2/5: Selecting Denture Teeth Flashcards
What is the point of anterior teeth?
Esthetics
What is the point of posterior teeth?
Function
What is valuable information to reach a happy medium when selecting teeth?
Previous dentures
- discuss likes and dislikes (color, shape, function)
- make impression of the dentures
Photographs
- make sure the teeth are showing
- most recent photograph
- photocopy of the photograph
Friends and family
What are factors to consider with anterior tooth selection?
Shade - easiest to determine
- patients always want the “whitest and brightest”
- narrow selection down to few shades
- offer input, but let patient make ultimate decision
Size - occlusal-gingival height and mesial-distal width
Mold - shape of the individual teeth
How should you determine the size of anterior teeth?
Use existing denture
- measure the height and width of the central incisor of the denture with a boley guage
Use anatomical landmarks
Use the Interalar Facial Meter
Use the Trubyte Tooth Indicator
How should you determine the width of the central incisor with anatomical landmarks?
The width of the central incisor is approx 1/16 the bizygomatic width (house and loop)
(bizygomatic width can be measured using a caliper-type facebow)
What is the width of the anterior sextant?
The approximate combined width of the 6 anterior teeth on a flat plane is the
bizygomatic width divided by 3.3
How should you determine the width of the anterior sextant with anatomical landmarks?
- mark corners of the wax rim
- measure the distance using the curve of the wax rim
- that distance will approximate the combined width of the 6 anterior teeth ON A CURVE
- Use the facial meter to measure the interalar distance
- classifies anterior sextant width into small, medium, large
What are the 5 ways to determine width of anterior teeth?
- Measure the width of the central incisor on existing
denture - 1/16 the bizygomatic width equals the width of the
central incisor - Bizygomatic width divided by 3.3 equals the
combined width of the 6 anteriors on a flat plane - Corners of the mouth marked on the wax rim
equals the combined width of 6 anteriors on a
curved plane - Use the Interalar Facial Meter
How should you determine the length of anterior teeth?
- Use an existing denture
- Use the patient’s lip line
- Using anatomical landmarks
- Evaluate the distance between the maxillary
and mandibular ridges
Why should you mark the “lip line” on the maxillary wax when a pt smiles?
To estimate the length of the max teeth and avoid a “gummy smile”
What equation can be done by utilizing the hairline to determine the length of the central incisor?
The distance from the hairline to the gnathion
(the most inferior bony portion of the chin)
divided by 16 equals the length of the central
incisor
What are 4 ways to determine the length of the anterior teeth?
- Measure the length of the central incisor on the existing
denture - Evaluate the “Smile line”
- 1/16 of the distance from the hairline to the gnathion equals
the length of the central incisor - Measure the distance between the maxillary and mandibular
ridges
What is the trubyte tooth indicator based on?
- Based on bizygomatic width for central incisor
width - Based on hairline and gnathion line for length
of central incisor
What are the two ideologies of anterior tooth mold selection?
- Dentogenics
- Geometric theory
What are dentogenics?
Frush and fisher
- based on age, sex, and personality
What is the geometric theory?
Williams, House and Loop
- based on the shape of the face
- the max central incisor resembles the inverted face form
What are the 4 categories of the geometric theory?
- square
- square tapering
- tapering
- ovoid
What are the 3 points of the face that connect in the geometric theory?
Temple
Zygomatic arch
Angle of the mandible
What should the facial contour of the anterior teeth mimic?
The contour of the face in profile
Curved vs flat
What is the objective of the geometric theory and dentogenics?
To harmonize the teeth with their surrounding structures in an attempt to avoid detection and provide an esthetic appearance
After the size and shape of the teeth are determined, the information must be applied to?
Bioform Mould Guide
- max anterior tooth guide consists of 2 numbers followed by a letter classification
What is the first number of a tooth tray?
Classification
What is the second number of a tooth tray?
Proportion and contour
What is the letter on a tooth tray?
Width of upper six anterior teeth on a curve
What should you use to select corresponding mandibular anterior teeth?
Portrait mould guide
- may have choice between multiple
What should you measure to select the posterior mandibular teeth?
Measure the distance from the distal of the canine to the ascending portion of the ridge to determine the combined length of the mandibular posteriors
What are the two types of denture tooth materials?
Porcelain
Acrylic resin
What are the pros and cons of procelain?
Pros – esthetics
Cons – clacking sound, abrasive, weight
What are the pros and cons of acrylic resin?
Pros – easily adjusted, chemical bond to resin
Cons – occlusal wear
When setting the maxillary anterior teeth, what should you remember?
goal of the final prosthesis is to defy detection. Therefore the teeth should appear to “grow out of the alveolar bone”
In the horizontal view, what should the measurement of the incisal edges of the maxillary central incisor be?
Approx. 8-10mm anterior to the midpoint of the incisive papilla
- A line drawn perpendicular to the mid-sagittal
suture and that bisects the incisive papilla
should extend though the center of the
maxillary canines
In occlusion with the lips together, what do the maxillary anterior teeth support?
the labial incisal 1/3 of the maxillary anterior teeth support the superior border of the lower lip
How much of the maxilalry anterior teeth should be visible at rest from the frontal view?
1-2mm of the max centrals should be visible
The plane of the max anterior teeth should be _________ to the interpupillary line
Parallel
When smiling, the incisal edges of the max teeth should follow _______________________
The line of the lower lip
How should mandibular anterior teeth be set?
On a curve that parallels the maxillary anterior teeth resulting in a uniform 1-2mm horizontal overlap.
There should be _______________ vertical overlap
Zero or minimal (0.5mm)
How should canines be positioned?
in a way in which the distal portion of the canine points to the desired position of the central fossae of the posterior teeth
What is the buccal corridor?
the space between the buccal surfaces of the upper
teeth and the corners of the mouth when the patient smiles
What is the golden proportion?
1,618
When setting posterior teeth, what distance should be measured?
distance from the distal of the canine to the upward slope of the residual ridge.
- A posterior tooth may be omitted due to a lack of space
The mandibular teeth should be on a ________ plane and extend _____ to ______ up the retromolar pad
flat plane; 1/2 to 2/3
The mandibular posterior teeth are set over the _______ to gain a _______ advantage
ridge; retentive
What should the maxillary posterior teeth occlude with?
Mandibular posterior teeth
The occlusal-gingival height should be maintained where?
From the anterior teeth to the posterior teeth
