9. 1.WHITE’S CONCEPT
J W White in 1872 – projected correspondence and harmony theory,
temperamental theory was fading out of medicine but white reached over
and suggested that temperaments called for similarity of form in faces
and teeth.
• The temperamental theory is a theory of fluids of the body, especially the
blood ,the phlegm and the bile.
It was conceived by the Hippocrates in 5th century BC and was used by
the medical profession in diagnosis and treatment planning.
10. The Psychological Effects of the Humors
The Four Humors are not just gross, physical
substances. They also pervade the whole organism
as subtle vapors, even affecting the mind,
thoughts, and emotions.
And so, the Four Humors also have psychological
effects, making them capable of affecting both
body and mind:
11.
Blood promotes a feeling of joy, mirth, optimism, enthusiasm,
affection and wellbeing.
Phlegm induces passivity, lethargy, subjectivity, devotion,
emotionalism, sensitivity and sentimentality.
Yellow Bile provokes, excites and emboldens the
passions. Being inflammatory, irritating and caustic, it provokes
anger, irritability, boldness, ambition, envy, jealousy and courage
.
Black Bile makes one pensive, melancholy and withdrawn. It
encourages prudence, caution, realism, pragmatism and
pessimism.
The Four Humors tend to have negative effects on the mind and
emotions only when they're excessive or aggravated. Otherwise,
they can also strengthen positive aspects of character.
12. FOUR TYPES OF TEMPERAMENT-
1. Sanguine, ಆಶಾವಾದಿಯಾದ
2. Nervous,(phlegmatic) ಸುಸ್ತಿನ-ಕಫ-
3. Bilious (choleric) ಸ್ತಟ್ಾಾಗುವ
4. Lymphatic(melancholic) ಖ ೇದ
JOY ANGER SAD
WORRY/
CALM
13.
14. Artificial teeth ---- patient’s temperament.
• A ‘‘bilious’’ short, broad, tapering
incisor teeth,
• A sanguineous long, thin, and narrow
teeth
18. DENTOGENIC CONCEPT-BY FRUSH &FISHER
•AGE, SEX AND PERSONALITY of the patient •
Frush and Fisher 1955. Frush JP, Fisher DR (1955) Introduction to
dentogenic restorations. J Prosthet dent 5:586–595
21. 3. WINKLER’S CONCEPT
This concept emphasises on three points.
1.BIOLOGICAL-PHYSIOLOGICAL
harmony of the facial musculature and physiological limit
with teeth arrangement.
2.•BIOMECHANICAL
mechanical limitations in placement of anterior teeth.
3• PSYCHOLOGICAL
aesthetics and facial appearance of psychological
plane of orientation
Raised in happy people—lowered in poor mental
temperament
22. ANTERIOR TOOTH SELECTION WINKLER'S 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
23. LEON WILLIAM’S CONCEPT
4.
Since 1885 J. Leon Williams,later in 1909 he proposed the
technique to build wax occlusal rims of proper height and
form, with patient’s lips at rest, marked the location of corner
of mouth ,high lip line, lower lip line ,and after removing the
occlusal rim the distal end of second molar is marked.
Williams did an extensive study in 1914 to give three basic
typal forms – ovoid, tapering, square.
24. According to him it was “combination forms”
tapering or ovoid or both in blended into
square Square or ovoid or both in blended
into tapering Square or tapering or both
inbleded into ovoid
25. TOOTH FORM CAN ALSO BE SELECTED BASED ON THE ARCH FORM
OF THE PATIENT
26.
27. FACTORS FOR ANTERIOR TEETH SELECTION
1.SIZE OF THE TEETH
2.FORM OF THE TEETH
3.COLOUR OF THE TEETH
4.COMPOSITION OF MATERIAL OF THE TEETH
28. SIZE OF THE TEETH
1.PRE EXTRACTION 2.POST EXTRACTION
1. PRE EXTRACTION RECORDS
•PHOTOGRAPHS –WIDTH OUTLINE FORM
•RADIOGRAPHS –size & form
•EXTRACTED TEETH-execellent size &form
•PREVIOUS DENTURE
•PATIENTS RELATIVES-colour,size & arrangement
29. SIZE OF THE TEETH
2. POST EXTRACTION
A• EXTRAORAL FACTORS:-
1. SIZE OF THE FACE
2. THE LIPS
3. MAXILLO MANDIBULAR RELATION
4. NOSE WIDTH
B• INTRAORAL FACTORS:-
1. SIZE OF MAXILLARY ARCH
2. INCISIVE PAPILLAE AND CUSPID EMINENCE
3. THE CONTOUR OF THE RESIDUAL RIDGE
4. VERTICAL DISTANCE BETWEEN THE RIDGES
30. 1. SIZE OF THE FACE
• Average width of the maxillary central incisor = 1/16th of
the width of the face measured between the zygoma.
• Combined width of the six maxillary anterior teeth = slightly
less than 1/3rd of the bizygomatic breadth of the face.
• The TRUBYTE® TOOTH INDICATOR
size of maxillary central incisors
31.
32. 2.SIZE OF MAXILLARY ARCH
• The mould selectors are used to make measurements of
the maxillary cast.
crest of the incisive papilla TO hamular notches,
hamular notch TO opposite side hamular notch.
• The combined length of the three legs of the triangle in
millimetres is used.
33. 3.PAPILLAE AND CUSPID
EMINENCE
• Canine eminence…
• A flexible ruler is used and the distance between the two
canine eminences at their distal side through the anterior
of the incisive papilla is measured in millimetres.
• This measurement gives the combined width of the six
anterior teeth.
• Another method with occlusal rim
• The vertical line drawn from this mark coincides with the
pupil of the eye. • The distance between the marks
following the contour is the total width of anteriors.
34. 4. MAXILLO MANDIBULAR RELATION
• Any disproportion in size between the maxillary and
mandibular arches influences the length, width and position
of the teeth.
• This is of importance in class ii and class iii
maxillomandibular relations.
If mandible is protruded; anterior teeth are larger,
if mandible is retruded; anterior teeth are smaller.
35. 5.THE CONTOUR OF THE RESIDUAL RIDGE
• The artificial teeth should
follow the contour of the residual ridges that existed
when natural tooth were present.
• As resorption occurs there is alteration in the contours of
the ridge.
36. 6.VERTICAL DISTANCE BETWEEN THE
RIDGES
• The length of the teeth is determined by the
available space between the existing ridges.
• It is advisable to use a tooth long enough to
eliminate the display of the denture base.
38. 8.WIDTH OF NOSE
C L C=L Boucher and Hoffman et al. referred to the nasal
index
width of nose =width of anterior from central to centre of
canine
39. FORM OF TEETH
1. FORM AND CONTOUR
2. PROFILE
3. SEX
4. AGE
5. PERSONALITY
40. 1.FORM AND CONTOUR
• The shape of the artificial tooth should harmonise with the
patient’s facial form . • By Leon Williams,
• Not scientifically correct, is undoubtedly the simplest and the
most useful guide.
• Shape of the upper incisors the shape of the face.
• He classified the form of the human face into three types:
square, tapering and ovoid forms.
HE FACIAL FORM IS DETERMINED BY USE OF TRUBYTE
INDICATOR
41. 2.FACIAL PROFILE
• THE FACIAL PROFILE IS DETERMINED BY THREE
POINTS.
1. THE FOREHEAD,
2. THE BASE OF THE NOSE AND
3. THE PROMINENT POINT OF THE CHIN
42. 3.SEX
• Curved facial features are associated with femininity
and square features are associated with masculinity.
43.
44. 4. AGE --YOUNGER PEOPLE OLDER
PEOPLE
Lighter shade Darker shade More incisal translucency Less
incisal translucency Minimal wear of incisal edges Increased
wear of incisal edges Curved smiling line Flat smiling line
Pointed canines Loss of tip of canines
45. 5.PERSONALITY
• Teeth should be selected according to the patients
personality • The patients
• vigorous
• delicate.
• More squarish and large teeth vigorous people.
• The anteriors should be in flat plane for executive people
• For executives teeth should be relatively smaller and
more symmetrical
51. In general Color or shade of anterior teeth Patients
age – With age, darker, while lighter teeth
are suitable for young patients.
Patients complexion—light teeth for fair skin,
blue eyes, dark teeth usually for dark skin
and black eyes.
54. Shade selection involves the perception of color,
which depends on three entities:
Illumination.
The environment.
The viewer.
55.
56. COMPOSITION OF MATERIAL OF
ANTERIOR TEETH
•Usually only two types of materials are used
1.Porcelain
2.Acrylic •
HMW resin because of
• Exceptional hardness
• Stable colour.
• Abrasion resistance
• Less retention of plaque
57. ACRYLIC TEETH/ PORCELAIN TEETH
Wear is clinically significant
Loss of vertical dimension
Have a soft impact sound
Easy to grind and alter
Does not bind to denture base
material need to create holes or
pins
Does not cause abrasion of
opposite natural teeth
1.When the opposite archteeth
have gold crowns or inlays.
2.Decreases inter arch distance;
the resin teeth help to grind and
accommodate into the free
space.
3.In removable partial denture,
the contacting teeth with the
clasps may need grinding.
Wear is clinically insignificant
No significant loss of vertical
dimension
Have a sharp impact sound
Difficult to grind and fit into
close interarch space
Chemically bonds to the
denture base material
Causes abrasion of opposite
natural or gold teeth
Indications 1. When interridge
space is present.
2. Well configured ridges
3.When high appealing look is
required.
58. POSTERIOR TOOTH SELECTION
1.SHADE OF POSTERIOR TEETH
2.SIZE AND NUMBER OF POSTERIOR TEETH
3.FORM OF POSTERIOR TEETH
1.SHADE OF POSTERIOR TEETH
• The shade of posterior teeth should harmonize to shade
of anterior teeth
• As bulk influences shade of teeth
• So lighter shade for bicuspids if it is used as aesthetic
purpose.
• Slightly lighter than posterior teeth but not lighter than
anterior teeth.
59. 2.SIZE AND NUMBER OF POSTERIOR
TEETH
• The size and number are closely related to usage
• Buccolingual dimension should be less than natural teeth
• Anterio posterior dimension is determined by the
edentulous area between cuspids and the area slightly
anterior to retromolar area.
• Not necessary to have the same number of teeth as in
natural dentition.
60. 3. FORM OF POSTERIOR TEETH
Occlusal form decided on the type of occlusion.
Types of teeth to be used :-
1. Balancing in centric and eccentric cusp form tooth
2. Disocclude during eccentric jaw movements cusp
or monoplane teeth
3. Arranged in a plane and balanced only in centric
monoplane is used
61.
62. ADVANTAGES /DISADVANTAGES OF ANATOMIC TEETH
Advantages
1.Aesthetically acceptable
2.More efficient there by reducing the forces
3.They can be arranged in balance
Disadvantages of anatomic teeth
1.More horizontal forces during function
2.Fast bone resorbtion
3.Cannot be used in severely resorbed cases
63. ADVANTAGES /DISADVANTAGES OF NON ANATOMIC
TEETH
1.Comfortable
2.Greater range of motion (in parafunctional jaw
habits)
3.Less horizontal and or torqueing forces
4.Can be used in severely resorbed ridges and
patients with poor neuro muscular coordination
Disadvantages of non anatomic teeth
1.They look unnatural
2.Less cutting efficiency
64. 4. MATERIAL COMPOSITION OF POSTERIOR
TEETH
• Both porcelain and acrylic are used
• Upper and lower posterior teeth can be
• Both porcelain • Both acrylic
• A combination of porcelain and acrylic teeth on
opposing dentures can be used. It softens the sound,
reduces friction and eliminates chipping
• Acrylic teeth is used in following situations:- 1.Limited
interarch distance
2.Maxillary single denture against natural dentition
3.Maxillary single denture opposing partial denture
4.Opposing natural teeth with gold occlusal surfaces
• Porcelain teeth;- • They have vey good esthetics • High
translucency • Does not wear • Long life
65. SINGLE MAXILLARY COMPLETE DENTURE:-
TEETH SET USED ARE ACRYLIC TEETH OPPOSING
NATURAL DENTITION
• GOLD TEETH OR INSERTS CAN ALSO BE USED BUT
PORCELAIN IS NEVER USED.
HIGHLY RESORBED RIDGES:-
• MONOPLANE TEETH OR NON ANATOMIC TEETH IS
USED
66.
67. CONCLUSION
The selection of teeth is the responsibility of the
dentist which he acquires through knowledge and
experience.
Proper placement of teeth should be appealing to
improve the mentality of the patient.
