2/5: Selecting Denture Teeth

Question 1

What is the point of anterior teeth?

Answer 1

Esthetics

Question 2

What is the point of posterior teeth?

Answer 2

Function

Question 3

What is valuable information to reach a happy medium when selecting teeth?

Answer 3

Previous dentures
- discuss likes and dislikes (color, shape, function)
- make impression of the dentures
Photographs
- make sure the teeth are showing
- most recent photograph
- photocopy of the photograph
Friends and family

Question 4

What are factors to consider with anterior tooth selection?

Answer 4

Shade - easiest to determine
- patients always want the “whitest and brightest”
- narrow selection down to few shades
- offer input, but let patient make ultimate decision
Size - occlusal-gingival height and mesial-distal width
Mold - shape of the individual teeth

Question 5

How should you determine the size of anterior teeth?

Answer 5

Use existing denture
- measure the height and width of the central incisor of the denture with a boley guage
Use anatomical landmarks
Use the Interalar Facial Meter
Use the Trubyte Tooth Indicator

Question 6

How should you determine the width of the central incisor with anatomical landmarks?

Answer 6

The width of the central incisor is approx 1/16 the bizygomatic width (house and loop)
(bizygomatic width can be measured using a caliper-type facebow)

Question 7

What is the width of the anterior sextant?

Answer 7

The approximate combined width of the 6 anterior teeth on a flat plane is the
bizygomatic width divided by 3.3

Question 8

How should you determine the width of the anterior sextant with anatomical landmarks?

Answer 8

• mark corners of the wax rim
• measure the distance using the curve of the wax rim
• that distance will approximate the combined width of the 6 anterior teeth ON A CURVE
• Use the facial meter to measure the interalar distance
• classifies anterior sextant width into small, medium, large

Question 9

What are the 5 ways to determine width of anterior teeth?

Answer 9

• Measure the width of the central incisor on existing
  denture
• 1/16 the bizygomatic width equals the width of the
  central incisor
• Bizygomatic width divided by 3.3 equals the
  combined width of the 6 anteriors on a flat plane
• Corners of the mouth marked on the wax rim
  equals the combined width of 6 anteriors on a
  curved plane
• Use the Interalar Facial Meter

Question 10

How should you determine the length of anterior teeth?

Answer 10

• Use an existing denture
• Use the patient’s lip line
• Using anatomical landmarks
• Evaluate the distance between the maxillary
  and mandibular ridges

Question 11

Why should you mark the “lip line” on the maxillary wax when a pt smiles?

Answer 11

To estimate the length of the max teeth and avoid a “gummy smile”

Question 12

What equation can be done by utilizing the hairline to determine the length of the central incisor?

Answer 12

The distance from the hairline to the gnathion
(the most inferior bony portion of the chin)
divided by 16 equals the length of the central
incisor

Question 13

What are 4 ways to determine the length of the anterior teeth?

Answer 13

• Measure the length of the central incisor on the existing
  denture
• Evaluate the “Smile line”
• 1/16 of the distance from the hairline to the gnathion equals
  the length of the central incisor
• Measure the distance between the maxillary and mandibular
  ridges

Question 14

What is the trubyte tooth indicator based on?

Answer 14

• Based on bizygomatic width for central incisor
  width
• Based on hairline and gnathion line for length
  of central incisor

Question 15

What are the two ideologies of anterior tooth mold selection?

Answer 15

1. Dentogenics
2. Geometric theory

Question 16

What are dentogenics?

Answer 16

Frush and fisher
- based on age, sex, and personality

Question 17

What is the geometric theory?

Answer 17

Williams, House and Loop
- based on the shape of the face
- the max central incisor resembles the inverted face form

Question 18

What are the 4 categories of the geometric theory?

Answer 18

• square
• square tapering
• tapering
• ovoid

Question 19

What are the 3 points of the face that connect in the geometric theory?

Answer 19

Temple
Zygomatic arch
Angle of the mandible

Question 20

What should the facial contour of the anterior teeth mimic?

Answer 20

The contour of the face in profile
Curved vs flat

Question 21

What is the objective of the geometric theory and dentogenics?

Answer 21

To harmonize the teeth with their surrounding structures in an attempt to avoid detection and provide an esthetic appearance

Question 22

After the size and shape of the teeth are determined, the information must be applied to?

Answer 22

Bioform Mould Guide
- max anterior tooth guide consists of 2 numbers followed by a letter classification

Question 23

What is the first number of a tooth tray?

Answer 23

Classification

Question 24

What is the second number of a tooth tray?

Answer 24

Proportion and contour

Question 25

What is the letter on a tooth tray?

Answer 25

Width of upper six anterior teeth on a curve

Question 26

What should you use to select corresponding mandibular anterior teeth?

Answer 26

Portrait mould guide - may have choice between multiple

Question 27

What should you measure to select the posterior mandibular teeth?

Answer 27

Measure the distance from the distal of the canine to the ascending portion of the ridge to determine the combined length of the mandibular posteriors

Question 28

What are the two types of denture tooth materials?

Answer 28

Porcelain Acrylic resin

Question 29

What are the pros and cons of procelain?

Answer 29

Pros – esthetics Cons – clacking sound, abrasive, weight

Question 30

What are the pros and cons of acrylic resin?

Answer 30

Pros – easily adjusted, chemical bond to resin Cons – occlusal wear

Question 31

When setting the maxillary anterior teeth, what should you remember?

Answer 31

goal of the final prosthesis is to defy detection. Therefore the teeth should appear to “grow out of the alveolar bone”

Question 32

In the horizontal view, what should the measurement of the incisal edges of the maxillary central incisor be?

Answer 32

Approx. 8-10mm anterior to the midpoint of the incisive papilla - A line drawn perpendicular to the mid-sagittal suture and that bisects the incisive papilla should extend though the center of the maxillary canines

Question 33

In occlusion with the lips together, what do the maxillary anterior teeth support?

Answer 33

the labial incisal 1/3 of the maxillary anterior teeth support the superior border of the lower lip

Question 34

How much of the maxilalry anterior teeth should be visible at rest from the frontal view?

Answer 34

1-2mm of the max centrals should be visible

Question 35

The plane of the max anterior teeth should be _________ to the interpupillary line

Answer 35

Parallel

Question 36

When smiling, the incisal edges of the max teeth should follow _______________________

Answer 36

The line of the lower lip

Question 37

How should mandibular anterior teeth be set?

Answer 37

On a curve that parallels the maxillary anterior teeth resulting in a uniform 1-2mm horizontal overlap.

Question 38

There should be _______________ vertical overlap

Answer 38

Zero or minimal (0.5mm)

Question 39

How should canines be positioned?

Answer 39

in a way in which the distal portion of the canine points to the desired position of the central fossae of the posterior teeth

Question 40

What is the buccal corridor?

Answer 40

the space between the buccal surfaces of the upper teeth and the corners of the mouth when the patient smiles

Question 41

What is the golden proportion?

Answer 41

1,618

Question 42

When setting posterior teeth, what distance should be measured?

Answer 42

distance from the distal of the canine to the upward slope of the residual ridge. - A posterior tooth may be omitted due to a lack of space

Question 43

The mandibular teeth should be on a ________ plane and extend _____ to ______ up the retromolar pad

Answer 43

flat plane; 1/2 to 2/3

Question 44

The mandibular posterior teeth are set over the _______ to gain a _______ advantage

Answer 44

ridge; retentive

Question 45

What should the maxillary posterior teeth occlude with?

Answer 45

Mandibular posterior teeth

Question 46

The occlusal-gingival height should be maintained where?

Answer 46

From the anterior teeth to the posterior teeth