Complete Denture Dent 482.01 and

1
Setting Anatomic Teeth
2
The anterior teeth should not be positioned any
further forward than the depth of the labial
vestibule, determined by a line drawn from the
depth of the vestibule and perpendicular to a
line drawn parallel to the occlusal plane. The
depth of the vestibule is the fulcrum point and
the further forward a tooth extends beyond this
point, the greater are the forces that tend to
dislodge the denture.
3

The middle of the depth of the vestibule should
be recorded on the maxillary mandibular casts.
The middle of the crest of the mandibular ridge
should also be recorded. These are marked on the
land areas because the baseplate will cover the
marks on the ridge or in the vestibules.
4

Next, mark the midline of the patients face by
placing a dot on the incisive papilla and marking
this midline on the maxillary anterior land area,
extending down the front of the cast. The
incisive papilla is a much more reliable landmark
for the midline than the labial frenum.
5

Make a cut with a heated, sharp knife, at the
midline in the anterior wax rim. Cut all the way
to the baseplate. Make a similar cut just distal
to the canine point. Remove this section of wax
in its entirety. Reduce the anterior ridge of the
maxillary baseplate to provide a little extra
space for the tooth, but reduce the tooth if
necessary to fit properly.
6

Use a flat plate resting flush with the
occlusion rim to position the central incisor so
that it contacts the occlusal plane.
Set the rest of the anterior teeth on the right
side according to the curve defined by the
plastic ruler. The labioincisal line angle of
the incisors should touch the ruler, as well as
the midbuccal surface of the canine.
7
Use a flexible plastic ruler to verify that the
incisal portion of the tooths labial surface is
properly located and in contact with the anterior
curvature of the occlusion rim.
8

An anterior view of the maxillary anterior
teeth shows that only the lateral incisors do not
touch the occlusal plane as recorded by
mandibular wax rim. With the maxillary anterior
teeth set, record the patients midline and set
the mandibular anterior teeth.
9
The maxillary cast is placed back on the
articulator. A quick look will show that the
maxillary teeth are set on the same plane that
the mandibular occlusion rim occupies, showing
the value of having the maxillary and mandibular
rims made in intimate contact. If the maxillary
teeth are not on the same plane as the lower rim,
they must be reset.
10

Mark the midline of the mandibular ridge on the
mandibular wax rim and cut out a section
representing the right mandibular anterior teeth
from the rim. Reduce the thickness of the Triad
baseplate from the middle of the ridge to the
labial to allow for easier setting of the
mandibular anterior teeth. A central incisor
placed in this space shows that considerable
reduction must be made on the cervico-lingual
ridgelap surface before the tooth can be set in
position.
11
Mark the midline of the mandibular ridge on the
mandibular wax rim and cut out a section
representing the right mandibular anterior teeth
from the rim. Reduce the thickness of the Triad
baseplate from the middle of the ridge to the
labial to allow for easier setting of the
mandibular anterior teeth. A central incisor
placed in this space shows that considerable
reduction must be made on the cervico-lingual
ridgelap surface before the tooth can be set in
position.
12
Remove enough wax to allow setting most of the
posterior teeth and thin the baseplate to allow
for their positioning. Leave a small segment of
the wax rim intact and clearly mark the midline
to facilitate the setting of the teeth anterior
to it. After these teeth are set, remove this
pillar to allow the last tooth to be set, and
those teeth anterior to it will indicate the
center of the ridge.
13
Check the position of the teeth to the center
of the ridge with a tongue blade used as a
straight edge. Once it is verified by your lab
bench instructor that this relationship is
correct, you may begin setting the teeth on the
other side, using the same steps for setting,
sequencing, and verification that were used on
the other side.
14
With all the mandibular teeth set, check the
occlusal plane with a flat metal plate to verify
that all the teeth contact the flat surface
evenly. Expect some changes because of the
shrinkage of the wax, which will shift the teeth
slightly. Correct any discrepancies before
moving on to setting the maxillary posterior
teeth.
15
With all the mandibular teeth set, check to see
that all the teeth contact the flat surface of
the maxillary wax rim evenly. If these teeth
contact the wax rim evenly, begin setting the
maxillary posterior teeth.
16
Remove the wax on one side of the maxillary
baseplate. A quick look will verify that the
maxillary posterior teeth should have plenty of
space to be set with little or no reduction. The
rim is left intact on the opposite side because
this will help you to maintain the location of
the occlusal plane.
17
Set the teeth on the maxillary right side so
that the mesiolingual cusp of the maxillary first
molar rests in the central fossa of the
mandibular first molar. Set the teeth so that the
buccal surfaces of the premolar(s) and mesial
cusp of the first molar line up with the
mid-buccal surface of the canine. The distobuccal
cusp of the first molar should deviate
approximately 20o from this plane and the second
molar will fall along this plane.
18
If a maxillary second molar were set, the buccal
cusps should line up with a second plane that is
determined by the buccal surfaces of the
maxillary first molar. In this case, there was
not room enough to do so, because the opposing
mandibular tooth would have to be set on the
incline of the retromolar pad.
19
Set the teeth on the maxillary right side so
that the mesiolingual cusp of the maxillary first
molar rests in the central fossa of the
mandibular first molar. Then move it up so that
the distobuccal cusp is ½ mm off the flat plane.
If there were room to set a maxillary second
molar, its mesiobuccal cusp would be 1 mm off the
flat plane and its distobuccal cusp would be 1½
mm off the flat plane.
20
Adjust the occlusal surfaces of all posterior
teeth to contact their opposing counterparts
properly. Note There is no vertical overlap of
the anterior teeth at this time. With the
anatomical maxillary posterior teeth properly
positioned and having established a compensating
curve and in harmonious centric occlusion with
the anatomical mandibular posterior teeth, the
mandibular anterior teeth are moved up to a point
where the mandibular incisors contact the
maxillary central incisors in protrusive and
simultaneously with posterior teeth.

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The mandibular molars are now adjusted so that
they contact the maxillary molars in their new
positions. The teeth are designed to fit
together with the mandibular teeth to the outside
of a curve. If they are set flat, there will be
spaces between the maxillary molars. There should
be a definite mediolateral component (Curve of
Wilson in natural teeth) visible when looking
from the back of the articulator ?.
22
The occlusal rims contoured to hold the lips in
proper position.
The teeth properly set in the wax to maintain
desired labial fullness.
The teeth set too far labially giving the lips a
pouched outappearance.
The teeth set too far lingually giving the lips a
dished in appearance.
23
B
C
A
Maximum horizontal overlap is shown in
illustration B. If teeth are set as in A the
mandibular denture would be very unstable during
function. When vertical overlap is desired, the
guide table must be set to record the anterior
guidance.
24
The position of the natural central incisors
and their relationship to the ridge.
25
A ridge immediately after the removal of the
tooth. Red dotted line indicates the position of
the natural root.
26
The direction of resorption in the maxillary
anterior ridge is up and back. The solid line
identifies the resorbed ridge. The red dotted
line identifies the original contour of the ridge.
27
One of the most common errors in tooth
positioning is positioning the teeth over the
ridge without considering the original position
of the natural teeth.
28
The denture with teeth set over the ridge is
superimposed over the original position of the
natural teeth. The loss of vertical dimension
and lip support, and the inevitable resulting
loss in aesthetics, is readily apparent.
29
The anterior teeth should not be positioned any
further forward than the depth of the labial
vestibule, determined by a line drawn from the
depth of the vestibule and perpendicular to a
line drawn parallel to the occlusal plane. The
depth of the vestibule is the fulcrum point and
the further forward a tooth extends beyond this
point, the greater are the forces that tend to
dislodge the denture.
30
Force increases with distance from the fulcrum.
If the teeth are inclined anteriorly to
compensate for a Class II relationship, a load
placed anterior to the middle of the anterior
vestibule will have the same destabilizing effect
on the lower denture as the man on a seesaw.
31
HANAUS QUINT

• Hanau described five factors (Hanaus Quint)
  that affect occlusal balance
• Condylar Inclination We dont change.
• Incisal Guidance Not with dentures
• Occlusal Plane Inclination Start with
  establishing plane parallel with Ala-Tragus line.
• Cuspal Inclination 0o, 10o, 20o, 30o, 33o
• Compensating Curve Set teeth (curve of Spee,
  curve of Wilson).

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HANAUS QUINT
Condylar Inclination
Compensating Curve
Incisal Guidance Not in dentures.
Cuspal Inclination
Occlusal Plane Inclination
Cuspal inclination Occlusal Plane
Inclination Condylar inclination
Compensating Curve
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Tooth Alignment

• Centrals
• Laterals
• Canines

37
Maxillary Anterior Teeth
The axial inclination of maxillary anterior
teeth in the basic arrangement. When viewed
facially, all the anterior teeth are tilted
mesially, with the lateral incisor inclined the
most and raised about 1-2 mm above the plane.
38
Maxillary Anterior Teeth
Cuspid
Lateral
Central
When viewed laterally, the incisors are
depressed at the cervical, with the lateral
incisor being the most depressed, and the canine
being straight with the long axis perpendicular
to the occlusal plane.
39
Mandibular Anterior Teeth
The axial inclination of mandibular anterior
teeth in the basic arrangement. When viewed
facially, all the anterior teeth except the
central incisors are tilted mesially, with the
canine inclined the most.
40
Mandibular Anterior Teeth
Central
Lateral
Cuspid
When viewed laterally, the mandibular central
incisors are depressed at the cervical, the
lateral incisor is straight, and the canine is
inclined lingual to the long axis.
41
Antero-posterior positioning of anterior teeth
give support to the lips, cheeks, and other
tissues of the oral cavity. The replacement
of artificial teeth in the original position of
the natural teeth frequently is not stressed or
simply overlooked and resorbed residual ridges
are used as the primary control of tooth
position. A resorbed residual ridge
because of what may be extreme changes in shape
and size is a questionable landmark for either
functional or esthetic tooth position.
42
Three different approaches to providing a
denture on the same patient. Note
the differences in the setting of the teeth and
the festooning. The same mold of teeth was used
in each case.
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Questions?
Questions?
Questions?