SETTING UP THE TEETH
Aims of Setting
 Preservation of the alveolar bone
 Esthetics
 Masticatory efficiency
 Retention and stability during function
 Health & comfort of the TMJ
Guidelines for Centric Occlusion
 the upper teeth should overlap the lower teeth
 the long axis of each upper tooth should be distal
to the long axis of the corresponding lower tooth
 each tooth except the lower central incisors and
the upper last molars should be opposed by two
teeth
Guides to Positioning of Anterior Teeth
 Payne stated, “Set the teeth where they grew”
Anteroposterior Position
 Distance from papilla, relation to residual ridge,
fullness of the lips (lip support), phonetics F &
V
Superoinferior Position
 Show of teeth, modiolus (lower canine &
premolar)
Mediolateral Position
 Midline, ala of the nose
Inclination or Slant
 Labial plate & facial profile
Guides to Positioning of Posterior Teeth
 Both upper & lower posterior teeth are centered
over the crest of the ridge whenever possible to
improve balance and stability of the denture
 Anterior limit (distal of canine)
 Posterior limit (maxillary tuberosity, retromolar
pad)
 Buccal limit (crest of the ridge)
 Lingual limit (mylohyoid ridge)
 Occlusal limit (corners of the mouth, ½ - 2/3 of
retromolar pad, equator of the tongue)
 Slant or Inclination of the occlusal plane
(curve upward posteriorly, lower have lingual
tilt, upper have buccal tilt)
Features of a Class I Relationship
 Overjet (2-4mm)
 Overbite (1mm, excessive overbite avoided)
 Canine Relation (mesial slope of upper opposes
distal slope of lower)
First Molar Relation (MB cusp of upper opposes
buccal groove of lower)
 Functional & Non-functional Cusps Relation
(cusps to fossae relationship)
Features of a Class II Relationship
 Pronounced overjet
 Lower canine more posterior and lingual
 Lower premolar maybe ground mesiodistally or
removed
 Nonanatomic teeth or teeth with shallow inclines
are selected to reduce stresses on the lower
 Buccal cusps of premolars are flattened to
stabilized centric occlusion
 Molars maintained cusps to fossae relation
Features of a Class III Relationship
 Overjet overbite eliminated
 Incisors can be set edge to edge
 Upper anteriors set are far forward for lip
support and esthetics; lowers as far lingual
without tongue interference
 Upper premolar maybe removed or add lower
teeth (premolar or molar)
 Molars maybe set in crossbite
 Buccallingual inclines & transverse ridges of
posteriors are flattened
Cross-Over Point
 the point at which the teeth change from one
relationship to another
 e.g. In a class 1 relationship with a posterior
cross bite
 the crossover point could be at the 2nd premolar
 teeth may be set in an end-on or cusp to cusp
relation
WAXING and FESTOONING
Role of the Polished Surface
Esthetics
 imitate the form of the tissues around the teeth
Retention
  form of denture base be shaped according the 3. Root indications
muscles and tissues ( lips, cheeks, tongue)
 wax is scraped out of the triangular markings, to
Phonetics which the root indications will manifest

 contour comparable to that of the palate MAXILLARY BASE CONTOUR

Essential for patient comfort and hygiene of the  Gingival Margins

denture  Gingival Bulge
 Interdental Papilla
Waxing
 Gingival Groove
 defined as the contouring of the wax base of a  Peripheral Roll
trial denture into the desired form  Root Prominences
 Canine Fossa
Methods of Adding Wax  Buccal Flange
 Rugae
A. press on method
 Stippling
B. drip on method
Palatal Surface
Festooning
 It has a uniform thickness of 2.5mm
 the procedure of carving the denture base to  Excess bulk can interfere with tongue function
simulate the contour of the natural tissues which and speech
are being replaced by the denture  Midline fracture can occur if the midline area is
too thin
Procedures in Festooning  Palatal slope is continuous with the palatal
surface of the teeth
1. Cervical cut
MANDIBULAR BASE CONTOUR
 cut wax back to the cervical line on the
artificial teeth, or a little beyond to simulate  The gingival features are similar to that of the
gingival recession maxilla
 sharp instrument is held at a 45 degrees angle  Buccal Flanges is made slightly concave
to the tooth surface  Lingual Flange is made slightly concave
2. Placement of triangular markings Lingual Festooning
* guide to the length and position of the root  It restores part of the lingual surface of the tooth
Indications that is not supplied in the artificial teeth
 It reduces anterior palatal bulk
* Maxillary denture
 It improves phonetics
Canine – longest  It gives this region a natural feel

Lateral incisors – shortest Errors in Waxing & Festooning

centrals incisors – in between  make the interdental papilla nonexistent or

too small
* Mandibular denture
– provide space for food impaction and
Canine – longest
makes denture difficult to polish
Central incisors –shortest
 place grooves on the denture base between
Lateral incisors – in between each tooth
 Excessive heating

- can cause movement of teeth & loss of carved

detail
  Overwaxing

- can cause excessive trimming of processed

denture, causing warpage

 Underwaxing

- can cause dimensional change during curing

- leaves inadequate material for finishing &

polishing

- make denture weak and prone to fracture

Significance of the Trial Denture

 Psychological benefit
 Evaluation of retention, stability and support
 Evaluation and verification of centric relation &
occlusion
 Evaluation and verification of facial esthetics
 Evaluation and verification of teeth arrangement
and esthetics
 Evaluation and verification of denture base
contour
 To complete the posterior palatal seal

Trial Fitting Procedures

1. Outside the mouth - wax denture should be correctly

contoured and extended into the sulci

2. Singly in the mouth - there should be correct

extension of the bases and stability should be
satisfactory

3. Together in the mouth

check the following:

a. Vertical dimension (check freeway space,

phonetics)

b. Occlusion (maximum intercuspation

c. Esthetics (correct lip support, proper amount

of show)

4. Patient’s opinion DENTURE PROCESSING

- the patient is asked to look at the teeth in a  The procedure that involves replacing the trial
hand mirror and asked for comments base and the waxed portion with the final
denture material
- any necessary alterations may be carried out
Denture Base Materials
- a further appointment for a retry may be
required  Heat cured acrylic resin
 Autopolymerizing resin
 Light cured resin
  Polystyrene and vinyl resin
 Type IV gold alloys
 Base metal alloys
Methods of Packing Acrylic Resin
 Split-flask loading
 Injection loading
PROCEDURES IN DENTURE PROCESSING
(SPLIT FLASK METHOD)
1, Sealing the cast
 Once waxing and festooning is complete, the
denture is sealed to the cast at its border with
molten wax
Purposes:
 This prevents plaster from getting under the
denture
 Also, maintains the position of the denture on
the cast
2. Separating the Cast
 Cast is separated from the plaster mounting on
the articulator by sharp taps of a mallet or a
knife placed at its junction
Purpose:
 For laboratory remounting
3. Flasking or Investing
 the process by which the trial denture is
surrounded in stone or plaster in a metal flask
 Techniques: 3 pour, 4 pour, 2 pour
Purpose:
 to create a mold which forms the acrylic into
the shape of the final denture
4. Wax Elimination (Dewaxing)
 Secured flask placed in boiling water for 5 to 10
minutes
 Wax and temporary denture base are discarded
 Mold is flash with clean boiling water
(detergent maybe added)
Purpose:
 to create a mold space
5. Trial Packing Of Acrylic Resin
 Separating media applied to stone surfaces of the
mold
 Acrylic resin is mixed and container covered to
prevent monomer evaporation until the dough
stage, 3:1 by volume or 2:1 by weight
 Acrylic dough is formed into a roll and adapted
into the mold space
 Plastic separating sheet place over the dough and
the halves of the flask and close slowly with
pressure
 Flask separated, plastic sheet removed & excess
acrylic (flash) trimmed off with a blunt
instrument
 Repeat until no flash is formed
 In final closure, plastic sheet is removed
Purpose:
 Acrylic dough is formed and adapted to the
mold space
6. Bench Curing
 Secured flask with acrylic placed aside for 30
minutes
Purposes:
 Permits equalization of pressure throughout the
mold
 For a more uniform dispersion of monomer
throughout the mass of dough
 Produces a better bond with plastic teeth
7. Curing
 Acrylic resin is cured through the process call
polymerization
Purpose:
 uncured acrylic converted to its final; usable
form
2 methods
 Short curing cycle
- Flask kept in water at room
temp & temp is raised to 74oC
(165oF) for 2 hours and boil for
1 hour
 Long curing cycle
 Water temp is maintained at 74oC for 8 hours
 Less risk of porosity
 Less residual monomer content
 Indicated for thick acrylic appliance
8. Cooling
 Flask is removed from the curing chamber and  Final gloss is obtained with high shine
allowed to cool (bench cooling) materials

Slow Cooling Denture Delivery

8. Flask is opened only after it has cooled
sufficiently, some laboratories leave it cool
overnight in the water in which it was processed
Faster Cooling
9. Allow flask to bench cool for 30 minutes then
place it under running tap water for 30 minutes
Purpose:
10. prevent distortion
 However carefully dentures are made, minor
modifications are frequently necessary at this
stage
Procedures
 Check the dentures before insertion
 Insert the upper denture
 Insert the lower denture
 Check both dentures together in the mouth
 Give advise to the patient
Checks before Denture Insertion

9. Deflasking 1. Fitting surface

11. The denture is retrieve from the flask  look and feel for pimples of acrylic resin
12. 2 halves of flask are separated by inserting a  remove if necessary
strong wedge between the halves
13. This permits the stone mold to be retrieved 2. Polished surface
intact
14. The 3 pour technique facilitates easy separation  check for roughness
of the 3 layers
3. Periphery
15. Care should be taken to prevent the separation of
the denture from the cast  should be rounded except in posterior border of
the upper denture
10. Remounting & Selective Grinding
4. Occlusion
 The casts are repositioned back on their plaster
mounts in the articulator using the index grooves  place dentures together by hand in maximum
on the base of the cast as guide intercuspation
 Processing can cause errors in occlusion causing  occlusal surfaces contact each other evenly
the incisal pin failing to contact the incisal table  this may reveal large error in occlusion
 Selective grinding is done until the pin touches
the incisal table Inserting the Upper Denture
11. Finishing and Polishing Check the following:
 Finishing 1. Retention
– Excess flash is trimmed off  check sulcus extension or width, check post dam
usingmounted wheel, bur or arbor band
2. Stability
– Any plaster adhering to the denture is
removed  check for denture mobility, apply finger pressure
to the alternate sides of the arch
 Polishing
3. Undercuts
– Denture are finished to a high polish
making the denture more hygienic  may aid in retention without pain if mucosa is
thick, if thin relieve to seat the denture without
– Wet rag wheel and pumice slurry are pain
used
4. Esthetics
  appearance should be satisfactory
Inserting the Lower Denture
1. Retention
 hardly ever possible to obtain good retention
with a complete lower denture
 Denture care (prevent fracture, drying, &
cleaning using hot water)
 Maintaining tissue health (remove denture,
tissue massage)
 Denture hygiene (manual or chemical cleaning)
 Post insertion check up (1st 24 hour recall,
periodic check up & recall)

2. Stability

 aided by the muscle balance where the lips,

cheeks and tongue do not act to displace the
denture during function

3. Extension

 posterior border should cover at least one-third

of the retromolar pad

4. Undercuts

 less likely on a lower denture

5. Esthetics

 appearance should be satisfactory

Both Dentures Together In the Mouth

1. Occlusion

 centric relation should coincide with centric

occlusion
 good balance in the lateral and protrusive
excursion
 occlusion may be recorded using articulating
paper
 there should be even distribution of marks
around the arch, if not grind the fossae until
there is even contact

2. Vertical Dimension

 only the Buccal Upper Lower Lingual cusps

(BULL rule) should be adjusted to maintain the
vertical dimension except in cases of cross-bite
 though sometimes grinding the forbidden cusps
is unavoidable (premature contact in balancing
lateral excursion)

3. Esthetics

 appearance should be satisfactory

Patient’s Instructions

 Eating with new denture (Cut food into small

pieces, bite on the premolar area, chew
bilaterally, avoid sticky food)