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1. ‫ميحرال‬
‫نمحرال‬
‫هلل‬‫ا‬
‫ب‬
‫س‬
‫م‬

2. SELECTION OF ARTIFICIAL TEETH
FOR EDENTULOUS PATIENT

3. To provide harmonious natural appearance
Pleasing and natural looking
The teeth and the base should be in harmony with
facial musculature, size and shape of the head

4. Tooth selection
Objectives:
1.Esthetics
2.Masticatory
function
3.Correction of
speech defects
4.Preservation of the remaining tissue and
muscle tone
- Primary selection of the teeth must be carried out
at the first appointment.

5. Anterior teeth selection
Need: Artistic skills & Scientific
Knowledge
Guides for the anterior teeth selection
1. Pre-extraction guides
a. Study cast
b. Photographs
c. Extracted teeth
2. Examination of existing denture

6. 3. Post extraction guides ( indirect methods)
- Selection of size (width , length &
thickness)
a. Size of the face and head
b. Size of the maxillary arch
c. Maxillomandibular relations
i. In class I – Normal relationship, the
teeth in one arch are compatible with
the teeth in the other arch.
ii. In class II – The mandible is
retruded
and the mandibular teeth are
frequently smaller
iii. In class III – The mandibular
teeth are

7. - Width of the anterior teeth:
d. Bizygomatic width:
-The average width of the maxillary central incisor
is estimated to be 1/16 of the bizygomatic width
that is, the distance between the cheek bones
measured just in front of the ears.
-The combined width of the six maxillary anteriors
is equal to the bizygomatic width divided by 3.3

8. Bi-zygomatic width

9. -Trubyte tooth indicator
Used to determine the facial
outline, for selection of the
tooth size and form

10. - The width of the nose – An estimation of the position
of the cusp tips of the upper natural canine can be
found by extending parallel lines from the lateral
surface of the ala of the nose onto the labial surface
of the upper occlusion rim.
- Corners of the mouth – The distance measured
between the two commisures (angles of the mouth )
will represent the width of the upper six anteriors
from the distal surface of the canine to the distal
surface of the other canine.
-

12. - Canine eminence:
- Cranial circumference: 10 times width of 6 ant. teeth
- B L center of hamular notch + 5 mm= width of 6
ant. teeth
 - Incisive papilla: Line passing through distal of incisive
papilla, Perpendicular to the palatal midline , Intersects cusp tips of
the canines

13. The length of the anterior teeth
- The vertical distance between ridges
- The lips: - length
- mobility
-The length width ratio of the patient’s face.
Length of face
Width of face
=
Length of tooth
Width
of tooth

14. -Contour of the lip----pleasing appearance
U2/3 La surface#1 support upper lip
L 1/3 support superior border of the lower
lip When teeth are in occlusionand lip
together

15. Selection of the tooth form:
- Guides for selecting the form of anterior teeth:
. Form and contour of the face
. Shape of the edentulous maxillary arch
. Sex
. Age

19. There is a relationship between the shape of the
upper
arch & the upper central incisor :
V shaped arch has incisor narrow at the neck
Square shaped arch has incisors with parallel
sides Rounded arch has incisor rounded in shape

20. Selection of shade

21. Guidelines
: Patients age: With old age, darker teeth, while
lighter teeth are suitable for young patients.
Patients complexion: light teeth for blond, light
skin and blue eyes, while dark teeth usually
for dark skin and black eyes.

22. Guidelines
: The neck of the tooth has a more pronounced
color than the incisive edge.
The incisal edge if not worn, is more translucent
than the body of the tooth

23. Guidelines
:
-The upper central incisors are lightest teeth in the
mouth followed by the laterals and canines.
- Posterior teeth are usually uniform in color.
-Teeth darken slightly with age.

24. Aid for selecting the shade:
-Shade guides – The tooth should be
moistened and selection made in the normal
light.
-Outside the mouth along the side of the
nose.
- Under the lip with the incisal edge exposed
-The color should be matched with the skin
of the cheeks.

25.  Don’t show all shades to patient
 Patients will pick the whitest
 Show 2 or 3 shades
 Colour perception affected by background

26. Check the Shade Against the Patients
Face
• Check shade of existing denture
• Ask if patient wants same shade or change
• Allow patient to view shade against lip with mirror
• Obtain patient approval

27. Disinfect Shade Tabs

28. Dentogenic
Concept:
Guide during teeth selection For establishing the esthetics
in C D pt.
1. Sex:
a.Females – All teeth are more curved, rounded line
angles, the teeth more ovoid or tapering than square.
b.Male – The teeth are larger with sharp line angles, the
teeth more square than ovoid or tapering.
1. Age:
With age wear, chips, or notches of the Incisal edge,
rough lab. Surface, amount of tooth show, the
interdental papilla become short, blunt and smooth,
gingival recession
3. Personality:
Large, rugged, vigorous manhave a teeth size and form
different from delicate woman

29. Masculine
• Prominent teeth
• Large sized teeth
• Square arch form
• Squarelabial surface
• Square incisaledgesand
corners
• Darker shade
• Flat smiling line
• Canine – cervical area is more
visible and prominent
Feminine
• Smaller teeth
• Round corners
• Curved contours &arch form
• Curved labial surface
• Round incisaledgesand corners
• Delicate appearance
• Curved smiling line
• Canine – mesial 3rd only seen
- Sex:

30. -Age:
 Younger people
Lighter shade
More incisal
translucency
Minimal wear of incisal
edge
Curved smiling line
Pointed canines
 Older people
Darker shade
Less incisal translucency
 increased wear of incisal
edges
Flat smiling line
Loss of tips of canine

32. Shade

33. Posterior teeth selection:
 Shade
 Size and number
 Form
 Material

34. Shade of the posterior teeth:
Should harmonize the shade of the anterior
teeth, especially the maxillary premolars.

35. Size and number of posterior teeth:
- Bucco-lingual dimension
- Mesio-distal dimension
- Occluso- gingival dimension

36. Posterior teeth should have a small bucco-lingual
width to keep forces on the supporting structure to
a minimum (Penetrating power)
-Tongue space
- Support of the cheeks
Bucco-lingual dimension:

37. Bucco-lingual dimension:
-Narrowing of occulsal table:
a. Bolus of food can be penetrated and
chewed with less effort
b.Less displacement of the denture on the
Mucosa
c.Proper sloping of the polished surfaces
For the action of tongue, and cheeck
muscles

38. The mesiodistal measurements of the upper posterior teeth
is taken from the distal surface of the canine to the
prominence of the tuberosity.
The lower posterior teeth should not extend posterior to the
mesial border of the retromolar pad.
Mesio-distal dimension

39. Occluso- gingival dimension
- Inte-arch distance
It isadvisable to select upper posterior teeth as long as
possible so that the premolars will be esthically in harmony
with the canine.
Actually there are long, medium and short posterior teeth.

40. Form of the posterior teeth
Three basic tooth forms
1 anatomic ( 33˚ cusp incline)
2semianatomic (20˚ cup incline)
3- nonanatomic (0- dgree)
33°

41. Form of the posterior teeth
Anatomic teeth:
- Balanced occlusion
- Young healthy patients
- Good ridges
Non anatomic form or monoplane teeth:
- Flat occlusal surfaces (without cusp)
- Not function efficiently
- Less destructive force to the tissues
- Old patients having poor ridges with poor
neuromuscular control.

42. Advantages of anatomic
teeth:
1.Esthetically acceptable
2.More efficient in cutting of
food,
thereby reducing
forces
that are directed to the supporting structures
during masticatory movement.
3.They can be arranged in balanced occlusion

43. Disadvantages of anatomic
teeth:
1.It is mandatory to use an adjustable articulator.
2.Eccentric records must be done for articulator
adjustments
3.Clinical remount is essential to adjust the occlusion
after denture settling.
4.Balanced occlusion lost when settling occurs.
5.More horizontal forces during functions.
6.Frequent relining, Fast bone resorption

44. Advantages of non anatomic
teeth:
1.Comfortable
2.Allow greater range of movementswhich is necessary in
patients with mal-related jaws (as those with Para
functional jaw habits or wide mandibular movement)
3.Non anatomic teeth exerts less horizontal or
torquing forces, so they are used with flat ridge
cases.
4.Centric record only is needed

45. Disadvantages of non anatomic
teeth:
1.They are of unnatural
look 2.Less cutting
efficiency

46. Indications of Non anatomic teeth:
1 pt. with crossbite tooth relation
2pt. with poor neuromusculour control or
coordination
3 pt. with severly resorbed ridges
4pt. with large discrepancy between
centric jaw relation and centric occlusion

47. T
eeth material:
• Porcelain
• Acrylic resin ( cross linked, IPN “inter penetrating polymer
network”)
•Combination between acrylic resin & metal

48. - Wear is clinically insignificant over a long period of time
- No significant loss vertical dimension
- Allow for the total rebasing procedures
- Maintain chewing efficiency
- Difficult to grind and fit into a close inter-ridge space
- Cause dangerous abrasion to opposinggold crown
and natural teeth.
- Have a sharp impact sound
- Will not bond to the base material except with
mechanical means.The anterior porcelain teeth have pins
at the back, while the posteriors have holes.
Porcelain teeth:

49. - Wear is clinically significant
- Loss of occlusal vertical dimension due to wear.
- Occlusal surface is altered by wear.
- Do not chip, and have softer impact sounds
- Easy to adjust and polish
- Easy to grind into close inter ridge space
- Will bond to base material by chemical union.
- Minimal wear to opposing natural teeth and gold
crowns.
Acrylic resin teeth: