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SETTING OF ARTIFICIAL TEETH

Setting of anterior teeth
Anterior artificial teeth are arranged in temporary bases. Even when great care is
taken to select the proper size, form and shade for a particular patient, an unnatural
denture can still be created if care is not taken during tooth arrangement. The
general pattern of bone loss, though modified by individual variations, is essentially
upwards and backwards for the maxillary anterior residual ridge and downwards for
the mandibular anterior residual ridge. Therefore, maxillary artificial anterior teeth
must be arranged anteriorly and inferiorly to the residual alveolar ridge to occupy
the position formerly occupied by the natural teeth.

Sequence of anterior teeth arrangement:
Most acceptable methods for arranging artificial teeth begin with the arrangement
of the maxillary central incisors, these teeth maintain the central line as indicated
by the dentist and most sequence requires the arrangement of all the maxillary
anterior teeth, other methods alternant between the maxillary and mandibular
teeth: maxillary central incisors, mandibular central incisors, maxillary lateral
incisors, mandibular lateral incisors. Many dentist and technician set the maxillary
anterior teeth then mandibular anterior teeth this method allows to check the
esthetic factor earlier.

Position of anterior artificial teeth
The teeth lip relationship varies between individual where the position of the teeth
and the mobility of the lips influence the amount of teeth exposed during smiling.
Usually the incisal edges of the upper incisors is placed 2-3mm bellow the rest
position of the upper lip at the time of the registration of the jaw relationship ,the
upper bite rim have been adjusted to provide a suitable support for the upper lip.

Guide lines of artificial teeth arrangement: Maxillary cast: 1. A line is drawn parallel to the frontal plane that touches the anterior margin of the Incisive papilla. Pleasing esthetics. 3. . aids in the buccolingual position of the mandibular posterior teeth. A line is drawn parallel to the frontal plane bisecting the residual ridge. aids in positioning of the mandibular central incisors. 2. 2. A line that bisects the vertical height of the retromolar pad aids in establishing the vertical position of the occlusal surfaces of the posterior teeth. Importance of anterior teeth arrangement: 1. aids in the positioning of the upper central incisors. A point designates the distal of the mandibular canines. 3. Mandibular cast: 1. Proper lip support. Permit satisfactory phonetics. 3. The canine eminence line is recorded on the cast when it's present. this line is perpendicular to line 1. 4. Also an important role is to set the teeth in place where they grow. 2. The midline follows the mid palatal suture and bisects the incisive papilla. A line follows the crest of the residual ridge from the canine point to the middle of retromolar pad.

4. Figure 5-2: The neck of the tooth should be slightly depressed. The long axis of the tooth should be perpendicular to the horizontal plane (occlusal plane or the mandibular occlusion rim). Figure 5-4: The facial surface of the upper central incisor is located about 1 cm to the incisive papilla.MAXILLARY ANTERIOR TEETH: Maxillary central incisors The criteria for arrangement of maxillary anterior teeth are as follows: 1. Figure 5-3: Arrangement of upper anterior teeth follows the contour of the lower lip. 3. 2. Figure 5-1: The long axis of the tooth shows slight distal inclination to the perpendicular. Figure 5-5: Upper central incisor in place . The contact point should coincide with the midline of the face. The incisal edge should touch the mandibular occlusion rim. The facial surface of the central incisors should be 5-9 mm anterior to the center of the incisive papilla.

The cervical portion of the tooth should incline slightly lingually. The long axis should be perpendicular to the occlusal plane. 3. The incisal edge of the canine should touch the mandibular occlusion rim. 2. The neck is depressed more than central incisor Figure 5-6: The long axis of Maxillary lateral incisor shows slightly more distal inclination than the central incisor.Maxillary lateral incisor 1. The cervical third of the labial portion of the canine should incline buccally to achieve some prominence. Figure 5-8: Upper lateral incisor in place. 3. The long axis of Maxillary lateral incisor shows slightly more distal inclination than the central incisor. 2. 4. Figure 5-7: The neck is depressed more than central incisor. The incisal edge of the lateral should be raised approximately 1 mm from the mandibular occlusion rim. . Maxillary canine 1.

The neck of canine is prominent. The mesiolabial aspect of the canine should be visible when viewed from the anterior. Figure 5-16: Setting the left lateral incisor. Figure 5-12: Upper anterior teeth (one side only). Mandibular anterior teeth .4. Figure 5-11: Upper canine in place. 5. Figure 5-15: Setting the left central incisor. Figure 5-17: Front view of upper anterior teeth. Figure 5-13: Front view of upper anterior teeth (one side only). This will be accomplished by tilting the neck of the canine slightly to the distal (in addition to being tilted to the buccal). Figure 5-14: Wax removal to set the central incisor of the other side. Figure 5-10: Lateral view of upper anterior teeth. Figure 5-9: The neck of canine is prominent.

The incisal guide angle: It is the angle formed by a line drawn through the incisal edges of the maxillary and mandibular incisors in a horizontal plane. Mandibular Central Incisors: . In denture fabrication the mandibular incisors should not touch the maxillary incisors in centric relation. Figure 5-18: Incisal guide angle. Figure 5-19: Vertical and horizontal overlaps.The incisal guide angle is the angle formed by a line drawn through the incisal edges of the maxillary and mandibular incisors in a horizontal plane. Overbite (vertical overlap): It is the vertical extension of the upper anterior teeth over the lower teeth in a vertical direction when the opposing posterior teeth are in contact in centric occlusion. In complete denture treatment this angle is determined by the person arranging the artificial teeth. The incisal guide angle should be kept as low as possible to allow free movement of the teeth in eccentric jaw movements without compromising denture stability. Overjet (horizontal overlap): It is the projection upper anterior teeth beyond their antagonist in a horizontal direction.

Figure 5-21: Lateral view of mandibular central incisor. . Figure 5-23: Front view of mandibular lateral incisor. The long axis of the mandibular central incisor should be set perpendicular to the occlusal plane. Mandibular lateral incisors 1. The occlusal height should be the same at the central incisors. Figure 5-20: Mandibular anterior teeth. 3. 2. 5. In horizontal view the distal edge rotated towards lingually to have the arch curvature. The contact point of mandibular incisors should coincide with the midline of the maxillary teeth. 1 mm vertically and 1 mm horizontally (1 mm horizontal and vertical overlap) if you are using anatomic posterior teeth. The long axis of the mandibular incisor should be slightly inclined distally at the cervical portion of the tooth. Arrange the anterior teeth. Set the mandibular central incisors so that the maxillary incisors cover them.1. Figure 5-24: Lateral view of mandibular lateral incisor. 2. 4. Figure 5-22: Mandibular central incisor in place.

The long axis of the mandibular canine is nearly perpendicular to the occlusal plane with a slight distal inclination. A square arrangement is indicated for a square-shaped maxillary residual . Anterior teeth are set to follow the arch form of the patient's residual ridges. The tip of the canine should be at the same occlusal height as the mandibular central and lateral incisors. Figure 5-29: Upper and lower anterior teeth. The incisal edges of the anterior teeth should be set to correspond to the shape of the arch. 2. The limit of compromise on a mandibular denture is the labial border. Figure 5-26: Front view of mandibular canine. Figure 5-28: Mandibular canine in place.Figure 5-25: Mandibular lateral incisor. Mandibular canines 1. such as when a large horizontal overlap (Class II) creates phonetic problems. a compromise position for the mandibular incisors may be necessary. Figure 5-27: Lateral view of mandibular canine. Arch Form: In some instances. You will make the mandibular denture unstable if you arrange the mandibular incisors any further labially than the labial border.

a tapering arrangement for a tapering ridge form.. . It may also be necessary to adjust the ridge lap portion of the denture tooth. When you will be using 0 degree posterior teeth (ex. ii. the incisal guide table is set at 0 degree and the anterior teeth are arranged so there is no vertical overlap. Use the occlusion rim as your guide to the labial contour and height. cut away the left side of the anterior portion of the maxillary occlusion rim and arrange the left central. iv. Seal the tooth in position on the lingual surface with wax. v. and canine teeth. Repeat the preceding operation to arrange the mandibular anterior teeth. Using a warmed knife cut enough wax from the right side of the maxillary occlusion rim to allow you to position the right central incisor. Also. Complete the tooth arrangement to the best of your ability. i. Figure 5-30: arrangement of upper anterior teeth should follow the arch form. Rational). lateral. vi. this line coincides with the center of the incisive papilla. vii. Arrange the upper central incisor with its mesial edge at the midline previously marked using the occlusion rim remaining on the left as a guide. iii. No other adjustment of the incisal guide table is necessary. Consult the Prosthodontics faculty in your Clinic for assistance. Extend this mark onto the land area of the maxillary cast with a pencil. This procedure is a technique to guide you in your first attempts. and an ovoid arrangement for an ovoid arch. Now. monoplane. Arrange the right lateral and canine in the same manner. Locate the midline on the maxillary occlusion rim. evaluating it based on the criteria provided in this manual. It may be necessary to grind on the record base with a rotating instrument. use the guidelines presented in the beginning of this section. Procedures: There are many different ways to arrange anterior teeth. Usually. Figure 5-31: Horizontal overlap. Evaluate the position of the incisal edges of these teeth relative to the plane of occlusion using a metal occlusion template or its substitute.ridge.

iii. when viewed from the buccal. Alternatively. ARRANGEMENT OF POSTERIOR TEETH Arranging the Upper posterior Teeth: i. The mesio-buccal cusp should be about 1 mm from the occlusal plane. iv. The mesio-buccal and mesio-lingual cusps of the right maxillary first molar touch the occlusal plane. When properly arranged. The buccal and lingual cusps are placed on the plane. and therefore the incisal guide angle. the mandibular canines can be arranged first in the proper relationship to the maxillary canines ( the cusp tip of the mandibular canine is placed between the maxillary canine and lateral).5 mm in normal jaw relations.When using posterior teeth with cuspal inclines. The disto-buccal cusp is raised about 1/2 mm and the disto-lingual cusp is raised about 1/2 to 3/4 mm above the occlusal plane. vi. v. Place the right maxillary second premolar in like manner. Place the right maxillary first premolar with its long axis at right angles to the occlusal plane. Follow the same procedure in placing the posteriors on the opposite side. the long axis of the maxillary canine will coincide with the distal surface of the mandibular canine. ii. viii. Remove enough wax from the mandibular occlusion rim on the right side to have space for the posterior teeth. Arranging the lower posterior teeth: i. Align the buccal surfaces of the premolars and the canine with the edge of metal or plastic occlusal plane template. set the mandibular anterior teeth in such a way that the maxillary anterior teeth have a horizontal overlap over the mandibular teeth of 1 to 1. The incisal guidance. is determined by the amount of horizontal and vertical overlap of the anterior teeth established by the dentist. You then arrange the centrals and laterals in the remaining space. All of the cusps of the second molar are raised from the occlusal plane following the position of the first molar. .

and using a straight edge. Figure 5-32: A line should be drawn from the center of the retromolar pad area to the canine area. iii. With a pencil. Mark the land areas of the mandibular cast with a pencil to serve as a guide in tooth arrangement. Close the articulator carefully to bring the mandibular molar into its proper position. Follow the same procedure in placing the right mandibular second molar and second premolar. This will represent the posterior limit for tooth arrangement (Don’t set teeth beyond this point).ii. . use a ruler to mark the crest of the mandibular ridge from the base of the retromolar pad to the canine area. extend the previous markings onto the wax rim to serve as a guide when arranging the maxillary teeth. Figure 5-33: Level of posterior teeth in relation to retromolar pad area.  Guide it to the correct occlusal relation with the maxillary first molar and maxillary second premolar  Making certain that the incisal guide pin remains in contact with the incisal table during all excursions. Replace the mandibular record base and occlusion rim. After removing the mandibular record base. iv. Set the right mandibular first molar in approximately its correct position but slightly high in occlusion. v. This will identify the crest of the mandibular ridge (B). • Repeat this procedure for the other side. place a mark on the land where the mandibular ridge turns superiorly (A).

Follow the same procedure in placing mandibular teeth on the left side. . Notice the relation of the buccal cusps to canine. Figure 5-41: Balanced occlusion. there is not sufficient space for the mandibular first premolar.vi. Figure 5-39: Upper right second molar in place. The buccal and lingual cusps are placed on the plane Figure 5-35: Lateral view of posterior teeth cusps relation to the occlusal plane. Figure 5-40: Occlusal view of upper posterior teeth in place. vii. it is usually advisable to grind the mandibular first premolar to fit the available space rather than altering the anteriors. Figure 5-34: Buccal view of right maxillary first and second premolars with their long axis at right angles to the occlusal plane. Figure 5-38: Upper right first molar in place. Figure 5-36: Occlusal view of upper right premolars in place. For esthetic reasons. In some instances. Figure 5-37: Lateral view of upper right premolars.working side contacts.

Figure 5-44: Carving of post-dam on the upper cast. Figure 5-43: balanced occlusion. .protrusive contacts.Figure 5-42: Balanced occlusion.non-working side contacts.