selecting artificial tooth

Karl Yveth A. Aquino

DDM2B

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• The anterior teeth are primary selected to satisfy

the aesthetic requirement.

•The posterior teeth are primarily selected to

satisfy the functional requirements

•The anterior teeth are composed of six maxillary

and six mandibular teeth

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The selection of artificial teeth for

complete denture can be divided into

two sections.

• Anterior teeth selection

• Posterior teeth selection

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1. Size of the teeth

2. Form of the teeth

3. Color / shade of the teeth

4. Composition of material of teeth

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1. Pre-extraction records

A. Photographs

B. Diagnostic cast

C. Radiographs

2. Post extraction records

3. Proper contour of occlusal rim and High lip line

4. Arch form and size

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PRE EXTRACTION

◦ Recent photographs

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◦ Diagnostic cast

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◦ Radiographs

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2.POST EXTRACTION◦Size and form of edentulous foundation

◦Matching teeth to face forms and arch form

◦Previous denture

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3. Proper contour of occlussal rim and high hip line

Indication for inciso-gingival length

The lower edge of the upper occlusion rim should be 2mm below

the lip when it is at rest.

The distance from the lower edge of the upper occlusion rim to the

high lip line is measured and it represent the length of the upper

anterior teeth

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The size of teeth comprises their width and length and is represented by the term mold.

The size compromise of:

1. Length (incisogingival)

2. Labiolingual width

3. Mesiodistal width

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1. A vertical line extending along the lateral surface of the ala often

will pass through the middle of the natural upper canine

2. Measure the distance between the previously marked canine

lines on the maxillary wax occlusion rim.

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3. Using the flexible ruler. This will indicate the width of the maxillary

six anterior teeth on the curve. Distance between the 2 canine

lines = MD width of the six anterior teeth

4. Measurement on skulls indicate that the width of the natural

central incisor, approximately 1/16 the bizygomatic width patient’s

face

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1. Outline form of the face

2. Shape of the arch

3. Gender and age

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Sex, personality, age are the factors which will determine the form of the anterior teeth

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Curved facial features are associated with femininity and square features are associated with masculinity

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MASCULINITY FEMININITYProminent teeth Smaller teeth

Square arch form Curved contours and arch form

Square labial surface Curved labial surface

Square incisal edges and corners

Round incisal edges and corners

Darker shade Delicate appearance

Flat smile line Curved smile line

Canine- cervical area is more prominent and visible

Canine-mesial 3rd only visible

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YOUNGER PEOPLE OLDER PEOPLE

Lighter shade Darker shade

More incisaltranslucency

Less incisal translucency

Minimal wear of incisaledges

Increased wear of incisaledges

Curved smiling line Flat smiling line

Pointed canines Loss of tip of canines

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Teeth should be selected according to the patients personality

The patients◦ vigorous ◦ delicate.

More squarish and large teeth vigorous people.

The anteriors should be in flat plane for executive people

For executives teeth should be relatively smaller and more symmetrical

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Color is described by means of

- hue

- saturation and chroma

- brilliance

-Transluscent

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1. Hue.

2. Saturation and Chroma

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3. Brilliance

4. Translucency

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There are two main types:

1. Porcelain,

2. Acrylic

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Acrylic teeth :1- Not brittle, but poor abrasionresistance.

2- Esthetic very good.

3- Chemical bonding with denture base.

4- Easily ground and polish.

5- Transmit fewer forces to the mucosa.

6- No clicking on contact.

7- Thermal expansion same as acrylic denture base.

PORCELAIN TEETH :

1- BRITTLE, MORE RESISTANCE TO ABRASION

2- EXCELLENT (DOES NOT STAIN).

3- MECHANICAL BONDING BY PINS OR UNDERCUTS HOLES.

4- DIFFICULT TO GRIND AND POLISH.

5- MORE FORCES TO THE MUCOSA.

6- CLICKING ON CONTACT.

7- MUCH LOWER THAN ACRYLIC CAUSES STRESSES IN ACRYLIC DENTURE BASE.

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It is classified under 2 division, namely:

Size of the teeth

Form of the teeth

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The ff. factors are considered while selecting the size of the teeth

Buccolingual width

Mesiodistal length

Occlusogingival height

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Buccolingual width

Should be greatly reduced from the width of natural teeth

that they replace.

It should be less than the buccolingual width of the

natural teeth to reduce the force cting on the alveolar

ridge, however ,that should not affect the check supprt

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Mesiodistal width (anteroposterior)

Upper (distal of canine to the tuberosity prominence)

Lower (use a ruler to mark the crest of the mandibular

ridge from the base of the retromolar pad to the canine

area, and then measure from the distal of the canine to

ascending area of the mandible

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Occluso-gingival height

It depends on:◦ The inter-arch distances between the ridge

◦ Amount of the bone resorption, resorbed residual ridge RRR

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Factors that control the selection of the form of the tooth

Condylar inclinationTeeth with a high cuspal height are require for the

patients with steep condylar guidance. This is because the jaw separation will increase for patient with acute condylar guidance during protrusion.

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Height of residual ridgeShallow cusped teeth go better with shallow ridge

Patient’s age:Teeth with shallow cusps are preffered in older age.

Ridge relationship:0 degree or monoplane teeth are preferred for

cases with posterior cross bite or severe class II relationship

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• Cusp teeth

oAnatomic teeth

oSemi anatomic or modified cusp or low cusp

teeth

• Cuspless teeth

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Advantages of anatomic teeth

1.Esthetically acceptable 2.More efficient thereby reducing the

forces3.They can arranged in balance4.Offer the maximum opportunity for fully

balanced occlusion5.more masticatory efficiency

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Disadvantages of anatomic teeth

1.More horizontal during function

2.Need eccentric records and required

adjustable articulator

3.Lateral torque in eccentric contacts and

higher chance for premature traumatic

contacts

4.Difficulty in relining and rebasing

5.Fast bone resorption

6.Cannot be used in severely resorbed cases

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Advantages of semi anatomic teeth1. Easier to arrange and obtain balance

2. Can provide freedom if setlling occurs

3. Reduction of lateral stresses (decrease lateral force)

4. Provides all the advantages of cusp teeth

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Disadvantage of semi anatomic teeth1. Less aesthetic (buccal cusp are shorter)

2. Less chewing efficiency (controversial:some claim greater)

Advantage of cuspless oclussal schemes

More stable lower denture during mastication

More vertical chewing stroke

More shear in the chewing stroke

Disadvantage of cuspless occlusal schemes

Less stability to the upper denture

No balance in excursive glide

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Advantage of 0 degree teeth Easy to set up

Least lateral stress

Least anterior posterior interference after settling

Best for patient with poor muscular control

Best for patient with poor ridge relationship

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Disadvantage of 0 degree teeth Very difficult to obtain balanced occlusion in

excursive movement

Less chewing efficiency especially for fibrous or tough food

Poor esthetic

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Boucher’s Prosthodontic Treatment for Edentulous Patients , Ninth Edition Textbook of complete Dentures Textbook of prosthdontics, deepak nallaswamy ; jaypee

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