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GOALS FOR THE SELECTIONGOALS FOR THE SELECTION
OF ARTIFICIAL TEETHOF ARTIFICIAL TEETH
Construct a denture to :Construct a denture to :
1.1. Function wellFunction well
2.2. Allow pt: speak normallyAllow pt: speak normally3.3. Esthetically pleasingEsthetically pleasing
4.4. Will not abuse the natural tissuesWill not abuse the natural tissues
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TOOTH SELECTION STAGESTOOTH SELECTION STAGES
1. ANTERIORTEETHSELECTION(ATS)
2. POSTERIORTEETHSELECTION
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ANTERIOR TEETH SELETIONANTERIOR TEETH SELETION
(ATS)(ATS) SELETION CRITERIA:SELETION CRITERIA:
a)a)
Selection of tooth sizeSelection of tooth sizeb)b) Selection of tooth shape (Form)Selection of tooth shape (Form)
c)c) Selectionoftoothcolour( shade)Selectionoftoothcolour( shade)
d)d) SelectionoftoothmaterialSelectionoftoothmaterial
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Selection of tooth sizeSelection of tooth size
Size has three dimensions:Size has three dimensions:
a.a. MesioMesio -- distalwidthdistalwidthb.b. OcclusoOccluso -- gingivalheightgingivalheight
c.c. FacioFacio --lingualthicknesslingualthickness
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GUIDES FOR THEGUIDES FOR THE
SELECTION OF ANTERIORSELECTION OF ANTERIORTEETH SIZETEETH SIZE
1.1. PrePre Extraction guidesExtraction guides
2.2. PostPost -- Extraction guidesExtraction guides
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PREPRE--EXTRACTIONGUIDES FOREXTRACTIONGUIDES FOR
THESELECTIONOFTOOTHSIZETHESELECTIONOFTOOTHSIZE
1.1. Diagnostic casts:Diagnostic casts:
mostreliable guidemostreliable guide
Helpstoduplicate pt:originalteethHelpstoduplicate pt:originalteethshape, size &positionalarrangement .shape, size &positionalarrangement .
Especiallyusefulinimmediate dentures.Especiallyusefulinimmediate dentures.
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PREPRE--EXTRACTIONGUIDES FOREXTRACTIONGUIDES FOR
THESELECTIONOFTOOTHSIZETHESELECTIONOFTOOTHSIZE
2.2. Photographs:Photographs:
Provide informationonwidth& formofteethProvide informationonwidth& formofteeth(rarelyoncolor).(rarelyoncolor).
Usefulnessdependsonthe extentofteethUsefulnessdependsonthe extentofteethvisibilityvisibility
Humansize photographsare more valuableHumansize photographsare more valuable
Digitizationofimagesmake computerassistedDigitizationofimagesmake computerassistedvisionpossible.visionpossible.
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PREPRE--EXTRACTIONGUIDES FOREXTRACTIONGUIDES FOR
THESELECTIONOFTOOTHSIZETHESELECTIONOFTOOTHSIZE
33.. RADIOGRAPHS:RADIOGRAPHS:
helpsinsize & formselectionhelpsinsize & formselection
Needcompensation formagnificationNeedcompensation formagnification
Distortionofradiographicimage isaninherentproblem.Distortionofradiographicimage isaninherentproblem.
4.4.EXTRACTEDTEETH:EXTRACTEDTEETH:
Excellentguide fortoothsize & formselection.Excellentguide fortoothsize & formselection.
Notagoodguide toselectshade ofteeth.Notagoodguide toselectshade ofteeth.
5.5. Previous Dentures:Previous Dentures:
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POSTPOST--EXTRACTIONGUIDES FOREXTRACTIONGUIDES FOR
THESELECTIONOFTOOTHSIZETHESELECTIONOFTOOTHSIZE
A.A. GUIDES TO DETERMINE THE TOOTHGUIDES TO DETERMINE THE TOOTHWIDTHWIDTH
a)a) Size of the face:
Size of the face:
a)a) Anthropometric MeasurementsAnthropometric Measurements
1.1. BiBi--zygomatic widthzygomatic width
2.2. Cranial circumferenceCranial circumferenceRatioofcranialcircumference totheRatioofcranialcircumference tothe
combinedupperanteriorsix teethwidthis10:1.combinedupperanteriorsix teethwidthis10:1.
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GUIDES TO DETERMINE THEGUIDES TO DETERMINE THE
TOOTH WIDTHTOOTH WIDTH
33.. CORNER OFTHE MOUTH:CORNER OFTHE MOUTH:
Line dropsoverthe max:rim fromcorneroftheLine dropsoverthe max:rim fromcornerofthemouthatrest, correspondstothe distalsurfacemouthatrest, correspondstothe distalsurfaceofthe canine.ofthe canine.
4.4
.ALAOFTHENOSE:ALAOFTHENOSE:A verticalline droppingfromthe alaofthe noseA verticalline droppingfromthe alaofthe noseusuallypassesalongthroughmiddle ofcanine.usuallypassesalongthroughmiddle ofcanine.
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GUIDES TO DETERMINE THEGUIDES TO DETERMINE THE
TOOTH OCCLUSOTOOTH OCCLUSO--GINGIVALGINGIVALHEIGHTHEIGHT
1.1. HIGHLIPLINE:HIGHLIPLINE:
22.. INTERINTER--ARCHSPACE:ARCHSPACE:
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GUIDES TO DETERMINE THEGUIDES TO DETERMINE THE
TOOTH FACIOTOOTH FACIO-- LINGUALLINGUAL
THICKNESSTHICKNESS
Thicker teeth should be prefer.Thicker teeth should be prefer.
Canbe rotated & space outto giveCanbe rotated & space outto givemore realisticappearance.more realisticappearance.
Allowmore depth while settingtheAllowmore depth while settingtheteeth.teeth.
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SELECTION OF TOOTH FORMSELECTION OF TOOTH FORM
Shape/form of artificial teeth is threeShape/form of artificial teeth is threedimensional. Therefore teeth has gotdimensional. Therefore teeth has gotthree important forms,three important forms,
1.1. FACIAL FORMFACIAL FORM
2.2. LATERA
L /PR
OXIMA
L FORML
ATERA
L /PR
OXIMA
L FORM
3.3. AN INCISAL FORMAN INCISAL FORM
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FACIAL FORMFACIAL FORM
Leon Williams Theory:Leon Williams Theory:
Face form corresponds to facial form ofFace form corresponds to facial form ofinvertedCentral incisor.invertedCentral incisor.
Similarly, Face form corresponds to arch form.Similarly, Face form corresponds to arch form.
Face form can be categorized into threeFace form can be categorized into threeprimary forms;primary forms;
1.1. Square formSquare form2.2. TaperingformTaperingform
3.3. Ovoid formOvoid form
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LATERAL /PROXIMAL FORMLATERAL /PROXIMAL FORM
&ANINCISAL FORM&ANINCISAL FORM
Lateral face form determine the lateralLateral face form determine the lateralform of the artificial teethform of the artificial teeth
Lateral face form can be categorizedLateral face form can be categorizedinto;into;
1.1. StraightStraight
2.2. convexconvex
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Selection of tooth colourSelection of tooth colour( shade)( shade)
Colour of an object is recognized when aColour of an object is recognized when a
light of a particular wavelength is reflectedlight of a particular wavelength is reflectedoff an object & then falls on the retina ofoff an object & then falls on the retina ofthe eyethe eye
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PropertiesofcolourPropertiesofcolour
Colour has got the three important qualities:Colour has got the three important qualities:
1.1. HUE:HUE:
Particular variety of colour(red, green,etc)Particular variety of colour(red, green,etc)
Determined by the wavelength of reflectedDetermined by the wavelength of reflected
light.light. Shorter the wavelength, the closer the hue isShorter the wavelength, the closer the hue is
to the violet portion.to the violet portion.
longer the wavelength, the closer the hue is tolonger the wavelength, the closer the hue is to
the red portion.the red portion.
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PropertiesofcolourPropertiesofcolour
CHROMA:CHROMA: Amount of colour.
Canine is more saturated then other anterior teeth.
VALUE: Represent amount of black or white.
The brightness depends on the amount of light energyreflects/transmits by an object.
TRANSLUCENCY: Represents the amount of light transmits
through an object.
Predominant in the area of incisal edges &/or
proximal surfaces
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FACTORS EFFECTS THEFACTORS EFFECTS THE
COLOUR OF NATURAL TEETHCOLOUR OF NATURAL TEETH AGE:AGE: Asage progressesteethbecome moreAsage progressesteethbecome more
opaqueopaque..
WEAR:WEAR: Teethlooksmore glossy, smooth&Teethlooksmore glossy, smooth&prone tostain.prone tostain.
GENDER:GENDER: Femaleshave more whiterteeth.Femaleshave more whiterteeth.
DEMINERALIZATION:DEMINERALIZATION: teethgetsmore proneteethgetsmore pronetoto staining.staining.
STAINS:STAINS: Bothextrinsic&intrinsicstainseffectsBothextrinsic&intrinsicstainseffectsthe actualshade ofthe naturalstandingteeththe actualshade ofthe naturalstandingteeth..
POSITIONOFTEETH INDENTALARCH:POSITIONOFTEETH INDENTALARCH:Canine ishavingmore saturationofaspecificCanine ishavingmore saturationofaspecific
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SHADE REPLICATIONSHADE REPLICATION
Process of replicating the colour ofProcess of replicating the colour ofadjacent teeth in an artificial prosthesis,adjacent teeth in an artificial prosthesis,having following steps:having following steps:
1.1. SHADE MATCHING PHASE:SHADE MATCHING PHASE:
a) visual shade matchinga) visual shade matchingb) Instrumental colour analysis.b) Instrumental colour analysis.
2.2. SHADEDUPLICATION PHASE:SHADEDUPLICATION PHASE:
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FACTORS INFLUENCE THEFACTORS INFLUENCE THE
APPERANT COLOUR OF ANAPPERANT COLOUR OF ANOBJECTOBJECT
Physical properties of an object.Physical properties of an object.
Nature of the light.Nature of the light.
Subjective assessment of an observer.Subjective assessment of an observer.
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SHADE SELECTION FORSHADE SELECTION FOR
EDENTULOUS PATIENTEDENTULOUS PATIENT
PRE_EXTRACTIONGUIDES:PRE_EXTRACTIONGUIDES:
Notparticularlyhelpfulforshade selection,Notparticularlyhelpfulforshade selection,
1.1. PhotographsPhotographs2.2. ExtractedteethExtractedteeth
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SHADE SELECTION FORSHADE SELECTION FOR
EDENTULOUS PATIENTEDENTULOUS PATIENT POSTPOST--EXTRACTIONGUIDES:EXTRACTIONGUIDES:
1.1. COLOUR OFTHEEYES & HAIRSCOLOUR OFTHEEYES & HAIRS
Little correlationexist (Hallarman).Little correlationexist (Hallarman).
Haircolourisunreliable.Haircolourisunreliable.
Blackeye individualshave darkerteethshadeBlackeye individualshave darkerteethshade
2.2. SKIN COLOUR:SKIN COLOUR: Fairskinnedindividualscanbe givenwithlighterFairskinnedindividualscanbe givenwithlighter
shades.shades.
Lightershadeson Darkerskinned individuallookLightershadeson Darkerskinned individuallook
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POSTPOST--EXTRACTION GUIDES:EXTRACTION GUIDES:
3.3. DENTOGENIC CONCEPT:DENTOGENIC CONCEPT: ConceptproposedbyFRUSH &FISHER.
Hasgotthe greatimpactonselectionofteeth.
Teethselectedaccordingtothisconceptconsiderthefollowing factorsinthe givenorder.
A.A. GENDER:GENDER:
FEMALESHAVE,FEMALESHAVE,
Delicate lookaccordedbyroundingthe pointangles&Delicate lookaccordedbyroundingthe pointangles&avoidingthe sharpanglesinthe contourofthe teeth.avoidingthe sharpanglesinthe contourofthe teeth.
Selectthe smalllateralincisorsSelectthe smalllateralincisors
Setthe lateralincisorathigherlevelthancentrals.Setthe lateralincisorathigherlevelthancentrals.
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DENTOGENIC CONCEPT:DENTOGENIC CONCEPT:
22. PERSONALITY:. PERSONALITY: Patientcanhave VIGOROUSorDELICATEpersonalityPatientcanhave VIGOROUSorDELICATEpersonality
Vigorouslookcanbe givenby,Vigorouslookcanbe givenby,
SelectingwidercentralsSelectingwidercentrals
Wearingthe centrals&canineWearingthe centrals&canine
Selectingthe darkershadeSelectingthe darkershade
Sharpline &pointanglesSharpline &pointangles
Delicate personalitycanbe created byDelicate personalitycanbe created by,,
More palerteethMore palerteeth
Roundedcontours.Roundedcontours.
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DENTOGENIC CONCEPT:DENTOGENIC CONCEPT:
3.3. AGE:AGE:
Aged appearance can be given by,Aged appearance can be given by,
Wearing the incisaledges.Wearing the incisaledges. Proximalwear can alsobe incorporated.Proximalwear can alsobe incorporated.
More ofthe cervicalportion visible togiveMore ofthe cervicalportion visible togivegingivalrecession appearance.gingivalrecession appearance.
Selectdarker shade.Selectdarker shade.
Age characterized moldsare alsoavailable.Age characterized moldsare alsoavailable.
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Posterior tooth selectionPosterior tooth selectionPosterior tooth selectionPosterior tooth selection
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CONSIDERATIONS FOR THECONSIDERATIONS FOR THE
SELECTION OF TEETHSELECTION OF TEETH
1.1. Masticatory functionMasticatory function
2.2. Preservation of ridgePreservation of ridge3.3. Denture stabilityDenture stability
4.4. Soft tissue healthSoft tissue health
5.5. EstheticsEsthetics
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SELECTION CRITERIA FORSELECTION CRITERIA FOR
POSTERIOR TEETHPOSTERIOR TEETH1.1. ColourColour
2.2. Mesiodistal widthMesiodistal width
3.3. Buccolingual widthBuccolingual width4.4. Occlusogingival lengthOcclusogingival length
5.5. Cuspal inclinationCuspal inclination
6.6. Material selectionMaterial selection
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SELECTION CRITERIA FORSELECTION CRITERIA FOR
POSTERIOR TEETHPOSTERIOR TEETH1.1. COLOURCOLOUR SELECTIONSELECTION::
T
heT
he upperupper prem
olarsprem
olars &&m
esiobuccalm
esiobuccal halfhalf ofof thethe11ststmolarmolar areare usuallyusuallyvisiblevisible duringduring smilesmile..
CanineCanine areare thethe darkestdarkest teethteeth
Prem
olarsP
rem
olars &&m
olarsm
olars shouldshould bebe slightlyslightly lighterlighter ininshadeshade thanthan caninecanine..
TheThe differencedifference shouldshould notnotbebe tootoomuchmuch obviousobvious..
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SELECTION CRITERIA FORSELECTION CRITERIA FOR
POSTERIOR TEETHPOSTERIOR TEETH2. Mesio2. Mesio--Distal width selection:Distal width selection: MesioMesio--distalwidthisdictatedbythe lengthofmand:distalwidthisdictatedbythe lengthofmand:
residualridge fromthe distalofthe canine toretroresidualridge fromthe distalofthe canine toretro--
molarpad.molarpad. Arrangement ofthree post:teethismore oftentheArrangement ofthree post:teethismore oftenthe
norm&willreduce the potential forthe placementofnorm&willreduce the potential forthe placementofthe 2the 2ndndmolartoo farposteriorly.molartoo farposteriorly.
Max:post:teeththatextendstooclose tothe post:Max:post:teeththatextendstooclose tothe post:borderofmax:denture maycause cheekbiting.borderofmax:denture maycause cheekbiting.
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SELECTION CRITERIA FORSELECTION CRITERIA FOR
POSTERIOR TEETHPOSTERIOR TEETH3.3.BUCCOBUCCO--LINGUALWIDTH SELECTION:LINGUALWIDTH SELECTION:
Shouldbe lessthanthe widthofnaturalteeth.Shouldbe lessthanthe widthofnaturalteeth.
Narrowocclusaltable reducesthe levelof forcesneededNarrowocclusaltable reducesthe levelof forcesneededtomasticate.tomasticate.
Narrowocclusaltable allowsthe developmentofcorrectNarrowocclusaltable allowsthe developmentofcorrectformof polishedsurfaces byallowingthe buccal&formof polishedsurfaces byallowingthe buccal&lingualdenture flangestoslope away fromocclusallingualdenture flangestoslope away fromocclusal
surface.surface. Correctpolishedsurface formassistcheeks&tongue inCorrectpolishedsurface formassistcheeks&tongue in
maintainingthe denture inposition.maintainingthe denture inposition.
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SELECTION CRITERIA FORSELECTION CRITERIA FOR
POSTERIOR TEETHPOSTERIOR TEETH5.5. CUSPAL MORPHOLOGY SELECTION:CUSPAL MORPHOLOGY SELECTION:
BasedoncuspalmorphologyposteriorteethcanbeBasedoncuspalmorphologyposteriorteethcanbe
classifiedinto:classifiedinto:
1.1. NonNon--anatomicalanatomical teethteeth
2.2. AnatomicalAnatomical teethteeth
3.3. CombinationCombination ofofanatomicanatomic&&nonnon--anatomicanatomic teethteeth
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CUSPAL MORPHOLOGYCUSPAL MORPHOLOGY
SELECTION:SELECTION:
NONNONANATOMICALTEETHANATOMICALTEETH AlsoknownasFlatorMonoplane orCusplessorZerodegree teeth.AlsoknownasFlatorMonoplane orCusplessorZerodegree teeth.
Historically,Historically,
HALL (1929)wasthe 1HALL (1929)wasthe 1stst persontodesigncusplessteethcalledpersontodesigncusplessteethcalled
INVERTED CUSPTEETH.INVERTED CUSPTEETH. TRUETRUE--KUSPdesignbyMyersonin1929.KUSPdesignbyMyersonin1929.
CHOPINGBLOCK byNelsonin1934.CHOPINGBLOCK byNelsonin1934.
NONNON--LOCK bySwensonin1939.LOCK bySwensonin1939.
VITALLIUM OCCLUSAL byHardyin1946.VITALLIUM OCCLUSAL byHardyin1946.
Introducedinordertoreduce lateral forcesactingonthe denture.Introducedinordertoreduce lateral forcesactingonthe denture. BalancedocclusionCanbe obtainedbyintroducingBalancingBalancedocclusionCanbe obtainedbyintroducingBalancing
ramps.ramps.
..
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NONNONANATOMICAL TEETHANATOMICAL TEETH
INDICATIONS:INDICATIONS:
1.1. Flatridge casesFlatridge cases
2.2. Abnormal jawrelationcaseAbnormal jawrelationcase
3.3. Where difficultyis facedinrecordingthe centricWhere difficultyis facedinrecordingthe centricrelation.relation.
4.4. Where balancedocclusionisnotplaned.Where balancedocclusionisnotplaned.
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NONNONANATOMICAL TEETHANATOMICAL TEETH
ADVANTAGES:ADVANTAGES:1.1. Freedomofocclusalmovementsfromcentrictoeccentric jawFreedomofocclusalmovementsfromcentrictoeccentric jaw
positions.positions.
2.2. Eliminationoflateral forcesthatcandestabilizedthe denture.Eliminationoflateral forcesthatcandestabilizedthe denture.3.3. Whendenture settlingtake place due todenture abuse nocuspalWhendenture settlingtake place due todenture abuse nocuspal
interference occur.interference occur.
DISADVANTAGES:DISADVANTAGES:1.1. Notestheticallypleasing.Notestheticallypleasing.
2.2. Difficultto balanceDifficultto balance
3.3. Reduced masticatory efficiencyReduced masticatory efficiency
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ANATOMICAL TEETHANATOMICAL TEETH
Can be classified on the bases of cuspalCan be classified on the bases of cuspal
inclines.inclines.
Cuspal inclines vary from 20 degree to 45Cuspal inclines vary from 20 degree to 45degree.degree.
INDICATIONS:INDICATIONS:
Good ridge form with sufficient retention & support.Good ridge form with sufficient retention & support. Where balanced occlusion is planed.Where balanced occlusion is planed.
Where possible to record & transfer the centric relation withWhere possible to record & transfer the centric relation with
accuracy.accuracy.
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ANATOMICAL TEETHANATOMICAL TEETH
ADVANTAGES:ADVANTAGES:
EasiertobalanceEasiertobalance
BettermasticatoryefficiencyBettermasticatoryefficiency
ReducedchewingcyclesReducedchewingcycles
BetterestheticsBetteresthetics
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EXAMPLES OF LINGUALIZEDEXAMPLES OF LINGUALIZED
INTEGRATION MOLDSINTEGRATION MOLDS
Mayerson Lingualized Integration(MLI).Mayerson Lingualized Integration(MLI).
Gysis cross bite posterior.( 1927)Gysis cross bite posterior.( 1927) Frenchs Modified posteriors.(1935)Frenchs Modified posteriors.(1935)
Max Pleasure Scheme.(1937)Max Pleasure Scheme.(1937)
Vita Linguoform.Vita Linguoform.
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LINGUALIZED OCCLUSIONLINGUALIZED OCCLUSION
ADVANTAGES:ADVANTAGES: Thisconceptprovidesmaximumintercuspation.Thisconceptprovidesmaximumintercuspation.
Absence ofdeflective contacts.Absence ofdeflective contacts.
Adequate cuspalheight forselective grinding.Adequate cuspalheight forselective grinding.
Natural&pleasingappearance.Natural&pleasingappearance.
Canbe usedinpt:where recordingthe CRisuncertain.Canbe usedinpt:where recordingthe CRisuncertain.
Occlusioncanbe balanced .Occlusioncanbe balanced .
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1. Acrylic resin teeth1. Acrylic resin teeth
INDICATIONS:INDICATIONS:
Whenthere isopposingnaturaldentition.Whenthere isopposingnaturaldentition.
Whenopposingdentitionhasgotthe goldcrownsorWhenopposingdentitionhasgotthe goldcrownsorinlays.inlays.
Where there isreducedinterarchspace.Where there isreducedinterarchspace.
Where occlusaladjustmentisrequired.Where occlusaladjustmentisrequired.
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1. Acrylic resin teeth1. Acrylic resin teeth
INDICATIONS
:IN
DICATIONS
:Whenthere isopposingnaturaldentition.Whenthere isopposingnaturaldentition.
Whenopposingdentitionhasgotthe goldcrownsWhenopposingdentitionhasgotthe goldcrownsorinlays.orinlays.
Where there isreducedinterarchspace.Where there isreducedinterarchspace.
Where occlusaladjustmentisrequired.Where occlusaladjustmentisrequired.
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Acrylic resin teethAcrylic resin teeth ADVANTAGES:ADVANTAGES:
InexpensiveInexpensive
Easytogrind& adjustEasytogrind& adjust
Absorb the occlusalstressesAbsorb the occlusalstresses Doesnotwearthe opposingnaturalteeth.Doesnotwearthe opposingnaturalteeth.
Bondchemicallytodenture base.Bondchemicallytodenture base.
Selfadjusting & polishing.Selfadjusting & polishing.
SofterimpactsoundSofterimpactsound
DISADVANTAGES:DISADVANTAGES: WeareasilyWeareasily
LossofVD because ofwear.LossofVD because ofwear.
Stainswith time.Stainswith time.
Shearing efficiencywith time.Shearing efficiencywith time.