setting of artificial teeth in complete denture.pptx

Several patient-specific factors guide the selection and arrangement of artificial teeth. Age plays a significant role in tooth selection; younger patients typically require teeth with more pronounced anatomical features, brighter shades, and fuller forms, while older patients benefit from teeth with flatter cusps, moderate wear facets, and slightly darker, more translucent shades that simulate natural aging.

1. Arrangement of artificial teeth Dr. Ahmed Gamal

2. Guide lines of teeth setting: In teeth setting ,there are certain guide lines that should be drawn in the casts to determine the position of the teeth: A- On Maxillary cast : we should draw line bisecting the incisive papilla horizontally , this line aids in setting of upper anterior teeth. midline which is drawn over the median palatine suture and bisecting the incisive papilla vertically then complete it on the anterior wall of the cast. Canine eminence lines: record these two lines on the lateral walls of the cast on both sides aid in setting of the six maxillary anterior teeth which occupy the space between the distal of right canine eminence & the distal of left canine eminence.

3. B- On Mandibular cast: we should draw line bisecting the residual ridge anteriorly, aid in setting of lower anterior teeth. Canine eminence lines. line that bisects the crest of the residual ridge posteriorly from canine area to retromolar pad on both sides of the cast used as a guid for the buccolingual position of the mandibular posterior teeth.

4. Upper cast Ridge crest Lower cast 1 1 midline 2 2 2 3 3 3 3

5. Sequence of artificial teeth arrangements:- there are several methods in sequence of teeth arrangement First method : starting with upper anterior because there is a constant relation between upper centrals and incisive papilla. Then we set lower anterior, then upper posterior teeth, and then lower posterior teeth. Second method : start with upper anterior teeth, then upper posterior teeth, then lower anterior teeth, and finally lower posterior teeth. Third method : start with upper anterior, then lower anterior, then lower posterior teeth, and finally the upper posterior teeth.

6. Setting Anterior Teeth

7. Arrangement of upper anterior teeth : In setting of teeth we must cut through the bite rim by wax knife a space equal to that of the tooth, and then seal the tooth in its position by wax.

8. Upper central incisor (C.I) : * in frontal plane, we should attach the tooth to the record base over the anterior region of the residual ridge, its incisal edge should be in contact with the occlusal plane (i.e touching the mounting table), its long axis is perpendicular to the occlusal plane & some times shows a slight distal inclination, its mesial contact area should touch the midline of the bite rim

9. * in sagittal plane , the tooth has a slight labial inclination to give support to the upper lip, the neck is slightly depressed (the incisal edge is more prominent than the cervical area of the tooth), and the facial surface of the tooth is nearly perpendicular to the occlusal plane.

10. * In horizontal or occlusal plane , the labial surface of the central incisor should be located at a distance of 6-8 mm from the centre of the incisive papilla.

11. The mesial of each tooth should be on the midline (arrow) and the incisal edge should be parallel to and in contact with the occlusal plane.

12. Viewed from the frontal plane, the maxillary central incisor is placed so that the long axis perpendicular or shows a slight distal inclination to the perpendicular.

13. When viewed from profile or sagittal , the tooth has a slight labial inclination to give support to the upper lip, the neck is slightly depressed (the incisal edge is more prominent than the cervical area of the tooth), and the facial surface of the tooth is nearly perpendicular to the occlusal plane. Inner edge of the land Occlusal plane

14. * In horizontal or occlusal plane , the labial surface of the central incisor should be located at a distance of 6- 8 mm from the centre of the incisive papilla.

15. In frontal plane The maxillary lateral incisor should be positioned with a slight distal inclination (5- 10 degree to the midline) and is usually ½ to 1 mm above the plane of occlusion. Lateral incisors

16. Lateral incisors * in sagittal plane it shows slight labial inclination, its neck is depressed more than the C.I.

17. *in horizontal plane,it must follow the arch curvature Lateral incisors

18. When viewed in frontal plane the cuspid has a slight distal inclination from the perpendicular and the incisal tip touches the occlusal plane (arrow). Canine

19. Cuspids

20. The cuspid has two planes on the labial surface – a mesial plane (yellow line) and a distal plane (red line). When viewed from the anterior only the mesial plane should be visible. the mesial plane should follow the contour of the anterior teeth while the distal plane follow the contour of the posterior teeth. Cuspids

21. * in sagittal plane , is perpendicular to the occlusal plane, the incisal tip of the canine touches the occlusal plane. Its neck is prominent & supports the corner of patient's the mouth *in horizontal plane, This tooth is rotated with arch and represents the transition from anterior teeth to posterior teeth and represents the corner or turning point of upper arch.

22. When viewed from the occlusal the anterior teeth follow the curvature of the dental arch.

23. Note the inclinations of the anterior teeth.

24. Setting the Mandibular Anterior Denture Teeth

25. Lower central incisor: * in frontal plane , the midline of lower C.I should be coinside with the midline of upper C.I , its incisal edge must be above the level of occlusal plane by 1mm . its tip it slightly labially. When we close the articulator we should have what we call it over bite or the vertical overlap Over bite is the vertical extension of the upper anterior teeth on the lower anterior teeth when the posterior teeth are in centric occlusion. This overlap depends on several factors, but generally speaking over bite should be about 1- 2 mm.

26. The other thing in arrangement of the lower anterior teeth is that we should have over jet which is the extension of the lower anterior teeth beyond the upper anterior teeth, this amount we call it over jet (2- 4mm). Vertical overlap 1- 2 mm Horizontal overlap2- 4 mm

27. Occlusal plane The incisal guidance angle is the angle formed by a line drawn through the Incisal angle incisal edges of the maxillary and mandibular incisors and the horizontal plane. It is generally advisable to keep the incisal angle to a minimum in complete dentures to enhance free movement of the teeth in protrusive and lateral excursions so that about 0.5mm over bite & 1-2mm over jet must be Vertical overlap

28. In denture construction, the mandibular incisors should touch never incisor in centric the maxillary occlusion and incisal guide angle should be kept as low as possible to enhance free movement of the teeth in protrusive and lateral excursions so that about 0.5mm over bite & 1- 2mm over jet must be exist to create a low incisal guidance angle.

29. Occlusal plane * in sagittal plane ,it has slight labial inclination & its neck is depressed .

30. The lateral incisors should be placed similar in angulation and position to the central incisors.

31. The cuspids the long axis is very slightly inclined mesially and the neck is more prominent than the tip, the tip of lower canine will be in the embrasure between upper lateral incisor and upper canine & its distal slope should be opposed to the mesial slope of upper canine, it's called normal canine position.

32. The horizontal overlap should be consistent throughout the anterior region. At this stage it should be about 1.5 mm.

33. SETTING THE LATERAL INCISORS AND CUSPIDS

34. Arrangement of the upper posterior teeth

35. Maxillary first premolar : The facial surface of the maxillary first premolar must harmonize with the canine.The long axis of the premolar should be perpendicular to the occlusal plane and the buccal and lingual cusp tips should touch the occlusal plane. its lingual cusp tip should contact the line inscribed on the lower occlusion rim indicating the crest of the lower residual ridge. The same thing is done to maxillary second premolar .

36. Occlusal plane The long axis of the premolars should be perpendicular to the occlusal plane and the buccal and lingual cusp tips should touch the occlusal plane.

37. Both the buccal and lingual cusp tips of the maxillary premolars should contact the plane of occlusion. The lingual cusp tips should also contact the line inscribed on the plane indicating the crest of the mandibular ridge. This will ensure that when the opposing mandibular denture teeth are properly positioned and in occlusion, their central fossae will be centered over the mandibular ridge. The Maxillary Premolars

38. The Maxillary 1st Molar The set up viewed in profile. Note that the mesial lingual cusp tip touches the plane of occlusion along with the buccal and lingual cusps of the premolars while the buccal cusps tips and the distolingual cusp tip are elevated about 0.5mm of the occlusal plane. The curve of Spee begins at the 1 st molar.

39. * Compensating curve : is the anterio-posterior curvature of the occlusal surface of a complete denture teeth (in sagittal plane) and the mediolateral curvature in the frontal plane. The compensating curves are called so because they compensate for that present in natural dention. Compensating curves may be increased or decreased in an artificial dentition to help achievement of balanced occlusion.

40. The compensatory curve of Wilson and the curve of Spee begin in the molar region. The mesial lingual cusp tip of the 1 st molar contacts the occlusal plane but the buccal cusp tips and the distal lingual cusp are elevated about .5mm off the occlusal plane. The Maxillary 1 st Molar

41. Compensating curve for curve of Spee is the curvature of the occlusal alignment of the teeth. It begins at the tip of the lower canine follows the buccal cusps of the premolars and molars and continues to the anterior border of the mandibular ramus. Compensatory curve for curve of spee

42. Compensating curve for curve of Wilson is the curvature in the frontal plane through the cusp tips of both the right and left molars.

43. The Maxillary 2 nd Molar Maxillary second molar , the compensatory curve is continued by elevating the 2nd molar above the plane of occlusion. The 2nd molar is elevated to an even greater degree than the 1st molar, about 15 degrees in the average patient, with a slight curve of Wilson.

44. Mandibular posterior teeth arrangement: In which, their central fossa must coinced or placed over the crest of the lower residual ridge.

45. The Mandibular 1st Molar is first tooth set into centric occlusion and checked carefully. its mesiobuccal cusp tip should engage the embrasure between the 1st molar and 2nd premolar.

46. The Mandibular 1st Molar Check the relationship from the lingual side. Make sure that the maxillary lingual cusp tips engage the the central fossa of the mandibular molar.

47. Mandibular second premolar : its buccal cusp should occlude with the adjacent marginal ridges of the maxillary 1st and 2nd premolars. Mandibular first premolar : its buccal cusp should engage the mesial marginal ridge of the opposing 1st premolar. Mandibular second molar : make sure that the lingual cusp of the maxillary 2nd molar properly occludes with the central fossa of the mandibular 2nd molar.