presentation selection of teeth2

8/8/2019 Presentation Selection of Teeth2

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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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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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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


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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TOOTH OCCLUSOTOOTH OCCLUSO--GINGIVALGINGIVALHEIGHTHEIGHT

1.1. HIGHLIPLINE:HIGHLIPLINE:

22.. INTERINTER--ARCHSPACE:ARCHSPACE:


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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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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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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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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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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.


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


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.

presentation selection of teeth2

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