To correlate and associate maxillary arch width with combined width of maxillary anterior teeth in south Indian and Malaysian population

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Research Article To correlate and associate maxillary arch width with combined width of maxillary anterior teeth in south Indian and Malaysian population Ashish R.

1 Research Article To correlate and associate maxillary arch width with combined width of maxillary anterior teeth in south Indian and Malaysian population Ashish R. Jain* ABSTRACT Background: Arrangement of artificial teeth for completely edentulous has become a challenge due to esthetics concern. Most of the completely edentulous patients walk in without any records. Maxillary anterior teeth play an important role in esthetics, its with maxillary arch width can provide vital information on the selection of teeth for the different population group. Aim: The aim of the study was to correlate and associate maxillary arch width with a combined width of maxillary anterior teeth in Indian and Malaysian population. Materials and Methods: A total number of 36 people from 18 Indians and 18 Malaysians participated in this study. The maxillary anterior arch measurement is from distal contact of canine to another distal contact of canine taken using a measuring tape. The maxillary arch width is taken by measuring the distances between buccal cusps of first premolars, buccal cusps of second premolars, mesiobuccal cusps of first molars, and mesiobuccal cusps of second premolars using a Vernier caliper. The between maxillary arch width and width of maxillary anterior teeth in Indian and Malaysian population is determined using s coefficient. Results: The overall parameter of South Indian population has a greater dimension than Malaysian parameter simple. The South Indian maxillary anterior width has shown a significant in the maxillary anterior arch and interdental width of the first premolar, the interdental width of the second premolar, interdental width of the first molar and interdental width of the second molar in Malaysian. However, there is no shown in the maxillary anterior arch and interdental width in either first premolars, second premolars, first molars, and second molars in South Indian. Conclusion: The maxillary dental arch of South Indians is relatively greater than Malaysians. In addition, there is a significant in the maxillary anterior arch and maxillary interdental arch in Malaysian, but not in Indians. KEY WORDS: Anterior arch, Arch measurement, Correlation, Dental arches, Dental prosthesis, Interdental width, Maxillary arch, Palatal width INTRODUCTION In dentistry, complete dentures are the artificial prosthesis that acts to substitute for living tissues that have lost the dentition. [1] An ideal complete denture must restore the form of living tissues at its best as well as the functions such as phonation, mastication, and esthetics. [2] Teeth are required for proper speech, mastication, esthetics, structural balance, as well as comfort for patients. [3] Changes and deviation of the denture from the natural arches cause unsatisfactory rehabilitation and will result as loss of facial form and inadequate function of the artificial prosthesis. [4] The Access this article online Website: jprsolutions.info ISSN: natural size and shape of the dental arches undergo gradually changes after the teeth are lost. [5] After extraction usually there will be a considerable reduce amount of residual alveolar ridges. [6] Over advancing time, this may result in excess bone loss and flabby ridge formation. [7] Eventually this leads to a condition where the maxillary alveolar ridge is more palatal in relation to the mandibular alveolar ridge. This becomes complicated for the setting of artificial teeth for the denture because the neutral setting zone for the maxillary denture should be labial and buccal in relation to the mandibular dentition. [8] An ideal setting of teeth within its neutral zone produces harmonious function and rehabilitation with the remaining soft tissue as well as the residual alveolar ridge. [9] The width, width and depth of dental arches have certain implications Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India *Corresponding author: Dr. Ashish R. Jain, Department of Prosthodontics, Saveetha Dental College and Hospital, Saveetha University, Poonamallee High Road, Chennai , Tamil Nadu, India. Phone: dr.ashishjain_r@yahoo.com Received on: ; Revised on: ; Accepted on:

2 in diagnosis and treatment planning in dentistry. [10] Dental arches varies in not only during growth and developmental period but also in different ethnical background. [11] A few studies have reported that the differences have been influenced by environmental factors, nutrition, as well as ethnic variations, where the state of systemic, health and the uniqueness of individuals. [12] This population-based study will provide an essential data as a comparative analysis in different population of relevant racial differences and s. In clinical practice, patients are treated as individuals and not a segment of populations, it is also true that people of different racial and ethnic background present as a group of similar traits. [13] The current literature lacks data seen in the different ethnical background, especially among the Asians. [14] Different ethical backgrounds present a wide diversity of traits and characteristics, which is considered to be unique for each ethnic group. In a country such as India and Malaysia, due to the diversity of ethnic background, the populations tend to have distinct anthropological characteristics. [15] There have been only a few studies associated with arch dimensions to describe and analyze the dental arch of Malaysians. [15] None of the study made was done to compare with another dental arch dimensions of another race as well as different ethnicity. Hence, the aim of this study is to correlate and associate maxillary arch width with a combined width of maxillary anterior teeth in Indian and Malaysian population. MATERIALS AND METHODS A total number of 36 people aged between 17 and 60 years old were selected for this study. A consent letter was given as a notice of the study purpose which requires an impression of the maxillary arch to be made. The impression and measurement should be taken carefully as the process can be uncomfortable for the patient. The sample size was counted using the following formula; Sample Size = [z 2 *p(1-p)]/e 2 /1+[z 2 *p(1-p)]/e 2 *N] The sample size was arrived with nmaster software Version 2.0 by applying following details in the above formula: Table 1 shows the required number of sample size used for the study. The inclusion criteria of the subjects were as the following: Complete dentulous maxillary arch subject Complete maxillary dentate arch until second molars or third molars bilaterally Naturally good maxillary dentition or teeth alignment Males and females of South Indian and Malaysian population only Subject age ranges from 18 or older. The exclusion criteria of the subject were as the following: Restoration of any maxillary teeth; composite, amalgam, full veneer crown Extensive carious lesion or broken tooth, root stump Previously had orthodontic treatment or orthognathic surgery Crowding or spacing of the teeth Supernumerary teeth or dentition Presence of fusion of one or more teeth Poor oral hygiene or motivation. Procedure Each subject is seated in upright position, and the plane of the maxillary teeth is parallel to the floor. An appropriate size of the perforated dentulous maxillary tray was selected for taking an impression for each patient. The alginate hydrocolloid impression (Zhermack Tropicalgin, India) material was used to take the impression of each patient and study model of the cast was poured using Type 3 dental stone (Vinayak Gypsum, India) within 12 min after impression was taken. The measurement of the anterior maxillary arch is taken using a measuring tape from distal contact of canine to distal contact of another canine, in the unit of millimeters (mm), as shown in Figure 1. The interdental palatal width measurement was taken using an electronic Vernier caliper (150 mm 6-inch with Display Screen) from buccal cusps of left first premolar to right first premolar, left second premolar to right second premolar, left first molar to right first molar, and left second premolar to right second molar, in millimeters (mm) were done in both Indian and Malaysian study models, as shown in Figure 2. The recorded data were analyzed using Statistical Package for the Social Sciences (SPSS) applications Table 1: The required number of sample size used for the study Single proportion absolute precision finite population correction Expected proportion 0.5 Precision (%) 15 Desired confidence level (1 alpha) % 95 Population size 200 Required sample size

to correlate them and associate with the maxillary arch width with a combined width of maxillary anterior teeth in Indian and Malaysian population.

Figure 1: The measurement of maxillary anterior arch from canine to canine Figure 2: The measurement of maxillary interdental width RESULTS Figure 3 shows the South Indian maxillary anterior arch

Interpremolar width between the buccal cusps of first premolars shows no significant difference.

3 to correlate them and associate with the maxillary arch width with a combined width of maxillary anterior teeth in Indian and Malaysian population. Based on measurements taken, the mean, minimum value, maximum value, standard deviation, and significant figures are obtained. Figure 1: The measurement of maxillary anterior arch from canine to canine Figure 2: The measurement of maxillary interdental width RESULTS Figure 3 shows the South Indian maxillary anterior arch from distal contact of canine to another distal contact of canine is greater than the maxillary anterior arch of Malaysians. Interpremolar width between the buccal cusps of first premolars shows no significant difference. The interpremolar width between the buccal cusps of second premolars also shows no significant difference between the South Indians and Malaysians samples, but the second premolar width shows with the maxillary anterior arch, respectively, in both populations. The intermolar width measured from mesiobuccal cusp of maxillary first molar to the maxillary first molar on the opposite arch shows a greater value in South Indians when compared to the Malaysians. The same results for the intermolar width of the second premolars measured from left mesiobuccal cusps to the right mesiobuccal cusp of corresponding second molar, in both populations. Table 2 shows the between maxillary anterior arch from canine to canine (I CC1 for South Indians and M CC1 for Malaysians) with interdental width of first premolars (I PP1 South Indians and M PP1 for Malaysians), interdental width of second premolars (I PP2 for South Indians and M PP2 for Malaysians), interdental width of first molars (I MM1 for South Indians and M MM1 for Malaysians), and interdental width of second molars (I MM2 for South Indians and M MM2 for Malaysians). Based on the, the maxillary anterior arch measured from distal contact of canine to another canine has with the interpremolar between first premolars, interpremolar between second premolars, intermolar between first molars, and intermolar between second molars, in both populations. Significant is only seen between maxillary anterior arch and interpremolar between first premolars, interpremolar between second premolars, intermolar between first molars, and intermolar between second molars in Malaysian population. DISCUSSION Figure 3: The mean of each parameter between South Indian and Malaysian samples In general, in this study, it is shown that the mean values of the measurements taken of the maxillary dental arch in South Indian population are higher than the dental arch of Malaysian population. This corresponds with the accepted view of Indians have large maxillary dental arch. On average, it means the Indians have significantly larger arch width than Malaysians. Along with this outcome, there are also differences in shape of proportionality and the most prominent measured landmark is in the canine- 823

4 Table 2: Intraarch of dental arch dimensions Correlation variables I CC1 I CC1 M CC1 I PP1 M PP1 I PP2 M PP2 I MM1 M MM1 I MM2 M MM ** ** ** 0.550* 0.651** 0.569* 0.642** Sig. (2 tailed) M CC ** ** ** ** ** Sig. (2 tailed) I PP ** ** ** Sig. (2 tailed) M PP ** 0.883** ** 0.483* 0.753** 0.473* 0.960** Sig. (2 tailed) I PP ** ** ** Sig. (2 tailed) M PP ** 0.755** ** ** ** Sig. (2 tailed) I MM * ** 0.483* 0.728** * 0.911** 0.491* Sig. (2 tailed) M MM ** 0.731** ** ** 0.584* * 0.834** Sig. (2 tailed) I MM * ** 0.473* 0.825** ** 0.483* Sig. (2 tailed) M MM ** 0.877** ** ** 0.491* 0.834** Sig. (2 tailed) *Correlation is significant at the 0.05 level (2 tailed), **Correlation is significant at the 0.01 level (2 tailed) premolar region. [16] The buccal cusps from canine to premolar region shows a definite convex in Indians, while the canine-premolar region is more straight in Malaysians. These dimensions show variations in mesiodistal dental arch width. In the present study, using the result shows there is in maxillary anterior arch and interpalatal width in both populations correspondingly. In tooth selection for edentulous patients, the anterior and posterior teeth should be arranged in its natural position in relation to the lips and alveolar arch to achieve its harmonious relationship. [17] The basic anatomy of the arch is fashioned according to the natural alveolar ridge and contours. [18] The between maxillary anterior arch and posterior arch should give an idea of shape and form of the arch to the dentist to prepare the denture for the patient. However, shade selection for edentulous patients can be chosen by comparing the age, sex, skin color, and sclera of the eye. [19] Various studies have been conducted to show variety interdental canine width. The size and shape of dental arches are governed by several influencing factors including the size and shape of the jaws and influence of musculature. [20] The denture size or arch 824

5 can be used as a base for further studies as age and sex determination. [21] There are various studies conducted to determine the relation of the maxillary anterior arch that exists with maxillary arch width indices in North Indian population showing s coefficient of r = with poor of p= Even so, the result obtained in present study disagrees with the results obtained for Kashmiri population showing s coefficient of r = with P < [22] and the Egyptian population showing r = with P < [23] In view from the result in this study, environmental is likely to be one of the influencing factor; genetic factors appear to be important in the difference of dental arch dimension between the populations. [20] There are some limitations applied to similar studies. Some technical problems may reduce or minimize the accuracy result of the study. The problem may raise concerns on the reliability of the results obtained. On the other hand, the selected subjects may appear normal after the event of trauma, and mild alterations might not be able to be appreciated. The study did not restrict the subjects into gender and age range categories which present the oral anatomy such as size, contour of alveolar ridge, and dimensions of the arch differently. CONCLUSION Knowledge of the standards for the dental arch dimensions in human population is of great value to the clinicians in different fields of dentistry as prosthodontics, orthodontics, and orthognathic surgery. The maxillary dental arch of South Indians is relatively greater than Malaysians. In addition, there is a significant in the maxillary anterior arch and maxillary interdental arch in Malaysian; however, it is not significant in South Indian sample. REFERENCES 1. Shigli K, Hebbal M. Does prosthodontic rehabilitation change the eating patterns among completely edentulous patients? Gerodontology 2012;29: Al-Dulayme DA. 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J Prosthet Dent 1973;29: Slaviero T, Fernandes TM, Oltramari-Navarro PV, de Castro AC, Conti F, Poleti ML, et al. Dimensional changes of dental arches produced by fixed and removable palatal cribs: A prospective, randomized, controlled study. Angle Orthod 2017;87: Al-Qudaimi NH. Evaluation of the occlusion and maxillary dental arch dimensions in the mixed dentitions of yemeni population. Am J Health Res 2015;3: Jain M, Mathur A, Kumar S, Dagli RJ, Duraiswamy P, Kulkarni S, et al. Dentition status and treatment needs among children with impaired hearing attending a special school for the deaf and mute in udaipur, india. J Oral Sci 2008;50: Lasker GW. Genetic analysis of racial traits of the teeth. Cold Spring Harb Symp Quant Biol 1950;15: Al-Khatib A, Rajion Z, Masudi S, Hassan R, Anderson P, Townsend G. Tooth size and dental arch dimensions: A stereophotogrammetric study in Southeast Asian Malays. Orthod Craniofac Res 2011;14: Nizam A, Naing L, Mokhtar N. 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The relationship between innercanthal dimension and interalar width to the intercanine width of maxillary anterior teeth in central Indian population. J Indian Prosthod Soc 2015;15: Fouda SM, Al-Attar MS, Virtanen JI, Raustia A. Effect of patient s personality on satisfaction with their present complete denture and after increasing the occlusal vertical dimension: A study of edentulous Egyptian patients. Int J Dent 2014;2014:1-7. Source of support: Nil; Conflict of interest: None Declared 825

Clinical measurements of the dimensions of the dental arches and its application on construction of dental prosthesis

ISSN: 1812 1217 Dimensions of dental arches and its application on dental prosthesis construction Clinical measurements of the dimensions of the dental arches and its application on construction of dental