Prepared by d.Sirag al-hamadiTripoli university

Dental faculty

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The carved occlusion rims should provide reliable guides for

placement of the teeth. These guides are:

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1-Guide lines (midline, high lip line and canine lines).

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2-The proper placement of the occlusal plane.

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3-Proper lip support.

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4-Correct jaw relationships (vertical dimension of occlusion and centric relation).

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Upper anterior teeth

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1 -Alveolar ridge resorption:

•Ridge resorption in anterior maxilla occurs upwards and back wards.

• In anterior mandible it occurs downward and lingually.

•The anterior teeth are placed in maxillary denture forwards and inferiorly.

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The distance from papilla to gingival margin 8 mmFrom papillae to incisal edge 10 mm

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2-EstheticsLip support by the teeth is important.Amount of tooth showing (about 2 mm)Lower lip pressure causes instability of mandibular

denture if placed anteriorly.

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Grinding incisal edge and changing position of teeth

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Too colored teeth to simulate natural teeth

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3-Phonetics Speech is

affected by the position of the teeth and the contour and bulk of the palate.

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The central incisor Edges in contact with the plane.

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The lateral incisorThe edge is l-2mm short of plane.

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The canine

Its cusp is in contact with the horizontal plane.

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The labial surfaces of the anterior teeth present a curve depending on the ridge.

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The long axes of the teeth are not made parallel. If this done it will

Appear artificial and unnatural.

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Lower anterior teeth

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General considerations

The midline of lower anterior as the upper one.

The teeth are set on the ridge.

The. overlap will be about 1.5 mm.

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Vertical and horizontal overlapIn natural teeth there is contact between upper and lower teeth

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In complete denture 1mm overjet is left and incisal angle less than 15 degree

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The central and lateral incisors

The incisive edge 1.5 mm above plane.

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The canineThe incisal tip may

be slightly higher than the lateral and central incisor.

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The following factors are considered

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1-The neutral zonethe neutral ِTeeth are in zone. This ensures denture stability.The cheek and lip press on the teeth from outside and the tongue from inside. The area of equilibrium between the two forces is called the neutral zone.

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2-The position of the posterior teeth in relation to the alveolar ridge

The posterior teeth are placed on the ridge crest especially the mandibular teeth. This position is important for lower denture stability.If it is necessary to place the teeth outside the ridge crest it is done for the maxillary denture .

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3-Balanced occlusion

It is maximum contact between the maxillary and mandibular teeth in centric and eccentric positions.Eccentric positions include protrusive position and lateral position in both working and balancing sides.

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There should be maximum contact in centric occlusion.

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Contact during protrusionAt least three widely separated points or areas of occlusion must exist.

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Contact during lateral movement

Working side Balancing side

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Contact during lateral movement

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To achieve balance there should be anteroposterior curve for the posterior teeth (curve of Spee) and mediolateral curve (curve of Monson).

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The maxillary posterior teethNote the anteroposterior curve.

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The posterior teeth buccal surfaces make contact with a straight line drawn from the labial surface of the canine backwards.

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The mandibular posterior teethThe mandibular teeth are set to occlude with maxillary teeth in anteroposterior and mediolateral curves.

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The buccal cusps of the lower posterior interdigitate with the

maxillary central fossae .

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The palatal cusps of the upper posterior teeth interdigitate with the central fossae of the mandibular teeth.

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A) Superior protrusion(Class II)

The lower ridge is narrower than the upper and associated with a receding chin.

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Setting up the posterior teeth

Setting the upper teeth inside the ridge does not produce marked instability

While setting, the lower teeth outside the ridge will lead to instability.

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Setting the anterior teeth

The large overjet is preserved.

Angulations of the upper teeth give the patient a rabbit appearance

Angulations of the lower tend to unstabilise the denture

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B-Inferior protrusion (Class III)The lower ridge is broader than the upper and usually associated with a protruded chin.

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Setting of the posterior teethCross biting the posterior teeth.

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Lingual view for cross bite arrangement

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Setting of the posterior teeth

Lower teeth that are narrow buccolingually are of great advantages

If the upper teeth set outside the ridge a metal plate should be incorporated in the denture to prevent fracture.

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Setting of the anterior teeth The anterior teeth in such cases are best set either edge to edge or with a negative overjet.

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Gum fitted anterior teeth

The absence of the anterior gum work affect denture retention and wings may be used.

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Indications gum fitted upper anterior teeth

a) When the teeth too prominent.

b) When the gum work presses the lip out e.g. in tight-lipped patients.

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ReferencesReferences11--Allen AA, Heath JR, Mc Cord: Allen AA, Heath JR, Mc Cord: Complete Prosthodontics; Complete Prosthodontics; Problems, Diagnosis and Management. Problems, Diagnosis and Management.

Mosby-Wolf, London, 1995Mosby-Wolf, London, 1995..

22 - -Beresin, V.E. and Schiesser, F. J.: The neutral zone in complete and partial dentures. 2nd ed. St. Louis, Beresin, V.E. and Schiesser, F. J.: The neutral zone in complete and partial dentures. 2nd ed. St. Louis, The C.V. Mosby Company: 1978The C.V. Mosby Company: 1978..

33 - -Coleman, R. D. and kaiser, W. B.: The Scientific Bases of Dentistry. Philadelphia, W. B. Sounders; Coleman, R. D. and kaiser, W. B.: The Scientific Bases of Dentistry. Philadelphia, W. B. Sounders; 19661966 . .

44 - -Craig, R.G.: Restorative Dental Materials. 8Craig, R.G.: Restorative Dental Materials. 8thth ed. St. Louis, C. V. Mosby Company ed. St. Louis, C. V. Mosby Company..55--Fenn, H.R.B.; Liddelow, K.P. and Gemson, A.B.: Clinical Dental Prosthetics. 2 ed. London, Staples; Fenn, H.R.B.; Liddelow, K.P. and Gemson, A.B.: Clinical Dental Prosthetics. 2 ed. London, Staples;

19741974..66 - -Geering AH,Kundert M , Kelesy C: Complete denture and overdenture Prosthetics. Theme medical Geering AH,Kundert M , Kelesy C: Complete denture and overdenture Prosthetics. Theme medical

publication Inc. New York, 1993publication Inc. New York, 1993..77--Grant AR, Heath JR, Mc Cord JF: Complete Prosthodontics; Problems, Diagnosis and Management. Grant AR, Heath JR, Mc Cord JF: Complete Prosthodontics; Problems, Diagnosis and Management.

Mosby-Wolf, London, 1996Mosby-Wolf, London, 1996..

88 - -Heartwell, C.M. and Rhan, A.G.:Heartwell, C.M. and Rhan, A.G.: Syllabus of Complete Dentures. 3 Syllabus of Complete Dentures. 3rdrd ed. Philadelphia, Lea and ed. Philadelphia, Lea and

Febiger; 1986Febiger; 1986..99 - -Sharry, J.J.:Sharry, J.J.: Complete denture prosthodontics. 3 Complete denture prosthodontics. 3rdrd ed. ed. NewYork, McGraw-Hill; 1974NewYork, McGraw-Hill; 1974..

1010 - -SowterSowter,, J.B.: J.B.: Dental labo Dental laboratory technology: prosthodontic techniques. Chapel Hill, University ratory technology: prosthodontic techniques. Chapel Hill, University of Northof North Carolina; 1968Carolina; 1968..

1111--Watt, D.M. andWatt, D.M. and Mac Gregor, A.R.: Mac Gregor, A.R.: Designing complete dentures. Philadelphia, Designing complete dentures. Philadelphia, W.B. Sounders; 1976W.B. Sounders; 1976..

1212 - -Winkler,Winkler, S.: Essential of complete Denture Prosthodontics. 2 S.: Essential of complete Denture Prosthodontics. 2ndnd ed. PSG ed. PSG Publishing Company; 1988Publishing Company; 1988..

1313 - -Zarb, G.A.; Bolender, C.L.; HicKey, J.C. and carlesson, G.E.:Zarb, G.A.; Bolender, C.L.; HicKey, J.C. and carlesson, G.E.: Boucher's Boucher's Prothodontic Treatment for Edentulous Patients. 7Prothodontic Treatment for Edentulous Patients. 7th.th. Ed. St-Louis, The Ed. St-Louis, The C.V.MosbyC.V.Mosby Company; 1990Company; 1990..

N, B. All pictures in these slides are copied from the above references and from N, B. All pictures in these slides are copied from the above references and from the internetthe internet..04/12/23 59D.SIRAG EDDIN AL-HAMADI