How To Set Denture Teeth

During the occlusal registration stage, the positioning of the inductive teeth and the selection of size, shape and shade is incorporated. The duplication of aesthetics tin can be determined based on the patient's natural teeth or through their existing dentures.

Technicians copy and retain the features of the existing dentures by having an impression. Having photographs of the patient wearing their dentures tin can also be very useful in establishing shortfalls or positive aspects nigh the dentures' appearance.

Selecting denture teeth

A)Size

To establish the overall width of the six inductive teeth, the distance between the canines tin be determined using various methods:

1. Marking the corners of the rima oris on the rim with the mouth at rest.
2. Measuring the width of the nose at its widest bespeak with the mouth at remainder. Add together 5 mm to this measurement to allow for the curvature of the teeth.
3. The width of the two key incisors may be estimated using the philtrum width.
4. The acme of the primal incisor should exist equal to or greater than the height of the smile line above the incisal edge.
5. This high grinning line should ideally exist marked onto the wax rim of the registration rim during the registration stage by the clinician.
6. Larger central incisors should exist used for people with a loftier lip line.

B)Shade

1. Colour is described using the terms 'value' (lightness), 'blush' (saturation) and 'hue' (colour).
2. In general, darker teeth should exist selected for older patients.

C)Shape

Several methods have been described for selecting tooth shape:

1. Utilize the patient'due south old dentures if they are happy with the teeth.
2. Select teeth based on the inverted shape of the patient's face to determine whether the teeth should exist square, tapered, ovoid or oblong.
3. Select teeth based on the shape of the patient's upper palate.
4. Masculine and feminine moulds are always bachelor for selection.

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Denture Teeth

The most widely used materials for manufacturing artificial teeth are:

ACRYLIC RESIN & PORCELAIN

Denture Teeth / Denture Base of operations Zipper Mechanisms

1. Gross mechanical retention (holes,pivot, undercuts)

2. Micromechanical retentivity (bur roughening, grinding, sandblasting)

3. Chemical bonding (denture base monomer penetration into teeth)

• Minimizes interfacial leakage and staining (hygienic and esthetic problem)
• Facilitates stress-transfer preventing cracks or crazes near interface with base

	Porcelain Teeth	Acrylic Teeth
Aesthetic	Higher (advantage)	Less (disadvantage)
Attachment to the denture base of operations	Mechanical (disadvantage)	Chemical (advantage)
Density	College (disadvantage)	Lower (advantage)
Brittleness	Higher (disadvantage)	Lower(advantage)
Compatibility with the denture base	Lower (disadvantage)	Higher (advantage)
Hardness	Higher (advantageous by less abrasion)	Less (disadvantage)
	(disadvantage when adjustments needed)	(reward when adjustments needed)
Forces to the supporting soft tissues	Higher (disadvantage)	Lower (reward)
Tissue biocompatibility	College (reward)	Less (disadvantage)

Anatomic Teeth

Utilize for patients with:

• Artful concerns
• Coordinated jaw movements
• Denture opposing natural teeth

Non-Anatomic Teeth

• No overbite
• Normal overjet (1-2mm)
• Jaw size discrepancies (Class Three)
• Severe ridge resorption
• Uncoordinated jaw movements
• Poorer esthetics, due to lack of cuspal inclines

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Positioning The Denture Teeth

ANATOMICAL LANDMARKS & AIDS USED TO POSITION DENTURE TEETH

A) Lip Line

• Highest signal of upper lip when smiling
• Cervical necks lie at or to a higher place this line
• If shorter teeth are selected, esthetics compromised

B)Palatal Midline

• Extend through eye of incisive papilla and mid-palatal raphe
• Check for symmetry  (If not symmetrical, suit rim)

C)Midline & Canine Reference

• Line passing through distal of incisive papilla
• Perpendicular to the palatal midline
• Intersects cusp tips of the canines

D)Incisive Papilla

• On average, facial of key incisors should be 8-10 mm anterior to this line.

E)Retromolar Pads

• Distal border of the lower denture.
• A point two-thirds the manner up the retromolar pads may exist used to approximate the occlusal plane.

F)Middle of Ridge – Posterior

• Maxillary lingual cusps should be centered over this line
• Mandibular teeth must be on the centre of the ridge
• Ensures denture stability
• Reduces fulcruming forces during function

G)Center of Ridge – Anterior

• If anterior teeth are too facial to centre of ridge, fulcruming tilting and dislodging occur

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Organisation of the Maxillary Anterior Teeth

Setting Upper Anterior Teeth:

• Incisal edges of primal incisors & canines at level of the occlusal aeroplane
• Laterals Incisors placed approximately 0.5 mm – 2 mm above the occlusal plane
• Circumference (labial contour) follows arch shape
• Expect for Symmetry where the correct and left maxillary anterior teeth should exist positioned symmetrically on either  side of the curvation

A) Maxillary Central Incisor

1. Outset an upper central incisor is placed to one side of the middle line, replacing the labial contour of the upper wax cake, and simply touching the occlusal plane.
2. Incisal edges placed more anteriorly than their necks to support the lips in a slightly prominent and natural position.
3. The long axis of the tooth is parallel to the vertical centrality when viewed from the front.
4. The long axis of the tooth is sloping labially when viewed from the side.
5. The incisal edge of the tooth evenly contacts the occlusal plane.

B) Maxillary Lateral Incisor

1. The lateral incisor should be positioned with the incisal border 0–two mm off the occlusal plane.
2. This will vary according to the age of the patient; older patients would not normally be expected to have a 'youthful' step betwixt their centrals and laterals, due to wear of the centrals and canines.
3. Incisal edges placed more anteriorly than their necks to support the lips in a slightly prominent and natural position.
4. The long axis of the tooth is tilted towards the midline when viewed from the front.
5. The long axis of the molar is sloping labially when viewed from the side. The inclination of the slope is greater than that of the fundamental incisor.
6. The incisal edge is 2 mm above the level of the occlusal plane. And the edge is tilted towards the midline.

C) Maxillary Canine

1. The canines should exist positioned to show their mesial aspects when viewed from the forepart.
2. The incisal edge should just affect the occlusal plane.
3. The cervix of the canine should be prominent and more anteriorly placed than the incisal edge to emphasise the canine eminence and to back up the lips.
4. The long axis of the tooth is parallel to the vertical axis when viewed from the front. A mild mesial tilt is supposed to better its aesthetics.
5. The cuspal tip of the canine touches the plane of occlusion.

Setting Upper Posterior Teeth:

• The upper posterior teeth are set over or slightly buccal to the ridge, such that their occlusal surfaces prevarication slightly buccal to the lower ridge.
• The teeth are positioned to create a compensating curve.
• The steepness of the curve depends on the condylar angle, the cusp angle of the teeth and incisal guidance angle.
• The steeper the bending, the steeper the compensating curve needs to be.
• The curve of Spee should match the condylar bending to maintain contact between the teeth in protrusive excursions.

D) Upper 1st Premolar

1. The long axis of the tooth is parallel to the vertical axis when viewed from the front.
2. The buccal cusp touches the occlusal plane and the palatal cusp is positioned about 0.v mm higher up  the occlusal plane.

E) Upper 2nd Premolar

• The long axis of the tooth is parallel to the vertical axis when viewed from the front.
• The long axis of the tooth is parallel to the vertical axis when viewed from the side likewise.
• Both the buccal and palatal cusps should bear upon the occlusal plane.

F) The Upper 1st Molar

• The long axis incline distally and buccally.
• The mesiopalatal cusp contact with the occlusal aeroplane.
• This tilt requite the lateral curve.

F) The Upper 2nd Molar

• The long axis of the tooth is tilled buccally when viewed from the front.
• The long axis of the tooth is tilted distally when viewed from the side
• No cusp touch on the occlusal plane but the mesiopalatal cusp should be the nearest cusp to the occlusal airplane.
• This is to create the compensatory curve.

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Arrangement of the Mandibular Anterior Teeth

a) Mandibular Fundamental Incisor

• The long centrality of the molar is parallel to the vertical axis when viewed from the front.
• The long axis of the molar slopes slightly labially when viewed from the side.
• The incisal border of the molar should be 2 mm above the aeroplane of occlusion.

b) Mandibular Lateral Incisor

• The long centrality of the tooth is parallel to the vertical axis when viewed from the front.
• The long axis of the tooth slopes slightly labially when viewed from the side but not so steeply every bit the central incisor.
• The incisal border of the molar should be 2 mm above the plane of apoplexy.

c) Mandibular Canine

• The long axis of the tooth is very slightly tilted lingually when viewed from the front end.
• The long axis of the tooth slopes slightly mesially when viewed from the side.
• The canine tip is slightly more than than two mm above the occlusal plane.

d) Mandibular 1st Premolar

• The long axis is parallel to the vertical plane.
• The buccal cusp of the mandibular 1st PM should engage the mesial marginal ridge of the maxillary 1st PM.
• Lingual cusp is beneath the occlusal aeroplane while the buccal cusp is 2 mm above the occlusal plane.

east) Mandibular second Premolar

• The long centrality is parallel to the vertical plane.
• The buccal cusp tip should engage the embrasure betwixt the maxillary 1st PM and 2nd PM.
• Its 2 cusps are about 2mm above the occlusal airplane.
• The central fossa of the mandibular 2nd premolar and the 1st premolar are over the crest of the ridge.
• The teeth need to be prepare over the crest of the ridge to maximise denture stability and back up.

f) Mandibular 1st Tooth

• The long axis of the tooth slopes slightly lingually when viewed from the front.
• The lingual cusp is below the occlusal plane and the buccal cusp should be 2 mm above the occlusal plane.

grand) Mandibular second Molar

• The long centrality of the tooth slopes slightly lingually when viewed from the front
• Both the cusps are 2 mm above the level of the occlusal plane.

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Important notes:

Overjet & Overbite:

• Avoid too much overbite or too little overjet.
• Increasing overbite steepens the angle, separating posterior teeth more quickly.
• Increasing overjet shallows the angle, separating the posterior teeth less quickly.

Lingual Centric Occlusion:

• Make certain that the palatal cusps of the maxillary 2nd molar occlude properly with the fundamental fossa of the mandibular second molar.

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Published June 26, 2022 June 26, 2022

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Source: https://mydentaltechnologynotes.wordpress.com/2018/06/26/complete-denture-selection-arrangement-of-artificial-teeth/

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