Aesthetics of complete dentures

Question 1

What are the three sub-sections when considering aesthetics of dentures?

Answer 1

• Extra-oral factors
• Intra-oral factors
• Tooth factors

Question 2

What are the extra oral factors

Answer 2

Lip support
Cheek support
Facial height
Skeletal relationship

Question 3

Importance of lip support

Answer 3

Lip support can affect lip form and length

Restores the nasiolabial angle

Question 4

what should the nasolabial angle be?

Answer 4

around 90o

Question 5

What is cheek support dependent on

Answer 5

Muscle tone - can be affected by incorrect placement of teeth

Question 6

what is facial height dependent on?

Answer 6

OVD, RVD and FWS

Question 7

What happens to facial height / appearance with inc OVD

Answer 7

stretched, strained or elongated face

incompetent lips, speech difficulties, may lead to TMJ issues

Question 8

What happens with a decrease in oVD

Answer 8

Over-closed appearance, looks prematurely ages

Can lead to reduced chewing efficiency, speech issues and angular cheilitis

Question 9

What are the intra-oral factors to consider

Answer 9

Occlusal plane (amount of tooth showing and orientation anteriorly and posteriorly) 
Tooth arrangement (centre line and tooth positioning) 
Individualisation

Question 10

How much tooth should be showing at rest

Answer 10

Average 2mm below lip line, judge based on age and clinical situation

Question 11

orientation of the occlusal plane anteriorly

Answer 11

Parallel to inter pupillary line

- prevents lop sided appearance

Question 12

Orientation of occlusal plane posteriorly

Answer 12

Parallel to ala-tragal angle

- avoids molars hanging down

Question 13

Where should the dental centre line be

Answer 13

In line with pt’s midline, use the philtrum

Question 14

Tooth position of incisors

Answer 14

10-12mm anterior to incisive papilla

Question 15

tooth position of canines

Answer 15

tip in line with inner canthus of eye

Question 16

Types of individualisation

Answer 16

rotations, crowding, misalignement, wear, diastems etc

Question 17

Tooth factors to consider

Answer 17

Shade 
Shape 
Size 
Length 
Characterisation
Incisal occlusion

Question 18

Selection of shade

Answer 18

Use pt input but avoid very bright teeth if older pt

Use natural light

Question 19

selection of tooth mould

Answer 19

Can assess face shape to achieve desirable shape of tooth

assess old pictures to create appearance of nature teeth

Question 20

Selection of crown length

Answer 20

depends on the upper lip and occlusal plane

depends on age of the patient - as you age, less tooth showing

Question 21

incisal occlusion

Answer 21

May recreate natural skeletal class e.g. retroclined incisors, increased overbite

Question 22

Soft tissue factors

Answer 22

Can be shade matched, stippled, controured, addition of embrasure spaces