Correlation between patient satisfaction and the location of incisive papilla as a guide to anterior tooth position on maxillary complete denture

Clinical evaluation of maxillary complete denture esthetics is subjective for both patient and clinician. There are several factors affecting patient’s satisfaction with maxillary complete denture such as maxillary central incisor (MCI) position, lip support, and phonation. The upper lip support esthetics are determined by properly placed MCI from the occlusion rim and the labial flange of denture base. In most cases, clinicians use the generalized horizontal guideline of 8-10 mm to locate the preliminary position of MCI for complete denture. However, this guideline is based on the biometric analysis of the incisive papilla (IP) and MCI in the dentate population or measurements from immediate complete dentures.

This study aimed to assess the relationships among the horizontal and vertical measures between the center of the IP and the MCI, to the patient’s satisfaction with the final prosthesis. .

Our study suggests that the previous studied horizontal value of 8-10 mm for dentate population may not provide an effective guideline to edentulous population especially for those who has severely resorbed ridge morphology of maxilla (the highest Prosthodontic Diagnostic Index system, PDI IV, on complete edentulism.) The clinical evaluation of complete denture on lip support, esthetics, and phonation is extremely subjective, especially by patients. Therefore, it is imperative for clinicians to understand the differences between dentate and edentulous populations before adapting previously studied general guideline of denture tooth set-up.