Selection of artificial teeth

2nd year

Lec 10 Dr. Mohanad Jameel

Denture teeth are artificial substitute for the coronal portions of the missing teeth.
Anterior teeth are primarily selected to satisfy esthetic requirements
Posterior teeth are primarily selected to satisfy masticatory requirements / occlusion

Objectives:
1. Aesthetic
2. Masticatory function
3. Correction of speech defect
4. Preservation of the remaining tissue and muscle tone
 Selection of anterior teeth

I. Selection of teeth with a pre-extraction records

Extracted teeth, photos, diagnostic casts, old x-rays, existing or previous dentures.

II. Selection of teeth without a pre-extraction records:

Sequence of Anterior Tooth Selection: 1. Size 2. Form 3. Shade

Size of anterior teeth:

The following anatomic entities are used as guides to select anterior teeth for size.
Width
1. Size of the face:
the average width of the maxillary central incisor is estimated to be one sixteenth of the width of
the face measured between the zygoma.
The combined width of the six maxillary anteriors is slightly less than one third of the
bizygomatic breadth of the face.

Bi-zygomatic width
The trubyte tooth indicator is useful in determining the maxillary central incisors size.

Trubyte tooth indicator

2. Size of the maxillay arch:

Three points are marked, one on the crest of the incisive papilla and one on each hamular notches.
Three points joined together to form a triangle. Each side of the triangle is measured and
combined to get a total value. The total value obtained equals the total width of all the maxillary
anterior and posterior teeth.
3. Incisal papilla & canine eminencies or the buccal frenum:
Measure the distance from the distal of one canine eminence to the distal of the other with a
flexible ruler, the combined width of the six maxillary anterior teeth is determined in millimeters.

4. Maxillomandibular relations:
Any disproportion in size between upper & lower arches influences the length, width & position
of the teeth.
1. In class I- normal relationship, the teeth in one arch are compatible with the teeth in the other
arch.
2. In class II- the mandible is retruded and the mandibular teeth are frequently smaller
3. In class III- the mandibular teeth are frequently larger than normal
5. Ala of the nose:
is used as a point to determine the width of the six anterior teeth, Since they thought that the root
of the canine is with the ala of the nose.
6. Corner of the mouth
Make the marks on maxillary occlusal rims corresponding to corners of mouth during rest
position.
These marks represent approximately the distal proximal surface of the canine.
The distance between these two points along the contour of occlusal rims gives the total width of
maxillary anterior teeth.
Length
1. 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 accepted to use teeth long enough to eliminate the display
of the denture base.

2. The lips:
when the lips are relaxed & apart, the labial surface of upper anterior teeth support upper lip & the
incisal edge extends slightly below the lip margin, this represent the level of the low lip line.
Level of the high lip line established by asking the patient to smile broadly. The distance between
high & low lip line will determine the length of the incisor teeth.
Form of anterior teeth
1. Form & contour of the face:
The general outline of the tooth should conform with the general outline of the face when viewed
from labial aspect. A tooth viewed from the mesial or distal should conform to the profile of the
face.
The geometric figures, square, tapering or ovoid & combinations therefore serve as a starting
point in selecting the tooth form as it is viewed from frontal aspect by using of the tooth indicator.
The labial surface of the artificial tooth as viewed from the proximal aspect should be harmonious
with the profile of the face which is either straight, concave or convex.
2. Form of the arch:
There is a relationship between the shape of the upper arch and the upper central incisor form:
 Square shaped arch has incisors with parallel sides
 V shaped arch has incisors narrow at the neck
 Rounded arch has incisor rounded in shape
3. Sex:
curved facial features are associated with femininity while square features are
associated with masculinity. The teeth of females are more ovoid or tapering than
square.

4. Age:
as the features change with the aging processes, so does the form of the teeth. the
lips lose their curves & the teeth wear at the incisal edges & interproximal surfaces,
the labial surfaces seem flatter & the outline form appears squarer. The female teeth
lose their curves and the male teeth become more square.
Color & shade of anterior teeth
teeth shade may be selected according to:
1. Age: teeth color becomes darker with age because of the death of the teeth pulp, attrition &
wear of teeth.
2. Gender: the teeth of women are less dark than those of the men.

3. Skin color: harmony should exist between the teeth color & the color of the skin, hair & eyes.
Light teeth for blond, light skin and blue eyes, while dark teeth usually for dark skin and black
eyes.
Many points put in our mind when we do selection of teeth, these are:
The position of the patient and the source of light are very important.
The shade should be selected in natural light or a proper situation.
The patient should be in upright position.
The teeth should be observed from different angles to make certain that the shadows do not
influence the color.
The eyes should not be focused on a tooth more than a few seconds.
Select two or three of the most suitable shades for the patient from the shade guide of the teeth
to be used.
Consult with the patient.
The large hand mirror will aid the patient in the determination.
 Selection of posterior teeth:
Size and number of posterior teeth
Posterior teeth must support cheeks & tongue & function in harmony with the musculature in
swallowing & speaking as well as in mastication. It is desirable to have the buccolingual
dimension of artificial posterior teeth less than that of the natural teeth to reduce the size of the
food table, the anteroposterior dimension of posterior teeth is determined between distal surface of
canines & anterior border of the maxillary tuberosity in upper arch & that of retromolar pad in
lower arch.
In case of sever residual ridge resorption, smaller teeth or even fewer in number can be used .
Length of posterior teeth is governed by inter-arch distance .
Form of posterior teeth:
The occlusal form will be decided by the type of occlusion to be developed.
Cusp form or anatomical posterior teeth : anatomic& semi-anatomic denture teeth differ
mainly in the degree of cuspal inclination with the horizontal plane. These teeth are used with
balanced occlusion.
Non cusp form or monoplane or non-anatomic posterior teeth:
They lack cuspal inclination like flat teeth or zero degree teeth, used for reducing horizontal
forces of occlusion like in patients with resorbed & flabby ridges, patient with poor
neuromuscular control, anxious & nervous patients who brux or clench, patient with skeletal class
II or class III or cross bite .
these teeth are used with neutrocentric occlusion.
Shade of posterior teeth:
Its shade should harmonize with shade of anterior teeth.
Upper premolars are sometimes used more for esthetic than for functional purposes so it is
advisable to select a slightly lighter shade for the premolars than the other posterior teeth but not
lighter than anterior teeth.

Composition of artificial teeth:

Porcelain material: porcelain teeth are hard to abrade & will retain their finish & color. It is
attached to the denture base mechanically by pins so it can’t be used in case of insufficient
interarch distance.
Plastic (acrylic) materials: acrylic teeth are not as hard as porcelain & can be abraded more
easily. It is attached to the denture base chemically so it can be grinded during selective grinding.