Selection and Arrangement of Artificial Teeth

SELECTION AND ARRANGEMENT OF
ARTIFICIAL TEETH FOR COMPLETE
DENTURE PROSTHESIS
Presented by–
HEMAM SHANKAR SINGH
1

Contents
1. INTRODUCTION
2. ANTERIOR TOOTH SELECTION
3. MATERIALS OF ANTERIOR TOOTH
4. POSTERIOR TOOTH SELECTION
5. ARRANGEMENT OF THE TEETH
6. ARRANGEMENT OF ANTERIOR TEETH
7. ARRANGEMENT OF POSTERIOR TEETH
8. COMMON ERRORS IN ARRANGEMENT OF TEETH
9. CONCLUSION
10. REFERENCE
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SELECTION

Introduction
• This tends towards art and less to science and while the
principles which follow will enable any clinician of average
artistic ability to select teeth suitable for the average
patient, the most pleasing results will always be obtained by
those with an aesthetic sense. Anterior teeth are primarily
selected to satisfy esthetic requirements.
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SELECTION

Introduction
• The selection of artificial teeth for edentulous patients
requires a knowledge and understanding of a number of
physical and biologic factors that are directly related to each
patient.
• The selection of artificial teeth is a relatively simple, non-time
consuming procedure, but it requires development of
experience and confidence.
• Any choice of artificial teeth must be considered as a
preliminary selection until the teeth are arranged on the
trial denture bases and can be critically viewed in the
patient’s mouth.
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SELECTION

Anterior tooth selection
• The selection of artificial teeth for edentulous patients when
all records of form, color, and size have been lost is a clinical
procedure.
• Trial in the patient’s mouth is the best way
• Much of the effectiveness of tooth selection depends on the
ability of dentists to interpret what they see
• Careful examination of the faces and teeth of people with
natural teeth will develop a sense of dentofacial harmony
that is the objective of tooth selection and esthetics
• There must be harmony of color, form, size, and
arrangement of teeth
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SELECTION

• Factors to be considered for selection of anterior teeth:
A. Shade (color).
B. Size.
C. Form.
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SELECTION

SHADE:
• A knowledge of the physics, physiology, and psychology of
color is of value in the selection of the color
• The color of most concern to dentist is the yellow color,
because the colors of teeth and faces are primarily yellow
• Colors have four qualities—
1. Hue
2. Saturation (chroma)
3. Brilliance (value)
4. Translucency
• All these are involved in selection of teeth
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SELECTION

Hue
• It refers to the dominant wavelengths present in a spectral
distribution e.g. red, green, yellow, etc.
• The hue of the teeth must be in harmony with the hue of
the patient’s face.
• Disharmony will make dentures look artificial
Saturation
• It is the amount of color per unit of area of an object
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SELECTION

Brilliance
• It refers to the lightness or darkness of an object
• Patient’s with fair complexion have lighter teeth than the
patient with dark complexion
Translucency
• It is the property of an object that permits the passage of
light through it but cannot give any distinguishable image
• Presence of translucency makes the teeth looks alive
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SELECTION

• The factors of shade selection are:-
1. Age.
2. Sex.
3. Complexion.
4. Patient -preference
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SELECTION

1. Age:-
 The younger the patient, the lighter the color is
preferred.
 The color of natural teeth darken with age because of
deposition of secondary dentin , wearing away of enamel
and external staining from oral fluids, foods or tobacco.
2. Sex: -
 The sex may effect color, it seems that females given
brighter teeth than males.
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SELECTION

3. Race:-
SELECTION
 The color of the face should harmonize the color of teeth.
Lighter teeth are suitable for lighter skin, while darker
teeth are suitable for darker skin, although darker people
with dark skin seemed to have very light teeth. This is
because of contrast in the skin and tooth color.
4. Patient preference (Method of pair comparison ):-
 Show the patient a complete shade guide and select the
two tabs that are lightest and darkest, hold them against
the patient lip and ask them to point to the one that they
prefer. More than two or three shades should be selected
and comparison between them would help in final right
selection. 12

SIZE
• The size of the teeth should be in proportion to the size of
the face and head
• Women’s teeth are often smaller than men’s
• A distinct difference between CI & LI is desirable in women
• Following factors are used as a guide to select the size of the
teeth
1. Methods using pre-extraction guides
2. Methods using anthropological measurements of the patient
3. Methods using theoretical concepts
4. Methods using anatomical landmarks
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SELECTION

METHODS USING PRE-EXTRACTION GUIDES
It includes-
• Diagnostic casts,
• Photographs,
• Radiographs,
• Observation of the teeth of close relatives, and
• Extracted teeth
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SELECTION

DIAGNOSTIC CASTS
• Diagnostic cast of natural teeth are the most reliable guides
in both selecting arranging anterior teeth.
• The size and form of the anterior teeth can be determined
on the diagnostic cast, and comparable artificial teeth are
selected
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SELECTION

PHOTOGRAPHS
• Provides information about the width of the teeth and
possibly the outline form
• An algebraic proportions may be established with some
known and unknown factors such as interpupillary distance
in patient and in the photograph, and the width or length of
the CI in the photograph (unknown factor)
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SELECTION

INTRA-ORAL RADIOGRAPH
• Radiographs made before the natural teeth were lost can
supply information about the size and form of the teeth to
be replaced.
• However, radiographic image is slightly enlarged and may be
distorted because of divergence of the x-ray
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SELECTION

EXTRACTED TEETH
• Provides excellent information as to size and form for the
artificial teeth
• Cannot be used in selecting color
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SELECTION

METHODS USING ANTHROPOLOGICAL MEASUREMENTS
• These methods measures certain anatomical dimensions and
derive the size of teeth using certain formula
1. Anthropometric cephalic index
2. Berry’s biometric index
3. H. Pound’s formula
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SELECTION

• Anthropometric cephalic index (Sears)
– Transverse circumference of the head is measured using a measuring
tape at the level of the forehead
Circumference of the head
– Width of the upper CI=-------------------------------------------
13
bi-zygomatic width
– Total Width of the upper anterior =-------------------------------------------
3.36
4
Total Width of the lower anterior =---- Width of the upper anteriors
5
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SELECTION

Berry’s biometric index
bi-zygomatic width
Width of the upper CI=-----------------------------
16
length of the face
20
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SELECTION

H. Pound’s formula
bi-zygomatic width
16
length of the face
length of the upper CI=-----------------------------
16
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SELECTION

METHODS USING THEORITICAL CONCEPT
1. Winklers concept
2. Typal form theory: Leon Williams (1917)
3. Temparamental theory: Dr. Sparzheim
4. Concept of harmony: J.W. White
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SELECTION

Winklers concept
• According to winkler, the teeth should be selected based on
three different view’s namely
1. Physiological
2. Psychological
3. Biomechanical
• Physiolgical
– Facial musculature contributes to the esthetics of a patient
– Increasing the thickness of the denture base in the labial and Buccal
sulci can produce a puffy appearance
– Facial wrinkles fade when the vertical dimension is increased
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SELECTION

Winklers concept
• Psychological
• Camper’s line is the psychological plane of orientation
• It is raised in happy people
• It is tilted in depressed people
• Biomechanical
• According to this teeth should be set in the neutral zone
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SELECTION

Typal form theory: Leon Williams (1917)
• According to this, the shape of the teeth should be inverse
of the shape of the face
Concept of harmony: J.W. White in 1872
• According to him, the size and color of the teeth should be
in harmony with the size of the head and color of the eye
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SELECTION

METHODS USING ANATOMIC LANDMARKS
Seven anatomic entities are used as guides to selection of
anterior teeth for size:
1. Size of the face
2. Size of the maxillary arch
3. Incisal papilla and the cuspid eminence or the Buccal
Frenum
4. Maxillomandibular relations
5. The contour of the residual ridges
6. The vertical distance between the ridges
7. The lips
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SELECTION

SIZE OF THE FACE:
• The average width of the maxillary CI is estimated to be one
sixteenth of the width of the face measured between the
zygoma.
• The combined width of the six maxillary anteriors is slightly
less than one third of the Bizygomatic breadth of the face
• The face-bow can be used as a caliper to record the
Bizygomatic breadth of the face.
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SELECTION

SIZE OF THE MAXILLARY ARCH:
• Make measurements from the crest of the incisal papilla to
the hamular notches and from one hamular notch to the
opposite hamular notch
• The combined length of the three legs of the triangle in
millimeters is used on the selector
• Mold selector can be used for the measurement
• The circular slide rule indicates the tooth sizes, anterior and
posterior, both arches
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SELECTION

INCISAL PAPILLA AND THE CUSPID EMINENCE OR THE BUCCAL FRENUM:
• if the cuspid eminence are discernible, a line can be placed
on the cast at the distal termination of the eminence.
• if the cuspid eminence are not discernible, the attachments
of the Buccal Frenum can be used. A lined placed slightly
anterior to the Frenum attachment will be distal to the
eminence
• the measured distance between this two cuspid eminence
gives the combined width of the six maxillary teeth
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SELECTION

INCISAL PAPILLA AND THE CUSPID EMINENCE OR THE BUCCAL FRENUM:
• occlusal rim can be used to to locate the distal of cuspid
eminence.
• A pointed instrument is passed to the occlusal rim at each
corner of the lips and a mark is recorded
• The distance between the marks following the contour of
the arch is the combined width of the six maxillary anterior
teeth
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SELECTION

MAXILLOMANDIBULAR RELATIONS:
• The sizes and the positions of the teeth will have to vary
from the accepted normal if the teeth in the one arch are to
complement the teeth in the other arch.
• In instances of protruded mandibles the mandibular teeth
are frequently larger than normal.
• If the mandibles are retruded, the mandibular teeth are
frequently smaller.
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SELECTION

• THE CONTOUR OF THE RESIDUAL RIDGES:
SELECTION
– The artificial teeth should be placed to follow the contour
of the residual ridges that existed when the natural teeth
were present.
– A knowledge of direction of resorption of the two arches
will allow a fairly accurate visualization of the original
contour.
– Resorption of maxillae in anterior segment is in a vertical
and palatal direction, Posteriorly in vertical and medial
direction
– In mandible in in anterior segment is in vertical and
lingual direction, Posteriorly in vertical and lingual
direction 33

• THE VERTICAL DISTANCE BETWEEN THE RIDGES:
– The length of the teeth is determined by the available
space between the existing ridges.
• THE LIPS
– When the teeth are in occlusion and the lips are together,
the labial incisal third of the maxillary anterior teeth
supports the superior border of the lower lip
– In speech the incisal edges of the maxillary anterior teeth
contact the lower lip at the junction of the moist and dry
surfaces of the vermilion border.
– It is best demonstrated when the letter F, as in fifty five is
pronounced
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SELECTION

FORM OF ANTERIOR TEETH:-
• The form and outline of the anterior teeth can be
determined using the following factors:
1. Shape of the patient’s face or facial form
2. Patient’s profile
3. Dentogenic concept and dynesthetics
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SELECTION

Shape of the patient’s face or facial form
– This is based on the Typal form theory by Leon Williams
– According to him, facial form can be described
• square,
• ovoid and
• tapering.
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SELECTION

Profile of the face:
• Can be divided into:
– Straight,
– convex and
– concave.
• The labial surface of Upper central incisor viewed from the
mesial aspect should be in harmony with profile of the face.
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SELECTION

Dentogenic concept and dynesthetics:
Dentogenics is the art, practice and technique of
creating the illusion of natural teeth in artificial dentures
and is based on the elementary factor influenced by sex,
personality and age of the patient.
It was first described by Frush and Fisher.
The term “Dynesthetics” is derived from Greek word
“dynamics” meaning power. It supports in working factor of
dentogenic concept.
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SELECTION

Dentogenic concept:
Sex:
– In female, the incisal angles are more rounded and the
teeth have lesser angulation while in males, the incisal
angles are rounded to a lesser degree and teeth are
more rounded.
– The incisal edge of the CI is parallel to the lips and the
laterals are above the occlusal plane in males. But in
females it follows curve of the lower lip (CI & LI)
– The distal surface of CI are rotated posteriorly for
females.
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SELECTION

Dentogenic concept:
Sex:
– Lateral incisors
• Mesial surface are rotated anteriorly in relation to CI in females
• The mesial ends are hidden by the CI. This makes the canine
very prominent in males
– Canines
• Only the mesial thirds are visible in females because they are
rotated anteriorly in relation to the CI whereas even the middle
two-thirds of the canine are visible in males
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SELECTION

Dentogenic concept:
Age:
– Age can be easily separated into young, middle or
elderly.
– Due to decrese in muscle tone, sagging of the cheeks
and the lower lips occur. To prevent cheek biting,
horizontal overlap of the posterior teeth can be increase.
– Inter occlusal distance reduces with age. Hence,
mandibular teeth are more visible than the maxillary
teeth.
– In old patients the teeth tend to have square form due
to attrition, more round features disappears and line
angle quite seen in those patients.
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SELECTION

Dentogenic concept:
Age:
– Old patient have gingival recession, & can be reproduced
in the dentures
– The color of the teeth also changes with age.
Personality:
– It seems reasonable that a large vigorous type of
persons have teeth of a size and form with prominent
markings, different from those of a delicate appearing
patient.
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SELECTION

Dynesthetics:
– The term “Dynesthetics” is derived from Greek word
“dynamics” meaning power.
– It supports in working factor of dentogenic concept.
– The technique of Dynesthetics is an auxiliary stimulus in
the creation of a dentogenic restoration.
– It is secondary to sex, personality and age factors.
– These are rules, which concern the three important
division of denture fabrication
1. The tooth
2. Its position
3. Its matrix
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SELECTION

MATERIALS OF ANTERIOR TEETH
MATERIALS OF ANTERIOR TEETH:-
There are two main types:
1. Porcelain,
2. Acrylic
Porcelain teeth:
We have vacuum fired and air fired. The vacuum is better
because they are harder and have luster. Generally
porcelain teeth are preferred particularly for young person
because they look more vital, very smooth and difficult to
abrade.
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SELECTION

MATERIALS OF ANTERIOR TEETH:-
Acrylic teeth:
They are made from acrylic resin, indicated when there is
insufficient inter-occlusal distance, and grinding becomes
necessary, also in situation where there are opposing
natural teeth, partial denture and gold bridge. They are
inferior when they are compared with porcelain because
they can not maintain luster for long time and abraded
easily.
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SELECTION

ACRYLIC TEETH :
1- Not brittle, but poor
abrasion resistance.
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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SELECTION

Posterior tooth selection
SELECTION
Posterior teeth are selected for color, buccolingual width,
mesiodistal length, vertical height (occluso-gingival length)
and occlusal form.
1- Shade (color):
Shade of posterior teeth should be harmonized to the
shade of anterior teeth, maxillary first premolars are
sometimes used for esthetic more than function, so it's
advisable to select premolar teeth with lighter color
than the other posterior teeth, but not lighter than
anterior teeth. Generally the shades of posterior teeth
are slightly darker than anterior teeth (post. Contain
dentin more than ant.). 47

2- Bucco-lingual width:-
SELECTION
The bucco-lingual width of posterior teeth should be
slightly narrower than natural teeth to decrease occlusal
surfaces which direct less stress during function to
supporting tissue, and also enhance the development of
the correct form of polished surfaces of the denture.
3- Mesio-distal width:
The mesio-distal width of posterior teeth should be equal
to the distance between canine line and anterior border of
maxillary tuberosity for upper teeth. For lower teeth should
be equal to distance between canine line and anterior
border of retro molar pad area.(the width with in design
limit) 48

4- The occluso-gingival height
The occluso-gingival height or length is controlled by the
available inter-arch distance. The length of the maxillary
first premolar should be comparable to that of maxillary
canine to have the proper esthetic effect. The height of
posterior teeth usually divided into long, short, medium.
Long posterior teeth are generally more esthetic in
appearance than are shorter teeth.
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SELECTION

5- Occlusal form:
Selecting the tooth to be used is based on the concept
of occlusion to be developed, the philosophy of occlusion to
be fulfilled, and the accomplishment approached. It is given
in the table below.
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SELECTION

51
COMPARISION OF DENTURE TOOTH MOLDS AND OCCLUSAL CONCEPTS
TOOTH MOLD OCCLUSAL CONCEPT ADVANTAGE DISADVANTAGE
SELECTION
20 or 30-
degree cusp
teeth
• Centric jaw record, face bow,
protrusive records to semi-adjustable.
• Set upper anterior and
posterior teeth, then lowers
to cross-arch contact or
“balanced-occlusion”
• Reported slightly more
efficient in chewing tests
• Posteriors appears more
natural
• Most time and
complexity of records
• Limitations of
anterior tooth
positions
• Restriction of
posterior tooth
positions to that
allowed by Cuspal
anatomy
Monoplane 0-
degree
• Centric jaw record only
• Simple articulator
• Set 12 anterior teeth with
Overjet but no overbite
• Set lower teeth in flat plane to
middle of retromolar pad
• Set upper to match; no
attempt on contact on
excursions
• Simplest of all recordings
• Simplest articulators
• Quick arrangement of
teeth
• Wide range of posterior
tooth positions possible
• No lateral stresses on
mucosa with parafunction
• Easier for patients with
uncoordinated closures
• Flat premolars may
appears less esthetic
• Reported as less
aesthetics
• Anterior esthetics
need more Overjet
and no overbite

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SELECTION
COMPARISION OF DENTURE TOOTH MOLDS AND OCCLUSAL CONCEPTS
TOOTH MOLD OCCLUSAL CONCEPT ADVANTAGE DISADVANTAGE
Flat teeth
with
compensating
curve or
second molar
ramp
 Centric jaw record
 Semi-adjustable articulator
 Anterior teeth with Overjet
and slight overbite
 Posterior set to contact on at
least 1 point on non-working
or balancing side
 Simple to set up; allows for
more esthetic overlap of
anterior teeth
 The posterior point contact
maintain denture base
stability on excursion or
parafunction
 Slightly more
laboratory set up
 Premolars appear
flat if visible
Combination
or
“lingualized”
occlusion
 Centric jaw record
 Monoplane lower posterior
teeth set to retromolar pad
 Anatomic upper posterior
teeth set with only lingual, not
buccal cusp touching
 Upper premolars appear
natural
 Some range of posterior
tooth position allowed
 Reported slightly better
chewing than monoplane
 Some grinding
needed to create
upper cusp
tip/lower fossa
contacts

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SELECTION
10° 20°
33°

ARRANGEMENT OF THE TEETH
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ARRANGEMENT

Arrangement Of The Teeth
Arrangement Of The Anterior Teeth
It is important that the artificial anterior teeth are
placed in the same antero-posterior position and at the same
length as the original natural esthetics and phonetics
55
ARRANGEMENT

Guides for arrangement of anterior teeth
1. Residual alveolar ridge
2. Incisive papilla
3. Reflections of soft tissues under the lip
• The carved occlusal rims should provide reliable guides for
placement of the anterior teeth in wax occlusion rims
• They indicate the likely antero-posterior and vertical
positions of the incisor teeth
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ARRANGEMENT

RESIDUAL ALVEOLAR RIDGE
• In patient with long edentulous period, much bone could
have been lost from the residual alveolar ridge. In this
situation, artificial teeth should not be placed against the
ridge
• As a general rule: the longer the natural teeth have been
out the farther the artificial teeth should be from the ridge
• The teeth should be placed closer to the residual ridge
when there is less shrinkage and farther from ridge when
there has been more resorption
57
ARRANGEMENT

RELATIONSHIP TO INCISIVE PAPILLA
• Incisive papilla is a guide to anterior tooth position because
it has a constant relationship to the natural CI
• A line marking the centre of the incisive papilla on the cast
is extended forward onto the labial surface of the cast and
CI are set on either side of this line
• Incisive papilla is also a guide to the antero-posterior
position of the teeth
• Labial surfaces of the Ci are usually 8-10 mm in front of the
papilla
58
ARRANGEMENT

RELATIONSHIP TO REFLECTION OF SOFT TISSUE
• Labial surfaces and incisal edges of the teeth are anterior to
the tissues at the reflection where the denture borders
would be placed
• The accuracy of this guide decreases as the resorption of
the residual ridge progresses
59
ARRANGEMENT

Arrangement of the maxillary anterior teeth:
• In placing and positioning the maxillary anterior teeth the
objective is to provide balance between maximum esthetics
and proper phonetics. The maxillary anterior teeth should
support the upper lip in a natural position.
• After the loss of the natural anterior teeth, bone resorption
usually occurs more on the labial aspect than on the palatal
aspect of the maxillary ridge. To compensate for this loss of
bone structure the maxillary anterior teeth should be placed
labial to the residual ridge.
60
ARRANGEMENT

• The incisive papilla in the edentulous maxillary arch acts as
a guide to proper placement of the maxillary central
incisors. The maxillary central incisors fall approximately 8
to 10 mm anterior to the point of intersection of a line that
bisects the midline of the palate perpendicularly through
the incisive papilla. (mid line is between the labial frenum
and the incisive papilla)
• The labial contour of the teeth should follow the labial
contour of the occlusal rim.
• The right and left maxillary anterior teeth should be
positioned symmetrically on either side of the arch.
61
ARRANGEMENT

Position of the maxillary central incisor:
– Mesio-distal inclination:
• The maxillary central incisor is placed, so that the long
axis shows a slight distal inclination, when viewed
from front.
62
ARRANGEMENT
– Labio-lingual inclination:
• The neck of the tooth
should be slightly
depressed when viewed
from this side, the tooth
slopes (incisal edge )
towards the labial side.
– The incisal edge:
• Is in contact with the occlusal plane.

Position of the maxillary lateral incisor:
Mesio-distal inclination:
The maxillary lateral incisor is placed with its long axis inclined
notesable distally when viewed from the front.
63
ARRANGEMENT
Labio-lingual inclination:
The neck of the maxillary lateral
incisor is depressed (of the neck)
more than the central incisor,
although the labial surface will
be nearly in line with the central
incisor.
The incisal edge:
is ½ to 1mm above the level of the occlusal plane.

Position of maxillary canine:
The maxillary canine is placed so that the long axis has
slight distal inclination from the front view.
64
ARRANGEMENT
The neck of the
maxillary canine is
prominent. The tooth
axis is vertical (straight )
when viewed from the
side.

The cusp tip:
Is in contact with the occlusal plane.
The maxillary canine has two planes on the labial surface;
mesial plane should follow the contour of the anterior teeth
while the distal plane will be in line with the posterior
teeth.
65
ARRANGEMENT

Arrangement of the mandibular anterior teeth:
1. The midline of the maxillary central incisor should be
followed while placing the mandibular central incisor.
2. The imaginary roots of the mandibular anterior teeth
should be directed towards the residual ridge. this will
often place the mandibular teeth labial to the residual
ridge.
3. The mandibular anterior teeth should not be in contact
horizontally with the maxillary teeth (over jet).
4. The mandibular anterior teeth should not be in contact
vertically with the maxillary anterior teeth (over bite).
66
ARRANGEMENT

67
ARRANGEMENT

Position of the mandibular central incisor:
The long axis is perpendicular to the occlusal plane
(vertically upright).
68
ARRANGEMENT
The central incisor is placed with its
neck depressed and the tooth will
show that it’s labially inclined when
viewed from one side.
The incisal edge:
Are 1-2 mm above the occlusal
plane.

Position of the mandibular lateral incisor:
The mandibular lateral incisor is placed with its long axis
showing a slight distal inclination.
69
ARRANGEMENT
The labial surface is
perpendicular to the occlusal
plane.
The incisal edge:
Are 1-2 mm above the occlusal
plane.

Position of the mandibular canine:
The mandibular canines are placed with a more distal
inclination (neck distally placed) than the mandibular
lateral incisors.
70
ARRANGEMENT
The neck of the tooth is placed
prominently. The tooth shows a
slight lingual inclination (at the
incisal edge) when viewed from
the side
The incisal tip:
Lies 1-2 mm above the occlusal
plane.

Horizontal overlap (over jet):
This the horizontal distance between the incisal edge of the
maxillary central incisor and the labial surface of the
mandibular central incisor.
71
ARRANGEMENT
Vertical overlap (over bite):
The maxillary anterior
teeth overlap the
mandibular anterior teeth
and this overlapon the
vertical axis is called the
vertical overlap.

Incisal guide angle:
The incisal guide angle is the angle formed with the
horizontal plane by drawing a line in the sagittal plane
between the incisal edges of the maxillary and
mandibular central incisors when the teeth are in centric
occlusion.
72
ARRANGEMENT
The amount of vertical and
horizontal overlap determines the
sagittal incisal guidance.
Incisal guidance is the path
traveled by the mandibular central
incisor from centric occlusion
position to the protrusive occlusal
position.

Arrangement Of The Posterior Teeth
Arrangement Of The posterior Teeth
Posterior teeth are set up in tight centric occlusion. The
mandibular teeth are set in the wax occlusion rim over the
residual ridge in their ideal bucco-lingual position and the
maxillary teeth are set in tight centric occlusion with them
regardless of their bucco-lingual position. The objective here is
to have the intercuspation of the posterior teeth so precise
that any deviation of this occlusion in the mouth will be easily
detected.
73
ARRANGEMENT

Standardized parameters
1. Curve of Wilson' as transversal compensating curve.
2. Curve of Spee' as sagittal compensating curve.
3.Optimum intercuspation of the antagonists.
74
ARRANGEMENT

Curve of Wilson
Transversal compensating curve. It runs frontally
(transversally), touching the cusp tips of the posterior teeth. In
the lower arch, it is produced by an even inclination of the right
and left molars towards the lingual, corresponding to an
inclination towards the buccal in the maxilla. When setting-up
complete dentures, the teeth should be positioned along this
curve
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Curve of Spee
Sagittal compensating
curve. Its bow-shaped line of
occlusion in dentition. Spee
described it as the "shifting
path" of the mandible. The
segment of the circle drawn
has its center in the orbital
cavity.
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ARRANGEMENT

The guide lines used in arrangement of posterior teeth:
1. The line of the crest of lower residual ridge. Which extend
between the middle of retromolar pad, and tip of lower
canine, the central grooves of the lower posterior teeth
should coincide with this line.
2. The line extending between the tip of lower canine and
upper 2/3 of retromolar pad will determine the height of
lower posterior teeth.
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Arrangement of maxillary posterior teeth:-
a. Maxillary premolars:
1. Premolars are set vertically to occlusal plane.
2. Facial cusp of maxillary 1st premolar touch the occlusal
plane while the lingual cusp is raised from occlusal
plane approximately 12 mm
3. The facial cusp of maxillary 1st premolar should be seat
into the embrasure between the mandibular 1st and
2nd premolars.
4. Lingual cusp should be over the crest of the ridge
5. Facial and lingual cusp of maxillary 2nd premolar touch
the occlusal plane.
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b. Maxillary molars:
1. The inclination of maxillary molars are mesially and slightly
lingually to create a 6 degree upward curve.
2. Mesio-lingual cusp of maxillary 1st molar should touch the
occlusal plane and the lingual cusps are over the crest of
the mandibular ridge
3. The mesiobuccal cusp of upper 1st molar should rest in the
buccal groove of the lower 1st molar, and the mesio-lingual
cusp should seat into the central fossa of lower 1st molar.
4. Maxillary 2nd molar are set with no cusp touches the
occlusal plane. All the lingual cusps are over the crest of the
mandibular ridge
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ARRANGEMENT

5. Facial cusps of maxillary teeth form a gentle curve, while
the lingual cusps form a similar curve about 12 mm below
the facial cusps .
6. Use a template to cheak the buccal alignment of, canine,
premolars and mesial buccal cusp of maxillary 1st molar
should touch the template, while the distobuccal cusp not
touch.
7. To check the buccal alignment of maxillary posterior teeth,
all four cusps of maxillary molars touch the template while
the premolar do not touch the template.
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Arrangement of mandibular posterior teeth
1. The Mandibular 1st molar is first set into centric occlusion.
2. Mesio-buccal cusp of maxillary 1st molar fit in to the buccal
groove of mandibular first molar.
3. The mesioligual cusp of Mandibular 1st molar fit into the
central fossa of the maxillary first molar.
4. Set the mandibular 2nd molar,the mesio-buccal cusp of
maxillary 2nd molar fit in to the buccal groove of
mandibular 2nd molar.
5. Then set mandibular 2nd premolar,its cusp tip should be
positioned in the embrasur between maxillary 1st and 2nd
premolars.
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5. The last tooth are mandibular 1st premolar which should be
position in the embrasure between maxillary canine and
maxillary 1st premolar.
6. Mandibular premolars follow the curvature of the canine.
7. Mandibular posterior teeth are set on or slightly lingual to
the crest of the ridge.
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85
ARRANGEMENT

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Common errors in arrangement of teeth.
1. Lack of rotation of anterior teeth to give a narrower effect.
2. Setting mandibular anterior teeth too forward in order to
meet maxillary teeth.
3. Failure to make the canine the turning point of the arch.
4. Setting mandibular 1st premolar to the buccal side of the
canines.
5. Setting the mandibular posterior teeth too far to the lingual
side in the 2nd molar region which cause tongue
interference and mandibular denture displacement
6. Failure to establish the occlusal plane at the proper level
and inclination.
7. Establishing the occlusal plane by an arbitrary line on the
face.
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CONCLUSION
Teeth selection should be in harmony in color, shape
and size with the patient’s face, sex and age for a successful
fabrication of complete denture prosthesis with a natural
looking also pleasing appearing teeth. Teeth should be
positioned in harmony with intraoral and circumoral muscle
activity and adjusted so that they occlude and articulate evenly.
Several different prosthetic tooth molds have been produced,
and each has some purported advantages. In the absence of a
clear advantage, dentists should use tooth molds that are
esthetically pleasing and have a simple procedure to set up.
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REFERENCE
1. Judson. C. Hickey (DDS, M. Sc.), Charles L. Bolender (DDS,
MS), George A. Zarb (DDS, MS) : Boucher’s Prosthodontic
Treatment for edentulous patients. 9th Edn. The c. v. mossy
co,1985: 324-364, 427-457.
2. Sheldon winkler: essentials of complete dentures
prosthodontics. 2nd edn, W. B. Sauders company,
3. Charles M. Heartwell, Jr; Arthur O. Rahn: Syllabus of
Complete Dentures, Fourth edition,pg 293-346; published
by Lea & Febiger Philadelphia
4. Omkar Shetty, Sabita Ram: Dentogenic concept Part-I, II:
Scientific Journal: Volume-I, 2007: Volume-II, 2008.
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Selection and Arrangement of Artificial Teeth

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