Setting Anterior Teeth Esthetics Phonetics Look for Symmetry

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 central incisor to canine

Contour of Gingiva – Expose to CEJ – Contour affects appearance Cervical Necks Covered in 2 nd Quadrant Cervical Neck of Canine Should be Longer than Incisors

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 maxillary teeth

Setting Mandibular Anteriors • Incisal edges are placed at same level • Even with 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

Bucco-Lingual Tilt Mandibular Anterior Teeth • View at different angles • Along facial surface • Occlusal

Anterior Tooth Setup • Check symmetry with reference lines • Anterior teeth don’t contact in centric position • Grazing contacts in excursions Overbite = 0 mm Overjet = 2 mm

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

Canine 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 • Can’t 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 No anchorage from roots Denture stability an issue

Avoid the ‘Denture Smile’ • Teeth too small • Too straight across anterior • “Chiclets” • Teeth not showing

Central & lateral incisors must begin to turn along 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

Videos: Setting Anterior Teeth • Set Maxillary Anterior Teeth • Set Mandibular Anterior Teeth