14. Set Anterior Teeth

Setting Anterior TeethSetting Anterior Teeth

Esthetics & PhoneticsEsthetics & Phonetics

Look for SymmetryLook for Symmetry

View from anterior, View from anterior, occlusalocclusal

View from many View from many anglesangles

SymmetrySymmetry

Perfect Perfect SymmetrySymmetry

Gross Gross AsymmetryAsymmetry

Facial AsymmetryFacial Asymmetry

2 Left Sides “Normal” 2 Right Sides

Smile AsymmetrySmile Asymmetry

2 Left Sides “Normal” 2 Right Sides

Setting Anterior TeethSetting Anterior Teeth

– Incisal edges of Incisal edges of central incisors & central incisors & canines at level of canines at level of the occlusal planethe occlusal plane

– Laterals placed Laterals placed approximately approximately 0.5 mm above 0.5 mm above the occlusal planethe occlusal plane

Cervical necks tilt posteriorly from the central incisor to the canineCervical necks tilt posteriorly from the central incisor to the canine

The greatest height The greatest height of the free gingival of the free gingival margin is slightly margin is slightly

distal to the distal to the mesiodistal center mesiodistal center

of the toothof the tooth

Setting Mandibular AnteriorsSetting Mandibular Anteriors

Lower Lower anterior teeth anterior teeth incline similar incline similar to the to the maxillary teethmaxillary teeth

Setting Mandibular AnteriorsSetting Mandibular Anteriors

• Incisal edges are placed at the same levelIncisal edges are placed at the same level• Even with the occlusal planeEven with the occlusal plane

Setting Mandibular AnteriorsSetting Mandibular Anteriors

• No overbite for No overbite for monoplane or monoplane or lingualized setupslingualized setups

Canines should be tilted more Canines should be tilted more posteriorly than other teeth, with a posteriorly than other teeth, with a

more prominent cervical neckmore prominent cervical neck

Bucco-Lingual TiltBucco-Lingual Tilt Maxillary Anterior TeethMaxillary Anterior Teeth

• Facial surface of central is Facial surface of central is

perpendicular occlusal planeperpendicular occlusal plane

• Neck of lateral is depressedNeck of lateral is depressed

• Neck of canine is prominentNeck of canine is prominent

Central Canine

Bucco-Lingual TiltBucco-Lingual Tilt Mandibular Anterior TeethMandibular Anterior Teeth

• Central is proclinedCentral is proclined

• Lateral is more Lateral is more

uprightupright

• Canine has a Canine has a

prominent neckprominent neckCentral Canine

Anterior Tooth SetupAnterior Tooth Setup

• Check symmetry with Check symmetry with reference linesreference lines

• Anterior teeth don’t contact Anterior teeth don’t contact in centric positionin centric position

• Grazing contacts in Grazing contacts in excursionsexcursions Overjet = 2mmOverjet = 2mm

Overbite = 0mmOverbite = 0mm

No Anterior No Anterior Contact in CentricContact in Centric

CorrectCorrect

InsufficientInsufficient

ExcessiveExcessive

Canine OffsetCanine Offset

• Check for one half tooth offset Check for one half tooth offset between maxillary & mandibular teethbetween maxillary & mandibular teeth

• Ensures posterior teeth have normal Ensures posterior teeth have normal cusp to fossa relationship for cusp to fossa relationship for lingualized occlusionlingualized occlusion

Cannine Cannine OffsetOffset

CorrectCorrect

InsufficientInsufficient

Improper offset Improper offset results in a space results in a space

or half tooth or half tooth replacementreplacement

Phonetic AssessmentPhonetic Assessment

• Maxillary centrals should Maxillary centrals should lightly touch vermilion border lightly touch vermilion border of lower lip for ‘F’, ‘V’ soundsof lower lip for ‘F’, ‘V’ sounds

• ‘‘S’ sounds - incisal edges should S’ sounds - incisal edges should approximate each otherapproximate each other

Intraoral Assessment of Intraoral Assessment of Anterior TeethAnterior Teeth

Incisal edges of Incisal edges of maxillary incisors maxillary incisors should follow line of should follow line of lower lip when lower lip when smiling (‘smiling (‘smile linesmile line’)’)

Follow the Follow the ‘Smile line’‘Smile line’

Placing & Moving Placing & Moving Anterior TeethAnterior Teeth

• Crown removing forceps to Crown removing forceps to bodily move and tilt teethbodily move and tilt teeth

• Grind record base/tooth if Grind record base/tooth if record base is impairing ability record base is impairing ability to position properlyto position properly

Intraoral Assessment of Intraoral Assessment of Anterior TeethAnterior Teeth

• Nasolabial angle ≈ 90°Nasolabial angle ≈ 90°

• If insufficient support, If insufficient support, the vermilion border the vermilion border will be reducedwill be reduced

Intraoral Assessment of Intraoral Assessment of Anterior TeethAnterior Teeth

• Junction of oral mucosa Junction of oral mucosa (glossy) should just be visible (glossy) should just be visible when lips are slightly separatedwhen lips are slightly separated

• If not visible - insufficient If not visible - insufficient supportsupport

• Lips meet at junction of oral & Lips meet at junction of oral & transitional epitheliumtransitional epithelium

Intraoral Assessment of Intraoral Assessment of Anterior TeethAnterior Teeth

Excessive block-out of record base will Excessive block-out of record base will push the lip out at the height of the push the lip out at the height of the vestibule, distorting appearancevestibule, distorting appearance

LispingLisping

• Too much horizontal overlap Too much horizontal overlap • Can’t approximate incisal edgesCan’t approximate incisal edges

• Anterior teeth too far labiallyAnterior teeth too far labially• Spaces allow air leakageSpaces allow air leakage

LispingLisping

• Palatal contour too constrictedPalatal contour too constricted• Remove wax to provide more roomRemove wax to provide more room

• Arch form too broadArch form too broad

• Experiment with placement of waxExperiment with placement of wax

Anterior TeethAnterior TeethNot Identical Position of Natural TeethNot Identical Position of Natural Teeth

• Slightly altered position from Slightly altered position from precursorsprecursors

• Denture stability compromisedDenture stability compromised

• No anchorage from rootsNo anchorage from roots

Avoid the ‘Avoid the ‘Denture SmileDenture Smile’’

• Teeth too smallTeeth too small

• Teeth not showingTeeth not showing

• Too straight across Too straight across anterioranterior

• ““Chiclets”Chiclets”

Central & lateral Central & lateral incisors must incisors must begin to turn begin to turn

along the along the curvature of the curvature of the

archarch

Circumference Follows Arch ShapeCircumference Follows Arch Shape

Facial Support, OVD & Tooth Setup Facial Support, OVD & Tooth Setup Can Dramatically Affect AppearanceCan Dramatically Affect Appearance

Effect of Incisor LengthEffect of Incisor Length

Variation of Appearance with Variation of Appearance with Different DenturesDifferent Dentures

Variation of Variation of Appearance with Appearance with

Different DenturesDifferent Dentures