Quantitative assessment of papillary proportions of the maxillary anterior dentition in the south Indian population.

Abstract

Gingival visibility, morphology and contour play a predominant role in creating a beautiful smile. They are the principal aesthetic objectives established in the phase of treatment planning during reconstruction in the anterior aesthetic zone and they vary significantly based on the study   population.  The objective of this study is to quantify clinical parameters that are useful as aesthetic guidelines when the gingival contour is modified for aesthetic purposes. Understanding and establishing the variations in these anatomical landmarks is an essential factor to create a predictable aesthetic smile in the course of anterior teeth oral rehabilitation and hence this study was undertaken to quantify mesial and distal papillary proportions in relation to clinical crown length.  Maxillary alginate impressions of 105 subjects were made and poured with Type III dental stone. The mesial and distal interdental papillary heights were noted on the impression casts and divided by the clinical crown length to determine mesial and distal papilla proportion for each maxillary anterior tooth. Interdental papillary heights of maxillary anterior teeth were determined from the gingival   zenith along with crown lengths. Percentages of papilla heights to the crown lengths were assessed and described as papilla proportions. The Mesial Papilla Proportion (MPP) and Distal Papilla Proportion (DPP) were noted for the 6 maxillary anterior teeth. The average MPP and DPP of the central incisors (CI), lateral incisors (LI) and canine (CA) measured were 45.51%, 44.83%, 45.64%,47%,43.24% and 47.08% respectively. The results showed significance in the mesial and distal papillary proportions in the left maxillary canine (p< 0.05). The central incisors showed significant difference in mesial and distal papilla proportion, whereas canines showed an increased distal papillary height.  it was ascertained that amongst the maxillary anterior teeth, the maxillary central incisor registered a significant difference in mesial and distal papilla proportions which might be  determined by the papillary heights whereas the maxillary canines showed a progression of increased distal papillary heights with the left maxillary canine showing significant difference in the MPP and DPP.