Effect of dental prosthesis on the facial appearance of elderly patient (Development of a esthetic evaluation system)

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In order to clarify the effect of prosthesis on the facial appearance of elderly patient, two kinds of esthetic evaluation tests were conducted. Faces of the complete denture wearers were photographed with a digital camera. The various images were processed with an image processing program. Twenty dentists and 20 dental students evaluated the images with "natural" and "old" appearance score.1. Test 1 was conducted to investigate the effects of different occlusal vertical dimensions (OVD) and labiolingual positions of article anterior teeth (LLP) on facial esthetic evaluation.(1) The changes of occlusal vertical dimensions of less than -3mm and more than 6 mm give the face an older appearance.(2) Displacement of the labiolingual position of artificial anterior teeth by 2mm or more in the lingual direction gives the face an unnatural and older appearance.(3) Displacement of the LLP by 2mm in the lingual direction does not confer an older appearance to the face in the frontal and lateral views when the occlusal vertical dimension is also increased.(4) Esthetic evaluation of the facial profile can be affected by the angle of photography.2. Test 2 was conducted to determine the esthetically acceptable range of deviation of the midline position and incisal inclination of complete dentures.(1) The variance in the results of esthetic evaluation was greater among dental students than among dentists.(2) Midline deviation within ±1.0mm is acceptable from the viewpoint of natural appearance.(3) Incisal inclination within ±1.5 degrees is acceptable from the viewpoint of natural appearance.(4) The imaginary line parallel to the denture midline drawn from the midpoint between the medial angles of the eyes seems be a useful indicator for determining the denture midline.