Lecture 2 Selection of posterior teeth

A- Shade C- Form A. shade of posterior teeth :o o

B- Size and number D- Material

Should harmonize with the shade of the anterior teeth . Maxillary premolars should have lighter shade than the other posterior teeth but not lighter than anterior teeth ? the give the denture teeth the natural appearance

B. Size and number a) buccolingual dimension(width) :should be less than that of the natural teeth to :o Decrease the stresses transferred to the denture supporting area o Increase tongue space o Allows for improved contouring of denture polished surface b) mesio-distal dimension :- Its determined from approximate position of the distal surface of the mandibular canine to the mesial en fog the retromolar pad . c) occluso-gingival dimension - Is determined by the amount of inter-arch distance. o Greater distance longer teeth (in severe resorption cases) o Short distance short teeth (when recent extraction occurs) C. Form of the posterior teeth determined (according to type of occlusion) :1. Anatomic teeth 2. Semi anatomic 3. Non-anatomic 1) Anatomic teeth - which are designed to simulate the natural teeth form (usually have inclines of 33 or more) - NOTE : the condylar angle determine the cusp angle ** advantages of anatomic teeth :a) Maximize esthetics b) Provide balanced occlusion with great success c) Provide better initial bolus penetration

2) Semi-anatomic teeth - cup incline is less steep than conventional anatomic teeth (less than 33 ** advantages :1. Still look natural 2. Develop balancing contacts in eccentric position 3. Provide function of flat plane posterior ** indication :- In cases with severe resorption

3) Non-anatomic teeth - are essentially flat which have no cusp height, there occlusal surfaces are flat plane . - bad esthetics - no balanced occlusion - less functioning * indicated in :a. b. c. d. With cross bite tooth relationship With poor neuromuscular control (elderly pts) With severely resorped ridges Who have a large discrepancy between centric jaw relation and centric occlusion (why?) to cuspal interference (dislodgment of denture)

NOTE : in moderate resorption use semi-anatomic teeth - the occlusal form of posterior teeth will be decided by the type of occlusion to be developed . o o Balanced occlusion in centric and eccentric position Anatomic teeth Non balanced occlusion in eccentric Non-anatomic teeth

Factors for selection of posterior teeth form :1. Ridge morphology A broad well developed ridge has the potential to resist lateral dislodgment movement of the denture base , therefore thin type of ridge can accept cusped teeth 2. Inter-arch distance o The more the bone resorption take place the greater is the indication for flat teeth type to prevent denture dislodgment (larger level arm) o Well-developed ridge and small inter-ridge space so >>> select short cusped teeth o Moderate resorption >>> short semi anatomic

o Short inter arch space and severe resorption >>> short flat teeth

3. Arch relationship :- class l jaw relation - Class ll jaw relation

permit any posterior tooth form select non-anatomic tooth form

(*Because lower teeth has a very large distance to reach the upper teeth angle > 33 (more than condylar angle) pain) recheck >> image 16
Class lll jaw relation Non anatomic teeth form (there is large discrepance between centric occlusion and relation

4- Neuromuscular control - If the muscle control of the patient during jaw relation registering has a little difficulty anatomic or semi anatomic teeth will be acceptable - If muscle control is questioned with great difficulty non anatomic 5- Esthetics 6- Communication of food The health of the supporting structures depends on the intelligent use of the occlusal form, so that the resultant force are vertical to the denture function area .

7- Previous denture wearing experience:Patient who have many years of denture wearing experience and have no complains about their chewing efficiency with flat teeth >>> select the teeth the same as the previous

D. materials:1) Acrylic resin with healthy well developed ridge . 2) Acrylic resin with metal to resist more force 3) Porcelain (air fired or vacuumed fired)