Evaluation of the utility of cephalometric parameters in constructing complete denture. Part II: placement of anterior teeth F. BASSI, A. RIZZATTI, G. SCHIERANO & G. PRETI Dental School, Department of Prosthodontics, University of Turin, Corso Dogliotti 14, 10126 Turin, Italy SUMMARY SUMMARY Various types of parameters, including cephalometric ones, have been used in the construc- tion of complete denture. This study aimed to evaluate the utility of cephalometric parameters for this purpose. The position of the anterior teeth in a group of 42 edentulous patients, successfully rehabilitated with complete denture according to clinical parameters, was evaluated by cephalomet- rics following the Ricketts' design. Data obtained were then compared statistically with those repor- ted by Ricketts for dentate subjects, the position of the maxillary incisors was slightly anterior. Introduction One of the aims of prosthetic rehabilitation is to restore accurate phonation and dentofacial harmony. The incisors and canines take on a fundamental role in ful®lling these functions. Everyday each person experi- ences the importance of these teeth in speaking and smiling (Martone, 1963; Pound, 1977b). Prosthetic dentistry has always tried to ®nd a method capable of establishing the correct position of the anterior teeth in an edentulous arch. The existence of varied techniques is proof of the lack of a single secure method. Pound (1962, 1977a,b, 1978) proposed a preliminary aesthetic evaluation during ®tting of the wax model. The maxillary rim must adequately support the upper lip and extend about 0á5±1 mm below the lip (Sears, 1938; Mombelli & Geering, 1982) in the semi-open position. Silverman (1967) recommends that the initial phase of phonetic control is also performed with the wax model, asking the patient to pronounce some words with the consonant `s' (e.g. `Mississippi' or `66'). According to Robinson (1969 2 ), in the pronunciation of the labio-dentals `f' and `v', the margin of the maxillary incisor should brush against the edge of the lower lip. The position of the maxillary incisors on the maxillary sagittal plane may thus be veri®ed. On the other hand, Pound (1962, 1977b) stresses the importance of the accurate positioning of the mandibular incisors in both supporting the lip and achieving correct phonation. The clinical method, which follows aesthetic and phonetic parameters, is currently the most commonly used. Although these two procedures combined are both valid and simple to apply, the dental literature contains many reports of research aimed at determining meth- ods with greater precision and reliability. With this in mind, researchers in the ®eld of orthognathodontics have developed cephalometric measurements in the analysis of cranial teleradiography in adult dentate patients. Tweed (1946, 1954) was the ®rst to deal with this problem, by estimating the position of the mandibular incisors through sections of plaster casts following the median sagittal plane. After the advent of teleradiogra- phy, he developed his cephalometric method, known as the diagnostic triangle. This work was followed by that of Margolis (1943), Ricketts (1956, 1960a,b) 3 who introduced different cephalometric methods to de®ne the anterior limit of the dentition. To that purpose, it is worth noting that almost all analysis starts from the position of the central lower incisor. There are many authors, like Holdway (1956), Downs (1956, 1971) who, with the aim of a pro®le estimation in particular, proposes repositioning the central maxillary incisor ®rst. ã 2001 Blackwell Science Ltd 349 Journal of Oral Rehabilitation 2001 28; 349±353