Setting Anterior Teeth

1. Setting Anterior Teeth Esthetics & Phonetics

2. Look for Symmetry View from anterior, occlusal View from many angles

3. Perfect Symmetry Gross Asymmetry Symmetry

4. 2 Left Sides “Normal”2 Right Sides Facial Asymmetry

5. Smile Asymmetry 2 Left Sides “Normal”2 Right Sides

6. Setting Anterior Teeth • Incisal edges of central incisors & canines at level of the occlusal plane • Laterals placed approximately 0.5 mm above the occlusal plane

7. Cervical necks tilt posteriorly from the central incisor to the canine

8. The greatest height of the free gingival margin is slightly distal to the mesiodistal center of the tooth

9. Setting Mandibular Anteriors Lower anterior teeth incline similar to the maxillary teeth

10. Setting Mandibular Anteriors • Incisal edges are placed at the same level • Even with the occlusal plane

11. Setting Mandibular Anteriors • No overbite for monoplane or lingualized setups

12. Canines should be tilted more posteriorly than other teeth, with a more prominent cervical neck

13. Bucco-Lingual TiltMaxillary Anterior Teeth • Facial surface of central is perpendicular occlusal plane • Neck of lateral is depressed • Neck of canine is prominent Central Canine

14. Bucco-Lingual TiltMandibular Anterior Teeth Central is proclined Lateral is more upright Canine has a prominent neck Central Canine

15. Anterior Tooth Setup • Check symmetry with reference lines • Anterior teeth don’t contact in centric position • Grazing contacts in excursions Overbite = 0mm Overjet = 2mm

16. Insufficient Excessive Correct No Anterior Contact in Centric

17. Canine Offset Check for one half tooth offset between maxillary & mandibular teeth Ensures posterior teeth have normal cusp to fossa relationship for lingualized occlusion

18. Cannine Offset Correct Improper offset results in a space or half tooth replacement Insufficient

19. Phonetic Assessment • Maxillary centrals should lightly touch vermilion border of lower lip for ‘F’, ‘V’ sounds • ‘S’ sounds - incisal edges should approximate each other

20. Intraoral Assessment of Anterior Teeth Incisal edges of maxillary incisors should follow line of lower lip when smiling (‘smile line’)

21. Follow the ‘Smile line’

22. Placing & Moving Anterior Teeth • Crown removing forceps to bodily move and tilt teeth • Grind record base/tooth if record base is impairing ability to position properly

23. Intraoral Assessment of Anterior Teeth • Nasolabial angle ≈ 90° • If insufficient support, the vermilion border will be reduced

24. Intraoral Assessment of Anterior Teeth • Junction of oral mucosa (glossy) should just be visible when lips are slightly separated • If not visible - insufficient support • Lips meet at junction of oral & transitional epithelium

25. Intraoral Assessment of Anterior Teeth Excessive block-out of record base will push the lip out at the height of the vestibule, distorting appearance

26. Lisping • Too much horizontal overlap • Can’t approximate incisal edges • Anterior teeth too far labially • Spaces allow air leakage

27. Lisping • Palatal contour too constricted • Remove wax to provide more room • Arch form too broad • Experiment with placement of wax

28. Anterior TeethNot Identical Position of Natural Teeth Slightly altered position from precursors Denture stability compromised No anchorage from roots

29. Avoid the ‘Denture Smile’ Teeth too small Teeth not showing Too straight across anterior “Chiclets”

30. Central & lateral incisors must begin to turn along the curvature of the arch

31. Circumference Follows Arch Shape

32. Facial Support, OVD & Tooth Setup Can Dramatically Affect Appearance

33. Effect of Incisor Length

34. Variation of Appearance with Different Dentures

35. Variation of Appearance with Different Dentures