This seminar gives in detail about anterior and posterior teeth setting

2. HISTORY
 Skillfully designed dentures
were made as early as 700
BC.and
 Talmud a collection of books
of hebrews in 352-407 AD
mentioned that teeth were
made of gold ,silver,and wood.
 Egypt was the medical center
of ancient world, the first
dental prosthesis is believed
to have been constructed in
egypt about 2500 BC.
Hesi-Re Egyptian dentist of about
3000 BC
2Dr Abhilash

3. Front and back views of mandibular fixed bridge, four natural incisor
teeth and two carved ivory teeth
Bound With gold wire found in Sidon-ancient Phoenicia about fifth
and fourth century BC.
3Dr Abhilash

4. WOOD
 For years, dentures were fashioned from wood .
 Wood was chosen
-readily available
-relatively inexpensive
-can be carved to desired shape
 Disadvantages
-warped and cracked in moisture
-esthetic and hygienic challenges
-degradation in oral environment
4Dr Abhilash

5. Wooden denture believed to be carved out of box wood in
1538 by Nakoka Tei a Buddist priestess
Wooden dentures
5Dr Abhilash

6. Bone
 Bone was chosen due to its availability,
reasonable cost and carvability .
 It is reported that Fauchard fabricated dentures
by measuring individual arches with a compass
and cutting bone to fit the arches .
 It had better dimensional stability than wood,
esthetic and hygienic concerns remained.
6Dr Abhilash

7. IVORY
 Denture bases and prosthetic teeth were fashioned by carving this
material to desired shape
 Ivory was not available readily and was relatively expensive.
 Denture bases fashioned from ivory were relatively stable in the oral
environment
 They offered esthetic and hygienic advantage in comparison with
denture bases carved from wood or bone.
Carved ivory upper denture retained in the mouth by springs with
natural human teeth cut off at the
Neck and riveted at the base. 7Dr Abhilash

8.  Since ancient times the most
common material for false
teeth were animal bone or
ivory,especially from elephants
or hippopotomus.
 Human teeth were also
used,pulled from the deceased
or sold by poor people from
their own mouths.
 Waterloo dentures
 1788 A.D. Improvement and
development of porcelain
dentures by DeChemant.
G.Fonzi an italian dentist in Paris
invented the
Porcelain teeth that revolutionized the
construction
Of dentures.Picture shows partial
denture of about
1830,porcelain teeth of fonzi’s design
have been
Soldered to a gold backing.8Dr Abhilash

9. One piece porcelain upper denture crafted by Dr John
Scarborough,Lambertville,New Jersey 1868.
9Dr Abhilash

10.  In 1794 John Greenwood began to swage gold bases for
dentures. Made George Washington's dentures.
George washington’s last dental prosthesis. The palate was
swaged from a sheet of gold and ivory teeth riveted
To it.The lower denture consists of a single carved block of ivory.
The two dentures were held togther by steel
Springs.
10Dr Abhilash

11.  In 1839 an important development took place
CHARLES GOODYEAR
discovered VULCANIZATION of natural rubber with
sulphur(30%) and was patented by Hancock in england
in 1843.
 NELSON GOODYEAR (brother of charles goodyear) got
the patent for vulcanite dentures in 1864.
 . They proceeded to license dentists who used their
material, and charged a royalty for all dentures made.
Dentists who would not comply were sued.
 The Goodyear patents expired in 1881, and the
company did not again seek to license dentists or dental
products.
 Vulcanite dentures were very popular until the 1940s,
when acrylic denture bases replaced them.
11Dr Abhilash

12. A set of vulcanite dentures
worn by Gen. John J. (Blackjack)
Pershing, commander of the
American Expeditionary Forces
in France during the First World
War Set of complete dentures having
palate of swaged
Gold and porcelain teeth set in
vulcanite.
12Dr Abhilash

13.  In 1937 Dr. Walter Wright gave dentistry its very useful
resin.
 It was polymethyl methacrylate which proved to be much
satisfactory material tested until now.
Dentures made of polymethyl methacrylate
13Dr Abhilash

14. DEFINITIONS
Occlusion - It is the static relationship
between the incising or masticating surfaces of
the maxillary or mandibular teeth or tooth
analogues [ GPT 7 ]
Articulation - The static and dynamic
contact relationship between the occlusal
surfaces of the teeth during function is called
as articulation 14Dr Abhilash

15. Development of occlusion in complete
dentures differs from that present in natural
dentition due to the difference in the support
system
15Dr Abhilash

16. Differences between natural and
artificial occlusion
• Presence of periodontium in natural dentition
• Teeth act individually in natural dentition and
as a single unit on an unyielding base in a
complete denture
• Bilateral balance is deemed necessary in
artificial occlusion but not in natural dentition
16Dr Abhilash

17. • Malocclusion in natural dentition may
remain uneventful but evokes severe
response in artificial occlusion
• Non vertical forces are well tolerated in
natural dentition but traumatic in
artificial dentition
• Incising with natural teeth is uneventful
but in complete dentures affects all
teeth and the base
17Dr Abhilash

18. • In natural dentition second molar is favoured
for mastication but in a complete denture it is
the first molar and second premolar which are
favoured for mastication
• Proprioception present in natural dentition but
absent in artificial occlusion
18Dr Abhilash

19. Preliminary selection of
Artificial Teeth
 Anterior teeth – Esthetic requirement
 Posterior teeth – Masticatory functional
requirement
 Compatibility with surrounding oral environment Preliminary selection is based on:
Size
Form
Color
19Dr Abhilash

20. SIZE
Selection of Anterior teeth
 Size of the face
 Size of Maxillary arch
 Incisal papilla and the cuspid eminence
 Maxillomandibular relations
 Vertical distance between ridges
20Dr Abhilash

21. Selection of Posterior teeth
 Functional harmony with musculature
 Less buccolingual dimension
 Anteroposterior dimension
21Dr Abhilash

22. FORM
 Conform to the general outline of face
 Facial forms
Square
Square tapering
Tapering
Ovoid
 Sex
 Ageing
22Dr Abhilash

23. Form of Posterior teeth
 Occlusal surface – primary concern
 Balanced in centric and eccentric positions – cusp
form
 Disocclusion in eccentric position – Cusp or
monoplane
 Balanced in centric position only – Monoplane
Arrangement of artificial posterior teeth for functional
harmony depends on a thorough understanding of 23Dr Abhilash

24. SHADE
 Harmony with color of skin, eyes and hair
 Shade of posterior teeth should harmonize
with shade of anterior teeth
 Bulk influences the shade . . . .
24Dr Abhilash

25. Horizontal orientation of Anterior teeth
 Insufficient support of lips
 Drooping of corner of mouth
 Deepening of nasolabial groove
 Deepening of sulci
 Reduction in prominence in philtrum
 Reduction in visible part of vermilion
border
25Dr Abhilash

26.  Excessive support of lips
 Stretched appearance of lips
 Elimination of contour of lips
 Distortion of lip and sulci
 Tendency of lip to dislodge the denture
26Dr Abhilash

27.  Incisive papillae
Midline of upper
denture
27Dr Abhilash

28.  Buccolingual position of posterior teeth
Mainly determined by Neutral zone
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29. If teeth located lingually .
. .
If teeth located buccally .
. .
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30. Vertical orientation
If the upper lip is relatively long .
. .
Anterior teeth
.
Length and movement of upper
lip
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31.  Lower lip is a better guide
 Cusp tips of canine and I premolar are even
with
lower lip
- If lower anterior - above this
level
- If lower anterior
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32.  Maxillary anterior teeth are arranged according to
phonetics
32Dr Abhilash

33.  Posterior teeth
 Two basic anatomic
guide
- Orifice of Stenson’s
Duct
- Retromolar pad
 If occlusal level is too low
 If occlusal level too high
 Character of residual
ridge
33Dr Abhilash

34. Inclination of teeth
 Labial surface of bone
 Profile form of the patient
34Dr Abhilash

35. Anteroposterior
curve
Mediolateral curve
Compensatory Curves
35Dr Abhilash

36. ARRANGMENT OF TEETH
The four principal factors that govern the
positions of the teeth for complete dentures are
(1) the horizontal relations to the residual
ridges,
(2) the vertical positions of the occlusal
surfaces and incisal edges between
the residual ridges,
(3) the esthetic requirements, and
(4) the inclinations for occlusion
36Dr Abhilash

37. Dr Abhilash 37
Guidelines for horizontal
Placement of Anterior Teeth

38. Dr Abhilash 38
Role of incisive papilla & mid
palatal suture
 It is found in Lingual
embrasure b/t Maxi.C.I.
 Labial surface of maxillary
incisors is approx. 8 to 10 mm
anterior to incisive papilla.
 A transverse line bisecting the
middle of I.P. passes through
the tip of canine.

39. Dr Abhilash 39
Cuspid eminences
When cuspid eminences are visible on cast,
a line marking the distal of eminences co-
incide with distal margin of cuspids.
Relation to residual alveolar ridge
Max. Anterior teeth are placed anterior
to residual ridge, depending upon
amount of resorption.

40. Dr Abhilash 40
Arch Form And Shape
 Square arch – C.I. in line
with the canine
 Tapering arch – C.I. at a
greater distance forward
than canine
 Ovoid arch - in between

41. Dr Abhilash 41
Esthetics
 Vermilion border of upper lip.
 Mento-Labial & Naso-Labial groove.
 Everted upper lip.
 Corner of mouth (no drooping appearance)

42. Dr Abhilash 42
RELATION WITH THE UPPER LIP
◦ If set too far posteriorly
Lip looks unsupported.
Vermilion border would not be
visible.
◦ If set too far anteriorly
Lip would taut & stretch.
Nasolabial fold may fill out.
Incisal two-thirds of labial surface of teeth
supports the lips.

43. Dr Abhilash 43
MEDIO- LATERAL POSITION
 Midline – midline of face
passes between 2 upper &
lower central incisors.
 Ala of nose – line dropped
from the Ala passes through
tip of canine.

44. Dr Abhilash 44
Guidelines for vertical Orientation
of Anterior Teeth

45. Dr Abhilash 45
Role of upper lip
 Visibility of upper anterior
teeth
 Incisal edges are visible by
1 to 2 mm below the upper
lip at rest.
 Short or long or
incompetent lip influences
the amount of teeth
visibility.
 Some racial types have
fuller lips, others have
thinner.

46. Dr Abhilash 46
Effect of aging
 In young pt, Incisal edges are visible by 1 to 2
mm below the upper lip at rest.
 While smiling or during speech,incisal & middle
1/3 are visible in normal person.
 With aging, tone of upper lip decreases, lesser
amount of maxillary teeth visible and more of
mandibular teeth become visible.

47. Dr Abhilash 47
Relationship of lower lip to anterior
teeth
Lower canine & Ist premolar
should be even with lower lip at
the corner of mouth.
If lower teeth are high
-Anterior plane of occlusion may be
too high
-excessive VDO
-Excessive vertical overlap
reverse is true if mandibular teeth are below
lower lip at corner of mouth.

48. Dr Abhilash 48
Guides to position of posterior
teeth

49. Dr Abhilash 49
Retromolar pad
The maximum extension posteriorly of any
artificial tooth is anterior border of Retromolar
pad. to avoid having a tooth over an incline which
results in denture sliding.
Sometimes space is available for only 3
mandibular posterior teeth, then drop Ist
premolar.

50. Dr Abhilash 50
Retromolar pad

51. Dr Abhilash 51
Maxillary Tuberosity
Teeth should not be set on the Tuberosity
as it can lead to lever imbalance and
might lead to cheek bite in posterior
region.
When space permits,4 maxillary posterior
teeth can be placed opposing 3
mandibular posterior teeth, to provide
support to cheeks

52. Dr Abhilash 52
OCCLUSAL PLANE
Anterior occlusal plane
parallel to interpupillary line
& at the level of commissure.
- posterior occlusal plane
should be at the level of 2/3
the height of retromolar pad

53. Dr Abhilash 53
Stenson’s duct –it exits at Bu mucosa in the
region of 2nd Molar. Occlusal plane is located of
1/8 of an inch below this.
 With these anterio-posterior guidelines,occlusal
plane is made parallel to lower mean foundation
plane and Ala-Tragus plane.
 Height of occlusal plane is also influenced by-
-length of lips
-Ridge height
-Amount of maxillomandibular space available

54. Dr Abhilash 54
Relationship with tongue
 Occlusal plane should be located in relation
to lateral surface of tongue near
demarcation zone b/w Dorsal keratinized
mucosa & ventral nonkeratinized mucosa.

55. Dr Abhilash 55
Buccal Limit
 Teeth should not be set too far
off the ridge.
 Placing too far Buccally can
cause:
- Cheek Biting
- Esthetic problems due to
obliteration of Buccal corridor.
- Denture instability due to lever
imbalance & muscle function.

56. Dr Abhilash 56
Lingual Limit
 Lingual cusps of molars are in
alignment with Mylohyoid ridge.
 Placing too far lingually can cause
◦ Crowding of tongue.
◦ Tongue biting.
◦ Imbalance due to tongue function.

57. Dr Abhilash 57
Overjet & Overbite
Class I – Normal , Class II – Retruded , Class III -
Protruded

58. Dr Abhilash 58
Canine & Molar Relationship
Mesial slope of cusp of upper
canine opposes the distal slope
of Lower canine cusp.
OR
Distal surface of lower canine is
in line with tip of upper canine.
M.B cusp of upper 1st molar
opposes the Buccal
groove of lower 1st molar.

59. Dr Abhilash 59
Buccal Corridor
Space b/w buccal surface of posterior teeth & inner surface of cheeks.
Excessive buccal corridor results when posterior teeth are set too far ligually.
Resulting dark space appears excessive & unaesthetic.
Inadequate buccal corridor occurs when posterior teeth are placed too far buccally,
causing obliteration of buccal corridor.

60. Dr Abhilash 60
Canine-retromolar Pad Reference
Line
 From tip of Canine to center
of Retromolar pad. This
designates centre of
mandibular Ridge.
 Central fossae of mandibular
Posterior teeth should
coincide with this line OR
 This in turn corresponds to
maxillary palatal cusps .

61. INDIVIDUAL
ORIENTATION OF
MAXILLARY TEETH
61Dr Abhilash

62. ARRANGING TEETH FOR COMPLETE
DENTURE OCCLUSION
Maxillary Central Incisor:
The long axis of the tooth is
perpendicular to the horizontal
(labiolingual inclination)
Its long axis slopes towards the vertical
axis
( mesiodistal inclination)
Slopes labially about 15 degrees when
viewed from the side.
Incisal edge is in contact with the 62Dr Abhilash

63. Teeth is set on the
occlusal rim
63Dr Abhilash

64. Maxillary Lateral Incisor:
Long axis slopes rather more
towards the midline
Inclined labially about 20 degrees
when viewed from
the side
The neck is slightly depressed
The incisal edge is about 1mm short
of the occlusal plane.
64Dr Abhilash

65. 65Dr Abhilash

66. Maxillary Canine :
Its long axis is parallel to the vertical
axis when viewed from both the front
and side or it may be slightly to the
distal.
The bulbous cervical half of the tooth
provides its prominence.
Its cusp is in contact with the
horizontal plane.
.
The neck of the tooth must be
prominent
66Dr Abhilash

67. 67Dr Abhilash

68. Dr Abhilash 68

69. Remaining maxillary teeth are arranged on the
other side of the arch to complete the anterior
set up.
To maintain the set teeth in position, the wax
supporting the teeth must be heated and
sealed both to the teeth and to the record base.
69Dr Abhilash

70. 70Dr Abhilash

71. Dr Abhilash 71

72. First premolar:
 Long axis is parallel to the
vertical axis when viewed
from the front or the side.
 Its palatal cusp is about
1mm short of, and its
buccal cusp in contact
with, the occlusal plane.
72Dr Abhilash

73. Second premolar:
 Its long axis is parallel
with
the vertical axis when
viewed
from the front or the
side.
 Both buccal and
palatal cusps
are in contact with the
occlusal plane.
73Dr Abhilash

74. First molar:
 Long axis slopes buccally
when viewed from the
front, and distally when
viewed from the side.
 Only mesiopalatal cusp is
in contact
with the occlusal plane.
74Dr Abhilash

75. Second molar:
 Long axis slopes buccally more
steeply
than the first molar when
viewed from
the front, and distally more
steeply
when viewed from the side.
 All four cusps are clear of the
occlusal
plane, but the mesiopalatal
cusp is
75Dr Abhilash

76. Maxillary teeth set checked on occlusal plane
76Dr Abhilash

77. 77Dr Abhilash

78. Dr Abhilash 78

79. Dr Abhilash 79

80. ORIENTATION AND
ARRANGEMENT OF
MANDIBULAR TEETH
80Dr Abhilash

81. Arranging the
Mandibular Teeth
Mandibular central incisor:
 Long axis slopes slightly towards
the vertical axis when viewed
from the front.
 Slopes labially when viewed from
the side.
 Incisal edge is about 2mm above
occlusal plane
81Dr Abhilash

82. Mandibular lateral incisor:
 Long axis inclines to
vertical axis when viewed
from the front
 Slopes labially when
viewed from side but not
so steeply as the central
incisor.
 Incisal edge is about 2mm
above occlusal plane
82Dr Abhilash

83. Mandibular canine:
 Long axis leans very slightly
towards the midline when viewed
from the front.
 Leans very slightly lingually when
viewed from the side
 Neck is slightly prominent and the
tooth is tilted to the distal
 Tip at same level as incisors.
83Dr Abhilash

84. Dr Abhilash 84

85. Dr Abhilash 85

86. Teeth arrangement checked in patient mouth
86Dr Abhilash

87. The retromolar pad is exposed and points are marked on pounds li
joining the cannine to retromolar pad.
87Dr Abhilash

88. First molar:
 Long axis leans lingually when viewed from the
front and mesially when viewed from the side.
 All cusps are at a higher level above the occlusal
plane than those of the second premolar.
 The buccal and distal cusps are higher than the
mesial and lingual.
 The mesiobuccal cusp occludes in the fossa
between upper second premolar and first molar.
88Dr Abhilash

89. Dr Abhilash 89
Mandibular 1st Molar
 Facial: Long axis leans mesially, when viewed from
side.
 Proximal : Long axis inclines Lingually, when
viewed from front.
 Occlusal: Buccal cusps are higher than Lingual
cusps.Distal cusps are higher than Mesial cusps.

90. 90Dr Abhilash

91. Second premolar:
 Long axis is parallel to the vertical plane
when viewed from both the front and the
side.
 Both cusps are about 2mm above the
occlusal plane.
 The buccal cusp contacts the fossa
between the two upper premolars.
91Dr Abhilash

92. Dr Abhilash 92
Mandibular 2ed Premolar
 Facial & Proximal : Long axis is vertical from both
views.
 Occlusal : Both cusps are about 1-2mm above
Occlusal plane

93. 93Dr Abhilash

94. First premolar:
 Long axis is parallel to the vertical plane
when viewed from the front and the side.
 Its lingual cusp is below the horizontal plane
 Its buccal cusp about 2mm above it as it
contacts the mesial marginal ridge of the
upper first premolar.
94Dr Abhilash

95. Dr Abhilash 95
Mandibular Ist Premolar
 Facial : Long axis is parallel to vertical plane.
 Proximal : Long axis is parallel to vertical plane.
 Occlusal : Bu cusp is above the occlusal plane,
whereas Li cusp is below occlusal plane.

96. 96Dr Abhilash

97. Second molar:
 Lingual and mesial inclination of the long axis is
more pronounced than in the case of the first
molar.
 All the cusps are at a higher level above the
occlusal plane than those of the first molar, the
distal and buccal cusps more so than the mesial
and lingual.
 The mesiobuccal cusp contacts the fossa between
the two upper molars.
97Dr Abhilash

98. Dr Abhilash 98
Mandibular 2nd Molar
 Facial : Mesial inclination is more than 1st
molar.
 Proximal : Lingual inclination is slightly more
than 1st molar.
 Occlusal : Buccal cusps are higher than
Lingual. Distal cusps are higher than Mesial.

99. 99Dr Abhilash

100. 100Dr Abhilash

101. Key of occlusion
 Cannine key of occlusion
◦ The distal arm of the lower cannine
should align with the mesial arm of the
upper cannine.
101Dr Abhilash

102.  Molar key of occlusion
◦ The mesiobuccal cusp of the maxillary
permanent molars should coincide with
the mesiobuccal groove of the mandibular
permanent molar
102Dr Abhilash

103. Overjet & overbite
 Overjet denotes the distance between
the upper & lower incisor measured in
horizontal plane - 2mm
 Overbite denotes the vertical overlap
of the maxillary and mandibular
anterior – 2mm
103Dr Abhilash

104. Overjet
overbite 104Dr Abhilash

105. Dr Abhilash 105

106. Dr Abhilash 106

107. Dr Abhilash 107