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Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
Tooth selection/  fellowships in orthodontics
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Tooth selection/ fellowships in orthodontics

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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 TOOTHANTERIOR TOOTH SELECTION.SELECTION. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.comwww.indiandentalacademy.com
  • 2. Introduction.Introduction. • Anterior teeth selection and arrangementAnterior teeth selection and arrangement is an area of prosthodontics where artis an area of prosthodontics where art dominates science,where esthetics is thedominates science,where esthetics is the major concern,and where knowledge mustmajor concern,and where knowledge must be applied to create a pleasingbe applied to create a pleasing appearance while simultaneouslyappearance while simultaneously maintaining oral function.maintaining oral function. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 3. • The anterior teeth are primarily selectedThe anterior teeth are primarily selected to satisfy esthetic requirements.to satisfy esthetic requirements. • Posterior teeth's are selected to satisfyPosterior teeth's are selected to satisfy masticatory functional requirements.masticatory functional requirements. Technically, the anterior teeth areTechnically, the anterior teeth are composed of 6 maxillary and 6composed of 6 maxillary and 6 mandibular teeth's.mandibular teeth's. Introduction. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 4. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 5. Introduction.Introduction. Exceptions:Exceptions: o Sometimes maxillary first premolar isSometimes maxillary first premolar is considered more for esthetics than forconsidered more for esthetics than for masticatory function.masticatory function. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 6. • Patients expect 3 basic things form theirPatients expect 3 basic things form their complete dentures.complete dentures. – Favorable appearance.Favorable appearance. – Comfort.Comfort. – Chewing ability.Chewing ability. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 7. • There are four main considerations inThere are four main considerations in selecting the anterior teeth.selecting the anterior teeth. 1.1. Tooth sizeTooth size 2.2. Tooth moldTooth mold 3.3. ColorColor 4.4. Tooth materialTooth material www.indiandentalacademy.comwww.indiandentalacademy.com
  • 8. PRE-EXTRACTION GUIDES.PRE-EXTRACTION GUIDES. • PHOTOGRAPHS.PHOTOGRAPHS. • RAIDOGRAPHS.RAIDOGRAPHS. • DIAGNOSTIC CASTS.DIAGNOSTIC CASTS. • TEETHS OF RELATIVES.TEETHS OF RELATIVES. • EXTRACTED TEETH.EXTRACTED TEETH. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 9. PhotographsPhotographs • More accurate than any other guide.More accurate than any other guide. • Shows the natural teeth or at least the incisalShows the natural teeth or at least the incisal edges.edges. • Provides information about width and outlineProvides information about width and outline form of the teeth.form of the teeth. • Known factors:Known factors: – Width/length on photo.Width/length on photo. – interpupillary distance on photointerpupillary distance on photo – Interpupillary distance on patientInterpupillary distance on patient • Unknown factor: length or width of teeth to beUnknown factor: length or width of teeth to be selected.selected. • Recent photographs are of much value.Recent photographs are of much value. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 10. NewNew denturesdentures made withmade with the help ofthe help of oldold photographphotograph •65 years: Poor esthetics with 15 year old dentures. •Natural teeth at 20 years www.indiandentalacademy.comwww.indiandentalacademy.com
  • 11. • However, it is of value only when theHowever, it is of value only when the photograph is a full-face portrait ofphotograph is a full-face portrait of sufficient size.sufficient size. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 12. DIAGNOSTIC CASTS.DIAGNOSTIC CASTS. • Diagnostic casts of patients natural orDiagnostic casts of patients natural or restored teeth.restored teeth. • Size and form of the anterior teeth can beSize and form of the anterior teeth can be determined.determined. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 13. RADIOGRAPHS.RADIOGRAPHS. • Can help in knowing size and form of theCan help in knowing size and form of the lost teeth.lost teeth. •DisadvantagesDisadvantages:: – Are always slightly enlarged.Are always slightly enlarged. – Distortion may be there.Distortion may be there. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 14. TEETH OF RELATIVESTEETH OF RELATIVES .. • Sons or daughters tooth size , color, andSons or daughters tooth size , color, and arrangement can be effectively used inarrangement can be effectively used in selecting and arranging artificial teeth forselecting and arranging artificial teeth for their parents.their parents. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 15. EXTRACTED TEETH.EXTRACTED TEETH. • Provides information as to the size andProvides information as to the size and form.form. • Not to be used for selecting color.Not to be used for selecting color. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 16. SELECTION OF SIZE.SELECTION OF SIZE. • There are 2 dimensions to considerThere are 2 dimensions to consider – The mesiodistal width.The mesiodistal width. – The incisogingival length.The incisogingival length. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 17. MEASUREMENTMEASUREMENT EDENTULOUS CASTS.EDENTULOUS CASTS. • Inaccurate due to resorption of ridges.Inaccurate due to resorption of ridges. • Occlusal rims to be constructed forOcclusal rims to be constructed for accurate measurements.accurate measurements. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 18. • Gives the estimation of placement ofGives the estimation of placement of apex of upper canines.apex of upper canines. • Extension of parallel lines from theExtension of parallel lines from the lateral surfaces of the alae of the noselateral surfaces of the alae of the nose onto the labial surface of the upperonto the labial surface of the upper occlusion rim.occlusion rim. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 19. Relationship betweenRelationship between intercanine distance and noseintercanine distance and nose widthwidth • 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 than the4mm more than the value of the nosevalue of the nose width.width. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 20. • Distal surfaces of the natural canines isDistal surfaces of the natural canines is usually located near the corner of theusually located near the corner of the mouth.mouth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 21. GENERAL GUIDE .GENERAL GUIDE . • Upper anterior teeth whose overall width isUpper anterior teeth whose overall width is less than 48mm are relatively smallless than 48mm are relatively small teeth. Those listed as over 52mm areteeth. Those listed as over 52mm are relatively large teeth.relatively large teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 22. Anthropometric measurements.Anthropometric measurements. Found from a study of 555 skulls.Found from a study of 555 skulls. • Greatest bi zygomatic width / 16Greatest bi zygomatic width / 16 -gives approximation of-gives approximation of the width of the upper centralthe width of the upper central incisors.incisors. - also known as- also known as HOUSEHOUSE AND LOOP’S RULE.AND LOOP’S RULE. • Greatest bi zygomatic width / 3.3Greatest bi zygomatic width / 3.3 -Overall width of the upper six-Overall width of the upper six anterior teeth.anterior teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 23. • Lateral incisor are approximately 2 mmLateral incisor are approximately 2 mm narrower and canine 1 mm narrowernarrower and canine 1 mm narrower than the central incisors.than the central incisors. • A facebow maybe used utilized toA facebow maybe used utilized to obtain these measurement.obtain these measurement. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 24. Length of central incisorLength of central incisor • Facial measurement methodFacial measurement method – Distance from the hair line to the gnathion inDistance from the hair line to the gnathion in millimeters with the face at rest and divide thismillimeters with the face at rest and divide this by 16.by 16. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 25. • Amount of central incisor visible inAmount of central incisor visible in young-3 mm.young-3 mm. • In old – 11/2 mm.In old – 11/2 mm. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 26. Using trubute tooth indicator.Using trubute tooth indicator. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 27. UNIVERSAL DENTALUNIVERSAL DENTAL COMPANY MOLD SELECTORCOMPANY MOLD SELECTOR www.indiandentalacademy.comwww.indiandentalacademy.com
  • 28. INCISAL PAPILLA – CUSPIDINCISAL PAPILLA – CUSPID EMINENCE/BUCCALEMINENCE/BUCCAL FRENUM.FRENUM. • A line is placed on the cast at the distalA line is placed on the cast at the distal termination of the cuspid eminence.termination of the cuspid eminence. • When eminence are not discernible a lineWhen eminence are not discernible a line is placed slightly anterior to theis placed slightly anterior to the attachment of buccal frenum.attachment of buccal frenum. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 29. MAXILLO-MANDIBULARMAXILLO-MANDIBULAR RELATIONS.RELATIONS. • In protruded mandible the anterior teeth'sIn protruded mandible the anterior teeth's are frequently larger than normal.are frequently larger than normal. • If mandibles are retruded, the mandibularIf mandibles are retruded, the mandibular anterior teeth are frequently smaller.anterior teeth are frequently smaller. • In protrusion the face is usually longer andIn protrusion the face is usually longer and longer faces usually require longer teeth's.longer faces usually require longer teeth's. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 30. VERTICAL DISTANCEVERTICAL DISTANCE BETWEEN THE RIDGES.BETWEEN THE RIDGES. • The length of teeth is determined by theThe length of teeth is determined by the space between the ridges.space between the ridges. • When space is available it is advisable toWhen space is available it is advisable to use long teeth.use long teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 31. Lips.Lips. • Help in determined the length of the teeth.Help in determined the length of the teeth. • The maxillary incisal edge extends inferior toThe maxillary incisal edge extends inferior to or slightly below the lip margin.or slightly below the lip margin. • .. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 32. • When teeth are in occlusion and lips areWhen teeth are in occlusion and lips are together, the labial incisal third of thetogether, the labial incisal third of the maxillary anterior teeth supports themaxillary anterior teeth supports the superior border of the lower lip.superior border of the lower lip. • In speech the incisal edges of theIn speech the incisal edges of the maxillary anterior teeth contact the lowermaxillary anterior teeth contact the lower lip at the junction of the moist and drylip at the junction of the moist and dry surfaces of the vermilion border. As insurfaces of the vermilion border. As in pronouncing fifty fivepronouncing fifty five www.indiandentalacademy.comwww.indiandentalacademy.com
  • 33. Inner canthal distanceInner canthal distance • Inner canthal distanceInner canthal distance can be used to estimatecan be used to estimate the mesiodistal width of athe mesiodistal width of a maxillary central incisormaxillary central incisor for an edentulous patient.for an edentulous patient. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 34. • Size of the teeth should be inSize of the teeth should be in proportion to the size of the face andproportion to the size of the face and head.head. • Larger persons have larger teethLarger persons have larger teeth • But a large person may have smallBut a large person may have small teeth with spaces between the teeth.teeth with spaces between the teeth. • Or a small person may have largeOr a small person may have large irregular aligned teeth.irregular aligned teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 35. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 36. • Woman have smaller teeth than men.Woman have smaller teeth than men. • Lateral incisor should look more delicate inLateral incisor should look more delicate in woman.woman. • Size difference between central andSize difference between central and lateral incisors should be more distinct inlateral incisors should be more distinct in woman.woman. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 37. Selection Of Form(shape orSelection Of Form(shape or mold).mold). • Form of artificial anterior teeth shouldForm of artificial anterior teeth should harmonize with the shape of the patientsharmonize with the shape of the patients face.face. • Outline form is considered from a front viewOutline form is considered from a front view of the patient.of the patient. • The face from is identified by connecting theThe face from is identified by connecting the following points on the lateral aspect of thefollowing points on the lateral aspect of the face;face; – the forehead,the forehead, – the zygomatic archthe zygomatic arch – Angle of the mandible.Angle of the mandible. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 38. 4 basic Outlines of faces4 basic Outlines of faces • This was firs considered important by williamsThis was firs considered important by williams and house and loopand house and loop (Leon Williams(Leon Williams classification)classification) – SquareSquare • Square taperingSquare tapering – TaperingTapering – ovoidovoid www.indiandentalacademy.comwww.indiandentalacademy.com
  • 39. • The shape of theThe shape of the maxillary centralmaxillary central incisor shouldincisor should resemble theresemble the shape of the faceshape of the face if it wereif it were inverted.inverted. • This methodThis method selection is alsoselection is also called ascalled as GEOMETRICGEOMETRIC THEORY.THEORY. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 40. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 41. RELATION BETWEENRELATION BETWEEN TOOTH SHAPE AND ARCHTOOTH SHAPE AND ARCH SHAPESHAPE www.indiandentalacademy.comwww.indiandentalacademy.com
  • 42. • Check three points: the forehead,the baseCheck three points: the forehead,the base of the nose,and the point of the chin.ifof the nose,and the point of the chin.if these three points are in line ,the profile isthese three points are in line ,the profile is straight.straight. • 3 types of profiles are3 types of profiles are • ConvexConvex • straightstraight • concaveconcave www.indiandentalacademy.comwww.indiandentalacademy.com
  • 43. SELECTION OF SHADE.SELECTION OF SHADE. •COLOR HAS 4 QUALITIES.COLOR HAS 4 QUALITIES. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 44. HUEHUE • The hue of the teeth must be in harmonyThe hue of the teeth must be in harmony with the color(Hue) of the the patientswith the color(Hue) of the the patients face.face. • In teeth guides yellow is the dominant hue.In teeth guides yellow is the dominant hue. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 45. • Saturation (chroma)Saturation (chroma) – It is the amount of color per unit area.It is the amount of color per unit area. – Some teeth appear more yellowSome teeth appear more yellow • Brilliance (value) it is the lightness orBrilliance (value) it is the lightness or darkness of an object.darkness of an object. – The relative amount of white or black in theThe relative amount of white or black in the teeth determines their lightness orteeth determines their lightness or darkness.darkness. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 46. THE COLOR OF HAIRTHE COLOR OF HAIR www.indiandentalacademy.comwww.indiandentalacademy.com
  • 47. Color of eyes.Color of eyes. • Color of eyes has been suggested asColor of eyes has been suggested as guide to select the color of teeth.guide to select the color of teeth. • Not a sound method since color of Iris isNot a sound method since color of Iris is so small compared to total face and theso small compared to total face and the eyes are not close to the teeth.eyes are not close to the teeth. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 48. Color of face.Color of face. • It should be the basic guide to select toothIt should be the basic guide to select tooth color.color. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 49. Age and colorAge and color • Color of natural teeth progressively darkens withColor of natural teeth progressively darkens with age.age. • Pulp chamber becomes smaller with age due toPulp chamber becomes smaller with age due to deposition of secondary dentindeposition of secondary dentin • This makes the tooth more opaque and reducesThis makes the tooth more opaque and reduces the effect of pulp color.the effect of pulp color. • As wear occurs due to abrasive forces the toothAs wear occurs due to abrasive forces the tooth becomes smoother and more reflective.becomes smoother and more reflective. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 50. Jaw relation and color.Jaw relation and color. • Class 1 same selected for both theClass 1 same selected for both the arches.arches. • Class 3 : prognathic patient slightly darkerClass 3 : prognathic patient slightly darker teeth for the lower arch than the upper asteeth for the lower arch than the upper as lighter teeth will stand out.lighter teeth will stand out. • Class 2 : lighter teeth than the upper toClass 2 : lighter teeth than the upper to give the illusion that the teeth are moregive the illusion that the teeth are more anterior than they really are.anterior than they really are. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 51. Selecting the color.Selecting the color. • It should be done in 3 positionsIt should be done in 3 positions • Outside the mouth along the side of theOutside the mouth along the side of the nose.nose. • It will establish the basicIt will establish the basic hue,brilliance,and saturation.hue,brilliance,and saturation. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 52. Selection of tooth material.Selection of tooth material. • Conventional acrylic resinConventional acrylic resin • Interpenetrating polymner network(IPN)Interpenetrating polymner network(IPN) acrylic resinacrylic resin • Composite resin teethComposite resin teeth • Porcelain.Porcelain. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 53. Indications for resin teeth.Indications for resin teeth. • Recent extractionsRecent extractions • Immediate denturesImmediate dentures • Limited interocclusal distance.Limited interocclusal distance. • If current denture producing clickingIf current denture producing clicking sound.sound. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 54. Composite resin teethComposite resin teeth • It consists of an organic filler andIt consists of an organic filler and liquid matrix based on a modifiedliquid matrix based on a modified Bowen resin.Bowen resin. • Liquid matrix and the organic fillerLiquid matrix and the organic filler contain approximately 20% Pyrolyticcontain approximately 20% Pyrolytic silicium dioxide,which is used as asilicium dioxide,which is used as a thickening and strengthening agent.thickening and strengthening agent. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 55. Porcelain teeth.Porcelain teeth. • Highest wear resistance.Highest wear resistance. • Good stain resistance.Good stain resistance. • Disadv: clicking sound inDisadv: clicking sound in nervous patients and withnervous patients and with those havingthose having neuromuscular coordinationneuromuscular coordination problems.problems. • More prone for chipping andMore prone for chipping and fracture.fracture. • Cannot be given whenCannot be given when interarch space is less.interarch space is less.www.indiandentalacademy.comwww.indiandentalacademy.com
  • 56. Dentogenic conceptDentogenic concept • By frush and fisher on 1957By frush and fisher on 1957 • Also called SPA theoryAlso called SPA theory • SexSex – malemale – FemaleFemale • PersonlityPersonlity – Vigrous delicateVigrous delicate • AgeAge – YoungYoung – Middle ageMiddle age – Old.Old. www.indiandentalacademy.comwww.indiandentalacademy.com
  • 57. www.indiandentalacademy.comwww.indiandentalacademy.com

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