the science of teeth selection

3. CONTENTS

INTRODUCTION

OBJECTIVES OF TEETH SELECTION

CONCEPTS OF TEETH SELECTION

ANTERIOR TEETH SELECTION

SIZE

FORM

SHADE OR COLOUR

COMPOSITION

POSTERIOR TEETH SELECTION

SIZE AND NUMBER OF TEETH

FORM

MATERIAL

REFERENCES.

4. INTRODUCTION
o“Smile is the most visible record of a dentist
care to an edentulous patient”.
oleft to the patient. Dentist should only
assists

5. oTeeth selection :-
1.Anterior teeth selection
2.Posterior teeth selection
o Anterior teeth– for aesthetic
function
oPosterior teeth- for masticatory
function.
o six maxillary and mandibular teeth
are considered as anterior teeth.

6. OBJECTIVES OF TEETH
SELECTION
1. Function efficiently
2. Normal speech
3. Aesthetically pleasing
4. No tissue abuse
5. Should maintain the vertical dimension.

7. CONCEPTS OF TEETH
SELECTION
1. WHITE’S CONCEPT
2. H.POUND’S CONCEPT
3. DENTOGENIC CONCEPT
4. WINKLER’S CONCEPT
5. LEON WILLIAM’S CONCEPT
The Science of Anterior Teeth Selection for a Completely
Edentulous Patient: A Literature Review J Indian Prosthodont Soc (Jan-Mar 2011) 11(1):7–13

8. WHITE’S CONCEPT
• 5th century BC concept
HIPPOCRATES.
• Temperamental types were (named for
the physiologic functions of blood,
nerves(phlegm),yellow bile and
lymph(black bile) of the individual
)
1. Sanguine,
2. Nervous,(phlegmatic)
3. Billious (choleric)
4. Lymphatic(melancholic)

9. • Artificial teeth  patient’s temperament.
• A ‘‘bilious’’ 
short, broad,
tapering incisor
teeth,
• A sanguineous 
long, thin,
and narrow teeth

10. H.POUND’S CONCEPT
• Evaluates tooth width by
‘‘measuring the distance from
zygoma to zygoma
• Width of the central
incisor=bizygomatic width/16
• Total width of
anteriors=bizogymatic width/3.36
• Total width of lower anterior
=3/4th width of upper anteriors
• Length of the central
incisor=length of the face/16
• Width of upper central
incisors=circumference of
head/13 Pound E (1954) Lost fine arts in the fallacy of ridges. J Prosthet
Dent 4:6–16

11. DENTOGENIC CONCEPT
•AGE, SEX AND PERSONALITY of the
patient
• Frush and Fisher 1955.
Frush JP, Fisher DR (1955) Introduction to dentogenic restorations.
J Prosthet dent 5:586–595

12. WINKLER’S CONCEPT
•This concept emphasises on three
points.
1.The biological- physiological,
2.Biomechanical
3.The psychological view- point.
Land LS (1996) Anterior tooth selection and guidelines complete denture esthetics. In: Winkler S (ed) Essentials of
complete denture prosthodontics, 2nd edn. Ishiyaku Euro America Inc., St. Louis, pp 200–216

13. •BIOLOGICAL-PHYSIOLOGICAL harmony of
the facial musculature and physiological
limit with teeth arrangement.
•BIOMECHANICAL mechanical limitations in
placement of anterior teeth.
• PSYCHOLOGICAL aesthetics and facial
appearance.

14. LEON WILLIAM’S CONCEPT
• William  the law of harmony.
• inverted face form  the form of maxillary
central incisor
• Three typal forms of teeth as
1. Square,
2. Tapering
3. Ovoid.
Williams JL (1914) A new classification of natural and
artificial
teeth. Dentists supply Co, New York City

15. FACTORS FOR
ANTERIOR TEETH
SELECTION
1.SIZE OF THE TEETH
2.FORM OF THE TEETH
3.COLOUR OF THE TEETH
4.COMPOSITION OF MATERIAL OF THE TEETH

16. SIZE OF THE TEETH
1.PRE EXTRACTION
2.POST EXTRACTION

17. 1. PRE EXTRACTION RECORDS
•PHOTOGRAPHS
•RADIOGRAPHS
•EXTRACTED TEETH
•PREVIOUS DENTURE
•PATIENTS RELATIVES

18. 2. POST EXTRACTION
• EXTRAORAL FACTORS:-
1. SIZE OF THE FACE
2. THE LIPS
3. MAXILLO MANDIBULAR RELATION
4. NOSE WIDTH
• INTRAORAL FACTORS:-
1. SIZE OF MAXILLARY ARCH
2. INCISIVE PAPILLAE AND CUSPID EMINENCE
3. THE CONTOUR OF THE RESIDUAL RIDGE
4. VERTICAL DISTANCE BETWEEN THE RIDGES

19. 1. SIZE OF THE FACE
• Average width of the maxillary
central incisor = 1/16th of the
width of the face measured between
the zygoma.
• Combined width of the six maxillary
anterior teeth = slightly less than
1/3rd of the bizygomatic breadth of
the face.
• The face bow bizygomatic width
• The TRUBYTE® TOOTH INDICATOR size
of maxillary central incisors

21. 2. SIZE OF MAXILLARY ARCH
• The mould selectors are used to make measurements
of the maxillary cast.
• crest of the incisive papilla hamular
notches,hamular notch opposite side hamular
notch.
• The combined length of the three legs of the
triangle in millimetres is used.

23. 3.PAPILLAE AND CUSPID
EMINENCE
• Canine eminence…
• A flexible ruler is used and the
distance between the two canine
eminences at their distal side
through the anterior of the incisive
papilla is measured in millimetres.

24. • This measurement gives the
combined width of the six
anterior teeth.
• Another method with occlusal rim
• The vertical line drawn from this
mark coincides with the pupil of
the eye.
• The distance between the marks
following the contour is the toal
width of anteriors.

25. 4. MAXILLO MANDIBULAR
RELATION
• Any disproportion in size between the
maxillary and mandibular arches influences
the length, width and position of the
teeth.
• This is of importance in class ii and
class iii maxillomandibular relations.

26. 5.THE CONTOUR OF THE
RESIDUAL RIDGE
• The artificial teeth shouldfollow the
contour of the residual ridges that existed
when natural tooth were present.
• As resorption occurs there is alteration in
the contours of the ridge.

27. 6.VERTICAL DISTANCE BETWEEN
THE RIDGES
• The length of the teeth is
determined by the available
space between the existing
ridges.
• It is advisable to use a
tooth long enough to
eliminate the display of the
denture base.

28. 7. THE LIPS
• Labial surfacesupports the
relaxed lip.
• Incisal edges extends inferior to
or slightly below the lip margin.
• Labial incisal third of the
maxillary anterior teeth 
superior border of the lower lip
in speech.
• Incisal edges of maxillary an
teeth junction of the moist and
dry surfaces of the vermilion
border

29. WIDTH OF NOSE
C L C=L
Boucher and Hoffman et al.
referred to the nasal indexwidth of nose
=width of anteriors from central to centre of
canine
Hoffman W Jr, Bomberg TJ, Hatch RA (1986) Interalar width as
guide in denture tooth selection. J Prosthet Dent 55:219–221

30. FORM OF TEETH
1. FORM AND CONTOUR
2. PROFILE
3. SEX
4. AGE
5. PERSONALITY

31. 1.FORM AND CONTOUR
• The shape of the artificial tooth
should harmonise with the patient’s
facial form .
• By Leon Williams,
• Not scientifically correct, is
undoubtedly the simplest and the most
useful guide.
• Shape of the upper incisorsthe shape
of the face.
• He classified the form of the human
face into three types: square,
tapering and ovoid forms.

33. • THE FACIAL FORM IS DETERMINED BY USE OF TRUBYTE INDICATOR

34. 2.FACIAL PROFILE
• THE FACIAL PROFILE IS DETERMINED BY THREE
POINTS.
1. THE FOREHEAD,
2. THE BASE OF THE NOSE AND
3. THE PROMINENT POINT OF THE CHIN

35. • TOOTH FORM CAN ALSO BE SELECTED BASED ON
THE ARCH FORM OF THE PATIENT

36. 3.SEX
• Curved facial features are associated with
femininity and square features are associated with
masculinity

37. MASCULINITY FEMININITY
Prominent teeth Smaller teeth
Square arch form Curved contours and arch
form
Square labial surface Curved labial surface
Square incisal edges and
corners
Round incisal edges and
corners
Darker shade Delicate appearance
Flat smile line Curved smile line
Canine- cervical area is
more prominent and visible
Canine-mesial 3rd only
visible

38. 4. AGE
YOUNGER PEOPLE OLDER PEOPLE
Lighter shade Darker shade
More incisal
translucency
Less incisal translucency
Minimal wear of incisal
edges
Increased wear of incisal
edges
Curved smiling line Flat smiling line
Pointed canines Loss of tip of canines

39. PERSONALITY
• Teeth should be selected according to the patients
personality
• The patients
• vigorous
• delicate.
• More squarish and large teeth vigorous people.
• The anteriors should be in flat plane for executive
people
• For executives teeth should be relatively smaller and
more symmetrical

40. COLOUR OR SHADE OF
THE TEETH
• The shade of the central incisor is
selected from an appropriate shade
guide.
• In choosing this shade, the dentist
should consider
1. The age of the patient,
2. The individual complexion pattern
3. The patient’s desires.
4. The colour of hair and eyes
5. Habits of patient
• Colour is described by means of hue,
value and chroma.

41. • Whenever possible it is advisable to record the size
form and colour of natural teeth before extracting
them.
• It is because patient have very poor memories of their
natural teeth.
• Many patient remember that there teeth where small
white and arranged in a straight line.

42. COMPOSITION OF
MATERIAL OF ANTERIOR
TEETH
•Usually only two types of materials are
used
1.Porcelain
2.Acrylic
• HMW resin because of
• Exceptional hardness
• Stable colour.
• Abrasion resistance
• Less retention of plaque

43. ACRYLIC TEETH PORCELAIN TEETH
Wear is clinically
significant
Wear is clinically
insignificant
Loss of vertical dimension No significant loss of vertical
dimension
Have a soft impact sound Have a sharp impact sound
Easy to grind and alter Difficult to grind and fit into
close interarch space
Chemically bonds to the
denture base material
Does not bind to denture base
material need to create holes
or pins
Does not cause abrasion of
opposite natural teeth
Causes abrasion of opposite
natural or gold teeth

44. POSTERIOR TOOTH SELECTION
1.SHADE OF POSTERIOR TEETH
2.SIZE AND NUMBER OF POSTERIOR TEETH
3.FORM OF POSTERIOR TEETH

45. 1.SHADE OF POSTERIOR TEETH
• The shade of posterior teeth should harmonize to
shade of anterior teeth
• As bulk influences shade of teeth
• So lighter shade for bicuspids if it is used as
aesthetic purpose.
• Slightly lighter than posterior teeth but not
lighter than anterior teeth.

46. 2.SIZE AND NUMBER OF POSTERIOR
TEETH
• The size and number are closely
related to usage
• Buccolingual dimension should be
less than natural teeth
• Anterio posterior dimension is
determined by the edentulous area
between cuspids and the area
slightly anterior to retromolar
area.
• Not necessary to have the same
number of teeth as in natural
dentition.

47. 3. FORM OF POSTERIOR TEETH
• Occlusal form decided on the type
of occlusion.
• Types of teeth to be used :-
1. Balancing in centric and
eccentric cusp form tooth
2. Disocclude during eccentric jaw
movements cusp or monoplane
teeth
3. Arranged in a plane and balanced
only in centric monoplane is
used

48. • Advantages of anatomic teeth
1.Aesthetically acceptable
2.More efficient there by reducing the
forces
3.They can arranged in balance
• Disadvantages of anatomic teeth
1.More horizontal forces during function
2.Fast bone resorbtion
3.Cannot be used in severly resorbed cases

49. • Advantages of non anatomic teeth
1.Comfortable
2.Greater range of motion (in
parafunctional jaw habits)
3.Less horizontal and or torqueing
forces
4.Can be used in severely resorbed
ridges and patients with poor neuro
muscular coordination
• Disadvantages of non anatomic teeth
1.They look unnatural
2.Less cutting efficiency

50. 4. MATERIAL COMPOSITION OF
POSTERIOR TEETH
• Both porcelain and acrylic are used
• Upper and lower posterior teeth can
be
• Both porcelain
• Both acrylic
• A combination of porcelain and acrylic
teeth on opposing dentures can be
used. It softens the sound, reduces
friction and eliminates chipping

51. • Acrylic teeth is used in following
situations:-
1.Limited interarch distance
2.Maxillary single denture against
natural dentition
3.Maxillary single denture
opposing partial denture
4.Opposing natural teeth with gold
occlusal surfaces.
• Porcelain teeth;-
• They have vey good esthetics
• High translucency
• Does not wear
• Long life

52. • SINGLE MAXILLARY COMPLETE DENTURE:-
• TEETH SET USED ARE ACRYLIC TEETH OPPOSING NATURAL
DENTITION
• GOLD TEETH OR INSERTS CAN ALSO BE USED BUT PORCELAIN
IS NEVER USED.
• HIGHLY RESORBED RIDGES:-
• MONOPLANE TEETH OR NON ANATOMIC TEETH IS USED
Single maxillary complete denture
Carl F. Driscoll, DMD*, Radi M. Masri, BDS, MS Dent Clin N Am 48 (2004) 567–583

53. ACRY ROCK TEETH SET

58. CONCLUSION
“There are two worlds; the world we can
measure with line and ruler, the world that we
can feel with ours hearts and imagination”
Leigh Hunt

59. REFERENCES
• HEARTWELL CM, ROHN AO (2002) TOOTH SELECTION. IN: TEXTBOOK OF COMPLETE DENTURES, 5TH
ED. BC DECKER, PP 305–319
• FRUSH JP, FISHER RD (1958) THE DYNESTHETIC INTERPRETATION OF DENTOGENIC CONCEPT. J
PROSTHET DEN 8:558–581
• YOUNG HA (1954) SELECTING THE ANTERIOR TOOTH MOULD. J PROSTHET DENT 4:748–760
• THE SCIENCE OF ANTERIOR TEETH SELECTION FOR A COMPLETELY EDENTULOUS PATIENT: A
LITERATURE REVIEW J INDIAN PROSTHODONT SOC (JAN-MAR 2011) 11(1):7–13
• HOFFMAN W JR, BOMBERG TJ, HATCH RA (1986) INTERALAR WIDTH AS GUIDE IN DENTURE TOOTH
SELECTION. J PROSTHET DENT 55:219–221

60. • ZARB GA, BOLENDER CL, HICKEY JC, CARLSSON GE (1998) SELECTING ARTIFICIAL
TEETH FOR THE EDENTULOUS PATIENT. TEXTBOOK ON BOUCHERS PROSTHODONTIC
TREATMENT FOR THE ELDERLY, 10TH EDN. BI PUBLICATIONS PVT LTD, NEW DELHI, PP
330–351
• SINGLE MAXILLARY COMPLETE DENTURE CARL F. DRISCOLL, DMD*, RADI M. MASRI, BDS,
MS DENT CLIN N AM 48 (2004) 567–583