Setting Anterior Teeth Esthetics & Phonetics. Look for Symmetry View from anterior, occlusal View...
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Transcript of Setting Anterior Teeth Esthetics & Phonetics. Look for Symmetry View from anterior, occlusal View...
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