1. Maxillofacial Prosthetics, Prosthodontic Unit
Comparison of facial types and maxillary anterior teeth width/length ratio among Bangladeshi, Malay and Chinese population
Maxillofacial Prosthetics, Prosthodontic Unit
School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
Md Minhaz Ul Islam Nizami (BDS), Ahmed Mushfiqur Rahman (BDS), Nafij Bin Jamayet (MScDent), Sumaiya Zabin Eusufzai (MPH)
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INTRODUCTION
Direct facial measurement were done by customized device in Figure 1 and calculated the facial index with following formula:
Facial index = facial height (Nasion to Menton) divided by facial width (Zygion to Zygion) and then multiply by 100 (Naini, 2011)
Tooth measurement were done from direct cast of the samples by a digital caliper and the crown width and height were recorded.
Table 4: comparison between central incisor, lateral incisor and canine of Chinese, Malay and Bangladeshi Narrow face. (CM/CF=Chinese male/Female,MM/MF=Malay male/female, BM/BF=Bangladeshi male/female)
Aesthetics is the primary consideration for patients seeking prosthetic treatment. Dental and facial aesthetics are interrelated therefore it is important that clinicians are acquainted with the 3 basic facial types. Based on the facial index value, the face could be divided as broad, average and narrow by facial index which was introduced by Kollmann. The value of crown width/ length ratio was accepted to be one of the most stable parameter and had been considered as an important factor for dental aesthetics to harmonize with facial contours. (Hasanresioglu et al, 2005).
Objectives of the Study:
- To determine the distribution of facial patterns in the study populations.
- To determine the mean crown width/ length ratio of six maxillary anterior teeth in male and female and/or among different facial types.
- To compare the mean crown width/length ratio of maxillary anterior teeth between male and female in broad, average and narrow facial type.
Results
In Chinese population, 51.42% broad face, 12.14% were average face and 36.42% were narrow face. In Malay population, 32.85% were broad face, 21.42% were average face and 45.71% were narrow face. In Bangladeshi population, for male 42.86% were average face and 57.14% were narrow face. But there was no broad face found(Table 1).
In multiracial comparison between different facial group, there were no significant association (p>.05) in mean crown width/length ratio between Chinese and Malay broad face groups for central incisor, lateral incisor and canine in male and female. (Table 2) since we could not found any broad face in Bangladeshi population.
Table 1: Comparison of facial classification results.
Discussion
This is the first comparison study conducted between Bangladeshi, Malaysian and Chinese population to determine and compare the different facial types and the crown width/length ratio. In regards to facial type, Chinese population in both gender showed the highest percentage of broad face that is 51.42% whereas no broad face found in Bangladeshi population. The other group of studies such as Sitthiphan et al., (2015), and Uttekar et al., (2012) revealed a high prevalence of broad facial type which are 94% in Laotian population and 78% in Indian population respectively. Studies conducted on the African (Omotoso et al., 2011) and Malaysian-Indian subjects (Negow and Aljunid, 2009) showed a high prevalence of average facial type. A high prevalence of narrow facial type was observed in studies by Nagham, (2005), Seher et al., (2008) and Heidari et al., (2009). In our study, Bangladeshi population showed highest percentage of average (42.86%) and narrow (57.14%) face among these three population.  
In regards to crown width/length ratio, Lateral incisor of Malay population showed significant association (p=0.049) in mean tooth ratio between genders. In Bangladeshi and Chinese population, there were no significant differences (p>.05) in mean tooth ratio between male and female sex groups for central incisor, lateral incisor and canine. Our findings are differed from other human studies that found that mostly canines tend to exhibit gender based morphologic difference compared to other tooth group (Garnet al. 1964, Ditch & Rose 1972, Potter 1972, Arya et al. 1974, Sterrett et al. 1999). 
In comparing multiple population’s different facial group, there were no significant association in crown width/length ratio with broad and average facial group of Bangladeshi, Malay and Chinese population. But regarding narrow face a significant association was found (p<0.05) in mean crown width/length ratio of central incisor. In regression analysis, we found R2 = .319 and degree of freedom = So there is 31.9% perfect relationship between facial proportion and mean tooth ratio of maxillary anterior teeth with multiracial population and sex. There is also highly significant coefficient regression (p=.001) of canine tooth ratio and race with facial proportion.
Table:2. Comparison between central incisor, lateral incisor and canine of Chinese and Malay broad face. (CM/CF=Chinese male/Female,MM/MF=Malay male/female)
Materials and Methods
This study was a descriptive, cross-sectional and analytical study. Subjects were selected from undergraduate dental student of Bangladesh and Malaysia. Measurement were done on 70 male and 70 female subjects aged between years selected from each Bangladesh, Malay and Chinese population who participated in this study (n=420).
Subjects those who were willing to participate with no missing anterior teeth, no gingival or periodontal disease and no history of orthodontic treatment were included. In the other hand subjects with periodontal disease or surgery, open bite or have any problem that could disfigure the dentition and face were excluded.
Table:3. Comparison between central incisor, lateral incisor and canine of Chinese, Malay and Bangladeshi average face. (CM/CF=Chines male/Female,MM/MF=Malay male/female, BM/BF=Bangladeshi male/female)
Conclusion
The results of the study can be useful to clinicians during rehabilitation of anterior teeth. The size of the maxillary anterior teeth obtained from the study included the variations among genders may be useful for the clinicians and artificial tooth manufacturers as a guide towards ideal rehabilitation or inventory planning of artificial teeth assortment for the Bangladeshi and Malaysian population as well as neighbouring population.
Figure: 1. Facial height and width measurement.
References
Ballard ML. (1944). Asymmetry in tooth size: a factor in the etiology, diagnosis and treatment of malocclusion. Angle Orthod, 14,
Heidari Z, Mahmoudzadeh-Sagheb H, Khammar T, Khammar M. (2009). Anthropometric measurements of the external nose in year-old Sistani and Baluch aborigine women in the southeast of Iran. Folia Morphol, Vol. 68, No. 2.
Hasanresioglu U, Berksun S, Arus K, Aslan I. (2005). An analysis of maxillary anterior teeth: facial and dental proportion. J Prosthet Dent, 94,
Nagham HK. (2005). The selection of maxillary anterior teeth width in relation to facial measurements at different types of face form. Al-Rafidain Dent J, 5(1),
Naini FB. (2011). Facial aesthetics concepts and clinical diagnosis
Similarly there were no significant association (p>.05) in mean crown width/length ratio between Chinese, Malay and Bangladeshi average face groups for central incisor, lateral incisor and canine in male and female.(Table 3). But in narrow face group, There were no significant association (p>.05) in mean crown width/length ratio between Chinese, Malay and Bangladeshi population for lateral incisor and canine in male and female except a significant association was found (p<.05) in mean crown width/length ratio central incisor (Table 4).
Figure: 2. Tooth Measurement.
Acknowledgement: This study has been supported by USM short term grant no: 304/PPSG/
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