総義歯人工歯排列に関する解剖学的研究 : 前歯の歯列および歯肉形態

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  • Anatomical Study on the Tooth Arrangement for Complete Dentures : Frontal Natural Dentition and the Contour of Alveolar Ridge

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On the anterior teeth arrangement and placement for complete denture constructions, morphological features of the natural dentition are generally used for reference materials as in Payne's statement of "Set the dental teeth where natural teeth grew". In this study, fifty three subjects (male : 11, and female : 42, 18.7±2.9 years old) from five thousand three handred and seventy seven with the individual normal occlusion were selected according to Miyamura's standards, and were examined about the frontal natural dentition and the contour of alveolar ridge. The results obtained are as follows : 1. On the central incisors 1) In the frontal view : Only 5.4% of the subjects possesed the deviation of 0.0mm to 0.1mm between the frenulum of upper lip and the midline of both central incisors, but no subject above 1.1mm in the deviation was recognized. In the deviation between the midline of the maxillary and the mandibular central incisors, no deviation was 7.5%, and most was bellow 1.0mm, and in the midline of the central incisors and the frenulum of the lower lip, no deviation was 21.1% in all subjects. 2) In the horizontal view : The central incisors were located at 8.7±1.3mm anterior to the line bisecting the incisive papilla. 3) In the sagittal view : The inclination of maxillary central incisors to the prosthetic plane was 98.6±6.3°, and that of mandibular ones 93.7±5.2°. 2. On the canines : Coronal plane through the middle of the incisive papilla passed through 0.1±1.9mm posterior to the cusp of canines on the dentulous casts. 3. On the vertical difference of the upper six frontal teeth : As to the vertical positions of the lateral incisal edges and the canine cusps to the central incisal edge, in the lateral incisal edge it was located higher by 0.5±0.5mm than the central incisal edge, and in the canine cusp lower by 0.2±0.8mm. 4. On the occlusal relationships of the central incisors : The vertical overlap of the central incisors was 2.3±1.1mm, and the horizontal overlap 2.9±1.0mm, and high correlation was recognized between their occlusal relationships. 5. On the sagittal alveolar ridge and tooth contour at the mandibular central incisor portion : The horizontal distances from the cervical portions to the central incisal edge, and the most protrusion and the deepest undercut of alveolar ridge were 0.4±0.7mm, 0.0±0.3mm, and -2.2±1.0mm respectively. 6. On labial surfaces of both maxillary central incisors as viewed from the incisal edge : Subjects classified into the soft lateral type, the hard lateral type, and the straight type were about 35.8%, 24.5%, and 39.6% respectively. And among the female subjects, the hard lateral type was recognized in about 29%, a against only in about 9% in the male. On the basis of the foregoing findings, constructive observations were obtained for the complete denture construction with regard to providing patients' SPA factors and making functional denture contours harmonized with the surrounding tissues such as the muscles of orbicularis oris and mentalis, as seen in the labial surfaces of the mandibular anteriors and the alveolar ridge contour on the sagittal plane, and more as evidenced in the labial surfaces and arrangement of the maxillary central incisors on the occusal plane.

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