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Anterior teeth selection /dental continuing education course

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Indian Dental Academy: will be one of the most relevant and exciting training

center with best faculty and flexible training programs for dental

professionals who wish to advance in their dental practice,Offers certified

courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry,

Prosthetic Dentistry, Periodontics and General Dentistry.

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  • 1. ANTERIOR TEETHANTERIOR TEETH SELECTIONSELECTION INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  • 2. CONTENTSCONTENTS IntroductionIntroduction Selection of anterior teethSelection of anterior teeth SizeSize FormForm ColourColour MaterialMaterial Dentogenic conceptDentogenic concept Review of literatureReview of literature ConclusionConclusion BibilographyBibilography www.indiandentalacademy.comwww.indiandentalacademy.com
  • 3. IntroductionIntroduction Anterior teeth selection and arrangement is anAnterior teeth selection and arrangement is an area of prosthodontics where art dominatesarea of prosthodontics where art dominates science,where esthetics is the major concern,andscience,where esthetics is the major concern,and where knowledge must be applied to create a pleasingwhere knowledge must be applied to create a pleasing appearance while simultaneously maintaining oralappearance while simultaneously maintaining oral function.function. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 4.  The anterior teeth are primarily selected to satisfyThe anterior teeth are primarily selected to satisfy esthetic requirements.esthetic requirements.  Posterior teeth's are selected to satisfy masticatoryPosterior teeth's are selected to satisfy masticatory functional requirements.functional requirements.  Technically, the anterior teeth are composed of 6Technically, the anterior teeth are composed of 6 maxillary and 6 mandibular teeth's.maxillary and 6 mandibular teeth's. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 5. Sometimes maxillary first premolar is consideredSometimes maxillary first premolar is considered more for esthetics than for masticatory function.more for esthetics than for masticatory function. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 6. Patients expect 3 basic things from their completePatients expect 3 basic things from their complete denturesdentures.. – Favorable appearance.Favorable appearance. – Comfort.Comfort. – Chewing abilityChewing ability.. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 7. There are four main considerations in selecting theThere are four main considerations in selecting the anterior teeth.anterior teeth. Tooth sizeTooth size Tooth shapeTooth shape ColorColor Tooth materialTooth material www.indiandentalacademy.comwww.indiandentalacademy.com
  • 8. Size of teethSize of teeth www.indiandentalacademy.comwww.indiandentalacademy.com
  • 9. PRE-EXTRACTION GUIDES -PRE-EXTRACTION GUIDES - wrightwright PHOTOGRAPHS.PHOTOGRAPHS. RADIOGRAPHS.RADIOGRAPHS. DIAGNOSTIC CASTS.DIAGNOSTIC CASTS. TEETHS OF RELATIVES.TEETHS OF RELATIVES. EXTRACTED TEETH.EXTRACTED TEETH. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 10. photographsphotographs www.indiandentalacademy.comwww.indiandentalacademy.com
  • 11. New denturesNew dentures made withmade with the help ofthe help of oldold photographphotograph •65 years: Poor esthetics old dentures. Natural teeth at 20 years www.indiandentalacademy.comwww.indiandentalacademy.com
  • 12. TEETH OF RELATIVESTEETH OF RELATIVES www.indiandentalacademy.comwww.indiandentalacademy.com
  • 13.  Diagnostic castsDiagnostic casts  Preserved extracted teethPreserved extracted teeth  Pre extraction radiographsPre extraction radiographs www.indiandentalacademy.comwww.indiandentalacademy.com
  • 14. Methods using landmarksMethods using landmarks www.indiandentalacademy.comwww.indiandentalacademy.com
  • 15. Anthropological measurementsAnthropological measurements Bi-zygomatic width: Berry, Williams, House www.indiandentalacademy.comwww.indiandentalacademy.com
  • 16. Length of central incisorLength of central incisor Facial measurement methodFacial measurement method Distance from the hair line to the gnathionDistance from the hair line to the gnathion in millimeters with the face at rest and dividein millimeters with the face at rest and divide this by 16.this by 16. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 17. INCISIVE PAPILLA-HAMULAR NOTCH-HAMULAR NOTCH www.indiandentalacademy.comwww.indiandentalacademy.com
  • 18. CANINE EMINENCE / BUCCAL FRENUMCANINE EMINENCE / BUCCAL FRENUM www.indiandentalacademy.comwww.indiandentalacademy.com
  • 19. INTER CANTHAL DISTANCEINTER CANTHAL DISTANCE  Considered as a reliable anatomic dimension because 93% of intercanthal dimension growth has been achieved in 5 years of age.  The maturity is reached between 8-11 years Average dimension 28-35 mm www.indiandentalacademy.comwww.indiandentalacademy.com
  • 20. ALA OF NOSE –ALA OF NOSE – PICARDPICARD www.indiandentalacademy.comwww.indiandentalacademy.com
  • 21. It falls in the rangeIt falls in the range 28-45mm28-45mm Since anterior teethSince anterior teeth are arranged in anare arranged in an arc. the divider hasarc. the divider has to be opened by 3-to be opened by 3- 4mm more than4mm more than the value of thethe value of the nose width.nose width. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 22. MOUTH WIDTH-MOUTH WIDTH- SILVERMANSILVERMAN www.indiandentalacademy.comwww.indiandentalacademy.com
  • 23. GENERAL GUIDEGENERAL GUIDE Upper anterior teeth whose overall width is lessUpper anterior teeth whose overall width is less than 48mm are relatively small teeth. Those listed asthan 48mm are relatively small teeth. Those listed as over 52mm are relatively large teeth.over 52mm are relatively large teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 24. MC ARTHURMC ARTHUR did a study on patients and averagedid a study on patients and average mesiodistal width of maxillary central incisor was :mesiodistal width of maxillary central incisor was : In young patients – 8.87 mm.In young patients – 8.87 mm. In adults due to proximal wear – 8.67 mm.In adults due to proximal wear – 8.67 mm. In denture patients – 8.36 mm.In denture patients – 8.36 mm. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 25. MAXILLO-MANDIBULAR RELATIONSMAXILLO-MANDIBULAR RELATIONS In protruded mandible the anterior teeth's are frequentlyIn protruded mandible the anterior teeth's are frequently larger than normal.larger than normal. In retruded mandible, the mandibular anterior teeth areIn retruded mandible, the mandibular anterior teeth are frequently smaller.frequently smaller. In protrusion the face is usually longer and longer facesIn protrusion the face is usually longer and longer faces usually require longer teeth's.usually require longer teeth's. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 26. VERTICAL DISTANCE BETWEEN THEVERTICAL DISTANCE BETWEEN THE RIDGESRIDGES The length of teeth is determined by the space betweenThe length of teeth is determined by the space between the ridges.the ridges. When space is available it is advisable to use long teeth.When space is available it is advisable to use long teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 27. LipsLips www.indiandentalacademy.comwww.indiandentalacademy.com
  • 28. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 29. TjanTjan did a study on 454 dental students anddid a study on 454 dental students and concluded that:concluded that: 10 % - high lip line10 % - high lip line 70 % - average smile line70 % - average smile line 20 % - low lip line20 % - low lip line www.indiandentalacademy.comwww.indiandentalacademy.com
  • 30. GOLDEN PROPORTION – Lombardi, LevinGOLDEN PROPORTION – Lombardi, Levin 1.618 x 62 /100 =1.0 www.indiandentalacademy.comwww.indiandentalacademy.com
  • 31. GOLDEN PERCENTAGE -GOLDEN PERCENTAGE - SNOWSNOW 23% 15% 12% www.indiandentalacademy.comwww.indiandentalacademy.com
  • 32. Winklers concept on estheticsWinklers concept on esthetics Physiological- biologicalPhysiological- biological PsychologicalPsychological biomechanicalbiomechanical www.indiandentalacademy.comwww.indiandentalacademy.com
  • 33. Leon williams theoryLeon williams theory www.indiandentalacademy.comwww.indiandentalacademy.com
  • 34. Temperamental theory – dr sparzheimTemperamental theory – dr sparzheim Sanguinous -Sanguinous - blood dominance –blood dominance – long thin narrowlong thin narrow teethteeth Melancholic –Melancholic – black bile dominance from spleenblack bile dominance from spleen short, broad , tapering incisor teethshort, broad , tapering incisor teeth Choleric –Choleric – yellow bile dominance from liveryellow bile dominance from liver Phlegmatic -Phlegmatic - watery fluid elaborated from brainwatery fluid elaborated from brain www.indiandentalacademy.comwww.indiandentalacademy.com
  • 35. Selection Of FormSelection Of Form www.indiandentalacademy.comwww.indiandentalacademy.com
  • 36. Selection Of Form(shape or mold).Selection Of Form(shape or mold). • Form of artificial anterior teeth should harmonize with theForm of artificial anterior teeth should harmonize with the shape of the patients face.shape of the patients face. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 37. 4 basic Outlines of faces4 basic Outlines of faces • This was first considered important by williams and houseThis was first considered important by williams and house and loopand loop (Leon Williams classification)(Leon Williams classification) – SquareSquare • Square taperingSquare tapering – TaperingTapering – ovoidovoid www.indiandentalacademy.comwww.indiandentalacademy.com
  • 38. RELATION BETWEEN TOOTH SHAPE AND ARCHRELATION BETWEEN TOOTH SHAPE AND ARCH SHAPESHAPE www.indiandentalacademy.comwww.indiandentalacademy.com
  • 39. Patients profilePatients profile www.indiandentalacademy.comwww.indiandentalacademy.com
  • 40. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 41. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 42. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 43. SELECTION OF SHADE.SELECTION OF SHADE. COLOR HAS 4 QUALITIES:COLOR HAS 4 QUALITIES: Hue –Hue – it denotes specific color produced by a specificit denotes specific color produced by a specific wavelength of lightwavelength of light Saturation -Saturation - it is the amount of color per unit area of anit is the amount of color per unit area of an objectobject Brilliance –Brilliance – it denotes the lightness or darkness of an objectit denotes the lightness or darkness of an object TranslucencyTranslucency – it is the property of an object to partially– it is the property of an object to partially allow the passage of light through itallow the passage of light through it www.indiandentalacademy.comwww.indiandentalacademy.com
  • 44. Hue and brilliance of teeth is influenced by :Hue and brilliance of teeth is influenced by : AgeAge HabitsHabits ComplexionComplexion Color of eyesColor of eyes Color of hairColor of hair www.indiandentalacademy.comwww.indiandentalacademy.com
  • 45. Hallarman, 1971Hallarman, 1971 • There is no correlation between tooth color andThere is no correlation between tooth color and – Natural hair colorNatural hair color – eye color.eye color. • Canines are darker than central incisorsCanines are darker than central incisors • Color darkens with age.Color darkens with age. • Females have lighter natural teeth.Females have lighter natural teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 46. Selecting the colorSelecting the color www.indiandentalacademy.comwww.indiandentalacademy.com
  • 47. Squint testSquint test • Helpful in evaluating colors of teeth with theHelpful in evaluating colors of teeth with the complexion of the face.complexion of the face. • With the eyelids partially closed to reduce light,theWith the eyelids partially closed to reduce light,the dentist compares prospective colors of artificial teethdentist compares prospective colors of artificial teeth held along the face of the patient.held along the face of the patient. • The color that fades from the view first is the one thatThe color that fades from the view first is the one that is least conspicuous in comparison to the color of theis least conspicuous in comparison to the color of the face.face. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 48. Selection of tooth material.Selection of tooth material. • Conventional acrylic resinConventional acrylic resin advantagesadvantages disadvantagesdisadvantages • Porcelain.Porcelain. advantagesadvantages disadvantagesdisadvantages www.indiandentalacademy.comwww.indiandentalacademy.com
  • 49. Dentogenic conceptDentogenic concept By frush and fisher in 1957By frush and fisher in 1957 Also called SPA theoryAlso called SPA theory • SexSex – malemale – FemaleFemale • PersonlityPersonlity – Vigrous delicateVigrous delicate www.indiandentalacademy.comwww.indiandentalacademy.com
  • 50. Age :Age : Muscle toneMuscle tone VisibilityVisibility Abraded teethAbraded teeth Gingival recessionGingival recession Color of teethColor of teeth www.indiandentalacademy.comwww.indiandentalacademy.com
  • 51. Review of literatureReview of literature www.indiandentalacademy.comwww.indiandentalacademy.com
  • 52. This study was conducted to determine the relationship between interpupillary distance, interalar distance and the width of the mouth to be used as a guide during selecting the width of the six anterior teeth. J. Prosthet. Dent. 1991, 65-250-4. 1.A high significant difference between all measurements in both sexes. 2. To estimate the combined width of the maxillary anterior teeth, he suggest the average multiplying factor of 1.56 to interalar width which was found in his study. 3. The authors suggest the use of more than one measurement in the selection of the anterior teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 53. THE RELATIONSHIP BETWEEN FACIAL REFERENCESTHE RELATIONSHIP BETWEEN FACIAL REFERENCES AND MESlODlSTAL WIDTH OF MAXILLARY ANTERIORAND MESlODlSTAL WIDTH OF MAXILLARY ANTERIOR TEETH . ADJ oct 1995; vol 20; no 1.TEETH . ADJ oct 1995; vol 20; no 1. A total of 439 patients were examined to determineA total of 439 patients were examined to determine if there is a correlation between the width of the maxillaryif there is a correlation between the width of the maxillary anterior: teeth and four anatomical facial references. Theanterior: teeth and four anatomical facial references. The bizygomatic width, interpupillary distance, intraalar width andbizygomatic width, interpupillary distance, intraalar width and the width of the mouth. All measurements done by using athe width of the mouth. All measurements done by using a modified Boley gauge except themodified Boley gauge except the bizygomaticbizygomatic which was donewhich was done by using a face bow.No correlation was found between theby using a face bow.No correlation was found between the measurements for the population as whole, nor when themeasurements for the population as whole, nor when the population was divided accordingly to sex.population was divided accordingly to sex. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 54. Use of Digital Photographs for Artificial Teeth SelectionUse of Digital Photographs for Artificial Teeth Selection Coll. Antropol.Coll. Antropol. 28 (2004) 2: 857–86328 (2004) 2: 857–863 The technique of use of digital photography is ofThe technique of use of digital photography is of proven value in calculating the width of a maxillary centralproven value in calculating the width of a maxillary central incisor.The photographs using a simple digital camera shouldincisor.The photographs using a simple digital camera should be taken from a distance of 70 cm to 1 m. Saving of suchbe taken from a distance of 70 cm to 1 m. Saving of such photographs may be helpful in calculating dimensions ofphotographs may be helpful in calculating dimensions of artificial teeth in future.artificial teeth in future. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 55. ReferencesReferences 1.Complete denture prosthetics- john p sharry1.Complete denture prosthetics- john p sharry 2.Essentials of complete denture- sheldon winkler2.Essentials of complete denture- sheldon winkler 3.Syallabus for complete dentures – charles heartwell3.Syallabus for complete dentures – charles heartwell 4.Treatment planning for completely edentulous – boucher4.Treatment planning for completely edentulous – boucher 5. introduction to dentogenic restorations j prosthet dent 1955; 6;5. introduction to dentogenic restorations j prosthet dent 1955; 6; 586-595586-595 6. the age factor in dentogenics j prosthet dent 1956; 6; 160-1726. the age factor in dentogenics j prosthet dent 1956; 6; 160-172 7. how dentogenics interprets the personality factor j prosthet7. how dentogenics interprets the personality factor j prosthet dent 1956;6; 441-449dent 1956;6; 441-449 www.indiandentalacademy.comwww.indiandentalacademy.com
  • 56. 8. the relationship between interpupillary distance, interalar8. the relationship between interpupillary distance, interalar distance and the width of the mouth to be used as a guidedistance and the width of the mouth to be used as a guide during selecting the width of the six anterior teeth. J. Prosthet.during selecting the width of the six anterior teeth. J. Prosthet. Dent. 1991, 65-250-4.Dent. 1991, 65-250-4. 9. The relationship between facial references and mesiodistal9. The relationship between facial references and mesiodistal width of maxillary anterior teeth. ADJ oct 1995; vol 20; no 1width of maxillary anterior teeth. ADJ oct 1995; vol 20; no 1 10. registration; stage 111 anterior teeth selection.10. registration; stage 111 anterior teeth selection. British DentalBritish Dental JournalJournal 2000;2000; 188:188: 660–666.660–666. 11. biometric relationship between intercanthal dimension and11. biometric relationship between intercanthal dimension and the width of maxillary anterior teeth j Indian prosthodont socthe width of maxillary anterior teeth j Indian prosthodont soc july 2007; vol 7; iss 3.july 2007; vol 7; iss 3. 12.12. Qualitative and Quantitative Guides to the Selection andQualitative and Quantitative Guides to the Selection and arrangement of the Maxillary Anterior Teetharrangement of the Maxillary Anterior Teeth J Prosthod 1992;J Prosthod 1992; I; 106- 111.I; 106- 111.    www.indiandentalacademy.comwww.indiandentalacademy.com
  • 57. 13.Geometric and MathematicaProportions and their Relations to13.Geometric and MathematicaProportions and their Relations to Maxillary Anterior TeethMaxillary Anterior Teeth The Journal of Contemporary Dental Practice, Volume 7, No. 5,The Journal of Contemporary Dental Practice, Volume 7, No. 5, November 1, 2006November 1, 2006 14. Digitized study of the correlation between the face and tooth14. Digitized study of the correlation between the face and tooth shapes in young adult individualsshapes in young adult individuals Brazilian Journal of Oral Sciences, Vol. 6, No. 22, 2007, pp.Brazilian Journal of Oral Sciences, Vol. 6, No. 22, 2007, pp. 1383-13861383-1386 www.indiandentalacademy.comwww.indiandentalacademy.com
  • 58. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 59. USING TRUBYTE TOOTH INDICATORUSING TRUBYTE TOOTH INDICATOR www.indiandentalacademy.comwww.indiandentalacademy.com
  • 60. UNIVERSAL DENTAL COMPANY MOLDUNIVERSAL DENTAL COMPANY MOLD SELECTORSELECTOR www.indiandentalacademy.comwww.indiandentalacademy.com
  • 61. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com