Objectives: To evaluate the typical appearance of natural anterior teeth in young and elderly people and to develop guidelines for the natural appearance of dentures.
Design: Clinical examination and photography. Inclusion criteria were a dental state with natural anterior teeth and no more than two crowns.
Subjects: A study group (SG) consisting of 64 patients ranging in age from 60 to 86 years (67.3 +/- 5.8) and a control group (CG) composed of 64 dental students aged 21-33 years (25.8 +/- 2.4).
Setting: Dental schools of the Johannes-Gutenberg-University Mainz and the University of Leipzig.
Results: Most participants were content with the appearance of their own natural teeth. With relaxed lips a mean of 1.5 (+/-0.19) mm of upper incisors and 1.6 (+/-0.19) mm of lower incisors were visible in the SG compared with 2.5 (+/-0.16) and 0.4 (+/-0.07) mm in the CG, respectively. The subjects in the SG showed a greater diversity in position of teeth in the anterior arch and this was more often with incisors than with canines. Features such as stains, cracks and defects were much more noticeable in the SG. An inter-dental 'black triangle' seemed to be a typical feature of an aged dental appearance.
Conclusion: The majority of people older than 60 years who still have their own natural anterior teeth would not wish for a change in appearance if they needed a prosthodontic reconstruction. Thus techniques for customisation should be promoted to obtain a natural appearance in dentures.