Incisive Papilla Line as a Guide to Predict Maxillary Anterior Tooth Display

Abstract

Oh and Hansen Oh and Hansen Maxillary anterior tooth display should be predicted and controlled for an esthetic outcome in an edentulous patient.1 The customary prosthodontic procedure requires an occlusion wax rim to be contoured for adequate lip support and occlusal vertical dimension determination.2 The lip line is marked on the rim when the patient is in the full smile to determine the amount of tooth display and guide the selection of the artificial denture teeth. However, the smile line is dynamic, and the degree of anterior tooth display will vary depending on gender, race, lip fullness, age, and upper lip length.3,4 The upper lip length is measured from the base of the columela to the tip of the philtrum to aid in the selection and positioning of the anterior teeth.3 In general, the longer the upper lip, the less the maxillary teeth are visible, and vice versa. However, the lip length as measured according to the facial morphology may not always provide an accurate estimation of the relative amount of tooth display, both at rest and in the full smile, because of a large variability in maxillary lip line relative to the incisal edge position.3,4 The incisive papilla remains relatively constant in both vertical and horizontal locations, except when combined with excessive resorption of alveolar bone, and is frequently used as an anatomic landmark in arranging maxillary anterior teeth.2,5-7 The mean vertical distance between the incisive papilla and the incisal edges of maxIncisive papilla line as a guide to predict maxillary anterior tooth display