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Setting Anterior Teeth
Esthetics & Phonetics
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View from anterior, occlusal View from many angles
Look for Symmetry View from anterior, occlusal View from many angles
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Symmetry Perfect Symmetry Gross Asymmetry
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Facial Asymmetry 2 Left Sides “Normal” Right Sides
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Smile Asymmetry 2 Left Sides “Normal” Right Sides
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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
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Cervical necks tilt posteriorly from the central incisor to the canine
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The greatest height of the free gingival margin is slightly distal to the mesiodistal center of the tooth
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Setting Mandibular Anteriors
Lower anterior teeth incline similar to the maxillary teeth
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Setting Mandibular Anteriors
Incisal edges are placed at the same level Even with the occlusal plane
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Setting Mandibular Anteriors
No overbite for monoplane or lingualized setups
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Canines should be tilted more posteriorly than other teeth, with a more prominent cervical neck
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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
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Bucco-Lingual Tilt Mandibular Anterior Teeth
Central is proclined Lateral is more upright Canine has a prominent neck Central Canine
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Anterior Tooth Setup Check symmetry with reference lines
Anterior teeth don’t contact in centric position Grazing contacts in excursions Overbite = 0mm Overjet = 2mm
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No Anterior Contact in Centric
Insufficient Correct Excessive
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Dentist Sets Incisal Guidance Overjet & Overbite
Avoid too much overbite or too little overjet Increasing overbite steepens the angle, separating posterior teeth more quickly Increasing overjet shallows the angle, separating the posterior teeth less quickly
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Canine Offset Check for one half tooth offset between maxillary & mandibular teeth Ensures posterior teeth have normal cusp to fossa relationship for lingualized occlusion
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Improper offset results in a space or half tooth replacement
Cannine Offset Correct Improper offset results in a space or half tooth replacement Insufficient
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Phonetic Assessment Maxillary centrals should lightly touch vermilion border of lower lip for ‘F’, ‘V’ sounds ‘S’ sounds - incisal edges should approximate each other
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Intraoral Assessment of Anterior Teeth
Incisal edges of maxillary incisors should follow line of lower lip when smiling (‘smile line’)
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Follow the ‘Smile line’
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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
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Intraoral Assessment of Anterior Teeth
Nasolabial angle ≈ 90° If insufficient support, the vermilion border will be reduced
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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
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Intraoral Assessment of Anterior Teeth
Excessive block-out of record base will push the lip out at the height of the vestibule, distorting appearance
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Lisping Too much horizontal overlap Anterior teeth too far labially
Can’t approximate incisal edges Anterior teeth too far labially Spaces allow air leakage
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Lisping Palatal contour too constricted Arch form too broad
Remove wax to provide more room Arch form too broad Experiment with placement of wax
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Anterior Teeth Not Identical Position of Natural Teeth
Slightly altered position from precursors Denture stability compromised No anchorage from roots
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Avoid the ‘Denture Smile’
Teeth too small Teeth not showing Too straight across anterior “Chiclets”
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Central & lateral incisors must begin to turn along the curvature of the arch
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Circumference Follows Arch Shape
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Facial Support, OVD & Tooth Setup Can Dramatically Affect Appearance
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Effect of Incisor Length
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Variation of Appearance with Different Dentures
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Variation of Appearance with Different Dentures
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