ANTERIOR TOOTH SELECTION

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ANTERIOR TOOTH SELECTION
dr shabeel pn
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SIZE OF THE TEETH

• Selection of the size and the teeth is a problem
  in three dimension .
• First we have to consider whether to use
  porcelain or acrylic teeth.

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SIZE OF THE FACE

• The average width of the maxillary central
  incisor is estimated to be one sixteenth of the
  face measured between the zygoma.
• The size of the maxillary central incisor is
  important for they are the most prominent teeth
  in arch as individual is viewed from frontal
  position.
• the tribute tooth indicator is useful in
  determining the maxillary central incisor.

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SIZE OF THE MAXILLARY ARCH

• The mold selector can be used to make measurement
  of the maxillary cast.
• Accurately contoured occlusion rims are required
• The mold selector is used in the selection of
  anterior teeth .The measurments are made from the
  midline on the maxillary occlusion rim to the
  distal of the cuspid eminence
• Measure the distance from the distal of one
  cuspid eminence to the distal of the other with a
  flexible.

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MAXILLARY MANDIBULAR RELATION

• Any disproption in size between thr maxillary and
  mandibular arches influence the length, width,
  and the position of the teeth.
• In instances of protruded mandible, the
  mandibular anterior teeth are frequently larger
  than normal. If the mandible are retruded the
  mandibular anterior teeth are frequently smaller.
  

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INCISAL PAPPILAE THE CUSPID EMINENCE OR THE
BUCCAL FRENUM

• If the cuspid eminence are visible, a line can be
  placed on the cast at the distal termination of
  the eminence.
• If the cuspid eminence are not visible the
  attachment of the buccal frenum can be used. A
  line placed slightly anterior to the frenum
  attachment will be distal of the eminence.
• Measure the distance from the distal of one
  cuspid eminence to the distal of the other with a
  flexible.

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CONTOUR OF THE RESIDUAL RIDGE

• The artificial teeth should be placed to follow
  the contour of the residual ridges that existed
  when the natural teeth were present.
• The loss of contour as a result of resorption,
  accident or surgery makes this a difficult task.

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THE VERTICAL DISTANCE BETWEEN THE RIDGES

• The length of the teeth is determined by the
  available space between the existing ridges.
• When the space is available, it is more
  esthetically acceptable to use a tooth long
  enough to eliminate the display of the denture
  base

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THE LIP

• When the lips are relaxed and apart the labial
  surface of the maxillary anterior teeth support
  the upper lip.
• The incisal edge extends inferior to or slightly
  below the lip margin.

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Length

• The length of the upper six anterior teeth is
  normally such that the neck of the teeth will
  overlap the anterior ridge by 2-3mm
• Cervically up the incisive edges of the centrals
  will show below the relaxed lip.

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HARMONY

• The face length is taken from supra orbital ridge
  line to inferior border of the chin.
• Breadth is the distance between the zygomatic
  process
• The length is greater than width would indicate
  teeth of htose proportions, irrespective of their
  shape.

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BERRYS BIOMETRIC INDEX

• Used to derive the length of central incisor
  using zygomatic width or the length of the face.
• Width of the maxillary central incisorzygomatic
  width/ 16
  length of the face/20

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POUNDERS FORMULA

• To determine the length and width of central
  incisor using the zygomatic width and length of
  face respectively.

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WIDTH

• Most satisfactory way of selecting teeth width
• Choose a set which are wide enough to allow the
  canines to be mounted on the canine eminence when
  set up.

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GOLDEN PREPORTION

• G.P for each patient is measured as follows
• The width of the central incisor was multiplied
  by 62 and compared with the width of central
  incisor is in G.P to the width of lateral
  incisor.
• In comparing with the width of lateral incisor
  multiplied by 62 with the width of adjacent
  canine it can be determined if the width of
  lateral incisor is in golden proportion to the
  width of canine.

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PHYSIOLOGICAL

• The facial musculature contributes to esthetics
  of the patient
• Increasing the thickness of the denture base in
  the labial and the buccal sulci can produce a
  puffy appearance.

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PSYCHOLOGICAL

• A patient with a ve self evaluation shows a
  broad smile up the one width a negative self
  evaluation shows a tight lipped small smile
• The campers line the psychological plane of
  orientation

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BIOMECHANICAL

• The teeth should be placed such that they fulfil
  the biomechanics of the denture.
• The teeth should be set in the neutral zone.

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COLOUR OR SHADE

• Colour is described by means of
• hue
• Chrome
• Value

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FORM OF THE ANTERIOR TEETH

• The form of the teeth should be coformed to
  contour of the face as considered from the
  labial, mesial, distal and incisal aspect
• The general outline of the tooth should conform
  to the general outline of the face when viewed
  from frontal aspect.
• Three factors are used as guides in the selection
  of anterior teeth for form.
• Sex
• The form and contour of the face
• Age

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THE FORM AND CONTOUR OF THE FACE

• According to Leon Willians classification face
• Three types
• Square
• Tapering
• Ovoid

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SEX

• Dentogenic concept sex, personality, age , are
  the factors which determine the form of anterior
  tooth