The Restoration of the Face and a Method of Taking Measurements before the Removal of the Natural Teeth

Abstract

T HE phrase “restoration of the face” does not here mean restoration after wounds and fractures, but restora­ tion of the face by artificial teeth after the removal of the natural teeth from pyorrhea or other cause. The restora­ tion of the face is perhaps one of the most important services, from an esthetic point of view, that the dentist has to offer. In his hands lies the power to improve or mar the face; the restoration to the patient of some family characteristic. The setting up of artificial teeth is only too often a matter of chance, and if fair mastication and articulation is obtained, the dentist is satisfied. But facial restora­ tion is left to chance; the result leaves much to be desired from an artistic point of view, and, with proper care, could be greatly improved. The setting of the natural teeth of the patient is often forgotten or ignored. In the lower dentures, often insufficient room is al­ lowed for the lower front teeth and therefore dentures are unsteady. The models of natural teeth shown illustrate this point. *Read before the Section on M axillofacial Surgery and Surgical Prosthesis, at the Seventh International Dental Congress, Phila­ delphia, Pa., A ug. 24-, 1926. Jour. A .D .A ., July, 1927 In endeavoring to restore the face to its original lines, the following pro­ cedure is adopted: Before any teeth are extracted, a model of the patient’s face is taken in plaster, the patient keeping the teeth closed. The plaster is tinted so that, in removing the mask from the cast, the difference between the mask and cast can easily be defined. The face is lightly covered with petrolatum. Small paper tubes are placed in the nostrils to permit breathing. Thin plaster is now run on the face, the mask following just below the orbit taking in the malar region, the mouth and chin. A strip of one-half inch bandage is embedded in the plaster to allow easy removal of the mask. As soon as the plaster is set, it is removed from the face, washed out with “Hudson’s” soap to allow of easy separation from the cast, and, as soon as sufficiently hard, separated. We now have a model from which we can take measurements and one that gives the accurate height of the bite, the natural droop of the mouth and the fulness of the lips and cheeks. Impressions of the natural teeth are now taken, before any teeth are re­ moved.