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  1. 1. Setting Anterior Teeth Esthetics & Phonetics
  2. 2. Look for Symmetry View from anterior, occlusal View from many angles
  3. 3. Symmetry Perfect Symmetry Gross Asymmetry
  4. 4. Facial Asymmetry 2 Left Sides “Normal” 2 Right Sides
  5. 5. Smile Asymmetry 2 Left Sides “Normal” 2 Right Sides
  6. 6. Setting Anterior Teeth <ul><ul><li>Incisal edges of central incisors & canines at level of the occlusal plane </li></ul></ul><ul><ul><li>Laterals placed approximately 0.5 mm above the occlusal plane </li></ul></ul>
  7. 7. Cervical necks tilt posteriorly from the central incisor to the canine
  8. 8. The greatest height of the free gingival margin is slightly distal to the mesiodistal center of the tooth
  9. 9. Setting Mandibular Anteriors <ul><ul><li>Lower anterior teeth incline similar to the maxillary teeth </li></ul></ul>
  10. 10. Setting Mandibular Anteriors <ul><li>Incisal edges are placed at the same level </li></ul><ul><li>Even with the occlusal plane </li></ul>
  11. 11. Setting Mandibular Anteriors <ul><ul><li>No overbite for monoplane or lingualized setups </li></ul></ul>
  12. 12. Canines should be tilted more posteriorly than other teeth, with a more prominent cervical neck
  13. 13. Bucco-Lingual Tilt Maxillary Anterior Teeth <ul><li>Facial surface of central is perpendicular occlusal plane </li></ul><ul><li>Neck of lateral is depressed </li></ul><ul><li>Neck of canine is prominent </li></ul>Central Canine
  14. 14. Bucco-Lingual Tilt Mandibular Anterior Teeth <ul><li>Central is proclined </li></ul><ul><li>Lateral is more upright </li></ul><ul><li>Canine has a prominent neck </li></ul>Central Canine
  15. 15. Anterior Tooth Setup <ul><li>Check symmetry with reference lines </li></ul><ul><li>Anterior teeth don’t contact in centric position </li></ul><ul><li>Grazing contacts in excursions </li></ul>Overjet = 2mm Overbite = 0mm
  16. 16. No Anterior Contact in Centric Correct Insufficient Excessive
  17. 17. Dentist Sets Incisal Guidance Overjet & Overbite <ul><li>Avoid too much overbite or too little overjet </li></ul><ul><li>Increasing overbite steepens the angle, separating posterior teeth more quickly </li></ul><ul><li>Increasing overjet shallows the angle, separating the posterior teeth less quickly </li></ul>
  18. 18. Canine Offset <ul><li>Check for one half tooth offset between maxillary & mandibular teeth </li></ul><ul><li>Ensures posterior teeth have normal cusp to fossa relationship for lingualized occlusion </li></ul>
  19. 19. Cannine Offset Correct Insufficient Improper offset results in a space or half tooth replacement
  20. 20. Phonetic Assessment <ul><li>Maxillary centrals should lightly touch vermilion border of lower lip for ‘F’, ‘V’ sounds </li></ul><ul><li>‘ S’ sounds - incisal edges should approximate each other </li></ul>
  21. 21. Intraoral Assessment of Anterior Teeth <ul><li>Incisal edges of maxillary incisors should follow line of lower lip when smiling (‘ smile line ’) </li></ul>
  22. 22. Follow the ‘Smile line’
  23. 23. Placing & Moving Anterior Teeth <ul><li>Crown removing forceps to bodily move and tilt teeth </li></ul><ul><li>Grind record base/tooth if record base is impairing ability to position properly </li></ul>
  24. 24. Intraoral Assessment of Anterior Teeth <ul><li>Nasolabial angle ≈ 90° </li></ul><ul><li>If insufficient support, the vermilion border will be reduced </li></ul>
  25. 25. Intraoral Assessment of Anterior Teeth <ul><ul><li>Junction of oral mucosa (glossy) should just be visible when lips are slightly separated </li></ul></ul><ul><ul><li>If not visible - insufficient support </li></ul></ul><ul><ul><li>Lips meet at junction of oral & transitional epithelium </li></ul></ul>
  26. 26. Intraoral Assessment of Anterior Teeth <ul><ul><li>Excessive block-out of record base will push the lip out at the height of the vestibule, distorting appearance </li></ul></ul>
  27. 27. Lisping <ul><ul><li>Too much horizontal overlap </li></ul></ul><ul><ul><ul><li>Can’t approximate incisal edges </li></ul></ul></ul><ul><ul><li>Anterior teeth too far labially </li></ul></ul><ul><ul><li>Spaces allow air leakage </li></ul></ul>
  28. 28. Lisping <ul><ul><li>Palatal contour too constricted </li></ul></ul><ul><ul><ul><li>Remove wax to provide more room </li></ul></ul></ul><ul><ul><li>Arch form too broad </li></ul></ul><ul><ul><li>Experiment with placement of wax </li></ul></ul>
  29. 29. Anterior Teeth Not Identical Position of Natural Teeth <ul><li>Slightly altered position from precursors </li></ul><ul><li>Denture stability compromised </li></ul><ul><li>No anchorage from roots </li></ul>
  30. 30. Avoid the ‘ Denture Smile ’ <ul><li>Teeth too small </li></ul><ul><li>Teeth not showing </li></ul><ul><li>Too straight across anterior </li></ul><ul><li>“ Chiclets” </li></ul>
  31. 31. Central & lateral incisors must begin to turn along the curvature of the arch
  32. 32. Circumference Follows Arch Shape
  33. 33. Facial Support, OVD & Tooth Setup Can Dramatically Affect Appearance
  34. 34. Effect of Incisor Length
  35. 35. Variation of Appearance with Different Dentures
  36. 36. Variation of Appearance with Different Dentures