Anterior & Posterior Tooth Arrangement Manual · Anterior & Posterior Tooth Arrangement Manual. 1 ... Suggested procedures for the arrangement and articulation of Dentsply Sirona

Anterior & Posterior Tooth Arrangement Manual

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Table of Contents Pages

Anterior Teeth.........................................................................................................2-8

Lingualized Teeth ................................................................................................9-14

0° Posterior Teeth .............................................................................................15-17

10° Posterior Teeth ...........................................................................................18-20

20° Posterior Teeth...........................................................................................21-22

22° Posterior Teeth..........................................................................................23-24

30° Posterior Teeth .........................................................................................25-27

33° Posterior Teeth..........................................................................................28-29

40° Posterior Teeth..........................................................................................30-31

Appendix..............................................................................................................32-38

Suggested procedures for the arrangement and articulationof Dentsply Sirona Anterior and Posterior Teeth

Contains guidelines for use, a glossary of key terms and suggestedarrangement and articulation procedures

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Antero-posterior positioning of anterior teeth is animportant factor in aesthetics since the teeth givesupport to the lips, cheeks, and other tissues of theoral cavity. The replacement of artificial teeth in theoriginal position of the natural teeth is frequently notstressed or simply overlooked. Too often, resorbedresidual ridges are used as the primary indicator fortooth position. Because of what may be extremechanges in shape and size, a resorbed, residual ridgeis a questionable landmark for either functional oraesthetic tooth position.

Setting artificial teeth directly over the center ofresorbed ridges makes the development of naturalaesthetics extremely difficult to achieve. This isbecause natural teeth seldom occupy the so-called“over the ridge” position. Dental restorations,complete dentures in particular, will not normally beaesthetically pleasing if teeth are improperlypositioned.

The loss of bone structure after tooth removal isusually greater on the buccal/labial aspects of themaxillary ridge than on the palatal aspect. Therefore,the ridge center is more palatal, smaller and differentin shape than it was previously.

The overall heights may vary, depending on theanatomical differences between individual patientsand on the degree of vertical overlap (overbite)incorporated into the anterior tooth arrangement. Anaccepted rule-of-thumb is discussed on page 3,bottom of column 2.

Description:Exceptional aesthetics, plus aninfinite variety of moulds to satisfyany need.

Indications For Use:Any full or partial denture case;also ideal for use in implantprosthetics and provisionalrestorations.

Factors to consider in the Aesthetic Arrangement ofDentsply Sirona Anterior Teeth

Natural antero-posterior placement of maxillary anterior teeth

Anteriors

When using Dentsply Sirona IPN® Dentureteeth, prior to placing teeth in wax, it issuggested the underside of the tooth beground (deglazed) to remove the polishedsurface to enhance retention.

Ridge resorption is a major factor inthe position of anterior teeth.

Natural Tooth Position

“A” illustrates the position of thenatural central incisor and itsrelationship to the ridge.

Position After Loss/Removal

“B” illustrates the same ridgeimmediately after removal of thetooth. Dotted lines indicateposition of the natural root.

Direction of Resorption

The direction of resorption is upand back. In “C”, the solid lineidentifies the resorbed ridge; thedotted line, the original contourof the ridge.

Improper Positioning of Teeth

“D” illustrates one of the mostcommon errors in anterior toothpositioning - positioning theteeth over the resorbed ridgewithout considering the originalposition of the natural teeth.

In “E,” with drawing “A”superimposed over drawing “D,”the denture with teeth set overthe ridge is compared to the original position of the natural central. The loss of vertical dimension and lip support, and resulting loss in aesthetics, is the most common result.

The following matrix studies further demonstrate therelationship between tooth position and ridgeresorption, and proper lip support:

Figure 1 shows a cross-section of the matrix andcast made before naturalteeth were removed.

In Figure 2, the cast hasbeen trimmed to simulate anormal amount of ridgeresorption in the anteriorarea.

In Figure 3, a graphicillustration is provided ofwhat happens to toothpositioning when the teethare set “up and back” on theresorbed ridge.

These figures illustrate the extent to which an artificialtooth set on the resorbed ridge may deviate from itstrue natural position. This “on the ridge” position ofthe teeth cannot provide proper lip and facial tissuesupport.

Proper vertical positioning of artificial teethaccording to averages.

(Note that the teeth in the schematic drawing aboveare labial to the residual ridges.)

Figure 1.

Figure 2.

Figure 3.

Figure 4.

For natural aesthetics and phonetics, artificialteeth should be placed as nearly as possible inthe same position antero-posteriorly, and be ofthe same length as the original natural teeth.

The measurements of 22 mm and 18 mm fromthe labial fold to the incisal edges of the maxillaryand mandibular incisors respectively, arereasonable averages. These distances may beused as a guide for the length of wax occlusalrims in the anterior area, and positioning of thecentral incisor teeth for preliminary tootharrangements.

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Tooth Arrangement in the Ovoid Arch

The Ovoid arrangement exhibits definite curvature;rotation is seldom observed.

A typical Ovoid alignment shows a fullness of labialsurface from canine to canine. This, in conjunction withsetting the teeth to the curved arch, gives a broadeffect that is in harmony with a round Ovoid face.

Figure 8A illustrates the averageantero-posterior distance from thecenter of the incisive papilla to thelabial surface of the centrals,based on the tooth form selected.

Basic placement ofanterior teeth

There are five important factors involved inpositioning anterior teeth:1. Anterior slope - Labial inclination2. Mesiodistal inclination - Mesial or distal tilt3. Inferior-superior positioning to a horizontal plane

- Above/below plane of occlusion4. Rotation on a long axis - Turning tooth on its

center axis 5. Antero-posterior positioning - How far labially or

lingually (in or out) the anterior or posterior teeth are located

Proximal View - Anterior Slope

On average, the central incisor, whenset at approximately the same angleas natural teeth, will be at aninclination slightly offset fromvertical. The incisal edge will contactthe occlusal plane.

The slope of the lateral incisor isoften slightly more accentuatedthan that of the central. Theincisal edge of the lateral may beslightly raised (superior to) about1/2 mm from the occlusal plane.

The canine may be setprominently, often to a line atright angles to the occlusal plane,with the incisal edge set on orslightly above the plane.

Frontal/Facial View - Mesiodistal Inclination

The desirable angulation to the median line may be correlated to the form of the arch and of the tooth.Generally, the Square Arch form and tooth, and theOvoid Arch form and tooth, may be set toapproximately the same angulations.

The Tapering forms are often set to a slightly greater angulation.

Any technique concerning the preliminaryarrangement of teeth is based upon averageconditions. Many times practical considerationsdictate modifications in these methods in order tocope with individual differences in oral and facialanatomy. However, if basic principles are followed,they will be a workable foundation for a harmoniousarrangement.

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The relationship of the arch form totooth arrangement

Nature tends to harmonize the form of maxillarycentrals with the form of the face, the dental arch, andthe arrangement of anterior teeth. Persons withdominantly square faces often have mainly squarearrangements of mostly square-shaped teeth. Ingeneral these same harmonious principles also applyto the square tapering, tapering, and ovoid type.

Tooth Arrangement in the Square Arch

In the Square Arch form, the two centrals are usuallyset to an almost straight line across the front of thearch. The laterals are also positioned with a nearly fulllabial aspect and exhibit very little rotation. This helpsgive prominence to the canines. The radius of squarearches tends to be wider than, for example, taperingarches. This provides sufficient room for placement ofthe incisor teeth without crowding or lapping.

Tooth Arrangement in the Tapering Arch

A common feature here is the rotation of the centralson their long axis inward at the distal, which sets thetwo teeth at an angle. Rotation and lapping of teeth isoften observed because there is less space in this archthan in any other type, and crowding is a result. Thisoften reduces the amount of labial surface visible.

A Tapering arrangement does not appear as wide as others, however, it is usually in harmony with thenarrowing effect visible in the lower third of thetapering face. The laterals are often raised from theocclusal plane and depressed at the gingival. Inaddition, the necks of the canines at the gingival areoften quite prominent. The incisal tips of the caninesmay be at the same height or slightly above theincisal edges of the laterals.

A Tapering arrangement may also exhibit some“slope”; that is, the incisals of the centrals and lateralsare projected forward, and the cervical area ofcanines is brought out.

Tooth Arrangement in the Square Tapering Arch

The Square Tapering arrangement combines charac-teristics of the Square and Tapering forms, modifyingboth. It has a characteristic Square placement of thecentrals, but is set in a “softer” arrangement. TheSquare Tapering arrangement may not exhibit theillusion of fullness or width as does the Square, andusually the canines exhibit more distal rotation than ina Square arrangement.

Figure 7. Mould 22G is illustrated.

Figure 6. Mould 45F is illustrated.

Figure 5. Mould 12G is illustrated. The centrals are set prominently with thelaterals and canines elevated. There may belittle or no rotation of the centrals combinedwith a typical Tapering effect or rotation oflaterals and canines.

The central incisors in the Ovoid anteriorarch are often set well forward of thecanines, in a position between that of theSquare and the Tapering arches.

Other appropriate mould forms are listed inthe IPN Mould Chart, Reference #905473and in the Individualized AnteriorArrangement brochure, Reference #3900.

In the Tapering arch, the central incisorsare often found to be a greater distanceforward of the canines than in other typesof arches.

Overall, in the Square arrangement the visualeffect is fairly straight from canine to canine.The teeth also tend to be straight up anddown, rather than sloping. The full or nearlyfull labial surface presented by all sixanterior teeth gives a broad effect which isin harmony with a broad, square face.

Mandibular ridge is used to determine archform due to resorption of maxillary ridge.

Figure 8. Mould 65G is illustrated.

Figure 8A.

5mm Square6mm Ovoid7mm Tapering

Figure 9A.Central

Figure 9B.Lateral

1/2 mm

Figure 9C.Canine

Figure 10A.Square Ovoid

Square-tapering Tapering

Figure 10B.

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The following drawings illustrate the principle of toothpositioning for visual effect:

In Figure 16A, two centralincisors are normally positioned. Viewed from thefront, these teeth would looknormal in their size or relationto each other.

In Figure 16B, the twocentrals have been positionedwith the mesials slightly moreprominent and with thedistals rotated inwardly sothey are less prominent. Viewed from the front view,the teeth in “B” would look smaller than thoseappearing in “A.” The illusion is created by merelyrotating the teeth, giving them a somewhat smallerand softer look.

To further soften this effect, a rubber wheel may beused to round the distoincisal surface of either tooth,thereby introducing a slight degree of asymmetry.

In Figure 16C, the same twocentral incisors are placed tomake the teeth look larger,creating the illusion ofboldness or strength. This isaccomplished by rotating themesial in and the distal out to show more facialsurface. If the laterals are also depressed slightlybehind the centrals, the boldness of the tootharrangement is further accentuated. This illusion maybe made even stronger by grinding the teeth incisallyto leave the distoincisal area prominent.

Procedures to be observed inarranging the mandibular anteriorteeth

Figures 17 and 18 show an anterior view of the loweranterior teeth arranged in average horizontalalignment of their incisal edges. Note that the long axisof the central incisors is perpendicular to the plane.The long axis of the lateral incisors is inclined slightlyto the distal at the neck. The long axis of the canines isinclined more to the distobuccal at the neck.

Figures 19 and 20 illustrate how to achieve greatercharacterization; lower anteriors should be rotatedand lapped with no two long axes of the teeth parallelto each other.

The horizontal plane used for thealignment of lower anterior teethmay be above the occlusal plane,a distance usually described asthe vertical overlap or overbite(Figure 21).The vertical overlap ofthe teeth may be influenced bythe aesthetic and phonetic needsof the patient. Anterior teethshould also be arranged inharmony with various degrees ofincisal guide table angulation.

Figure 22 shows a proximal view of the loweranteriors indicating their average antero-posteriorinclinations to a horizontal plane.

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Procedures

Occlusion Rims

A wax occlusion rim is fabricated and defines theposition, size and shape of the teeth to be replaced.Critical information about the patient’s correct verticaldimension of occlusion, occlusal registration and thegeneral arrangement of the denture teeth areindicated on the occlusion rims. From this wax“template”, a technician can proceed to position andarrange the teeth in the initial set-up.

1. Place the central incisors in position with incisaledges touching the occlusal plane or amandibular occlusion rim (Figure 11).

2. Position the laterals with the incisal edge raisedapproximately 1/2 to 1 mm (Figure 12).

3. Place the canines with the incisal tip close to ortouching the occlusal plane, and tilt the cervicalthird buccally to give it prominence. Often, themesiolabial aspect of the canine is visible whenviewed from the anterior.

In nature, the position of the canine teeth plays animportant part in the aesthetic appearance of thedentition. In a denture, they play an equally importantrole. They have aesthetic and functional influence onboth the anterior and posterior tooth arrangements(Figure 13).

Positioning of maxillary canines

Figures 14 and 15 show the importance of theproper positioning of the upper canines.

Figure 14. Viewed from the anterior, the mesiolabialsurface of the canine is prominent, and the gingivalone-third is positioned more facially than the incisalone-third.

Figure 15. Profile or side view emphasizes the almostvertical long axis and position of the canine.

Factors of softness and vigor

In nature there are a number of conditions which may beobserved that directly affect the individual arrangementand aesthetic appearance of natural dentition.

Softness in a tooth arrangement is a reduction of thelabial surface in terms of its visual appearance. Arounded mesiodistal curvature of the tooth combinedwith an ovoid outline of the tooth appears softer thana flat tooth with more angularity. A rounded form isfar softer to the eye than a straight line or a flat plane.

A characteristic of the bold, vigorous face is thedominant size and alignment of the teeth. Therelatively larger size of the lateral incisors andcanines, and their straight bold arrangement, areimportant considerations in achieving the effect ofstrength. Vigor and boldness are not necessarilysolely masculine characteristics, since strong, boldfaces may be found in many female patients.

More information regarding use of waxocclusion rims, waxing-up and general set-up guidelines are available in the Appendix,page 32.

Figure 11.

Figure 13.

Figure 12.

Figure 16A.

Figure 16B.

Figure 16C.

Figure 17.

Figure 18.

Figure 19.

Figure 20.

Vertical Overlap

Horizontal Overlap

Figure 21.

VerticalOverlap(Overbit

e)

HorizontalOverlap (Overjet)

Central Lateral Canine

Figure 22.

Central Lateral Canine

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Overall evaluation of anterior tootharrangement

Although there are varying methods and guides in thearrangement of artificial anterior teeth, it is the overallvisual effect of the teeth in the mouth of the patient,created by their shape, size, color, and position, thatdetermines acceptance or rejection. The teeth mustfulfill the Aesthetic, Phonetic and Functionalrequirements of the individual patient. This is why awax try-in and acceptance of the denturearrangement by the patient is so important.

A wide variety of patient communication materialsand denture selection aids are available from DentsplySirona to help educate patients and assist in thedelivery of essential information from the dentist tothe laboratory.

Dentsply Sirona Digital Prescription

Dentsply Sirona can help to simplify the dentureprocess guiding the dental office through the keyinformation laboratories need to make a high-qualitydenture. The Dentsply Sirona Digital Prescription Appprovides reliable options for teeth, moulds, anddenture base; therefore, providing greater dentureprescription detail from clinicians to dentallaboratories and helping labs to more preciselymanage tooth inventories. Download the app today!

Asymmetry and its influence ontooth arrangement

Another aspect of interest in tooth arrangement is therelationship of facial asymmetry. Few faces will beobserved with true symmetry of the left and rightside. Many faces which appear on first observation tobe symmetrical, on closer study will be found to havedifferences. Similarly, these differences may beobserved in the arrangement of the teeth. (CompareFigure 21 with Figure 22.)

Asymmetry may be brought about by as little as thedepression or rotation of a canine. At times it may beaccompanied by a difference in the size of the laterals,or by positioning one central slightly anterior to theother. This is shown in natural dentition (Figure 22).

Characterization of artificial tooth arrangements -using asymmetry, spacing, crowding, lapping, andgrinding modifications - should be approached withcaution. Pre-extraction study casts and photographsare the best guides for these individualized touches.This is an area of complete denture treatment whichis more in the realm of the artistic than the scientificand requires patient acceptance.

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Posteriors

Figure 22. Natural smile showing asymmetry.

Figure 21. Smile created using only the right side ofthe natural smile in Figure 22.

Background and Objective

Lingualized occlusion* was first documented in dentalliterature in 1927 by one of the founding-fathers ofarticulation, Dr. Alfred Gysi, of Switzerland. It isdefined as, “setting the upper posterior teeth in aturned-out position (cusps toward the cheeks), sothat only the lingual cusps of the maxillary teethcontact the center of the occlusal table (the fossa) ofthe mandibular posterior teeth” (see Figure 1 below).

The focus of this posterior arrangement method is on elimination of the tooth contact points on the buccalcusps. Thus, the occlusal contacts are moved as farlingually as practical, while still maintaining thephysiologic positioning of the prosthetic teeth.Preservation of the lingual contacts assures seatingand minimizes tipping of the lower denture upontooth contact and during function.

Within practical limits, it is aesthetically optimal when denture teeth are arranged close to where the naturalteeth were originally located, prior to ridgeresorption. Radiographs and pre-edentulousphotographs of the patient are important indetermining this position. However, patients withresorbed ridges and restricted neutral zones (thechannel where the teeth are located that should not be affected by tongue, lip and cheek forces whichcould unseat the denture) may determine the extentto which aesthetics will be sacrificed for functionalimprovements. In such cases, lingualized occlusionminimizes aesthetic compromises and optimizesfunctionality.

Description:A posterior arrangement methodthat eliminates tooth contactpoints on the buccal cusps toassure seating and minimizetipping of the lower denture uponcontact.

Indications For Use:Ideal for use with full dentures.

Ridge Type:30˚or 33˚–Healthy ridge with

minor resorption.22˚–Moderately resorbed ridge.0˚ or 10˚–Advanced ridge resorption.

LingualizedOcclusion

Figure 1. Lingualized Set-Up

*Glossary Prosthodontic Terms 1999 (S. Howard Payne, 1941; Earl Pound, 1970’s)

iPhone and iPad are registered trademarks of Apple Inc. App Store is a service mark of Apple Inc.Google Play is a trademark of Google Inc.

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Arranging Portrait® IPN® Posteriors (33° Maxillary Posteriors with 22°Mandibular Posteriors)

1. Place the 33° maxillary premolars with their longaxes at right angles to the occlusal plane (Figure 6).The lingual cusps should touch the plane and thebuccal cusps should be raised approximately 1/2mm above the plane (Figures 6 and 7). A straightedge may be used to align the lingual cusps asshown previously.

2. The first and second molars may be set with their longaxes inclined slightly mesially (Figure 6).

3. The mesiolingual cusp of the first molar touches theplane, and the mesiobuccal cusp is approximately1/2 mm above the plane. The distolingual cusp isslightly above the plane, and the distobuccal cusp isapproximately 1 mm above (Figures 6 and 7).

4. The second molar is set to follow the same angle orplane of the first molar. The distolingual cusp isapproximately 1-1/2 mm above the plane, and thedistobuccal cusp is approximately 2 mm above theplane (Figures 6 and 7).

5. Follow the same procedure in placing the posteriorteeth on the opposite side.

6. Occlude the central fossae area of the mandibular22° teeth to the lingual cusps of the maxillary 33°teeth. A typical relationship of upper to lower isillustrated in Figure 8. The relationships of thecompleted arrangement are shown in Figures 9-17on page 12.

Arranging Portrait IPN 33° MaxillaryPosteriors with Portrait IPN 0°Mandibular Posteriors

7. Occlude the central fossae area of themandibular 0° teeth to the lingual cuspsof the maxillary 33° teeth. A typicalrelationship of upper to lower is illustratedin Fig. 8. The relationships of thecompleted arrangement are shown inFigures 18-26 on page 13.

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Lingualized Set-up Techniques

For a lingualized occlusion, select a higher degreecusp angle on the upper posterior teeth than thedegree of cusp angle of the lower posterior teeth.

We recommend that the maxillary posterior teeth bea 30˚ occlusal slope or greater and that themandibular posterior teeth be a 22˚ slope or less.However, when proper lingualized articulationtechniques are used, almost any combination of teethwill function properly.

Dentsply Sirona suggests the following process forlingualized articulation and arrangement of posteriorteeth to achieve function, comfort, and aesthetics fora fully edentulous patient.

1. Set the upper arch first with ideal Curve of Spee,Curve of Wilson, and Lingual Curve except whena linear arrangement is desired.

NOTE: Set the anterior denture teeth in theirphysiologic position for aesthetic and phoneticreasons. Posterior teeth can be set over the resorbedridge when adequate tongue space exists, or facial tothe ridge when aesthetics require facial placement ofthe teeth (Figure 2).

2. If a lingualized arrangement is desired, when allmaxillary teeth have been set insert an object theapproximate thickness of a 2mm ruler betweenthe buccal cusps of the posterior teeth and thetable while the set-up wax is still soft (Figure 3).Apply pressure. This technique will elevate themaxillary buccal cusps to the right position forproper contact between the opposing stampcusps. This also eliminates any contact betweenthe maxillary buccal cusp and the opposingmandibular buccal cusp in the workingmovement.

3. Begin setting the mandibular arch with the firstmolars. The mandibular first molars are the “keyto occlusion” (Figures 4, 5). Use the mesiolingualmaxillary cusp as the stamp cusp. A stamp cusp isa working cusp, which occludes into a fossa in theopposing dentition. In lingualized occlusion themaxillary stamp cusps are preserved. No grindingshould occur on these teeth. Use the rule of BULLfor adjustments: if needed, occlusal grindingshould eliminate contact on the Buccal cusps ofthe Upper teeth and remove premature contactfrom Lingual cusps of the Lower teeth. Set theremaining mandibular posterior teeth.

4. Grind-in option: You also have the option to grindin occlusion. Prior to setting the mandibular teeth,open the articulator pin 1mm. Grind a saucershape approximately 2mm wide to accommodatethe stamp cusps. The saucer shape is developedby marking both centric and eccentric occlusionwith articulating paper. Continue to develop thesaucers until the pin contacts the incisal guidetable.

Figure 2. Posterior Resorption

Figure 3.

Figure 4. Mandibular first molar- Buccal View

Figure 5. Mandibular first molar- Lingual View

Figure 8.

Figure 7.

Figure 6.

10˚ MINUS

If a “deeper” or “tighter” occlusion is desired, someslight grinding modification in the developmentalgroove areas of the 0° lower posteriors will permit amore intimate lingualized relationship with thelingual cusps of the upper 33° posteriors. Themodification may be done with small, mountedpoints.

Lingualized Occlusion VideoReference # DP-0000130

1312

Figure 18. Centric occlusion, buccal view. Figure 20. Centric occlusion, lingual view.

Figure 21. Working occlusion, buccal view. Figure 23. Working occlusion, lingual view.

Figure 24. Balancing occlusion, buccal view. Figure 26. Balancing occlusion, lingual view.

Portrait® IPN® Teeth - 33˚/ 0˚ Example for Unlingualized Occlusion

Tooth Arrangement In All Relations

Figure 19. Cross sectionof centric occlusion.

Mandibular Movement

WorkingSide

Figure 22. Cross sectionof working occlusion.

MandibularMovement

BalancingSide

Figure 25. Cross sectionof balancing occlusion.

An alternative for lingualized cases requiring flat mandibular occlusion.

Tooth Arrangement In All Relations

Figure 9. Portrait IPN Lingualized balancedarrangement in centric occlusion, buccalview.

Figure 12. Working occlusion, buccal view.

Figure 11. Centric occlusion, lingual view.

Figure 15. Balancing occlusion, buccal view.

Figure 14. Working occlusion, lingual view.

Figure 17. Balancing occlusion, lingual view.

Note: Arrangements shown are average. Modifications may be made as needed for a given situation.

Mandibular Movement

WorkingSide

MandibularMovement

BalancingSide

Portrait® IPN® Teeth - 33˚/ 22˚ Example for Lingualized Occlusion




A simplified approach to tooth selection, ordering and set-up.

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Dentsply Sirona® Portrait® IPN® 0° Posterior teeth arethe first flat plane posterior teeth to be rated superiorin overall aesthetic appearance. They are suitable forcomplete dentures where a zero degree tooth isindicated or preferred. A wider bucco-lingual tablepromotes efficient function and ease of set-up. Zerodegree cusp areas are non-interfering and providecomplete freedom in lateral excursions. When viewedin the mouth, the mesiofacial appearance of 0° teethresemble well-worn natural teeth. A modified rationalocclusal design gives the illusion of anatomical teeth.

Portrait IPN 0° teeth may be arranged for continuous bilateral balanced occlusion with the propercompensating curve or in flat linear occlusion. Openocclusal angles are ideal for lingualized set-up withsemi or fully anatomical upper posteriors, especially“even-dimensioned” 10° and 33° posteriors. To aid inarrangement, the maxillary teeth may be positionedwith the lingual surfaces set to a straight edge. Thispositioning automatically provides a proper degree ofbuccal contour for good aesthetic appearance and function.

All Dentsply Sirona 0° Posterior teeth follow the samesuggested arrangement and articulation guidelines asPortrait IPN 0° Posterior teeth.

Arranging Dentsply Sirona Flat PlaneIPN Posteriors in linear occlusion

1. Place the maxillary premolars and molars withtheir long axes at right angles to the occlusalplane (Figure 1). The buccal and lingual cuspareas should touch the plane (Figures 1 and 2).

2. A straight edge may be used to align the lingualcusps of all four posteriors to a straight line(Figures 3 and 4). When this is done, a properbuccal contour results.

Description:Non-anatomical, with the illusion ofwell-worn anatomical teeth. Zerodegree cusps are non-interferingand provide complete freedom inlateral excursions.

Indications For Use:Ideal for use with full dentures.Open occlusal angles permit alingualized set-up with semi or fullyanatomical upper posteriors.

Ridge Type:Advanced ridge resorption.

Recommended Technique:Bilateral Balanced, LinearOcclusion, and LingualizedOcclusion.

Posteriors 0˚(Monoline® 0˚)

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Dentsply Sirona provides a large selection of posteriortooth options to assure that technicians will have avariety of predictable ways to approach lingualizedocclusion – with the cutting edge on top and the foodtable below.

Lingualized arrangements can be successfullyaccomplished for each of the mould combinationsillustrated below.

For more detailed tooth arrangementoptions, contact your Dentsply SironaRepresentative or call Customer Serviceat 1-800-786-0085 to receive a copy of“Individualized Anterior Arrangements ofDentsply Sirona Teeth” Reference#3900).

Figure 1.

Figure 2.

Lingualized Occlusal Options from Dentsply Sirona

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Arranging Flat Plane Posteriors inbilateral balanced occlusion

1. Place the maxillary premolars with their long axes atright angles to the occlusal plane (Figure 16). The lingualcusp areas should touch the plane, and the buccal cuspareas of the premolars should be raised approximately1/2 mm above the plane (Figures 16 and 17).

A straight edge may be used to align the lingual toothsurfaces as shown previously (Figures 3 and 4).

2. The first and second molars may be set with their longaxes inclined very slightly toward the mesial (Figure 16).

3. Position the first molar with the mesiolingual cusp areatouching the plane, and the mesiobuccal cusp areaapproximately 1/2 mm above the plane. The distobuccalcusp area should be approximately 1 mm above theplane (Figures 16 and 17).

4. The second molar is set to follow the same angle or planeof the first molar. The mesiolingual cusp should be about 1mm above the plane, and the mesiobuccal anddistolingual cusp areas approximately 2 mm off the plane.


6. Then, occlude the mandibular teeth to the maxillaryteeth (Figures 18-26). A 30° condylar inclination and 0°incisal inclination were used in this arrangement. Otherguidance factors may be used as individual conditionsindicate.

When using flat plane posteriors, it is advisable to modifythe canines so that the incisal edges tend toward bluntnessrather than a sharp point. A somewhat blunted canineenhances the appearance of the contact area andembrasure between the canine and the first premolar.

To ensure the best occlusal efficiency, there should be closecontact of the occlusal surfaces when viewed from thelingual, as well as the buccal.

16

3. Follow the same procedure in placing theposteriors on the opposite side.

4. Then, occlude the mandibular teeth to themaxillary teeth (Figures 7-15). There should beapproximately 1.5 mm of buccal overjet by themaxillary teeth as shown in Figure 5. This buccaloverjet is essential to prevent “cheek biting”.

The arrangement illustrated here was done with a 30°condylar inclination and a 0° incisal inclination. Otherguidance factors may be used as individual conditionsindicate. In this type occlusion with 0° Posteriors, therewill normally be no contact in balancing positions.

Note: The maxillary and mandibular teeth do notinterdigitate. They may be set end-to-end asshown in Figure 6. It is possible to positionpremolars to oppose molars because there is nointerdigitation of the cusps.

Figure 18. Portrait IPN 0° balancing arrangement, incentric occlusion, buccal view.



Figure 24. Balancing position, buccal view.


Figure 26. Balancing position, lingual view.

Figure 17.Figure 16.




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

Figure 7. Portrait IPN 0˚ flat linear type tootharrangement in centric occlusion, buccal view.






Figure 3.

Figure 5.

Figure 4.

Figure 6.




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

0˚ Posteriors: The Completed Tooth Arrangement In All Relations In Linear Occlusion

0 ̊Posteriors: The Completed Tooth Arrangement In All Relations In Bilateral Balanced Occlusion

19

When this is done, a proper degree of buccal curvatureresults (Figure 4).

This also aligns the lingual cusps to, in effect, form alingual knife for exceptional cutting efficiency.

3. Follow the same procedure in placing the posteriorson the opposite side.

4. Then, occlude the mandibular teeth to the maxillaryteeth as shown in Figures 5-10. This arrangement wasdone with a 30° condylar inclination, and a 10° incisalinclination. Other guidance factors may be used asconditions indicate.

Arranging 10° posteriors inbilateral balanced occlusion

1. Place the maxillary premolars with their long axes atright angles to the occlusal plane (Figure 14). The lingualcusps should touch the plane and the buccal cuspsshould be raised approximately 1/2 mm above the plane(Figures 14 and 15). A straight edge may be used toalign the lingual cusps as shown previously (Figures 3and 4).

18

Dentsply Sirona IPN® 10° Posterior teeth are a beautifully carved tooth form with moderately inclined cuspal slopes.Their natural anatomic form makes them aesthetically andfunctionally well suited for use in complete and partialdentures.

10° Posteriors resemble well-worn natural teeth, but withwell-defined sluiceways and ridges to promote goodchewing efficiency without packing - important for patientcomfort. Cusps are shallow and non-interfering to facilitatefreedom in excursions. A slight protrusive lift allows anterioroverbite for improved aesthetics.

These teeth may be arranged in a linear type occlusion orwith a compensating curve for continuous bilateral balancedocclusion. For convenience in tooth arrangement in bothconfigurations, when viewed from the occlusal aspect, themaxillary teeth may be set with the lingual surfaces set to astraight edge. This automatically provides a proper degreeof buccal curvature.

Arranging Dentsply Sirona 10° posteriorsin linear occlusion

1. Place the maxillary premolars and molars with their longaxes at right angles to the occlusal plane (Figure 1). Thebuccal and lingual cusps should touch the plane(Figures 1 and 2).

2. A straight edge may be used to align the lingual cuspsof all four posteriors to a straight line (Figure 3).

Description:Semi-anatomical, with the look ofwell-worn natural teeth. Shallowcusps minimize interference, yetprovide a definite centric.

Indications For Use:Ideal for use with full dentures. Inocclusion the upper lingual cuspsalign to form an efficient lingual“cutting knife”.

Ridge Type:Semi to fully resorbed ridge.

Recommended Technique:Bilateral Balanced, Lingualized andLinear Occlusion.

Posteriors 10˚(Anatoline®/Functional®)

Figure 1.

Figure 2.

Figure 3.

Figure 5. 10° linear arrangement in centricocclusion, buccal view.

Figure 8. The linear arrangement inworking occlusion, buccal view.

Figure 7. The linear arrangement incentric occlusion, lingual view.

Figure 11. The linear arrangement inbalancing position, buccal view.

Figure 10. The linear arrangement inworking occlusion, lingual view.

Figure 13. The linear arrangement inbalancing position, lingual view. Balancingcontacts may be minimal.

Figure 14.

Figure 15.

Figure 4.

Proximal view

Buccal view




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

10˚

10˚

10˚ Posteriors: The Completed Tooth Arrangement In All Relations

21

Dentsply Sirona 20° Posteriors are designed to overcomecertain problems of the edentulous patient by utilizingshallow cusp angles as an aid in reducing lateral thrustforces. Because the occlusal surfaces have interactingridges and intercommunicating clearance spaces,masticating efficiency is greatly enhanced. Dentsply Sirona20° Posteriors will be found desirable for use whenever asemi-anatomical cuspal design is preferred or indicated.

• DESIGNED to function in accordance with anatomicalrequirements of mandibular movements.

• ENGINEERED for increased masticating efficiency withshallow cusp inclinations, interacting ridges and intercom-municating clearance ways.

• A CORRECT AXIS for each tooth to direct masticatingforces and to assist in stability and retention of thedenture.

• SELF-CLEANSING SULCI to help prevent food packing onchewing surfaces and to maintain a high degree ofmasticating efficiency.

• READILY ADAPTABLE to both steep and shallow condylepaths without destructive change in the occlusal surface.

Arranging Dentsply Sirona 20° maxillaryposteriors

Theoretical positions of the upper posteriors are shown inthe following diagrams:

1. Place the maxillary first premolar with its long axis atright angles to the occlusal plane. The buccal andlingual cusps are placed on the plane.

2. Place the maxillary second premolar in a similarmanner.

3. The mesiobuccal and mesiolingual cusps of the upperfirst molar touch the occlusal plane. The distobuccalcusp is raised about 1/2 mm and the distolingual cuspwill be raised accordingly (see Figure 2 next page).

Description:Semi-anatomical, shallow 20˚cusps offer minimal interferenceand interacting ridges withclearance spaces to enhancechewing efficiency.

Indications For Use:Ideal for use with full dentures,when ease of set-up anduninterrupted function is desired.

Ridge Type:Semi-resorbed ridge.

Recommended Technique:Bilateral Balanced and/orLingualized Occlusion.

Posteriors 20˚

10˚ 15˚ BENNETT

20


6. Then, occlude mandibular teeth to the maxillary teeth(Figures 16-24). A 30° condylar inclination and a 10°incisal inclination are recommended. However, otherguidance factors may be used as individual conditionsindicate.

Figure 16. The balancing arrangement incentric occlusion, buccal view.

Figure 19. In working occlusion, buccalview.

Figure 18. The balancing arrangement incentric occlusion, lingual view.

Figure 22. In balancing position, buccal view.

Figure 21. In working occlusion, lingualview.

Figure 24. In balancing position, lingualview.



Figure 20. Crosssection of workingocclusion.

Figure 23. Crosssection of balancingocclusion.

Mandibular Movement

Working Side

Mandibular Movement

Balancing Side


Figure 1. Buccal view

2. The first and second molars may be set with their longaxes inclined slightly mesially (Figure 14).

3. The mesiolingual cusp of the first molar touches theplane, and the mesiobuccal cusp is approximately 1/2mm above the plane. The distolingual cusp is slightlyabove the plane, and the distobuccal cusp isapproximately 1 mm above the plane (Figures 14 and 15).

4. The second molar is set to follow the same angle orplane of the first molar. The distolingual cusp isapproximately 1-1/2 mm above the plane, and thedistobuccal cusp is approximately 2 mm above theplane (Figures 14 and 15).

23

Dentsply Sirona 22° Posterior teeth mimic naturaldentition with moderately inclined cuspal slopes. Theirnatural anatomic form makes them aesthetically andfunctionally well suited for use in complete dentures,as well as for removable partial dentures.

The 22° Posteriors resemble well-worn natural teeth,but with well defined sluiceways and ridges topromote good chewing efficiency without packingfood - important for patient comfort. Cusps areshallow and non-interfering to facilitate freedom inexcursions, yet provide a definite point of centriccontact. A slight protrusive lift allows anterioroverbite for improved aesthetics.

These teeth may be arranged with a compensating curve for continuous bilateral balanced occlusion. Forconvenience in tooth arrangement, when viewed fromthe occlusal aspect, the maxillary teeth may be setwith the lingual surfaces set to a straight edge. Thisautomatically provides a proper degree of buccalcurvature.

Arranging Dentsply Sirona 22°Posteriors in bilateral balancedocclusion

1. Place the maxillary premolars with their long axes

at right angles to the occlusal plane (Figure 1).The buccal cusps should touch the plane and thelingual cusp of the maxillary 1st premolar shouldbe raised approximately 1/2 mm to 1 mm abovethe plane (Figures 1 and 2).

Description:Semi-anatomical, long crown formswith moderately inclined cuspalslopes.

Indications For Use:Ideal for use with partial dentures,in combination cases and implantoverdentures; also for use in fulldentures.

Ridge Type:Moderately resorbed ridge.


Posteriors 22˚(BioStabil®)

22

4. All the cusps of the second molar are raised from thelower occlusal plane following the same angle orplane of the first molar. The mesiobuccal cusp shouldbe about 1 mm from the occlusal plane (see Figure 2below).

5. A straight edge may be used to align the labial ridgeof the canine, the buccal ridges of the first andsecond premolars, and the mesiobuccal ridge of thefirst molar. The buccal ridges of the molars aresimilarly aligned, but angled slightly inward (seeFigure 3).

6. Follow the same procedure in placing the posteriorson the opposite side.

Articulation of mandibular first molar

Bilateral balanced occlusion contributes greatly to thecomfort and efficiency of complete dentures. Withoutbalanced occlusion there may be greater resorption, lessmastication efficiency, and a recurrence of sore spots. Thiscan be accomplished with a minimum of effort if each toothis brought into function.

If careful attention is paid to the positioning of themandibular first molar, articulation of the remainingposteriors will be greatly facilitated.

Relation of the maxillary and mandibularfirst molarThe first molars are the keystone to posterior occlusion.Illustrated here are ideal relationships.

Centric Occlusion,Buccal View.Note: Generous overjet of maxillary molar over the mandibular molar.

Note: Seating of upper mesiolingual cusp in lower central fossa.

Centric Occlusion,Lingual View.

WorkingOcclusion,Buccal View.

WorkingOcclusion,Lingual View.

WorkingOcclusion,Distal View.

BalancingPosition,Buccal View.


The remaining teeth are inter-digitated in a similar manner. Check the centric and lateral relationships of each toothas it is positioned - as well as the completed tooth arrangement in all relations.

Figure 4. In centric occlusion, buccal view.

Figure 7. In working occlusion, buccal view. Figure 9. In working occlusion, lingual view.

Figure 10. In balancing relation, buccal view. Figure 12. In balancing relation, lingual view.

Figure 6. In centric occlusion, lingual view.

20˚Posteriors - The Completed Tooth Arrangement In all Relations

Figure 3. Use of straight edge, occlusal view.




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side


Figure 2. Proximal view

Figure 2. Interproximal view

10˚

25

Dentsply Sirona 30° Posteriors are designed to meetthe anatomical requirements of the mandibularmovements of the majority of patients. They areparticularly suitable for partial and complete dentureswhich oppose natural teeth, and for completedentures in which a cuspal form is preferred.

When the teeth are properly occluded, they will havebilateral balance without cuspal interference. The 5°buccal slope and the engineered buccal overjetprotects the cheeks and helps to virtually eliminatecheek biting.

The natural form and function of the5° buccal slope

The 30° Posteriors are designed with a 5° buccalslope of the maxillary premolars, which followsnature’s plan and greatly improves the aesthetics offinished dentures. Studies of thousands of naturalteeth reveal the importance of this 5° slope inaesthetics. Figure 1 below shows two representativenatural maxillary pre-molars compared with the 30° premolars. Note how closely the 5° buccal slopefollows nature’s plan.

A greater degree of comfort andefficiency for the patient

An important feature of the 30° Posteriors is theadequate food table and narrow occlusal contact.Greater stability of the denture is provided by theshallow transverse or lateral angle of the teeth.Mastication is made easier and more efficient,assuring a new and greater degree of comfort to thepatient.

Description:Fully anatomical, long crown formsand long buccal-short bite mouldsavailable.


Ridge Type:Healthy ridge with minorresorption.


Posteriors 30˚(Pilkington-Turner®)

24

A straight edge may be used to align the lingual cusps ofall four posteriors to a straight line. When this is done, aproper degree of buccal curvature results (Figure 3).

2. The first and second molars may be set with their longaxes inclined slightly mesially.

3. The mesiobuccal cusp of the first molar isapproximately 1/2 to 3/4 mm above the plane. Themesiolingual cusp of the first molar is approximately3/4 to 1 mm above the plane (Figures 1 and 2).

4. The second molar is set to follow the same angleor plane of the first molar. The distolingual cuspand the distobuccal cusp are approximately 1-1/2mm above the plane (Figures 1 and 2).

5. Follow the same procedure in placing theposterior teeth on the opposite side.

6. Then, occlude mandibular teeth to the maxillaryteeth (Figures 4-9).

Figure 4. Centric occlusion, buccal view.







Figure 3.




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side


Figure 1.

For the lingualized occlusion techniqueusing 33˚ posteriors over 22˚ posteriors,and 33˚ over 0˚, see pages 9-14.

30˚ 15˚ BENNETT

2726

Natural conformation and size areideal for removable partial dentures

30° Posteriors conform closely in size and shape tonatural teeth. Buccolingually, their width closelyapproximates that of natural teeth. Mesiodistally, theyare provided in sizes harmonious with natural teethwhich they may replace.

Procedures to be observed inarranging 30° Posteriors

Bilateral balanced occlusion is an important elementin securing maximum comfort and efficiency incomplete dentures. Without balance, there may bemore resorption of the ridges, lessening ofmasticating efficiency and greater recurrence oftender, sore tissue.

Balanced occlusion can be accomplished by emphasison two factors:

A. The correct positioning of the upper teeth.

B. The correct arrangement and individual positioningof each lower tooth in a functioning relationship tothe uppers.

A major advantage in the arrangement andarticulation of the 30° Posteriors lies in theiradaptability to most techniques and the ease withwhich balanced occlusion may be obtained.

Following are suggestions for the arrangement and articulation of the 30° Posteriors. These suggested procedures follow generally observed principles.

Figure 3. This buccolingual sketch of each posteriortooth shows the individual relationship to the occlusalplane. Note that the lingual cusp of the first andsecond premolars and the mesiolingual cusp of thefirst molar touch the occlusal plane. The buccal cuspsare raised approximately 1/2 mm. The molars alsofollow this proportionate relation. The arrangement ofposterior teeth in this manner forms thecompensating curve (Curve of Wilson), thecounterpart of the Curve of Spee in a naturaldentition.

Figure 4. The long axis of the premolars should be atright angles to the occlusal plane, while the molarsincline very slightly toward the mesial.

The mesiobuccal cusp of the first molar is raised 1/2 mmto position it out of contact with the occlusal plane. Themesiolingual cusp touches the plane. The distobuccalcusp should be raised approximately 1 mm.

The mesiobuccal cusp of the second molar should be raised about 1 mm, while the distobuccal cusp should beraised approximately 1-1/2 mm.

Figure 5. Illustrated is an occlusal view of the settingof the maxillary posteriors.

30° Posteriors - Articulation ofmandibular first molar

Balanced articulation contributes greatly to thecomfort and efficiency of complete dentures. Withoutbalance there may be greater resorption, lessefficiency, and a recurrence of sore spots. Balancedocclusion can be accomplished with a minimum ofeffort if each tooth is brought into function.

Bear in mind that the mandibular first molar is a keytooth in articulation. If careful attention is paid to thepositioning of this tooth, articulation of the remainingposteriors will be greatly facilitated.




Figure 12. Balancing occlusion, buccal view.


Figure 14. Balancing occlusion, lingual view.






Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

Figure 15. Centric. Figure 16. Working. No Cuspal Disclussion.

Figure 2. Showing the ample foodtable provided in the occlusal designof the premolars and molars.

Buccolingual view.

Buccal view.

Occlusal view.

29

3. The mesiobuccal and mesiolingual cusps of the maxillaryfirst molar touch the occlusal plane (red dots in Step 3).The distobuccal cusp (green dot) is raised about 1/2 mmand the distolingual cusp (green circle) is raised about 1/2to 3/4 mm above the plane.

4. All the cusps of the second molar are raised from theocclusal plane following the position of the first molar(red circles). The mesiobuccal cusp (red dot) should beabout 1 mm from the occlusal plane.

5. Follow the same procedure in placing the posteriors onthe opposite side.

6. An occlusal view of the positioning of Dentsply Sirona33° maxillary posteriors is illustrated in Figure 3, Page 28.

A straight edge may be used to align the labial ridge of thecanine, the buccal ridge of the first and second premolars,and the mesiobuccal ridge of the first molar.

The buccal ridges of the molars may be similarly aligned,but angled slightly inward. This is an average arrangement,and modifications can be made as individual conditionsindicate.

Dentsply Sirona 33° Posteriors -Articulation of mandibular first molarBilateral balanced occlusion contributes greatly to thecomfort and efficiency of complete dentures. Withoutbalance there may be greater resorption, less efficiency,and a recurrence of sore spots. Balanced occlusion can beaccomplished with a minimum of effort if each tooth isbrought into function.

Keep in mind that the mandibular first molar is a key toothin articulation. If careful attention is paid to the positioningof this tooth, articulation of the remaining posteriors will begreatly facilitated.

28

Dentsply Sirona 33° Posteriors are ideally designed forcomplete dentures and removable partial dentures whichoppose natural teeth. They are a standard of excellence formaxillary and mandibular complete dentures where ananatomical tooth form is preferred or indicated.

Cuspal contours are comparable to those of moderatelyworn natural teeth. Their inclinations and well defined sulciprovide pathways which are adaptable to mostrequirements in complete and partial denture construction.

Arranging Dentsply Sirona 33°maxillary posterior teeth

The procedures described are normal methods.Occasionally, compromises must be made for mechanicalreasons dictated by the conditions present. It may benecessary, for the purpose of creating required tongueroom, to alter the position of the posterior teeth.

The master carvings of Dentsply Sirona 33° posteriorteeth were planned to simplify occlusion and articulation.The relationship of the various cusps of the maxillaryposterior teeth should be related to a flat occlusal planefor easy initial positioning and later occlusion andarticulation with the mandibular posterior teeth. Anillustration of initial positioning of each tooth and therelationship of each cusp to a flat occlusal plane is shownin Figures 1 and 2.

1. Place the maxillary first premolar with its long axis atright angles to the occlusal plane. The buccal andlingual cusps are placed on the plane.

2. Place the maxillary second premolar in a similarmanner. Align the buccal surfaces of the premolarsand the canine with the edge of an occlusal plane(see Figure 3).

Description:Fully anatomical, long crown formsand long buccal-short bite mouldsavailable.




Posteriors 33˚ 30˚

Figure 1. Buccal view Figure 2. Proximal view

Figure 3.

Please note: Portrait® IPN® 33° posteriors can bealigned with a straight edge on the lingual for fasterset-ups (see 10°, page 18).


Figure 7. Working occlusion, buccalview.

Figure 9. Working occlusion, lingualview.

Figure 10. Balancing contact, buccalview.


Figure 12. Balancing contact, lingualview.


33° Posteriors: The Completed Tooth Arrangement In All Relations

Buccal/Cheek

Lingual/Tongue

Step 3Buccal/Cheek

Lingual/Tongue

Step 4

Figure 5. Cross section ofcentric occlusion.



Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

For the lingualized occlusion techniqueusing 33˚ posteriors over 22˚ posteriors, seepages 9 and 14.

31

1. Place the maxillary premolars with their long axesat right angles to the occlusal plane (Figure 1). Aslight mesial inclination is also acceptable. Thebuccal cusps of the premolars should touch theplane and the lingual cusp of the maxillary 1stpremolar should be raised approximately 1/2 to 1mm above the plane (Figures 1 and 2).

2. The first and second molars may be set with theirlong axes inclined slightly mesially.

3. The mesiobuccal cusp and the mesiolingual cuspof the first molar (red dots) areapproximately 1/2 to 3/4 mmabove the plane (Figures 1, 2, 2Band Step 3 illustration).

4. The second molar is set tofollow the position of the firstmolar. The distolingual cusp andthe distobuccal cusps (greendots) are approximately 1-1/2mm above the plane (Figures 1, 2, 2B and Step 4 illustration).

5. Follow the same procedure in placing theposterior teeth on the opposite side.

A straight edge may be used on the facial to align thebuccal ridge of the first and second premolars andthe mesiobuccal ridge of the first molar (Figure 3).The buccal ridges of the molars may be similarlyaligned, but angled slightly inward. This is an averagearrangement and modifications can be made asindividual conditions indicate.

30

Designed by master dental technicians in Europe,Dentsply Sirona Portrait® IPN® 40˚ posterior teeth are fullyanatomical. Their wider, deeper occlusal table and longercrown form integrate more completely with naturaldentition. This young anatomic form makes them ideallysuited for use in removable partial dentures andcombination cases.

Portrait 40° Posteriors are similar to the 22° posteriors inbucco-lingual and ridge lap design. This full-form toothwill fill a space and fit on a natural ridge with morestability and will more easily interdigitate with opposingnatural dentition and fixed bridge restorations.

Using 30° incisal and condylar guidance, the deepcusp/fossa angles can be arranged to maximize efficiencyand minimize interference. A definite occlusal stop in thecentral fossa area and an open ridge-groove pathwayprovide more freedom of movement in lateral excursions,as compared to other European posterior designs.

These teeth may be arranged with a compensating curvefor bilateral balanced occlusion with complete dentures.Balancing contacts may be achieved on all teeth exceptthe first bicuspid. Either the lowers or the uppers can beset first. When setting the upper teeth first, follow thedirections provided here. If setting the lower teeth first,use a Dentsply Sirona 20° Template.

Arranging Portrait IPN 40°Posteriors in a bilateral balancedocclusion

The relationship of the cusps of the maxillary posteriorteeth may be related to a flat occlusal plane for easy initialpositioning and later occlusion and articulation with themandibular posterior teeth, if necessary. An illustration ofinitial positioning of each tooth and the relationship ofeach cusp to a flat plane are shown in Figures 1 and 2.

Description:Fully anatomical, long crown form.




Posteriors 40˚(EuroLine®)

Figure 2B. Cusp view


Figure 2. Proximal view








Figure 3. Occlusal surface view




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

40° Posteriors: The Completed Tooth Arrangement In All Relations

30˚

3332

This chapter contains selected information and proceduresthat are important to routinely achieving successful denturetooth arrangement.

Stabilized Baseplate – The purpose of a stabilized baseplate isto provide a foundation representing the base of a completedenture, which is used for making jaw relation records andarranging denture teeth. Baseplates should be strong andrigid, fit accurately, and be stable without rocking. Thebaseplate borders should be full and rounded as in thefinished denture. If desired, a post-dam or posterior palatalseal can be added to the upper to give additional stabilitywhen placed in the mouth.

Wax Occlusion Rims – The purpose of occlusion rims is todefine the position, size and shape of the teeth to bereplaced. They enable dental professionals to establish andrecord the correct vertical dimension of occlusion, theocclusal registration and provide a positioning template to setdenture teeth for proper lip support.

In overall design, the wax occlusal rims should be smooth,centered buccolingually over and parallel to the residual ridgecrest, and properly contoured. In the anterior, use a millimeterruler to measure the distance from the mucobuccal fold tothe occlusal plane: 22mm on the upper and 18mm on thelower. (These measurements are for the “average” patientand may be increased or decreased by the dentist.) Theanterior upper should extend horizontally about 6 to 8mmfrom the middle of the incisive papilla.

The posterior plane of occlusion should not exceed 2/3 of theretromolar pad height on the lower and 8mm up from thetuberosity on the upper. The anterior occlusal width shouldbe about 3 to 4mm, and the posterior width at the first molarregion should be between 8 to 10mm.

Stabilized Baseplates

Wax Occlusion Rims

Tooth Morphology

Appendix forRelatedInformation

Figure 1. Mark and smooth/trim the wax to thesedimensions.

Figure 2. The anteriorportion of the maxillaryocclusal rim is labiallyoriented, i.e. it slants tothe anterior.

Figure 3. The posterior areas ofthe wax rims should be trimmed ata 30 ̊angle to eliminate potentialinterference during bite registrationprocedures.

Posterior Mould/Shade Availability

0˚ Non-Anatomical (Flat-Plane) Posteriors Moulds Shades

Portrait® IPN® 0° 630 Portrait IPN Shades (All Shades):632 P1, P2, P3, P3.5, P4, P11, P12, P13, P14,634 P21, P22, P23, P24, P32, P33, P34,

P59, P62, P65, P66, P67, P69, P77, P81,PW2, PW4, PW7

Bioform® IPN® 0° (Monoline®) 429 Bioform IPN Shades (All Shades):431 B51, B52, B53, B54, B55, B56, B59, B62,433 B63, B65, B66, B67, B69, B77, B81, B83,

B84, B85, B91, B92, B93, B94, B95, B96

TruExpression® MXL 0° 429 TruExpression Shades (All Shades):431 A1, A2, A3, A3.5, A4, B1, B2, B3, B4,433 C1, C2, C3, C4, D2, D3, D4, i2, i4630632634

Classic® 0° 29M Classic Shades (All Shades):31M A1, A2, A3, A3.5, A4, B1, B2, B3, B4,33M C1, C2, C3, C4, D2, D3, D4, 59C, 62C,

65C, 66C, 67C, 69C, 77C, 81C, CW2

*Supplied in sets of 1x8 only (consisting of 2 blocks of 4 right and left - upper or lower).

3534

Figure 1: *Bioform IPN 20° moulds are long buccal-short lingual moulds. They are speciallydesigned for short bite and partial cases. They are engineered with a “scooped-out” ridgelap which eliminates unnecessary bulk and reduces grinding to a minimum.

Figure 1.

20˚ Semi-Anatomical Posteriors Moulds Shades

Portrait® IPN® 20° 29M, L Portrait IPN Shades (All Shades):31M, L P1, P2, P3, P3.5, P4, P11, P12, P13, P14,33M, L P21, P22, P23, P24, P32, P33, P34,35M P59, P62, P65, P66, P67, P69, P77, P81,

PW2, PW4, PW7

Bioform® IPN® 20° * 29S, M, L Bioform Shades (All Shades): 31S, M, L B51, B52, B53, B54, B55, B56, B59, B62,33M, L B63, B65, B66, B67, B69, B77, B81, B83,

B84, B85, B91, B92, B93, B94, B95, B96

TruExpression® MXL 20° 29M TruExpression Shades (All Shades):31M A1, A2, A3, A3.5, A4, B1, B2, B3, B4, 33M C1, C2, C3, C4, D2, D3, D4, i2, i4

Classic® 20° 29M, L Classic Shades (All Shades):31M, L A1, A2, A3, A3.5, A4, B1, B2, B3, B4,33M C1, C2, C3, C4, D2, D3, D4,59C, 62C,

65C, 66C, 67C, 69C, 77C, 81C, CW2

10˚ Semi-Anatomical Posteriors Moulds Shades

Portrait® IPN® 10° (Anatoline®) 330 Portrait IPN Shades (All Shades):332 P1, P2, P3, P3.5, P4, P11, P12, P13, P14, 334 P21, P22, P23, P24, P32, P33, P34, 336 P59, P62, P65, P66, P67, P69, P77, P81,

PW2, PW4, PW7

Bioform® IPN® 10° (Anatoline®) 330 Bioform IPN Shades (All Shades):332 B51, B52, B53, B54, B55, B56, B59, B62, 334 B63, B65, B66, B67, B69, B77, B81, B83,

B84, B85, B91, B92, B93, B94, B95, B96

TruExpression® MXL 10° 330 TruExpression Shades (All Shades):332 A1, A2, A3, A3.5, A4, B1, B2, B3, B4, 334 C1, C2, C3, C4, D2, D3, D4, i2, i4

Classic® 10° F30 Classic Shades (All Shades):F32 A1, A2, A3, A3.5, A4, B1, B2, B3, B4, F33 C1, C2, C3, C4, D2, D3, D4, 59C, 62C, 65C,

66C, 67C, 69C, 77C, 81C, CW2

Posterior Mould/Shade AvailabilityPosterior Mould/Shade Availability

3736

Figure 2.

Figure 3: *Classic 33° moulds 30LS, 32LS, and 34LS are specially designed for short bitecases. They are engineered with a “scooped-out” ridge lap which eliminates unnecessarybulk and reduces grinding to a minimum.

Figure 3.

33˚ Posteriors Moulds Shades

Portrait® IPN® 33° 30M, L Portrait IPN Shades (All Shades)32M, L P1, P2, P3, P3.5, P4, P11, P12, P13, P14,34M, L P21, P22, P23, P24, P32, P33, P34,

P59, P62, P65, P66, P67, P69, P77,P81, PW2, PW4, PW7

Bioform® IPN® 33° 30M, L Bioform IPN Shades (All Shades)32M, L B51, B52, B53, B54, B55, B56,34M, L B59, B62, B63, B65, B66, B67,

B69, B77, B81, B83, B84, B85,B91, B92, B93, B94, B95, B96

TruExpression® MXL 33° 30M TruExpression Shades (All Shades):32M A1, A2, A3, A3.5, A4, B1, B2, B3, B4, 34M C1, C2, C3, C4, D2, D3, D4, i2, i4

Classic® 33° 30M, L, LS* Classic Shades (All Shades)32M, L, LS* A1, A2, A3, A3.5, A4, B1, B2, B3, B4,34M, L, LS* C1, C2, C3, C4, D2, D3, D4, 59C, 62C,

65C, 66C, 67C, 69C, 77C, 81C, CW2


Portrait® IPN® 40° (EuroLine®) 730 Portrait IPN Shades (All Shades)732 P1, P2, P3, P3.5, P4, P11, P12, P13, P14, 734 P21, P22, P23, P24, P32, P33, P34,

P59, P62, P65, P66, P67, P69, P77, P81,PW2, PW4, PW7

TruExpression® MXL 40° c31 TruExpression Shades (All Shades):c34 A1, A2, A3, A3.5, A4, B2, B3, B1, B2, B3,c36 B4, C1, C2, C3, C4, D2, D3, D4, i2, i4c34R**c36R**c34XR†c36XR†c34XL†c36XL†

22˚ Posteriors (BioStabil®) Moulds Shades

Portrait® IPN® 530 Portrait IPN Shades (All Shades)532 P1, P2, P3, P3.5, P4, P11, P12, P13, P14,533 P21, P22, P23, P24, P32, P33, P34,536* P59, P62, P65, P66, P67, P69, P77, P81,

PW2, PW4, PW7


Bioform® IPN® 30° 230S, M, L, LS† Bioform IPN Shades (Limited)(Pilkington-Turner®) 233M, L B59, B62, B65, B66,

B67, B69, B77, B81

* Special large fully contoured mould ideal for implant and partial cases where indicated.

**R Variation: Exactly the same dimensions as normal moulds, except for a reduction in the ridge laps.

†XL/XR Variation: Enlarged premolars, molar size is unchanged.

Posterior Mould/Shade AvailabilityPosterior Mould/Shade Availability

Figure 2: †Bioform IPN 33° mould 230LS is specially designed for short bite and partialcases. It is engineered with a “scooped-out” ridge lap which eliminates unnecessary bulkand reduces grinding to a minimum.

39

Portrait® IPN® and Bioform® IPN® Combination Table TruExpession® Combination Table

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4140

Classic® Combination Table Tooth Anatomy Chart

Anatomy of Natural Teeth

DENTSPLY International570 West College Ave, York PA 17401www.dentsplysirona.com(800) 243-1942

©2017 Dentsply Sirona. All rights reserved. 4087-A Rev.4 (08/2017)

Documents

Anterior & Posterior Tooth Arrangement Manual · Anterior & Posterior Tooth Arrangement Manual. 1 ... Suggested procedures for the arrangement and articulation of Dentsply Sirona