as compared
to the rapid reduction
during
the first year of denture
wear. Thus, the mean rate of reduction
for both the upper and lower ridge during the follow-up
periods was less than one tenth of that observed during
the
initial
year. Moreover,
the rates for the maxillary
and for the mandibular
reduction were found to be of the same magnitude
in the two samples. These findings
seem to indicate
that during
extended
wearing
of complete
dentures. the rate of
anterior
reduction
for the residual ridges and the relationship
between the maxillary
and mandibular
reduction,
on the average, remains fairly constant.
Regarding
the variability
in resorption,
a few subjects in both samples displayed no further
reduction
of the upper ridge after the respective seven-year and
ten-year stages of observation,
whereas the lower ridge showed a continued
reduction in all subjects. The magnitude
of alveolar bone loss, however> showed great
individual
variation.
The marked correlations
observed in the present follow-up
study between
the
shape of the mandible
and the anterior
bone loss of the lower ridge confirmed
previous findings from a seven-year study.16 A pronounced
mandibular
bone loss
was observed in subjects with a marked mandibular
base bend and a less marked
resorption
in subjects with a flattened
mandibular
base.
A pronounced
resorption
of the residual
ridges related to the shape of the
mandible
may be due to an interaction
of various factors-anatomic,
functional
and prosthetic.
In regard
to the load transmitted
to the tissues underlying
the
dentures, one factor especially to be considered
is the muscular
force. Attention
is
drawn
to electromyographic
findings,
in young individuals
with natural
teeth, of
a relationship
between
the mandibular
shape and jaw muscular
activity. In subjects with a marked mandibular
base bend and a small gonial angle MolleP
observed strong activity of the masseter and the anterior temporal muscles in the forced
closure. A similar relationship
between the size of the gonial angle and the messeter
activity during
chewing was observed by WitP
and Ahlgren.*l
A marked response
of the lower lip and mentalis
muscles, observed electromyographicallyZ
in longterm complete
denture wearers with impaired
retention
and stability of the lower
denture, may be considered
a contributing
factor with regard to the anterior
mandibular
resorption.
As pointed out by Atwood, 23 the various prosthetic factors are difficult to evaluate
due to the great number of variables included.
This is especially true in a long-term
investigation
like the present one. However,
the findings in a previous seven-year
study= of a pronounced
mandibular
bone loss in subjects with a more lingual
placement
of the artificial
lower incisors than that of the natural teeth should be
considered.
Regarding
rebasing
or remaking
of the dentures,
an interesting
observation
in the present study was that of the seven subjects in Group C, who had

Reduction

of

ridges

in denture

wearers

131

been using their original

dentures during
25 years without
any corrections,
four
subjects were among the five who showed the smallest mandibular
resorption
in
the whole group.
With regard to the shape of the resorbed mandibular
areas great variability
was
observed. The individual
resorption
pattern, on the other band, seemed to be fairly
consistent throughout
the period of denture wear.
SUMMARY

AND

CONCLUSIONS

This mixed-longitudinal
study of edentulous
individuals
covering 25 years of
complete
denture
wearing
revealed a continued
reduction
of the residual
ridges
throughout
the observation
period.
The reduction
of the lower ridge was particularly
marked, the mean reduction
in anterior
ridge height being approximately
four times as great as that of the
upper ridge.
The magnitude
and pattern
of alveolar
bone loss showed
great individual
variation.
Correlations
between the shape of the mandible
and the anterior
mandibular
bone loss indicated
a pronounced
resorption
in subjects with a marked mandibular
base bend, and a less marked resorption
in subjects with a flattened
mandibular
base. These findings suggest that careful examination
of the mandibular
shape can
provide valuable information
on the response of the residual ridges to the wearing
of dentures.
Regarding
the clinical
consequences
of the alveolar
bone loss it should be
emphasized
that by regular
control
and prosthetic
measures marked
instability
of the dentures
and undesirable
changes in jaw and occlusal relationships
can
be prevented.
As the rate of resorption
is most rapid during the first year of denture
wear, regular control during the first year and thereafter
at least once a year is advisable.
However,
with the continuing
resorption
over years, the prosthetic
replacement
of the lost tissues will give rise to increasing
treatment
problems
and may cause
the patient extreme difficulties
in management
of the dentures.
especially of the lower ridge, therefore,
constitutes
The continuing
resorption,
a serious prosthodontic
problem.
References
1. Tallgren,
A.: Changes
in Adult
Face Height
Due to Ageing,
Wear
and Loss of Teeth
and Prosthetic
Treatment;
A Roentgen
Cephalometric
Study Mainly
on Finnish
Women,
Acta Odont.
Stand.
15: Suppl.
24, l-122,
1957.
2. Tallgren,
A.: The Reduction
in Face Height
of Edentulous
and Partially
Edentulous
SubA Longitudinal
Roentgenographic
Cephalojects
During
Long-Term
Denture
Wear;
metric
Study,
Acta Odont.
Stand.
24: 195-239,
1966.
3. Tallgren,
A.: The Effect
of Denture
Wearing
on Facial Morphology;
A 7-Year
Longitudinal
Study,
Acta Odont.
Stand.
25: 563-592,
1967.
4. Tallgren,
A.: Positional
Changes
of Complete
Dentures;
A 7-Year
Longitudinal
Study,
Acta Odont.
Stand.
27: 539-561,
1969.
5. Atwood,
D. A,: A Cephalometric
Study
of the Clinical
Rest Position
of the Mandible.
Part I. The Variability
of the Clinical
Rest Position
Following
the Removal
of Occlusal
Contacts,
J. PROSTHET.
DENT. 6: 504-519,
1957.

132

.I. Prosthet.
Felmary,

Tallgren

6.

Dent.
1972

Duncan,
E. T., and Williams,
S. T.: Evaluation
of Rest Position
as a Guide
in Prosthetic
Treatment,
J. PROSTHET.
DENT.
10: 643-650,
1960.
7. Swerdlow,
H.: Roentgencephalometric
Study
of Vertical
Dimension
Changes
in Immediate Denture
Patients,
J. PROSTHET.
DENT.
14: 635-650,
1964.
8. Carlsson,
G. E., and Ericson,
S.: Postural
Face Height
in Full Denture
Wearers;
A Longitudinal
X-Ray
Cephalometric
Study,
.4cta Odont.
Stand.
25: 145-162,
1967.
9. Nairn,
R. I., and &tress,
T. W.: Changes
in Mandibular
Position
Following
Removal
of
the Remaining
Teeth
and Insertion
of Immediate
Complete
Dentures,
Br. Dent.
J. 122:
303-306,
1967.
10. Ismail,
Y. H., George,
W. A., Sassouni,
V., and Scott, R. H.: Cephalometric
Study of the
Changes
Occurring
in the Face Height
Following
Prosthetic
Treatment.
Part I. Gradual
Reduction
of Both Occlusal
and Rest Face Heights,
J. PROSTHET.
DENT.
19: 321-330,
1968.
11. Watt,
D. M.: Morphological
Changes
in the Denture
Bearing
Area Following
the Extraction
of Maxillary
Teeth,
Thesis,
Univ.
of Edinburgh,
1960.
12. Wictorin,
L.: Bone Resorption
in Cases With
Complete
Upper
Denture;
A Quantitative
Roentgenographic-Photogrammetric
Study,
Acta
Radiol.
(Stockholm)
Suppl. 228, pp. l-97,
1964.
13. Johnson,
K.: A Three-Year
Study
of the Dimensional
Changes
Occurring
in the Maxilla
Following
Immediate
Denture
Treatment,
Aust. Dent. J. 12: 152-159,
1967.
14. Car&on,
G. E., Bergman,
B., and HedegSrd,
B.: Changes
in Contour
of the Maxillary
Alveolar
Process Under
Immediate
Dentures;
A Longitudinal
Clinical
and X-Ray
Cephalometric
Study
Covering
5 Years, Acta Odont.
Stand.
25: l-31,
1967.
15. Carlsson,
G. E., and Persson,
G.: Morphologic
Changes
of the Mandible
After Extraction
and Wearing
of Dentures;
A Longitudinal,
Clinical,
and X-Ray
Cephalometric
Study
Covering
5 Years, Odontol.
Revy 18: 27-54, 1967.
16. Tallgren,
A.: Alveolar
Bone Loss in Denture
Wearers
as Related
to Facial Morphology,
Acta Odont.
Stand.
28: 251-270,
1970.
17. Lindegard,
B.: Variations
in Human-Body-Build;
A Somatometric
and X-Ray
Cephalometric
Investigation
on Scandinavian
Adults,
Acta Psychiat.
(Copenhagen)
Suppl.
86,
pp. I-163,
1953.
18. BjBrk,
A., and Solow, B.: Measurement
on Radiographs,
J. Dent. Res. 41: 672-683,
1962.
19. Moller,
E.: The Chewing
Apparatus;
An Electromyographic
Study
of the Action
of the
Muscles
of Mastication
and Its Correlation
to Facial
Morphology,
Acta Physiol.
Stand.
69: Suppl. 280, pp. l-229,
1966.
20. Witt,
E.: Kieferwinkel
und Kaumuskulatur,
Fortschr.
Kieferorthop.
24: 295-300,
1963.
21. Ahlgren,
J.: Mechanism
of Mastication;
A Quantitative
Cinematographic
and Electromyographic
Study
of Masticatory
Movements
in Children,
With
Special
Reference
to
Occlusion
of the Teeth,
Acta Odont.
Stand.
24: Suppl. 44, I-109,
1966.
22. Tallgren,
A.: An Electromyographic
Study
of the Behaviour
of Certain
Facial
and Jaw
Muscles
in Long-Term
Complete
Denture
Wearers,
Odontol.
Tidskr.
71: 425-444,
1963.
23. Atwood,
D. A.: Some Clinical
Factors
Related
to Rate
of Resorption
of Residual
Ridges,
J. PROSTHET.
DENT.
12: 441-450,
1962.
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