The relationship of the pulp chamber to the external surface of the tooth.
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The definition of the crown-to-root ratio, its manifestation as a clinical problem, and associated problems were reviewed. Treatment possibilities were discussed in terms of plaque control, periodontal surgery, occlusal adjustment by selective grinding, splinting, restorative considerations, and extraction. The original guidelines for crown-to-root ratio in the selection of abutments were found to be exceptionally conservative and treatment limiting. New treatment modalities were considered in light of increased understanding of periodontal inflammation and its control. With inflammation controlled and with a carefully designed occlusion, some degree of mobility may be tolerated, thereby permitting the retention of teeth with minimal alveolar support.
The outline forms of both maxillary central incisor teeth were compared with the "actual" and "apparent" face-forms in 70 subjects, to determine whether a close similarity of face-forms and tooth forms exists, which would support the "law of harmony" method for the selection of replacement of teeth. The results of the investigation do not support the contention of Williams but rather invalidate this method of teeth selection because more than two-thirds of the individuals showed no similarity between face-form and incisor tooth form.
The evaluation of the collated results demonstrated that 86% to 90% of the subjects examined did not have identical dimensions or form of the left and right maxillary central incisors. In over 60% of these subjects the differences were quite substantial.
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A investigation of 64 Angle Class I, skeletal Class I dental students showed that the interalar nasal width is a reliable guide for selecting the mold of anterior teeth, and that the incisive papilla provides a stable anatomic landmark for arranging the labial surfaces of the central incisors at 10 mm anterior to the posterior border of the papilla. The mesiodistal width of the set of anterior teeth (four incisor and the mesial halves of the canines) should be determined by adding 7 mm to the patient's nasal width (Fig. 8). The tips of canines on the horizontal plane, should be set on a line which passes through the posterior border of the incisive papilla (Fig. 9). The distance between them should equal the patient's nasal width, so that from the frontal view they would each seem to lie on a perpendicular line drawn from each of ala of the nose (Fig. 6).
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Three methods were used to obtain a ratio of the maxillary to the mandibular anterior teeth, with results of 1.29, 1.30, and 1.31. It can be concluded that a ratio of 1.30 is sufficient to determine the approximate width of the six maxillary anterior teeth when given the size of the mandibular natural anterior teeth. This ratio should be valid to select a maxillary denture mold of sufficient width mesiodistally to obtain a Class I canine relationship. However, the ratio may need a slight adjustment to compensate for the intentional disocclusion of the maxillary denture teeth with the natural mandibular teeth. In Fig. 1 the canine to canine measurement of the mandibular anterior teeth was 35 mm; when multiplied by a factor of 1.30, a maxillary measurement of 45.5 mm is obtained. The denture teeth were to be set with approximately 1 mm of horizontal overjet and 1 mm of vertical overlap (Fig. 2), therefore a slightly larger mold of 48.5 mm was chosen (Fig. 3). This maxillary mold produced a Class I canine relationship (Fig. 4). The 48.5 mm ratio of the chosen maxillary mold to the mandibular measurement of 35 mm yielded a ratio of 1.38. When this ratio of 1.38 is applied, the desired prosthetic mold is not always available. There is a range of acceptability above and below the desired ratio.(ABSTRACT TRUNCATED AT 250 WORDS)
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The average width of a natural maxillary central incisor is 8.92 mm. This value is determined from the results of three studies of natural dentitions. The average width of a mandibular central incisor is 5.5 mm. The average ratio produced by dividing the average maxillary central incisor width by the average mandibular incisor width is 1.62. The factor of 1.5 times the width of a mandibular central incisor produces a maxillary central incisor width that is too narrow. The width of a mandibular central incisor plus half the width of the mandibular lateral incisor also produces a maxillary central incisor width that is too narrow. There may be a tendency to undersize the maxillary prosthetic dentition. The ratio of 1.62 can be used to select the appropriate width for a missing maxillary central incisor when given the width of the mandibular central incisor. This ratio of 1.62 is also valuable to verify the dimension of a selected artificial maxillary central incisor when the patient complains that the tooth is too large. If substitutions or adjustments are made in the mold, the desired canine-to-canine measurement produced by the ratio range of 1.3 to 1.38 reported in Parts I and II of this study should be maintained.
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Impressions were made from the anterior segment of the mouth in 25 subjects with their teeth in centric occlusion. Measurements were made on each impression to determine the relation of the maxillary and mandibular vestibular folds and of the anterior teeth to the maxillary and mandibular mucolabial reflections. The mean distance between the depth of the mucolabial reflections in the canine region was 36.70 mm for the right side and 36.94 mm for the left side. The mean distances for the right and left central incisor regions were 34.20 mm and 34.06 mm. The variations in the measurements of different teeth confirmed the anatomic individuality of each patient. Nevertheless, the findings of this study will be helpful as guides in the initial placement of the maxillary and mandibular anterior teeth and in the initial determination of the vertical dimension of occlusion.
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Photographic data revealed that in natural teeth, straight emergence profiles are the norm. Since one objective of restoration design is to accurately replace missing tooth structure by using reliable anatomic model, reproduction of the appropriate emergence profile is essential.
Fracture of cusps on posterior teeth, especially those carious or restored, is a major cause of tooth loss, Nonfunctional cusps fracture more often than the functional; mandibular cusps fracture more often than maxillary cusps. This study examined functional and nonfunctional cusps of the maxillary and mandibular posterior teeth in four different parameters; (1) buccolingual width, (2) angle of cuspal inclination, (3) thickness of enamel, and (4) angle of inclination of the dentinoenamel junction. Measurements of functional cusps, except those in maxillary premolars established differences that may explain the frequency of frequency of fracture. These parameters of functional and nonfunctional cusps suggest that the cuspal anatomy has a relationship to the fracture potential of cusps.