guidelines to lip position in the construction of complete dentures

8/9/2019 Guidelines to Lip Position in the Construction of Complete Dentures

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GUIDELINES TOGUIDELINES TOLIP POSITION IN THELIP POSITION IN THE

CONSTRUCTION OFCONSTRUCTION OF

COMPLETE DENTURESCOMPLETE DENTURES

BRUNTON & McCORDBRUNTON & McCORDQUINT. INT. 1994; 25: 121-124QUINT. INT. 1994; 25: 121-124


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INTRODUCTIONINTRODUCTION

MORE NO. OF RPD : RETAIN MOREMORE NO. OF RPD : RETAIN MORE

NATURAL TEETHNATURAL TEETH

ELDERL PATIENTS : BETTERELDERL PATIENTS : BETTER

EDUCATEDEDUCATED

MORE REGARDS FOR ESTHETICS &MORE REGARDS FOR ESTHETICS &

FUNCTIONFUNCTION


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PHSIOLOGIC LIP SUPPORT &PHSIOLOGIC LIP SUPPORT &

CONTOURCONTOUR

IN DENTATE :IN DENTATE :

1.1. INTRINSICINTRINSIC SUPPORTSUPPORT


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SUPPORT FROMSUPPORT FROM UNDERLINGUNDERLING

STRUCTURESSTRUCTURES

!ANTERIOR!ANTERIOR

TEETH & ASSO.TEETH & ASSO.

AL"EOLAR AL"EOLARBONE#BONE#


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RIC$ETTS !195%#RIC$ETTS !195%#

ESTHETICESTHETIC PLANEPLANE''

ELLINGERELLINGER!19()#:POOR!19()#:POOR

REFERENCE PLANEREFERENCE PLANE


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RESORPTI"E CHANGESRESORPTI"E CHANGES

LOSS OF BUCCAL BONE &LOSS OF BUCCAL BONE & AN ASSO. DECREASE IN RIDGE H*. IN AN ASSO. DECREASE IN RIDGE H*. IN

ANTERIOR REGION OF MA+ILLA ANTERIOR REGION OF MA+ILLA


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DENTOFACIAL PROFILOMETERDENTOFACIAL PROFILOMETER

!SCHER,19%9#!SCHER,19%9#

TO QUANTIF FACIAL PROFILETO QUANTIF FACIAL PROFILE

HELP TO PRESER"E NATURAL FACIALHELP TO PRESER"E NATURAL FACIAL

CONTOURCONTOUR

IT MEASUREDIT MEASURED NASOLABIAL ANGLE,NASOLABIAL ANGLE,

LENGTH OF UPPER LIP & HORI. PARTLENGTH OF UPPER LIP & HORI. PART OF NOSEOF NOSE AT THE PRE-E+TRACTION AT THE PRE-E+TRACTION

PHASEPHASE


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DENTOFACIAL PROFILOMETERDENTOFACIAL PROFILOMETER


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FRIEDMAN IN 19%%FRIEDMAN IN 19%%

USEUSE FACIAL MEASUREMENTS,FACIAL MEASUREMENTS,

PROFILE PATTERNS & PHOTOGRAPHSPROFILE PATTERNS & PHOTOGRAPHS

TO OBTAINTO OBTAIN INDE+INDE+ OF LIP CONTOURSOF LIP CONTOURS

SER"E ASSER"E AS GUIDEGUIDE TO POSITIONINGTO POSITIONING

THE ANTERIOR TEETHTHE ANTERIOR TEETH


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PHSIOLOGIC LIP SUPPORTPHSIOLOGIC LIP SUPPORT

IMPORTANT : NATURAL & PLEASINGIMPORTANT : NATURAL & PLEASING

APPEARANCE APPEARANCE

FROM FUNCTIONAL POINT OF "IEFROM FUNCTIONAL POINT OF "IE

MUSCLES : FUNCTION MOST EFFICIENTLMUSCLES : FUNCTION MOST EFFICIENTL

/ / MAINTAINED & SUPPORTEDMAINTAINED & SUPPORTEDESTHETIC CONSIDERATIONESTHETIC CONSIDERATION : LIPS ARE IN: LIPS ARE IN

REPOSE FUNCTIONREPOSE FUNCTION


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AFTER RESORPTION: IF TEETH AFTER RESORPTION: IF TEETH

ARE PLACED O"ER RESI. AL". ARE PLACED O"ER RESI. AL".RIDGERIDGE

-- UNPHSIOLOGIC LIP-- UNPHSIOLOGIC LIPSUPPORTSUPPORT

RESULTANT SPACE BETEENRESULTANT SPACE BETEEN

UPPER LIP & INCISORS /UPPER LIP & INCISORS /PHONETIC PROBLEMPHONETIC PROBLEM


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DENTUREDENTURE :: REPRODUCEREPRODUCE NATURALNATURAL

ANATOM ANATOM AROUND TEETH TO AROUND TEETH TO

ENHANCE LIP SUPPORTENHANCE LIP SUPPORT!PHSIOLOGIC LIP SUPPORT #!PHSIOLOGIC LIP SUPPORT #


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SIGNS OFSIGNS OF E+CESSI"EE+CESSI"E LIPLIP

SUPPORTSUPPORT


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TENSED, STRETCHEDTENSED, STRETCHED

APPEARANCE OF THE LIPS APPEARANCE OF THE LIPS

TENSION LINESTENSION LINES AROUND THE AROUND THEMOUTHMOUTH


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DISTORTION OFDISTORTION OF PHILTRUMPHILTRUM


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OBLITERATIONOBLITERATION OF THEOF THE

MENTOLABIAL, NASOLABIAL &MENTOLABIAL, NASOLABIAL &

LABIOMARGINAL SULCILABIOMARGINAL SULCI


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ERADICATION OFERADICATION OF

NATURAL CONTOURSNATURAL CONTOURS

OF LOER PART OF FACEOF LOER PART OF FACE


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SIGNS OFSIGNS OF INSUFFICIENTINSUFFICIENT LIPLIP

SUPPORTSUPPORT


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PERPETUATION OFPERPETUATION OF GENERALGENERAL

APPEARANCE OF COLLAPSE APPEARANCE OF COLLAPSE

AROUND THE MOUTH AROUND THE MOUTH


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REDUCTION IN SI0E OFREDUCTION IN SI0E OF

"ERMILION BORDERS"ERMILION BORDERS OF THEOF THE

LIPSLIPS


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DROOPINGDROOPING OF CORNERS OFOF CORNERS OF

THE MOUTHTHE MOUTH


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DEEPENINGDEEPENING OFOF

MENTOLABIAL,MENTOLABIAL,

NASOLABIAL &NASOLABIAL &LABIOMARGINALLABIOMARGINAL

SULCISULCI


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OBLITERATIONOBLITERATION OF PHILTRUMOF PHILTRUM


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ATT & McGREGORATT & McGREGOR

HORI. NASOLABIAL ANGLEHORI. NASOLABIAL ANGLE


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ATT!19)1# / CONSTRUCTION & USEATT!19)1# / CONSTRUCTION & USE

OFOF BIOMETRIC TRASBIOMETRIC TRAS::

BUCCAL SULCI DEPTH & IDTHBUCCAL SULCI DEPTH & IDTH

/ / PRE-E+TRACTION RECORDPRE-E+TRACTION RECORD


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COMPARISION OF THECOMPARISION OF THE

EDENTULOUS &EDENTULOUS &DENTATE STATESDENTATE STATES


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SOFT TISSUE PROFILESOFT TISSUE PROFILE : DENTURES: DENTURES

RESTORED THE LIPS TO PRE-E+TRACTIONRESTORED THE LIPS TO PRE-E+TRACTION

CONTOURCONTOUR

GRADUAL REDUCTION IN "ERT. & HORI.GRADUAL REDUCTION IN "ERT. & HORI.

DIMENSIONS OF LIP CONTOURDIMENSIONS OF LIP CONTOUR - PATTERN- PATTERNOF AL"EOLAR RESORPTIONOF AL"EOLAR RESORPTION

ISMAIL * 3!19()# ANDISMAIL * 3!19()# AND

CARLSSON & ERICSON!19(%#CARLSSON & ERICSON!19(%#


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ATSON & BHATIA!19)9#ATSON & BHATIA!19)9# ::

IN EDENTULOUS GROUP UPPERIN EDENTULOUS GROUP UPPER

LIP HAD CHANGED INLIP HAD CHANGED IN

CHARACTER &CHARACTER &

FLATTENING OF PROFILEFLATTENING OF PROFILE


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TALLEGREN * 3!1991#TALLEGREN * 3!1991#

IMMEDIATE DENTURE CASES :IMMEDIATE DENTURE CASES :

MORE ANTERIOR POSITION OF THEMORE ANTERIOR POSITION OF THE

MA+ILLAR LIP MA+ILLAR LIP DENTURE FLANGEDENTURE FLANGE


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DECREASE "DO & ANTERO-SUPERIORDECREASE "DO & ANTERO-SUPERIOR

ROTATION OF MANDIBLE :ROTATION OF MANDIBLE :OUTARD POSITIONINGOUTARD POSITIONING OF UPPER LIPOF UPPER LIP


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ANTERIOR TOOTH POSITION ANTERIOR TOOTH POSITION

FRUSH & FISHERFRUSH & FISHER : /: /NATURAL & PLEASING LIPNATURAL & PLEASING LIP

SUPPORTSUPPORT

INDEPENDENT, NOTINDEPENDENT, NOTCONTROLLED B CRANIALCONTROLLED B CRANIAL

RELATIONRELATION


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ANTERIOR ANATOMIC ANTERIOR ANATOMIC

LANDMAR$ !OCCLUSAL PLANE#LANDMAR$ !OCCLUSAL PLANE#


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ELLINGER!19()#ELLINGER!19()#

/ / FAILURE TO PLACE THEFAILURE TO PLACE THE ANTERIORS ANTERIORS

UNSUPPORTED LIPS,UNSUPPORTED LIPS,IMPROPER MUSCLE TONE,IMPROPER MUSCLE TONE,PREMATURE AGING,PREMATURE AGING,

ALTERED FACIAL ALTERED FACIALE+PRESSION & FAULTE+PRESSION & FAULTCONTOURSCONTOURS


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PLACE ANTERIORS O"ERPLACE ANTERIORS O"ERRESIDUAL RIDGESRESIDUAL RIDGES


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"IG !19(1#"IG !19(1#IF LABIAL FLANGE IS THIC$ENED 6IF LABIAL FLANGE IS THIC$ENED 6

SUN$EN, UNCOSMETIC O"AL PROFILESUN$EN, UNCOSMETIC O"AL PROFILE

ITH IN"ERTED PROFILEITH IN"ERTED PROFILE


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FORSBERG!19%9#:FORSBERG!19%9#:

LIP LENGTH DENTATE,LIP LENGTH DENTATE,

UPPER LIP LENGTH INCREASES ITHUPPER LIP LENGTH INCREASES ITH

AGE AGE

MA+ILLAR INCISORS : AT ORMA+ILLAR INCISORS : AT OR

SUPERIOR TO THE UPPER LIPSUPERIOR TO THE UPPER LIP

A"OID A"OID DENTURE LOO$DENTURE LOO$


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REPLACEMENT OF CENTRALREPLACEMENT OF CENTRAL

INCISORSINCISORS

A"G : 12.5 77 A"G : 12.5 77

BIOMETRIC GUIDEBIOMETRIC GUIDE


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MA+ILLAR & MANDIBULARMA+ILLAR & MANDIBULAR

INCISORSINCISORS

SET TO A LOER LE"ELSET TO A LOER LE"EL

ACC TO LONGER EDENTULOUS ACC TO LONGER EDENTULOUSUPPER LIPUPPER LIP

SO, 1-2 77 BELO THE "ERMILIONSO, 1-2 77 BELO THE "ERMILION

BORDERBORDERFORSBERG,FORSBERG, FRUSH & FISHERFRUSH & FISHER


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SUMMARSUMMAR


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"ARIET OF METHODS :"ARIET OF METHODS :

TO ESTABLISH GUIDELINESTO ESTABLISH GUIDELINES

NO ONE METHOD CAN BE SAID TO BENO ONE METHOD CAN BE SAID TO BE

FOOLPROOFFOOLPROOF

INCISAL PAPILLA & PRE-E+TRACTIONINCISAL PAPILLA & PRE-E+TRACTION

PHOTOGRAPHSPHOTOGRAPHS

guidelines to lip position in the construction of complete dentures

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