Setting Anterior Teeth

Esthetics & Phonetics

Look for Symmetry

View from anterior, occlusal View from many angles

Symmetry
Perfect Symmetry Gross Asymmetry

Facial Asymmetry

2 Left Sides

Normal

2 Right Sides

Smile Asymmetry

2 Left Sides

Normal

2 Right Sides

Setting Anterior Teeth

Incisal edges of central incisors & canines at level of the occlusal plane Laterals placed approximately 0.5 mm above the occlusal plane

Cervical necks tilt posteriorly from the central incisor to the canine

The greatest height of the free gingival margin is slightly distal to the mesiodistal center of the tooth

Setting Mandibular Anteriors

Lower anterior teeth incline similar to the maxillary teeth

Setting Mandibular Anteriors

Incisal edges are placed at the same level Even with the occlusal plane

Setting Mandibular Anteriors

No overbite for monoplane or lingualized setups

Canines should be tilted more posteriorly than other teeth, with a more prominent cervical neck

Bucco-Lingual Tilt
Maxillary Anterior Teeth
Facial surface of central is perpendicular occlusal plane

Neck of lateral is depressed

Neck of canine is prominent

Central

Canine

Bucco-Lingual Tilt
Mandibular Anterior Teeth
Central is proclined Lateral is more upright

Canine has a
prominent neck

Central

Canine

Anterior Tooth Setup

Check symmetry with reference lines Anterior teeth dont contact in centric position Grazing contacts in excursions Overbite = 0mm Overjet = 2mm

No Anterior Contact in Centric

Insufficient

Excessive

Correct

Canine Offset
Check for one half tooth offset between maxillary & mandibular teeth Ensures posterior teeth have normal cusp to fossa relationship for lingualized occlusion

Cannine Offset
Correct

Insufficient

Improper offset results in a space or half tooth replacement

Phonetic Assessment
Maxillary centrals should lightly touch vermilion border of lower lip for F, V sounds S sounds - incisal edges should approximate each other

Intraoral Assessment of Anterior Teeth

Incisal edges of maxillary incisors should follow line of lower lip when smiling (smile line)

Follow the Smile line

Placing & Moving Anterior Teeth

Crown removing forceps to bodily move and tilt teeth Grind record base/tooth if record base is impairing ability to position properly

Intraoral Assessment of Anterior Teeth

Nasolabial angle 90 If insufficient support, the vermilion border will be reduced

Intraoral Assessment of Anterior Teeth

Junction of oral mucosa (glossy) should just be visible when lips are slightly separated If not visible - insufficient support Lips meet at junction of oral & transitional epithelium

Intraoral Assessment of Anterior Teeth

Excessive block-out of record base will push the lip out at the height of the vestibule, distorting appearance

Lisping
Too much horizontal overlap
Cant approximate incisal edges

Anterior teeth too far labially Spaces allow air leakage

Lisping
Palatal contour too constricted
Remove wax to provide more room

Arch form too broad Experiment with placement of wax

Anterior Teeth Not Identical Position of Natural Teeth Slightly altered position from precursors Denture stability compromised No anchorage from roots

Avoid the Denture Smile

Teeth too small Teeth not showing Too straight across anterior Chiclets

Central & lateral incisors must begin to turn along the curvature of the arch

Circumference Follows Arch Shape

Facial Support, OVD & Tooth Setup Can Dramatically Affect Appearance

Effect of Incisor Length

Variation of Appearance with Different Dentures

Variation of Appearance with Different Dentures