SELECTION OF TEETH &

ARRANGEMENT OF TEETH
Praveen V Badwaik
 SELECTION OF TEETH
 Requires knowledge of no. of physical & biological
factors

 Goals of this phase is construct CD that

1, function well
2, allow the patient to speak normally
3, are esthetically pleasing
4, will not abuse the tissues

Comes with experience & confidence

 Anterior Teeth Selection
Based on theories

Tooth shape relates to head shape

(William’s method) &
Tooth appearance is influenced by
Patient’s Sex, Personality & Age [SPA]
(Dentogenics – Frush & Fisher)

1. Listen to the patient

2. Get records of existing & previous teeth
3. Proper light facility in clinics (hand mirror of about 6 inches)
4. Select colour by Method of Pair comparison
5. Select size by Method of Pair comparison
6. Select the Mold of teeth
Shade & Mold guides assist in
tooth selection
Photocopy of Original Photo
for selection of teeth
 Patient’s Childhood photo & Daughters
diagnostic cast & Shade was taken into account
Mold Selection
 Select the Colour
by Method of Pair Comparison
Select Tooth Size
Confirm the acceptability of selected teeth
at impression (early) appointment
 Tapered arch form &
illusion of prominent right central incisor
 Tooth Factors
Position, Colour
Size, Form

Male Characteristics

 Larger Teeth
 Square shapes
 Depressed and irregular
positioning
 Rugged anatomy
Female Characteristics

 Smaller teeth
 Rounder shapes
 Rounder and pronounced
positioning
 Softer labial anatomy
AGE
 Older the patient, darker the natural teeth

 Dark, swarthy complexions – darker teeth

 Blonde hair, pale skins – lighter teeth
 Spacing and staining
 Irregular incisal edges
Shape and Size
 Shape of upper anterior teeth compliment shape of patient’s
face

 3 shapes: square, ovoid, tapering

 Width of anterior teeth:

width of upper philtrum similar to width of central incisor

 Length of tooth:
height of recording rim
 Types of Teeth

Acrylic teeth Porcelain teeth

 Chemical retention  Mechanical retention
 Wear easily  Expensive
 Most common  Used when ridge shape is
 May adapt to long term good
changes in occlusal  Need adequate interridge
relationships space
 Absorb force  Difficult to adjust
 Brittle with tendency to
chip and fracture
Types of Teeth

Acrylic Teeth

Porcelain
Teeth
Posterior teeth
 Function more important that aesthetics
 Occlusal form of teeth important

 Choice between different occlusal forms purely driven by

clinician
Occlusal Form
Anatomical teeth
 Approximate to natural tooth
form
 Cusp inclines vary from
relatively steep to narrow
 Can achieve fixed centric
occlusion (ICP)
 Produce balanced occlusion
over full range of mandibular
movements
 Produce lateral forces in
eccentric occlusal contacts
Non-anatomical teeth
 Approximate to form of
human teeth
 Occlusal surface modified,
usually flat occlusal surface
with variation in depth of
inverted cusp
 Variable centric occlusion
 Balanced occlusion only
obtained over small range of
movement
 Do not produce lateral forces
 Cont’d
Anatomical teeth
 Errors in articulation very
difficult
 Difficult to adapt to class II &
class III jaw relationship
 Aesthetics good
 Lab stages difficult
 Penetrate food more easily
thus good masticatory
efficiency
Non-anatomical teeth
 Errors easily discernible
 Easy to adapt to class II &
class III jaw relationships
 Aesthetics not good
 Lab setup much easier
 Masticatory efficiency can
be compromised
Mold
 Pre-extraction records of patients
 Characteristics in arrangement of natural teeth e.g.
Diastema

Characterization by grinding
Characterization by grinding
Characterization with restorations & wear
 Characterization by natural arrangement
Small maxillary
teeth

Subtle variations
Better lip support & in angle &
visibility rotations
 Indications of anteroposterior
positioning of teeth

By measurement

By visualization of
roots Transverse line between
canine & incisive fossa
Incisive papilla used to locate
Midline of dental arch
Anterior teeth arrangement
Anterior teeth arrangement
 Low Incisal guide angle
is both esthetic & functional
 Posterior teeth selection
The tooth size, or mold, is generally dictated by the size of the
edentulous space, however, following guidelines may be followed,
Buccolingual Width: narrow (to develop correct form of polished
surfaces)
Mesiodistal Length: Distance from the distal surface of the natural
Canine to the upward incline of the ramus or mesial aspect of
maxillary tuberosity.
Vertical height of facial surfaces: esthetics
 Arrangement
of the posterior teeth
 Orientation of the occlusal plane:
* Anteriorly: according to esthetics
(usually 1-2 mm below the resting upper lip).

* Posteriorly: according to the junction between middle

and the distal third of the retromolar pad
 Mandibular teeth positioning

Too far Too far

buccally linguall Corrected position
y

Reduced Stability
 Occlusal Concepts for CD
 1 Bilateral balance
 2 Monoplane / Nonanatomical
 3 Lingualized articulations
Bilateral balance Monoplane Lingualized
Anatomical molds Nonanatomical Combination:
/ Cuspless teeth upper anatomical & lower
nonanatomical
Nonanatomical teeth with Myerson Lingualized
OCCLUSA compensating curves Integration (MLI) molds
L
Controlled contact (CC)-
SCHEMES
uncertainty exists in CR
Maximum contact (MC)- CR
easily repeated
Guidances used in buccolingual &
anteroposterior positioning
 Retromolar pad
as guide for arrangement
Anteroposterior compensating curve &
Mediolateral curve
molar
 Occlusal modifications &
the Selective reshaping process

 Establishing maximum intercuspation

 Adjusting the working & balancing contacts
 Adjusting the protrusive contacts
LINGUALIZED OCCLUSION
Right working movement
Non-working side
Protrusive movement
Summary
1. Listen to the patient
2. Get records of existing & previous teeth
3. Proper light facility in clinics (hand mirror of about 6
inches)
4. Select colour by Method of Pair comparison
5. Select size by Method of Pair comparison
6. Select the Mold of teeth