Introduction
Facial esthetics and beauty components play an inevitable role in modern era of dental practice. With the rising broad-spectrum awareness, voluminous children are becoming conscious of their looks and appearance. Any early loss of deciduous anterior teeth or permanent tooth also has a psychological impact along with physical trauma on many children. Anterior teeth form an invincible component of one’s smile and its loss can have a definite impact on child personality and confidence. Therefore, exact rehabilitation of child anterior segment should be the primacy of Pediatric dentist. Varied biometric guidelines are accessible in dental works to use as a guide for selecting the characteristics like size and shape of anterior teeth; intercommisural width and combined mesiodistal width of the anterior teeth are one of them. The inter-commissural width measures the distance of corners of the mouth. Combined mesiodistal width of the anterior teeth is the measured by adding the mesio-distal measurement of all anterior teeth from incisors to canine individually. These parameters are used in prosthetic treatment, oral rehabilitation treatment and in many dental procedures like orthodontics and as a forensic tool. 1, 2, 3, 4
This study evaluates the association between intercommisural width, combined mesiodistal width of the maxillary and mandibular anterior teeth, its site variation with gender in school going children of Ranchi city.
Materials and Methods
This pilot study was carried out in school going children of a government school in Ranchi city of Jharkhand. This research was performed before a large scale research intended to be carried out in Department of Pediatric and Preventive Dentistry, Hazaribag College of Dental Sciences & Hospital, Hazaribag. The research was approved from the Institutional Ethical Committee of H.C.D.S.H, Hazaribag, which is affiliated to Vinoba Bhave University of Hazaribag, Jharkhand, India. A total number of 32 children aged 12 to 15 years were selected for the study. The children were randomly selected using lottery method out of 50 school students fulfilling inclusion criteria. The written consent of the parents/guardians was taken as an obligatory document.
Determination of inter- commisural width
The participants were comfortably seated on a dental chair in an upright position and were asked to widely open and close the mouth to allow fatigue of the muscles to relax during the measurement. In addendum to this, subjects were not allowed to smile to avoid the changes in shape of the commissure. The lip vermilion was measured between left and right commissure of mouth using metallic scale (Figure 1) and parameters was measured and recorded in millimetres in the study performa.
Determination of combined mesiodistal width of the anterior teeth
The impressions of the selected subjects were made with an irreversible hydrocolloid impression material and poured into a type III dental stone. The mesiodistal width of the each maxillary and mandibular anterior tooth was measured respectively from the casts with the digital vernier caliper. The combined mesiodistal width of the anterior teeth is the measured by adding the mesio-distal measurement of all anterior teeth from incisors to canine individually. Also, segment wise combination of mesio-distal measurement of right central incisor, right lateral incisor and right canine was done and same was followed for the left side respectively.
Results
Data collected was tabulated and Statistical analysis was performed in SPSS software version 20.0 Descriptive statistics were calculated (mean and standard deviation) and also tabular presentation was done. For inferential statistics, Pearson’s correlation coefficient was applied to find out significant co-relation between the groups. P value <0.05 was considered to be significant.
Table 1
Comparison ofInter-commissural width of Females with Males after applying Un-paired ‘t’ test
|
|
Inter-commissural width in cm (Mean ± S.D.) |
|
p value |
|
Female |
5.02 ± 0.36 |
-1.68 |
0.102 (>0.05) Not Significant |
|
Male |
5.21 ± 0.25 |
Table 2
Comparison of maxillary and mandibular CombinedMesiodistal Width of anterior teeth of Females with Males after applying Un-paired ‘t’ test
Table 3
Correlationof maxillary Combined Mesiodistal width of anterior teeth with Inter-commissural width according to sex
Table 4
Correlation of Mandibular CombinedMesiodistal width of anterior teeth with Inter-commissural width according to sex
Table 5
Comparison of Mesiodistal width of right maxillary anterior half with left maxillary anterior half after applying Paired ‘t’ test according to sex
Table 6
Comparison of Mesiodistal width of right mandibular anterior half with left mandibular anterior half after applying Paired ‘t’ test according to sex
The mean Inter-commissural width in Males (5.21 ± 0.25 cm) is more than females (5.02 ± 0.36cm) (Table 1). In maxillary arch, the combined mesiodistal width of anterior teeth in Males (4.765±0.64 cm) is significantly more than females (4.492±0.26 cm), whereas females showed non-significantly more combined mesiodistal width of anterior teeth in mandible when compared to males (Table 2). When Inter-commissural width was co-related to combined mesiodistal width, it was inferred that a significant positive co-relation exists in maxillary arch for females and in mandibular arch for males (Table 3, Table 4). When Mesiodistal width of Right maxillary anterior half were compared with left maxillary anterior half, it was inferred that right segment width is more than left segment width for males and females and significant results were noticed for females (Table 5). When Mesiodistal width of Right mandibular anterior half were compared with left mandibular anterior half, it was inferred that right segment width (1.898±0.237 cm) is significantly more than left segment width (1.819±0.154 cm) in females and left segment width (1.815±0.50 cm ) is significantly more than right segment width (1.797±0.32 cm) in males (Table 6).
Discussion
In the present study, the mean inter-commissural width was greater than the mean combined mesiodistal width of anterior teeth measured in both the genders respectively. This finding was similar to the findings of Stephan CN, 5, 6 in which the inter-commissural width differed significantly from the Inter canine width.
Findings in males
The mean Inter-commissural width in Males is more than females as similarly noted previously by Kurien A. 7 In maxillary arch, the combined mesiodistal width of anterior teeth in Males is significantly more when compared to females. Our findings are in line with a study by H X Yang et al, 8 where 300 students from medical university were studied for maxillary anterior teeth width and males had more mesio-distal width than females. When Inter-commissural width was co-related to combined mesiodistal width, it was inferred that a significant positive co-relation exists in mandibular arch for males as previously studied by Scandrett, F. R 9 where a significant correlation was determined between six anterior teeth width and Intercommisural width. When Mesiodistal width of Right maxillary anterior half were compared with left maxillary anterior half, it was inferred that right segment width is more than left segment width for males. When Mesiodistal width of Right mandibular anterior half were compared with left mandibular anterior half, it was inferred that left segment width is significantly more than right segment width in males.
Findings in females
The mean Inter-commissural width in females is less than males. In maxillary arch, the combined mesiodistal width of anterior teeth in females is significantly less when compared to males. When Inter-commissural width was co-related to combined mesiodistal width, it was inferred that a significant positive co-relation exists in mandibular arch for females. When Mesiodistal width of Right maxillary anterior half were compared with left maxillary anterior half, it was inferred that right segment width is more than left segment width for females. When Mesiodistal width of Right mandibular anterior half were compared with left mandibular anterior half, it was inferred that right segment width is significantly more than left segment width in females.
