Relationship of Complete Denture Maxillary Incisors to the Incisive Papilla

Objective: This study investigated the relationship of the maxillary central incisors to the incisive papilla in patients wearing complete dentures. Methods: Occlusal views of 120 maxillary casts of fully dentate subjects were recorded with digital photography. Using image analyser software (Leica Qwin Lite Vers. 2, Leica Microsystems Imaging Solutions, Cambridge, U.K.) the computer images were used to determine the distance of the labial surfaces of the maxillary central incisors to i). the midpoint of the incisive papilla (MIP) and ii). a line joining the tips of the maxillary canines (IC). Maxillary complete dentures of 31 patients who requested replacement dentures were examined. The position of the labial surface of the maxillary central incisor teeth on the dentures in relation to the midpoint of the incisive papilla (CIP) was determined using the Alma denture gauge (Asden Limited, Cheshire, U.K.). Results: The mean incisor to the MIP distance was 9.59 ± 1.01 mm while the mean incisor to IC distance was 9.18 ± 1.09 mm. Only in 33% of the subjects did the IC pass through the MIP. In 55% of the subjects, IC was 1.30 ± 0.78 mm. anterior to the MIP, while in the remaining subjects, IC was 1.01 ± 0.59 mm posterior to MIP. The mean CIP distance in the complete denture subjects was 6.34 ± 1.87 mm. In 55% of the complete denture patients, the maxillary central incisors were set at approximately 6 mm or less to the MIP. Conclusion: In the sample studied, the anterior teeth in complete dentures may not replicate the position of the natural anterior teeth as they were generally set at least 3 mm closer to the incisive papilla.