Principles Of Teeth Arrangement in Complete

Denture
Contents:
A complete denture is defines as the “ Dental prosthesis which replaces the
entire dentition and associated structures of maxilla and mandible.” (GPT)

There are two main parts of a denture:

• Base which acts as :
1. Providing retention and stability
2. Acting as a gingiva
3. Assist in supporting lips and cheeks

• Teeth which acts as:-

1. Assist in preparing food for deglutition and assisting in speech
2. Impart a natural appearance
Selection of teeth
On the basis of shape

Arch form:
Leon’s Williams classification
Shape of upper central incisor bears a definite relation to face. When the tooth is enlarged
the incisal edges are placed above eyebrows and Neck of tooth on chin. Then the outline
of the tooth coincides with face. The outline is the face is determined by lines on each side
running about 2.5 cm infront of tragus of ear through angle is jaw.

• Square- lines are almost parallel

• Tapering – lines converge

• Ovoid- diverge at the chin

On basis of size-

• Bizygomatic width of face ÷ 16 = width of upper central incisor

• Bizygomatic width of face ÷ 3.3 = width of anterior 6 teeth

• Mark corner of mouth with pins and place it on the occlusal

Rim and then we get measurements of 6 anterior teeth.

• H. Pound evaluated that length is a measure of distance

Of lower hair line to Lower edge to bone of chin ÷16
= length of Central incisor
Fisher told that the Size of the teeth must be according to:-

• Male or female

• Delicate or vigorous

• Young or old age

On basis of colour:-

• Important terms:

1. Hue- dominant color of an object. Shade guides are placed

according to hue

2. Value – lightness or darkness of the color of an object. Shade guides are

arranged in decreasing order of value that is lightest to darkest.

3. Chroma- saturation of a particular hue. The higher the chroma

most intense is color.
Colour of natural tooth varies as:

• Neck of tooth has more pronounced color then incisal edge.

• Incisal edge of the tooth has more bluish tint then the neck of tooth.

• Upper central incisors are lightest in mouth.

• Upper and lower lateral incisors with lower central incisors have
slightly darker colour.

• Upper and lower canines are still darker.

• Posterior teeth are lighter than canines.

• Teeth darker slightly with age.

• Yellow colour teeth – fair person, light colour hair and blue eyes.

• Grey colour teeth- dark hair, Brown eyes and dark complexion

• Opal colour teeth- Pale complexion and clear skin

• Perly white small teeth – look unnatural.

How to use a shade guide:-

• Moisten a shade guide as it affects the reflection and rarefaction of the teeth shade.

• Place the tooth under shade of lip than in hand , it will appear lighter.

• Take both lighter and darker colour of the teeth and match it till get
a satisfactory colour.

• Take the opinion of the patient’s assistant .

Natural teeth arrangement:-

• Crowns of teeth are situated according to over center of alveolar ridge.

• In mandible the alveolar ridge supporting the molar teeth forms a

Buttress of bone on lingual aspect of mandible called as body of mandible or basal bone.

• Ridge support:-
1. Molars- above the mandible
2. Lower incisors and canine - slightly labial to main body of mandible

• Wheereas the maxillary alveolar process is situated inferior and external surface ofbasal maxilla.
Mechanism of teeth loss:
• Muscles provide the interaction of forces to teeth and alveolar ridges to support them.

• Labially and lingually these actions are carried out by tongue, lips and cheeks respectively.

• If the function of lip, cheeks and tongue are normal then they form two parabolic shaped arches
which when occlude gets integrated with one another perfectly.

• When the natural teeth are lost there is no longer bone present to support them

Occurence of bone loss after resorption pattern:

• Molar in mandible- lingual side , so artificial teeth are situated more buccally
• Premolar – downward
• Incisor region-labial side so, incisors are situated slightly more lingually
• The maxilla has bone loss entirely so rifle is situated more palataly.
Natural teeth
Teeth support by
periodontal ligament
Each tooth moves
independently
Malocclusion effects are
not immediate
Forces affects each tooth
individually and forces are
well tolerated
Bilateral balance is rare
Tactile sense is present
Artificial teeth
Mobile base on mucosa
All teeth moves as a unit
Malocclusion effects are
immediate and affects
entire base
All teeth are affected and
is Traumatic
Bilateral balance is main
for stability
Tactile sense is Decreased
Extremely
Placement of artificial teeth:

• Teeth are placed according to resorption of teeth that has occurred.

• An imaginary lines are created as from the ala of the nose to External auditory meatus which Should be
parallel to the occlusal rim , so a glass plate is taken for establishing this horizontal plane.

• The teeth are placed anteriorly on the rim

• Placement of the teeth is done one by one in the correct position.

Teeth Front Side Horizontal plane Pictorial
representation

Upper Central Long axis parallel to Sloping slightly Incisive edge contact
incisisors vertical axis labially horizontal plane

Upper lateral incisors Sloping towards Inclined labial to a 0.5 mm to 2mm short
midline of the mouth greater degree of incisal edge

Upper Canine Long axis parellel to Long axis parellel to Cusp contact the
vertical axis vertical axis horizontal plane

Upper first premolar Long axis parellel to Long axis parellel to Palatal cusp is short
vertical axis vertical axis about 2mm whereas
the buccal cusp
touches the
horizontal plane
Upper second Long axis parellel to Long axis parellel to Buccal and palatal
premolar vertical axis vertical axis cusp are arranged
parellel to plane

Upper molar Long axis slopes Long axis slopes Mesiopalatal cusp is
buccally distally in contact with
horizontal plane

Upper second molar Long axis steeped Distally more steeply Four cusp are short
buccally and more than first molar of horizontal plane,
steeply than first mesiopalatal cusp
molar appears to touch the
horizontal plane
Teeth Front Side Horizontal Pictorial
plane representat
ion
Lower Long axis Slopes Incisive
central parellel to labial when edge above
incisor vertical axis viewed 2mm
from side
Lower Long axis Slopes Cusp are
lateral parellel to labially slightly
incisors vertical axis when more than
viewed 2 mm
from side
but not So
steeply as
central
incisor
Lower Slightly Slightly Cusp is
Canines tilted tilted slightly
towards lingually more than
midline 2mm
Lower Long axis Long axis Lingual
premolars parellel to parellel to cusp is
vertical axis vertical axia below
horizontal
plane and
Lower Long Long Both
secon axis axis cusps
d parell parellare
premo el to el to 2mm
lar vertic verticabove
al axis al axis
horizo
ntal
plane
Lower Long Long Buccal
molar aXis axis and
leans leans distal
lingual mesial cusps
ly ly are
higher
than
mesial
and
lingual
cusp
Lower Lingua Long The
secon l and axis of distal
d mesial this and
molar inclina tooth buccal
tion of is cusp
long more are
Compensating curves:

• Curve of spee- Was given by F. Gran von spee in year 1980.

It is an anteroposterior curving and mesiopalatal curving within the alignment of occluding surfaces and incisal edges of
artificial teeth that is used to develop artificial occlusion. {Gpt-9}

• There is an imaginary line created touching the buccal cusp of lower teeth starting from canines going backwards and
approximate the arc of a circle.

• A continuation of this arc in natural dentition will pass through condyle.

• The teeth are arranged in anteroposterior curve so when the Mandible moves forwards and condyle travels
downward all the teeth can remain in contact.
• Curve of monsoon- Curve of occlusion in which each cusp and incisal edge touches to form a sphere of 8 inches in
diameter with its center within region of its glabella. (GPT-9)
• There is a specific arrangement of teeth as by law of curve of monsoon:
1. First Molars- arranged as downward and
2. Second premolar- arranged horizontally straight
3. First premolars- arranged in a reverse curve of monsoon

• This curve functions as keeping the teeth aligned during lateral and downward movement.
The teeth 9cvlude each other as:-
• Six upper front teeth overlap six lower front teeth by 2mm. Horizontal overlap is overjet and vertical overlap is
overbite.
• Buccal cusp of upper molars and premolars overlap those of lower. The palatal cusps of upper posterior teethand
buccal cusp of lower posterior tweth integrated opposing teeth.
• Every tooth except lower central incisors and upper last two molars contact only one teeth rest all contact two
teeth.
• Labial surfaces of six anterior teeth present a curve when viewed from occlusal surface due the shape of
alveolus.
• There is a lateral glass plate relationship where buccal cup of posterior teeth and distal surface of canine are in
straight line.
Gum fitted Anterior teeth Patients where denture is overdeveloped in anterior region
• If a wax flange is placed over this region it pushes the upper lip out, making patients to have swollen
lip.
• Six upper anterior teeth are fitted directly on alveolar ridges without labial flange. To overcome the
retention deficiency the wings are provided in anterior region.
Setting up the teeth for abnormal jaw relation that

superior teeth protusion- Lower ridge is narrowrer thanthe upper and associated with recording chin

Setting posterior teeth: Upper posterior teeth to be set inside the ridge So that they should occlude lower teeth .
Lower teeth should never be outside the ridge
• Setting lower teeth: in case of Superior teeth protusion give the patient a rabbity appearance and in case of
lower tend to unstabalize the denture by placing the lower teeth in way of lower lip.
Inferior protusion- Lower ridge is broader than the upper and associated with protrusive chin

Setting posterior teeth- It is necessary to cross bite. This means that instead of buccal cusp Of molars fitting Into
fossae of upper molars, the reverse occurs.Occasionally the width of the Lower ridge is so great that the Second
molars can’t be occluded without moving the upper teeth outside the ridge. Mastication in these cases is
performed by first molars and molars. Also metal plate should be incorporated in denture.

Setting anterior teeth- To provide an overbite In large number of cases of inferior protrusion will mean setting
the long axis at considerable angle to vertical, giving patient a hog like appearance. Teeth are set as edge to
edge Or with negative overjet.
Patient with old Dentures:

• Patient when given new denture may have reduced tongue space.
• This can be overcome by taking alginate impression above the denture that was present before.
• Also setting the teeth that were present before.