Dimensions of the denture: back to basics

The three dimensions of the denture, height, width, and length, allow tooth movements in six directions. The limitation of the tooth movements that can be accomplished is the physical environment of bone, muscle, and soft tissue. By using clinical records of more than 200 cases, each dimension of the denture was analyzed as to lateral, anterior, posterior, and vertical protraction and contraction. A study of 40 successful treatments indicated that posttreatment adjustments reflected contraction of the dentition and that protraction would not be tolerated by the dental environment of patients with normal muscular balance. A total dentition space analysis system was devised to help differentiate proper treatment strategy for all the dimensions of the denture. The space analysis emphasized the point that orthodontics is a space management procedure, and the orthodontist must become skilled in determining the space available, as well as future space increase through growth and development. Finally, guidelines were suggested for space management of all the dimensions of the dentition. These guidelines were based on an anterior, a midarch, and posterior space analysis so that the major areas of disharmony could be identified and proper space management decisions could be made.