Aesthetics of complete dentures Flashcards
What are the three sub-sections when considering aesthetics of dentures?
- Extra-oral factors
- Intra-oral factors
- Tooth factors
What are the extra oral factors
Lip support
Cheek support
Facial height
Skeletal relationship
Importance of lip support
Lip support can affect lip form and length
Restores the nasiolabial angle
what should the nasolabial angle be?
around 90o
What is cheek support dependent on
Muscle tone - can be affected by incorrect placement of teeth
what is facial height dependent on?
OVD, RVD and FWS
What happens to facial height / appearance with inc OVD
stretched, strained or elongated face
incompetent lips, speech difficulties, may lead to TMJ issues
What happens with a decrease in oVD
Over-closed appearance, looks prematurely ages
Can lead to reduced chewing efficiency, speech issues and angular cheilitis
What are the intra-oral factors to consider
Occlusal plane (amount of tooth showing and orientation anteriorly and posteriorly) Tooth arrangement (centre line and tooth positioning) Individualisation
How much tooth should be showing at rest
Average 2mm below lip line, judge based on age and clinical situation
orientation of the occlusal plane anteriorly
Parallel to inter pupillary line
- prevents lop sided appearance
Orientation of occlusal plane posteriorly
Parallel to ala-tragal angle
- avoids molars hanging down
Where should the dental centre line be
In line with pt’s midline, use the philtrum
Tooth position of incisors
10-12mm anterior to incisive papilla
tooth position of canines
tip in line with inner canthus of eye
Types of individualisation
rotations, crowding, misalignement, wear, diastems etc
Tooth factors to consider
Shade Shape Size Length Characterisation Incisal occlusion
Selection of shade
Use pt input but avoid very bright teeth if older pt
Use natural light
selection of tooth mould
Can assess face shape to achieve desirable shape of tooth
assess old pictures to create appearance of nature teeth
Selection of crown length
depends on the upper lip and occlusal plane
depends on age of the patient - as you age, less tooth showing
incisal occlusion
May recreate natural skeletal class e.g. retroclined incisors, increased overbite
Soft tissue factors
Can be shade matched, stippled, controured, addition of embrasure spaces
