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Removable Pros > Tooth Selection > Flashcards

Tooth Selection Flashcards

1
Q

tooth selection is part of what patient visit?

A

intermaxillary records (3rd)

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2
Q

lines on rim that serve as rx for the lab? in terms of teeth?

A
  1. midline
  2. high smile line
  3. canine lines
  4. interpupillary line
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3
Q

is labial frenum a good indicator of pt midline? what about lower anterior teeth?

A

no
and
no

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4
Q

best thing to determine midline for teeth?

A

look at pt. FACE

plus incooporate patient – what they really want

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5
Q

relationship of incisal edge to teeth/ lip line?

A

it should MIMICK THE patients lip line

  • the incisal edges of the maxillary anteriors should follow the contours of the lower lip during the smile

most people have incisal edges that are contouring the lower lip

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6
Q

reversed smile?

A

when the centrals and laterals are lifted up slightly more than the canines

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7
Q

what is the guide for tooth selecton and set-up?

A

the rim

we also built the rim to form the arches of the bone

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8
Q

what are the rim guidleines for tooth selection

A
  1. midline- comes from the face
  2. high smile line - determines the length of maxillary centrals
  3. canine lines
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9
Q

high smile line indicates?

A

length of the maxillary centrals

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10
Q

what helps determine the position of the maxillary canines?

A
  1. 1/2 the ala-modiolus
  2. mid-pupillary line
  3. canine -eminence on cast – if it is prominent
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11
Q

canine eminence line should also extend where? what does this represent and what are the implications

A

onto the land of the cast – determining the height of contour of the cuspids

since this is the height of countor – we see this when we look at a patient straight on but there is still part of canine tooth distal to this point and need to account for this as well

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12
Q

in many people width of 6 anterior teeth = what?

A

width of the nose - these are about the same distance

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13
Q

what to keep in mind for canine lines

A
  1. consider each side separately – not always symmetrical

2. lines represent the M-D height of contour – so will need more space distal

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14
Q

what is your prescription??

A

YOUR RIM

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15
Q

do we add the centric lines to rim?

A

YES – so we know position is reproducible and lines on the rim are where they should be

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16
Q

what do we measure with the rulers on the rim?

A
  1. high smile line – from base of wax to the beginning of the land
  2. Midline to each canine on either side (2 measurements) – we can have some assymmtry here
  3. distal of one canine – distal to the other

this gives you a range

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17
Q

range numbers on rulers correspond to what?

A

range between 42-58 mm?

different letters – which indicate molds of teeth

represent different molds of teeth we can choose from

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18
Q

patients face falls into what 4 major categories?

what does this suggest?

A
  1. square face
  2. the swuare tapering face
  3. tapering face
  4. the ovoid face

follows the arches of persons teeth – square face? – probably a square arch of patient – square tooth

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19
Q

describe square face

+ incisal aspect of teeth

A

Sides of the face from the hairline to the levels of the condyles to the angles of the jaw are straight and parallel

+ incisal aspect of teeth– central incisors are set practically straight across with the laterals also having full labial aspect

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20
Q

describe square tapering face

+ incisal aspect of teeth

A

sides of the head are parallel from the condyles upward – from condyles downward along the sides of the face – outline tapers in to the angle of the jaw

+ incisal aspect of teeth– centrals are more prominent than the laterals and canines- which are slightly elevated – but set at softer arrangement than a typical square taper

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21
Q

describe tapering face

+ incisal aspect of teeth

A

tapered face is widest at teh hairlien and most narrow at the angles of the haw – lines converge towards the jaw

+ incisal aspect of teeth– tapering arch converges to a point midline between the two centrals – centrals start to curve even

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22
Q

describe ovoid face

+ incisal aspect of teeth

A

widest through the center at the level of the condyles it curves upward and downwards to form an oval outline

+ incisal aspect of teeth— teeth set to full curve and demonstrate the ovoid characteristics

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23
Q

long face = what in terms of tooth selection

A

long tooth

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24
Q

mold guide comes with?

A

mold chart –

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25
Q

mold chart

A

lists sizes

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26
Q

first column in mold chart gives you what?

A

height/length of tooth / centrals

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27
Q

second column in mold chart gives you what?

A

width width of centrals

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28
Q

third column in mold chart gives you what?

A

canine to canine distance – distance of anteriors ON A CURVE

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29
Q

once you pick maybe two different styles of teeth what do you do?

A

first, compare your mold choices with the guidelines you have on your occlusion rim

  1. then can evaluate intra-orally via a rim selector kit
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30
Q

if first number is different but second letter is the same what is the same/ different for the tooth?

A

height is different

width is the same

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31
Q

underneath the upper anterior molds are?

A

recommended mandibular anterior molds

usually come in cards – 6 teeth for

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32
Q

mold chart articulations for what type of typical patient?

A

Class I patient

with different degrees of tapering, etc.

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33
Q

mold chart for class II or class III patient

A

II– pick a smaller mold

III- pick a larger mold

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34
Q

Types of posterior molds?

indicating what?

A

CUSP height

0 degree - monoplane

10 degree

20 degree

22 degree

30 degree

33 degree

40 degree

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35
Q

posterior molds available in cards of_____

A

1X8 “cards”

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36
Q

12 degree means?

A

Functional – anatoline posteriors

next level up

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37
Q

how do we select posterior tooth width m-d?

A

measure from DISTAL of cuspid to RISE OF THE RAMUS on mandible

available from 29-36 mm

38
Q

available height/ length of posterior teeth?

A

short, medium, long, or L/S (long buccal - short lingual)

39
Q

rule of thumb for posterior teeth selection?

A

the flatter the ridge the flatter the cusp

40
Q

monoplane posterior cusp height an rational

A

0 degrees

resorbed ridge

41
Q

semi-anatomical posterior cusp height an rational and what is it called?
used when?

A

12 degree, 20 degree, and 22 degree

(10-20)
rational – LINGUALIZED – lingual contact occlusion – most often used for implant overdenture

contains aesthetics of anatomical – somewhat of a cusp but reduces lateral sheer forces

42
Q

anatomical posterior cusp height an rational

A

30, 33, and 40 degree

rational – excellent rdige– you have enough ridge

43
Q

class II or III patient what plane tooth?

A

monoplane

44
Q

list the 8 major rationals for choosing monplane posterior tooth height

A
  1. resorbed rigde
  2. class II or class III patient
  3. bruxism patient
  4. cross-bite
  5. debilitation –pt. weak
  6. interum U/L
  7. when in doubt
  8. when CR is difficult
45
Q

list the 6 major rationals for choosing anatomical posterior set ups

A
  1. excellent ridges
  2. natural opposing teeth
  3. bilateral balance
  4. severe overbite – so need to accomodate for anterior guidance
  5. improve aesthetics
  6. chewing efficiency
46
Q

resorption on lower but upper is okay?

A

always resort to the lower – so we choose what teeth will match most efficiently with the ridge

so severe resorption on lower = monoplane

47
Q

10 major analysis in the anterior for tooth selection? when should this start?

A

DURING INTAKE – understand the patients expectations from the start

  1. face shape
  2. smile line - length
  3. canine distance - width
  4. gender -
  5. complexio - shade
  6. old dentures (likes/dislikes)
  7. old photos
  8. old x-rays
  9. old casts
  10. PATIENT OPINION /SIGNIFICANT OTHER
48
Q

9 major patient analysis for posterior tooth selection

A
  1. ridge status
  2. arch relatonship - what class is pt.
  3. cross-bites?
  4. bruxism
  5. coordination
  6. health
  7. old dentures
  8. anterior overbites
  9. canine- to pad distance
49
Q

denture tooth material?

A
  1. acrylic
  2. IPN
  3. Porcelain
50
Q

porcelain drawbacks?

A

brittle

what is does to ridge over long term wearing

51
Q

can porcelain teeth chemically bond to denture base?

A

NO

- they need tooth retention deviced for denture base acrylic

52
Q

retention for acrylic, IPN, and porcelain teeth? - general

A

Acrylic and IPN teeth are CHEMICALLY retained in denture bases

Porcelain teeth must be MECHANICALLY retained in denture bases

53
Q

porcelain anterior teeth have what for retention?

porcelain posterior teeth have?

A

PINS = anterior

Diatoric = posterior
- holes in undersurface

54
Q

opposing dentition consideration?

A

important because over time can ware down natural teeth

example - porcelain can cause ware on the enamel

55
Q

opposing dentition for acrylic?

best / okay / not good

A

acrylic and enamel are good

IPN is okay –but acrylic would ware because the IPN is harder

against polished porcelain – porcelain would ware the acrylic

56
Q

plastic = acrylic

A

yeah, basically

57
Q

long term effects of porcelain anteriors and plastic posteriors?

A

acrylci waring at a different rate than the porcelain

eventually leaving occlusion in the anterior – and anterior would increase in pressure and increase in bone resorption

58
Q

effects of long term use of porcelain denture tooth misuse

A

severe mandibular and anterior maxillary resorption

pre- maxilla like gone

mental foramen coming up to the occlusal table

loss of the flange

no premaxilla

59
Q

loss of pre-maxilla?

A

bad combination of materials used

60
Q

denture base coloring?

basic ones

A
  1. fibered dark, light
  2. lucitone 199
  3. custom blends and custom shading
  4. custom staining
61
Q

sequence of monoplant tooth set up

A

A-B-C-D

set anterior teeth first

2/3 height of pad – because do not use curves

62
Q

two techniques to setting teeth?

which do we use?

A
  1. setting one side at a time
  2. setting 2 pairs at a time
    - - we will use this one
63
Q

what touches occlusal plane in anterior set up?

A

centrals and cuspids touch

laterals are a little above table - about 1-2 mm above

64
Q

canine points?

A

towards chin with neck outwards

65
Q

for upper anterior set up where do we align incisal edges? where will roots diverge?

A

PARALLEL to the plan so the roots will all DIVERGE DISTALLY – by desgin and canines point towards the chin

and the incisal edges will give the illusion of a curved plane – aka smile

66
Q

steps to make room for teeth - height

A
  1. 1st grind record base
  2. make window in base (placing foil)
  3. grind tooth (last resort – we WILL NOT DO THIS IN OUR LAB)
67
Q

ridge lapping?

A

reduce from lingual at SAME CURVE AS THE RIDGE

  • we will not do this
68
Q

in which direction do you NOT cut to reduce height of teeth

A

do NOT cut horizontally – so do not cut top or bottom

69
Q

which lower anteriors touch plane in monoplane set up?
roots diverge?
canines point?

A

ALL touch the plane

roots diverge distally and cuspids now point TOWARDS THE FOREHEAD

70
Q

Tilt and angulation of canines?

A

uppers — angle towards chine
lowers – angle towards forehead

both roots diverge distally with prominent necks and distal tilt

71
Q

do anterior teeth touch in centric?

A

NO – no anterior contact

72
Q

what is holding VDO?

A

wax and pin – teeth should not touch

C+D+ pin

73
Q

cuspid lines indicate what

A

anterior or mesial half

74
Q 
with a completed anterior set up of monoplane posteriors what is the:
tilt
axes
appearance
roots
incisals
A 
tilt -- M-D tilt
axes-- they converge
appearance-- curved appearance
roots -- diverge distally
incisals -- these align

slight a-p tilt

75
Q

what is the a-p tilt in anterior set up?

A

slight proclination

slight a-p tilt

so each tooth is individually angles away from the plane to reflect light and give a natural appearance

76
Q

T/F we should treat each side of the rim separately?

A

YES
asymmetry exists in patients
– influence on tooth arrangement

77
Q

creating natural looks to dentures can include doiong what?

A

including staining, restorations, overlapping (vertical overlap), stippling, diastemas

78
Q

*4 Major BASIC rules of denture occlusion.
Include reasons for each…
If change to more anatomical set up what is the big difference?

A
  1. NO ANTERIOR CONTACT IN CO
    - decreases pressure
  2. NO CANINE GUIDANCE IN LATERAL
    - decreases movement
  3. NO ANTERIOR GUIDANCE IN
    PROTRUSION
    - decreases movement
  4. CO=CR
    - decreases movement

ANATOMICAL SET-UPS HAVE BALANCE

79
Q

Bone loss will come from?

A
  1. tooth loss
  2. pressure
  3. movement
80
Q

guidance definition and implication?

A

any contact in anterior alone and will result in increased movement and pressure

81
Q

group function definition and implication?

A

unilateral posterior contact and results in increased movement

82
Q

balance definition and implication?

A

bilateral posterior contact and will DECREASE movement

83
Q

if unsupported posterior in dentures?

A

resorption in the maxilla and mandible

pressure in anterior so no anterior contact in CO

84
Q

only time there can be contact in the anterior in dentures?

A

if there is SIMULTANEOUS CONTACT in the posterior DURING PROTRUSION

NO ANTERIOR CONTACT IN OCCLUSION ALONE

85
Q

two main denture goals

A
  1. prevent guidance

2. promote balance

86
Q

fixed factors (things we cannot change on patient)

A
  1. HINGE POSITION of condyle (CR)
  2. Protrusive path of condyel — HORIZONTAL condylar inclination
  3. Lateral path of condyel — lateral inclinations of condyle
87
Q

what can we alter in dentures?

4 MAIN THINGS

A
  1. HORIZONTAL OVERLAP OF ANTERIORS (H)
  2. VERTICAL OVERLAP OF ANTERIORS (V)
  3. CUSP HEIGHT OF POSTERIORS
  4. CURVE OF POSTERIOR PLANES
88
Q

How to manipulate anteriors for monoplane occlusion in terms of overlap to not get contact

A

increase horizontal

decrease vertical

combination of both

89
Q

2 main objectives of anterior denture setup in terms of occlusion

A
  1. PREVENT anterior contact as long as possible

2. MAINTAIN posterior contact as long as possible

90
Q

aspects of the a-p tilt

A

Labial - incisal

  1. root location
  2. lip support
  3. light reflection
91
Q

ridge lap? will we do this?

A

how you can fix the vertical height if tooth too tall BY REDUCING FROM THE LINGUAL AT SAME CURVE AS THE RIDGE

after base is thinned and window is made

N0 – WE WILL NOT GRIND, ADJUST, OR RIDGE LAP ANY TEETH IN EITHER SET UP

92
Q

overlap allowed in class III patient

A

horizontal – up to 3-5 mm (usually only 1-2)

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