ARRANGEMENT OF ARTIFICIAL TEETH

Aims of Arrangement
1. 2. 3. 4. 5. Preservation of alveolar bone Esthetics Masticatory efficiency Retention and stability during function Health and comfort of the TMJ

Factors Affecting Position of Teeth

1. Esthetics

Lip support Tooth visibility Buccal corridor

Speech and mastication

2. Function
3. Stability
Neutral zone

Guides to Positioning Anterior Teeth

Payne stated, Set the teeth where they grew.

However, patient may not want the original tooth position and arrangement an esthetically correct position may be functionally unstable

Preextraction Guide
Photographs Cast

Postextraction Guides
Anteroposterior position Supeoinferior position
Visibility of upper incisors

Mediolateral position
- Midline of face - Ala of nose

Inclination or slant

Anteroposterior Position
Distance from the incisive papilla
8-10mm

Relation to the residual ridge

Anterior to the ridge

Fullness of lips (esthetics as guide) Phonetics as guide

Phonetics
Labial sounds Labiodental sounds Dental and alveolar sounds Palatal and velar sounds

Labial Sounds
b, p, m Insufficient lip support can cause these sounds to be defective

Labiodental Sounds
f, v If the upper anterior teeth are too short, the v sound will be more like an f If they are too long, the f will sound more like av

Dental Sounds
th Tip of tongue extends slightly between the upper and lower teeth About 3mm of the tongue should be visible

Alveolar Sounds
t, d, n, s, z Contact between the tip of the tongue and the alveolus or the lingual side of the anterior teeth If teeth are too lingual, t will sound like d If too anterior, d will sound like t

Sibilants
S, z, sh, zh, ch, and j Upper and lower teeth should approach but not touch

Inclination of the anterior teeth.

Relationship to the labial plate
The roots of anterior teeth are parallel to and close to the labial surface of the bone. The cervical third of teeth appear to be continuous with the labial plate of bone.

Relationship to the facial profile

Teeth are inclined parallel to the lower third of the face.

Relationship to the labial plate

Relationship to the facial profile

Arrangement of Posterior Teeth

Guides to Positioning Posterior Teeth

Both upper and lower posterior teeth are centered over the crest of the ridge whenever possible. This improves the balance and stability of the denture.

Guides to Positioning Posterior Teeth

Dont place teeth too far buccally as it can cause: 1. Cheek biting 2. Denture instability 3. Esthetic problems

Guides to Positioning Posterior Teeth

Placing the teeth too lingually can cause: 1. Crowding of the tongue 2. Tongue biting 3. Imbalance due to tongue function

Approaches to Posterior Setting

1. Setting all the maxillary teeth first 2. Setting all the mandibular teeth first 3. Setting the mandibular teeth before the corresponding maxillary teeth

Maxillary should not be placed over the maxillary tuberosity as it can cause lever imbalance.

Mandibular teeth should not be placed over the retromolar pad or on the slope as it can result in denture sliding and instability.

Occlusal Schemes in CD
A. B. C. D. Balanced Occlusion Non-balanced Occlusion Lingualized Occlusion Functionally generated occlusal scheme

Christensens Phenomenon
Separation of the posterior teeth caused by the downward movement of the condyle during mandibular protrusion and lateral movement (balancing side)

Balanced Occlusion
Bilateral, simultaneous, anterior and posterior occlusal contact of teeth in centric and eccentric positions

Balanced Occlusion
Ideal occlusal scheme for CD Achieved by incorporating compensating curves into the posterior setting

Compensating Curves
are artificial curves introduced into the CD occlusion in order to achieve a balanced occlusion

Compensating Curves
Curve of Spee - an anteroposterior curve along the cusp tips and incisal edges of teeth Curve of Wilson - a mediolateral or side-to-side curve contacting the cusp tips of posterior teeth

Advantages of Balanced Occlusion

1. Improves stability and retention of the denture bases 2. Reduces soreness and resorption caused by the denture base movement 3. More comfortable to the px

Non-balanced Occlusion
No attempt is made to create balanced occlusion. Creating multiple uniform contact in centric relation was sufficient

Lingualized Occlusion
Forces are directed towards the lingual side It was claimed that this improved the stability of the lower denture