Comparison of face anthropometry and digital 2D face photogrammetry as a method for predicting vertical dimension of occlusion.

PURPOSE: The objective of the study was to determine the values of 15 craniofacial linear distances in the Serbian ethnic group and the correlations between them that are predictive or can serve as proxy for OVD using and compare two methods of face-anthropometric and digital 2D face-photogrammetric measurement. MATERIAL AND METHODS: A total of 90 adults were selected. Facial distance as a tool to measure the OVD was Sn-Gn - distance between septum of the nose (Sn) and tip of the chin (Gn). Face-anthropometric measurements were made with a Boley Gauge (Buffalo Dental Manufacturing Co.NY,USA). Digital 2D photogrammetric facial measurements were performed using the computer program DrCeph (FYI Technologies, USA). RESULTS: Determined mean value for the distance Sn-Gn by face-anthropometric was Sn-Gn(f) X=63.55 and by face-photogrammetric was Sn-Gn(ph) X=63.56. Multivariate regression analysis revealed that Sn-Gn(f) depended on ExL-ExR(f) p<0.001, ZyL-ZyR(f) p=0.077, N-Sn(f) p=0.096, Sn-Sto(f) p=0.043 and gender and that Sn-Gn(ph) depended on ExL-ExR(ph) p<0.001, EnL-EnR(ph) p=0.029, N-Sn(ph) p=0.013, Sn-Sto(ph) p=0.001 and gender. CONCLUSIONS: A comparison of facial anthropometry and digital 2D facial photogrammetry reveals no statistical significance differences in the values obtained and shows that facial photogrammetry could be a reliable method as a facial anthropometry.

Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.

OBJECTIVES: To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions. METHODS: An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions. RESULTS: Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1). CONCLUSION: According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.

Pediatric patients' reasons for visiting dentists in all WHO regions.

BACKGROUND: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral health-related quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their dentists' assessment, the study aimed to evaluate whether pediatric dental patients' oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. METHODS: Dentists who treat children from 32 countries and all WHO regions were selected from a web-based survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health concerns fit into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric patients' oral health problems and prevention needs were computed. FINDINGS: Data from 101 dentists treating children only and 523 dentists treating children and adults were included. For 90% of pediatric patients, their current oral health problems fit well in the four OHRQoL dimensions. For 91% of oral health problems they intended to prevent in the future were related to these dimensions as well. Both numbers increased to at least 96% when experts analyzed dentists´ explanations of why some oral health problems would not fit these four categories. CONCLUSIONS: The study revealed the four fundamental components of dental patients, i.e., the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact) are also applicable for pediatric patients, regardless of whether they have current or future oral health concerns, and should be considered when measuring OHRQoL in the pediatric dental patient population.

Why Patients Visit Dentists - A Study in all World Health Organization Regions.

OBJECTIVE: The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. METHODS: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated. RESULTS: For every 100 dental patients with current oral health problems, 96 had problems related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact. For every 100 dental patients who wanted to prevent future oral health problems, 92 wanted to prevent problems related to these 4 OHRQoL dimensions. Both numbers increased to at least 98 of 100 patients when experts analyzed dentists' explanations of why some oral health problems would not fit the four dimension. For the remaining 2 of 100 patients, none of the dentist-provided explanations suggested evidence against the OHRQoL dimensions as the concepts that capture dental patients' suffering. CONCLUSION: Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact capture dental patients' oral health problems worldwide. These 4 OHRQoL dimensions offer a psychometrically sound and practical framework for patient care and research, identifying what is important to dental patients.

Self-perception and satisfaction with dental appearance and aesthetics with respect to patients' age, gender, and level of education.

Introduction: Patient's subjective evaluation of dental appearance and aesthetics is becoming an increasingly important factor in aesthetic treatments and prosthetic therapy. Objective: The aim of this study was to investigate the influence of age, education level, gender, and different dental status and the appearance of the upper anterior teeth (color, size, shape, position and alignment of the anterior teeth) on the satisfaction of the respondents with dental appearance and aesthetics of their upper anterior teeth and their desire for improvement. Methods: The study encompassed 480 people aged 20 to 50 years with an average age of 30.84 years. There were 236 male and 244 female subjects. The respondents were interviewed using a questionnaire specially designed for the purpose of this research. For the study, the subjects were divided into the following three age groups: the younger age group (20­30 years of age), the middle age group (31­40 years of age), and the older age group (41­50 years of age). Results: The conducted study did not reveal statistical significance with respect to gender in any of the examined parameters (p > 0.05). A little more than one half of the respondents in each age group were satisfied with their dental appearance and aesthetics (60.3% of the respondents in the age group of 20­30 years, 55.7% in the age group of 31­40, and 53.7% in the age group of 41­50 years of age). Satisfaction with dental appearance and aesthetics increases linearly with the increase in the level of education and was the highest among the respondents with university degree (33.3%). Conclusion: Female respondents were more dissatisfied with their dental appearance and aesthetics as compared with male respondents, but the difference was found to be non-significant. Patients with higher education level were more satisfied with their dental appearance and aesthetics than those with lower education.

Analysis of abutment teeth in partially edentulous patients.

The aim of the study was to examine changes in the position of the abutment teeth (AT), size of undercuts for a denture clasp, as well as an existence of an adequate preparation of abutment teeth. A total of 156 casts of partially edentulous jaws, with 460 AT, were analyzed. The size of undercuts, a degree of abutment rotation, inclination and migration were measured using a dental parallelometer. The abutment teeth position was related to the level of occlusal plane in a dental articulator. Furthermore, the existence of an adequate preparation of abutment teeth, as well as a type of a denture and a type of a denture retention element were also considered. Analysis were carried out twice on casts made from a hard stone, the first time before the denture treatment had begun and the second time on the new casts obtained after new dentures had been delivered. The first analysis (prior dental treatment) revealed that a total of 33.9% of the analyzed AT were rotated, 31.3% were inclined, 12.1% had migrated, and 57.3% were elongated above the occlusal plane. On the casts obtained after the new dentures had been made, it was observed that none of the AT had an adequate preparation. Only 37.6% of all retention elements were located in adequate undercut positions on the AT. Upon the results of the present study a conclusion can be established that many abutment teeth are rotated, elongated, inclined, and migrated, which point to a requirement for AT preparation prior the manufacture of new denture; however none of the AT was adequately prepared considering insertion plane and many denture elements were located in an inadequate undercut size.

The significance of biometric parameters in determining anterior teeth width.

BACKGROUND/AIM: An important element of prosthetic treatment of edentulous patients is selecting the size of anterior artificial teeth that will restore the natural harmony of one's dento-labial structure as well as the whole face. The main objective of this study was to determine the correlation between the inner canthal distance (ICD) and interalar width (IAW) on one side and the width of both central incisors (CIW), the width of central and lateral incisors (CLIW), the width of anterior teeth (ATW), the width between the canine cusps (CCW), which may be useful in clinical practice. METHODS: A total of 89 subjects comprising 23 male and 66 female were studied. Their age ranged from 19 to 34 years with the mean of 25 years. Only the subjects with the preserved natural dentition were included in the sample. All facial and intraoral tooth measurements were made with a Boley Gauge (Buffalo Dental Manufacturing Co., Brooklyn NY, USA) having a resolution of 0.1mm. RESULTS: A moderate correlation was established between the interalar width and combined width of anterior teeth and canine cusp width (r = 0.439, r = 0.374). A low correlation was established between the inner canthal distance and the width of anterior teeth and canine cusp width (r = 0.335, r = 0.303). The differences between the two genders were highly significant for all the parameters (p < 0.01). The measured facial distances and width of anterior teeth were higher in men than in women. CONCLUSION: The results of this study suggest that the examined interalar width and inner canthal distance cannot be considered reliable guidelines in the selection of artificial upper anterior teeth. However, they may be used as a useful additional factor combined with other methods for objective tooth selection. The final decision should be made while working on dentures fitting models with the patient's consent.

Computerized cephalometric evaluation of changes following treatment with complete dentures.

The aim of this study was to provide longitudinal evaluation of the changes after complete dentures therapy and the rate of residual ridge resorption through a six-year period of denture wearing. The authors presented the case of a 76-year-old patient, edentulous for twelve years, wearing complete dentures for six years, with the eugnat jaw relationship. Cephalometric radiograph was carried out in the process of new complete denture production, while the evaluation was carried out after six years. Cephalometric analysis was performed by using "Dr. Ceph" computer software (FYI Technologies, GA, USA). After six years, the reduction of anterior total facial height was 5.5 mm and the anterior lower facial height was 5.5 mm, the vertical residual ridge reduction of the maxilla was 1.4 mm and the reduction of the mandible was 3mm. The study confirms the reliability and advantages of cephalometric analyses and reveals their application possibilities in prosthetic diagnostics and therapy, as well as in evaluation of rehabilitative results in edentulous patients and longitudinal analysis of changes on the orofacial complex tissues and intemaxillary relationships.

[Application of cephalometric analysis for determination of vertical dimension of occlusion--a literature review].

INTRODUCTION: Optimal reconstruction of vertical dimension of occlusion is crucial for functional and physiognomic rehabilitation of edentulous patients. This article is aimed at presenting attitudes and studies on application of cephalometric analysis in obtaining optimal vertical dimension of occlusion. The review of literature presents the studies which analyse the possibilities of cephalometric analysis aimed at improving the clinical methods for vertical dimension of occlusion determination in treatment of edentulous patients. The research carried out so far can roughly be divided into: cephalometric vertical dimension of occlusion evaluation in dentulous patients performed to determine precise indicators of vertical dimension of occlusion and to establish cephalometric standards for practical application in prosthodontics; the method of producing pre-extraction cephalometric registries involves the production of cephalometric radiographs for potential prosthodontic patients in dental pre-extraction period which are kept for reference to be used in later therapy; the cephalometric method of registering the position of physiologic rest position of the mandible involves measuring cephalometric parameters in cephalometric radiographs made when the mandible is in physiologic rest position; cephalometric evaluation of vertical dimension of occlusion in complete denture therapy after clinical determination of intemaxillary relationship is recommended for timely detection of possible mistakes, with a possibility of correction in the process of complete denture production; and cephalometric analysis in edentulous patients with old complete dentures for a planned vertical dimension of occlusion extension. CONCLUSION: Data from the literature give no proof of a scientific and universally accepted method for precise determination of vertical dimension of occlusion, which is a point many authors agree upon. Different methods proposed for vertical dimension of occlusion determination in everyday practice are usually recommended in combination with other methods. Determination of individual, morphological vertical dimension of occlusion indicators by cephalometric analysis is, in this sense, one of the directions for finding a better solution when planning an artificial occlusion complex.

[The effects of orthognathic surgery on mandibular movements in patients with mandibular prognathism].

INTRODUCTION: Mandibular prognathism, one of the most severe dentofacial deformities, affects the person's appearance, psychological health and the quality of life in the most sensitive age period. OBJECTIVE: The aim of this study was to evaluate the effects of sagittal split ramus osteotomy on the range of mandibular border movements in the early postoperative period. METHODS: The study was conducted on 20 patients, of mean age 20.8 years, with mandibular prognathism. All patients included in this study were operated on by bilateral sagittal spliting ramus osteotomy according to Obwegeser and Dal Pont followed by mandibular immobilization during eight weeks. In all patients mandibular border movements were recorded before and six months after surgery using the computerized pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany). RESULTS: The analysis of the chosen kinematic parameters revealed that sagittal split ramus osteotomy followed by eight weeks of mandibular immobilization had severe effects on the mouth opening. Six months after surgery the range of maximal mouth opening decreased for approximately 13.9 mm in relation to the preoperative stage. On the contrary, the ranges of maximal protrusion and the border of laterotrusive excursions increased significantly after surgery. CONCLUSION: In patients with mandibular prognathism where enormous mandibular growth was the main causal factor of the deformity, the sagittal split ramus osteotomy yielded good results. The rigid fixation of bone fragments and reduced period of mandibular immobilization followed by appropriate physical therapy could considerably contribute to a more rapid recovery of mandibular kinematics in the postoperative period.

[Contemporary methods and mobile denture cleansers and theirs significance for older population].

A dramatic increase in the number of people living in their seventies, eighties and nineties is associated with a loss of teeth and the use of mobile dentures. The aim of this paper was to highlight the consequences of poor denture hygiene on oral and general health in vulnerable elderly people, in long-term hospitalized elderly patients and in long-term institutionalized elderly in nursing homes. DENTURE DEPOSITS AND CONSEQUENCES OF POOR DENTURE HYGIENE: The number of bacteria living in the mouth is getting larger after putting denture on. Namely, a small "space" develops between jaw and denture, creating perfect conditions for bacterial growth. Denture becomes a "reservoir" of micro-organisms. Denture deposits such as bacterial plaque, fungi, tartar and remnants could be responsible for stomatitis prothetica, cheilitis angularis, inflammatory fibrous hyperplasia, halitosis (bad breath), dental caries in mobile denture carriers, mucositis and periimplantitis in mobile implant over-dentures carriers, accelerated destruction of denture materials for underlying, such as denture base soft liners, respiratory airways diseases, bacterial endocarditis and gastrointestinal infections. REMOVAL OF DENTURE DEPOSITS: It is recommendable to combine mechanical and chemical denture cleaning. Denture submersion into a commercial cleansing solution for less than one hour is an effective cleaning method. Commercial cleanser: specifically intended for dentures with metal parts should be used for those dentures. Commercial cleansers with a new component of silicon polymer, whose thin layer surrounds all denture surfaces and disables oral bacteria to agglomerate, are effective and useful. Preventive hygienic treatments are very important in hospitals and homes for the aged, bearing in mind that old and ill persons reside here. Those institutions are recommended to get equipped with ultrasound denture cleaners. IMPORTANCE OF WRITTEN BROCHURE ON PROPER DENTURE HYGIENE: Patients should be verbally instructed and showed about cleaning techniques, but also written instructions inform of brochure should be distributed in order to achieve better effects.

Cephalometric indicators of the vertical dimension of occlusion.

The aim of this investigation was to establish precise indicators of the vertical dimension of occlusion (VDO) which could be used as objective parameters in prosthodontic treatment providing exact control of the reconstructed vertical dimension of occlusion, early detection of errors and correction of the vertical dimension of occlusion during complete denture manufacturing. A total of 60 lateral cephalometric radiographs of subjects with natural dentition and class I skeletal jaw relationship, of Serbian nationality from the region of Vojvodina, were included in the investigation. Thirty subjects were males, and thirty females, their age range was 20 to 29 years. Cephalometric analysis was performed by using "Dr. Ceph" computer software (FYI Technologies, GA, USA). By evaluation of the craniofacial complex in subjects with natural dentition, horizontal dentofacial developmental growth was established in the examined sample and it was based on the relationship between the posterior and anterior total facial height (S-Go:N-Me, female X=68.96%, male X=72.8%) and statistically significant differences were found between the sexes in almost all linear dimensions and in the relation between the posterior and the anterior total facial height. Highly significant differences (p<0.001) between the sexes were found in regard to anterior total facial height (N-Me, male X=120.75 mm, female X=112.72 mm) and the anterior lower facial height (ANS-Me, male X=67.87 mm, female X=61.50 mm) (p<0.05). The proportions of the upper and lower anterior facial heights (N-ANS:ANS-Me, male X=79.36%, female X=80.63%) were within normal values in both sexes. Facial harmony existed both in men and women. Cephalometric study of the subjects with complete natural dentition included in this study provided important and specific parameters for optimal reconstruction of vertical dimension of occlusion in the treatment of edentulous patients.

[Effects of smoking on edentulous alveolar ridge mucosa].

INTRODUCTION: Tobacco use is an important risk factor for advanced histopathological findings on edentulous alveolar ridge mucosa. The aim of this study was to examine the effects of smoking on histopathological findings on edentulous alveolar ridge mucosa. MATERIAL AND METHODS: The experimental group consisted of 48 patients (29 smokers and 19 nonsmokers). The mean age of smokers was 42.6 and of nonsmokers 48.7 years. The anamnesis included the following data: age, sex, diseases and toxic habits--cigarette smoking. Biopsy samples were taken from the edentulous alveolar ridge mucosa without gross signs of symptoms. RESULTS: The mean number of cigarettes smoked per day was 11.5 +/- 7. The results of chi2 test proved that there were no statistically significant differences (p > 0.05) in histopathological findings on the alveolar ridge mucosa. The mean duration of smoking was 12.7 +/- 5 years. Hyperkeratosis was established in 76.92% of smokers who smoked longer than 15 years. The mean age at which smokers began smoking was 27.3 +/- 8 years and there were no statistically significant differences in histopathological findings on the alveolar ridge mucosa correlated with the beginning of smoking. CONCLUSION: On the basis of our research we conclude that smokers who have been smoking for 15 years are at risk for developing histopathological changes of the alveolar ridge mucosa, but there were no statistically significant differences in histopathological findings on the alveolar ridge mucosa correlated with the number of cigarettes per day and the beginning of smoking.

[Determination of placement of anterior teeth in removable dental prostheses]. / Odredivanje polozaja prednjih zuba kod mobilnih zubnih nadoknada.

INTRODUCTION: The aim of this paper was to present methods of placement of artificial anterior teeth in edentulous individuals. The following review takes account of the majority of papers published during the last 100 years. The review has been divided into sections regarding the method used to determine the position of artificial anterior teeth. GEOMETRIC ASPECT: Gysi (1895-1920) produced the first scientific theory about the position of artificial anterior teeth. PHYSIOGNOMIC THEORY: The aim of this theory is to find the most natural position for artificial anterior teeth for each individual. Camper's "face angle" as a physiognomic criterion, has been introduced in papers of Wehrli (1961), Marxhors (1966). Tanzer (1968). Lombardi (1973). ESTHETIC ASPECT: Important names in the field of dental esthetics are: Schn and Singer (1961), Arnheim (1965), Krajicek (1969), Tanzer (1968), Lombardi (1973), Goldstein (1976). They have introduced principes of visual aspects for selection of contours, dimension and position of artificial anterior teeth. CONSTITUTION ASPECT: Flagg (1880), Williams (1913) and Hrauf (1957, 1958), have considered body constitution and individual characteristics regarding position of artifical anterior teeth. PHYSIOLOGICAL THEORY: In 1971, Maxhors pointed to the fact that the position of artificial teeth corresponds with the function of the surrounding soft tissue and from the aspect of physiognomy as well. PHONETIC ASPECT: According to Silverman (1962) artificial anterior teeth are nearest when we pronounce the sound "S". CEPHALOMETRICAL RESEARCH: Rayson (1970), Watson (1989), Strajnic Lj. (1999), Bassi F. (2001) have presented cephalometric radiographic analyses of natural anterior teeth compared with cephalometric radiographic analyses of artificial anterior teeth. A review of dental literature shows several factors suggesting modalities which should determine the position of artificial anterior teeth. Numerous methods have been designed for evaluation of the position of artificial anterior teeth. However, there is no universally reliable method regarding determination of the position of artificial anterior teeth.