Setting 30-Degree Teeth

When viewed facially, all maxillary anterior teeth are tilted mesially, with the
lateral incisor inclined the most and raised about 1-2 mm above the plane. 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.

When viewed facially, all the mandibular anterior teeth except the central incisors
are tilted mesially, with the canine inclined the most. When viewed laterally, the
central incisors are depressed at the cervical, with the lateral incisor being straight,
and the canine being inclined lingual to the long axis.
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. The wax rims must
be configured so that this plane is recorded in their relationship. They must also have
established an occlusal plane that is parallel with the upper member of the articulator
and they must be in intimate contact when the guide pin on the articulator is set at
zero.

1.

Prior to setting the maxillary anterior teeth,, 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.
2. 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.

3.

Reduce the anterior ridge of the maxillary baseplate to provide a little extra space
for the tooth, but reduce the tooth if necessary for it to fit properly.
4. Use a flat plate resting flush with the occlusion rim to position the central incisor
so that it contacts the occlusal plane.

5. 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.
6. 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.

Set the rest of the anterior teeth according to the curve defined by the plastic
ruler. Again check to see that only the labioincisal line angles of the incisors
should touch the ruler, as well as the midbuccal surface of the canines.

8.

9.

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 on the land area of the
lower cast to begin setting the mandibular anterior teeth.

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.
10. With the mandibular anterior teeth set, the anterior to posterior position of the
mandibular posterior teeth is established. The posterior teeth are set so that their
central grooves fall over the crest of the ridge as indicated by the line drawn on
the wax. Each tooth is set so that it contacts its neighbor proximally.

11. 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 it to allow the last tooth to be set, and those
teeth anterior to it will indicate the center of the ridge.

12. 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 verifying that were used on the other side.

13. 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.

14. When all the mandibular teeth are 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.

15. 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.

16. Set the teeth on the maxillary left side so that the mesiolingual cusp of the
maxillary first molar rests in the central fossa of the mandibular first molar. The
maxillary molars should be raised so that the mesiobuccal cusp of the first molar
touches the plane defined by the central incisors, canines, and premolars and its
distobuccal cusp is raised mm above the plane, the mesiobuccal cusp of the
second molar is 1 mm above this plane and its distobuccal cusp is 1.5 mm above
the plane.

The distobuccal cusp of the maxillary first molar deviates approximately 20o palatally
from the plane defined by the buccal surfaces of the canine, premolars, and
mesiobuccal cusp of the first molar and the buccal cusps of the maxillary second
molar fall along the plane established by the buccal surface of the cusps of the
maxillary first molar.

17. Verify that occlusal surfaces of the central incisors, canine and premolar teeth lie
flat to the surface of the flat metal plane. The mandibular molars must be raised
to intercuspate with the maxillary molars since the occlusal plane is developed in
the maxillary arch.

18. Check to see that occlusal surfaces of all posterior teeth contact their opposing
counterparts properly in both centric and lateral aspects. The key to occlusion is
the first molar, therefore this tooth is the factor upon which all these evaluations
are based. Note that there is no vertical overlap of the anterior teeth at this time.

19. Inspect them from the lingual aspect to see if the cusps of the teeth are contacting
properly. If they are not, then they must be adjusted to the correct cusp/fossa
relationship. If adjustments are made, verify again the working and balancing
contacts.

20. Once the posterior occlusion is verified as having bilateral balance, the desired
anterior overlap can be established. First, the anterior teeth are adjusted as
follows:

The mandibular incisor teeth are adjusted so that they contact the maxillary central
incisors in protrusive relation. The maxillary lateral incisors should not contact the
mandibular incisors. The mandibular canines are adjusted last and are raised to
contact the maxillary lateral incisors in protrusive relation but are just slightly out of
occlusion when the mandible is moved laterally. They should not interfere during any
lateral or protrusive movements. All anterior teeth must contact simultaneously with
the posterior teeth in protrusive excursion to have the bilateral balance that is so
essential for stability in complete dentures.