ZA

Skillfully designed dentures

were made as early as 700 BC.and

HISTORY

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

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.

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

Wooden denture believed to be carved out of box wood in 1538 by Nakoka Tei a Buddist priestess

Wooden dentures

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.

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.

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
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 fonzis design have been Soldered to a gold backing.

1788 A.D. Improvement and development of porcelain dentures by DeChemant.

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

09/01/2014

ZA

In 1794 John Greenwood began to swage gold bases for dentures. Made George Washington's dentures.

George washingtons 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.
09/01/2014 ZA

 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.

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

09/01/2014

ZA

Set of complete dentures having palate of swaged Gold and porcelain teeth set in vulcanite.

 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

DEFINITIONS
Occlusion It is the static relationship

between the incising or masticating surfaces of the maxillary or mandibular teeth or tooth

analogues
Articulation -

[ GPT 7 ]
The static and dynamic contact

relationship between the occlusal surfaces of the teeth during function is called as articulation

Development of occlusion in complete

dentures differs from that present in natural dentition due to the difference in the support system

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

 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

 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

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

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

Selection of Posterior teeth

Functional harmony with musculature Less buccolingual dimension Anteroposterior dimension

FORM
Conform to the general outline of face Facial forms

Square Square tapering Tapering Ovoid

Sex Ageing

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 occlusion

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

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

 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

 Incisive papillae
Midline of upper denture

 Buccolingual position of posterior teeth Mainly determined by Neutral zone

If teeth located lingually . . .

If teeth located buccally . . .

Vertical orientation
Anterior teeth Length and movement of upper lip

If the upper lip is relatively long . . . .

 Lower lip is a better guide

Cusp tips of canine and Ist premolar are even with lower lip

 Maxillary anterior teeth are arranged according to phonetics

 Posterior teeth
Two basic anatomic guide
- Orifice of Stensons Duct - Retromolar pad

If occlusal level is too low

If occlusal level too high Character of residual ridge

Inclination of teeth
Labial surface of bone

Profile form of the patient

Compensatory Curves Anteroposterior curve

Mediolateral curve

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

Guidelines for horizontal Placement of Anterior Teeth

 It is found in Lingual

Role of incisive papilla & mid palatal suture

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.

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.
ZA

Arch Form And Shape

Square arch
with the canine

C.I. in line

Tapering arch C.I. at a

greater distance forward than canine

Ovoid arch - in between

09/01/2014 ZA

Esthetics
Vermilion border of upper
lip.

Mento-Labial & Naso-Labial

groove.

Everted upper lip.

Corner of mouth (no

09/01/2014 ZA

drooping appearance)

RELATION WITH THE UPPER LIP

Incisal two-thirds of labial surface of teeth supports the lips.

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.

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.

Guidelines for vertical Orientation of Anterior Teeth

Role of upper lip

Visibility of upper anterior

Incisal edges are visible by 1

to 2 mm below the upper lip at rest.

teeth

Short or long or Some racial types have

fuller lips, others have thinner. incompetent lip influences the amount of teeth visibility.

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.

GUIDES TO POSITION OF POSTERIOR TEETH

Retromolar pad

The maximum extension posteriorly of any artificial tooth is anterior border of Retro molar 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.

Retromolar Pad

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

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

09/01/2014

ZA

Stensons 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

Buccal Limit

Teeth should not be set too far

Placing too far Buccally can
cause:

off the ridge.

Cheek Biting
Esthetic problems due to obliteration of Buccal corridor.

Denture instability due to lever imbalance & muscle function.

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.

Overjet & Overbite

Class I Normal ,

Class II Retruded ,
Class III Protruded

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.

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.

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 .

Individual orientation of maxillary teeth

Teeth is set on the occlusal rim

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.

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

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.

09/01/2014

ZA

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.

 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.

 Long axis slopes buccally

when viewed from the front, and distally when viewed from the side.

First molar:

Only mesiopalatal cusp is in

contact
with the occlusal plane.

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 nearest to it.

Maxillary teeth set checked on occlusal plane

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

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.

Teeth arrangement checked in patient mouth

The retromolar pad is exposed and points are marked on pounds lines joining the cannine to retromolar pad.

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.

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. ZA 09/01/2014

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.

Mandibular 2ed Premolar

Facial & Proximal : Long axis is vertical from both

views.

Occlusal : Both cusps are about 1-2mm above

Occlusal plane
ZA 09/01/2014

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.

 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.

Mandibular Ist Premolar

ZA

09/01/2014

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.

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.
ZA 09/01/2014

 Cannine key of occlusion

The distal arm of the lower
cannine should align with the mesial arm of the upper cannine.

 Molar key of occlusion

The mesiobuccal cusp of the maxillary

permanent molars should coincide with the mesiobuccal groove of the mandibular permanent molar

Overjet

overbite