Bingham, Marc Philip
The selection of artificial anterior teeth appropriate for the age and gender of the complete denture wearer. A study into the variation of choices made by general dental practitioners, final year dental students and fine art students.
MSc(R) thesis, University of Glasgow.
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An historical overview of the methods used to aid artificial tooth selection was undertaken. This showed that no universally reliable method has been found for determining tooth form. It also revealed that the aesthetic outcome of complete denture construction has received little attention in the dental literature, although some surveys have focused on the perception of aesthetic dentistry in relation to dentures (Brisman, 1980; McCord et al., 1994; Hyde et al., 1999).
Sellen et al. (2001, 2002) carried out two studies to assess the ability of dental undergraduates and dental school staff to choose appropriate artificial teeth when prescribing complete dentures. From these studies it was concluded that there was a need for improved training and guidance on artificial tooth selection and arrangement.
The studies of Sellen et al. (2001, 2002) have been the springboard for this particular study to assess the variation of choice made by general dental practitioners, final year dental students and fine art students when it comes to choosing appropriate artificial teeth for the age and gender of the denture wearer.
Aims and objectives
Central to the study was to determine if any significant differences, in choices made, exist between the three groups of participants. It was also important to determine if any significant preferences exist when different moulds and arrangements of teeth were considered for different age groups and genders of individuals. Finally, determining if an obvious need for improved training and guidance, in this area of dentistry, was needed.
Methods and materials
Photographs of six subjects representing youth, middle age and old age for both genders were produced for the study along with two three-dimensional aesthetic guides. Using the guides, 40 general dental practitioners, 40 final year dental students and 40 fine art students were each asked to select the teeth that they would use to construct a denture for the subjects detailed in the photographs.
Data analysis showed that there were no relevant, significant differences in tooth or arrangement choice between the three groups.
Similar trends in tooth and arrangement choice were shown when testing for significance within the individual groups. There was a highly significant association for all three groups between the subject and tooth size, with a tendency to choose large teeth for males and smaller teeth for females. There was also a highly significant association for all three groups between the age of the subjects and the age arrangement, with a tendency to choose arrangements indicative of youth for young subjects and arrangements indicative of old age for old subjects.
No significant associations were found within the groups surveyed when choosing a tooth shape or gender arrangement.
Certain trends within all three groups of participants, with regards tooth size and age arrangement, may suggest that an obvious training need does not exist.
Inconsistent choices with regards gender arrangement and tooth shape may be as a result of factors which are too subtle to perceive and not necessarily because of inadequate training. Subsequently, it may be argued that, tooth shape and gender arrangement are less important than other aesthetic factors.
The idea that a reliable method of selecting artificial anterior teeth exists has lessened as this study has progressed and with it the idea of providing specific training in this area of dentistry.
Making assumptions about what may exist in the natural dentition and rigidly trying to impose this in a clinical setting may increase the likelihood of failure. Attempting to instil a strong perception of an individualised approach to denture construction may make the process more difficult if patient perceptions are generally different.
Building an understanding of the methods used for tooth selection over the years can help provide dentists with a starting point and allow them to develop their own selection methods in combination with patients’ preferences.
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