Tooth Arrangement and Positions Quiz
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Questions and Answers

What is Christensen’s phenomenon, and why is it unacceptable for complete denture patients?

  • It improves the aesthetic appearance of the dentures.
  • It is the space between opposing occlusal surfaces during excursive movements. (correct)
  • It causes discomfort during mastication.
  • It enhances the stability of the dentures.

    • Which anatomical landmark is primarily used to determine the position of the maxillary anterior teeth?

  • The incisive papilla. (correct)
  • The labial frenum.
  • The midline suture.
  • The buccolabial aspect of the ridge.

    • What happens to the crest of the residual ridges as resorption progresses after tooth extraction?

  • It remains at the same position as before extraction.
  • It becomes more buccal and prominent.
  • It shifts more palatal than it was prior to extraction. (correct)
  • It stays constant relative to the palatal aspect.

    • Why is the antero-posterior positioning of anterior teeth crucial?

    <p>It provides support to the lips, cheeks, and oral tissues. (A)</p> Signup and view all the answers

    Which line is described as bisecting the anteroposterior position of the upper dental arch?

    <p>A line between the incisive papilla and the labial frenum. (D)</p> Signup and view all the answers

    What is the recommended position of the incisal edge of the maxillary anterior teeth for most patients?

    <p>It should provide esthetics and phonetics. (B)</p> Signup and view all the answers

    Where should the labial surfaces of the maxillary anterior teeth be placed?

    <p>Slightly labial to the surface of the labial flange. (B)</p> Signup and view all the answers

    What is the vertical overlap in terms of anterior teeth arrangement?

    <p>The vertical distance between the incisal edges of maxillary and mandibular teeth. (C)</p> Signup and view all the answers

    Why is horizontal and/or vertical separation of opposing anterior teeth generally desirable?

    <p>To minimize premature contact and excessive forces. (C)</p> Signup and view all the answers

    What is the primary function of the midline of the teeth?

    <p>To coincide with the facial midline. (B)</p> Signup and view all the answers

    What is the consequence of arranging the anterior teeth with a steep incisal guidance?

    <p>It leads to disclusion of posterior teeth in excursive movements. (D)</p> Signup and view all the answers

    What aids in determining the midline during tooth arrangement?

    <p>The incisal papilla. (B)</p> Signup and view all the answers

    In tooth arrangement, what should not be indicated unless specified by the clinician?

    <p>Vertical overlap of the anterior teeth. (C)</p> Signup and view all the answers

    What is the approximate distance from the center of the incisive papilla to the labial surface of the central incisors?

    <p>6-8 mm (C)</p> Signup and view all the answers

    Which of the following factors is NOT considered in the arrangement of teeth?

    <p>Size of the teeth (D)</p> Signup and view all the answers

    Where should the incisal edges of the mandibular anterior teeth NOT be positioned?

    <p>Above the anterior land area of the cast (A), In front of a plane perpendicular to the center of the labial vestibule (C)</p> Signup and view all the answers

    What is a common feature of the positioning of the central incisors in relation to the canine line?

    <p>They end at the canine line. (C)</p> Signup and view all the answers

    What may happen if the incisal edges of the mandibular anterior teeth are positioned too far forward?

    <p>They will create undesirable cantilever forces. (C)</p> Signup and view all the answers

    Which arrangement follows after setting the two central incisors?

    <p>Lateral incisors and cuspid on one side then the other side (D)</p> Signup and view all the answers

    What is a characteristic of the neck of the upper centrals in tooth arrangement?

    <p>Slightly depressed (C)</p> Signup and view all the answers

    What is a key consideration for minimizing horizontal overlap of opposing anterior teeth?

    <p>Occasionally placing them over the land area (D)</p> Signup and view all the answers

    What is the ideal position for the incisal edges of the central incisors and canines?

    <p>At the level of the occlusal plane (D)</p> Signup and view all the answers

    How should the cervical necks of anterior teeth be aligned from the central incisor to the canine?

    <p>Tilted posteriorly (A)</p> Signup and view all the answers

    In terms of bucco-lingual tilt, how should the maxillary central and canine teeth be positioned?

    <p>Central is slightly depressed and canine has a prominent neck (D)</p> Signup and view all the answers

    What is indicated by the relationship of the incisal cusp tip of maxillary canines to the central incisors?

    <p>It should be at the same level as the central incisors (D)</p> Signup and view all the answers

    How should the maxillary lateral incisors be positioned relative to the occlusal plane?

    <p>Approximately 1mm above the occlusal plane (B)</p> Signup and view all the answers

    What is the desired overbite measurement in anterior tooth arrangement?

    <p>0mm (C)</p> Signup and view all the answers

    Which of the following describes the lateral incisors in the mandibular arch?

    <p>Upright position compared to central incisors (B)</p> Signup and view all the answers

    What should be avoided in anterior tooth setup for proper esthetics?

    <p>Insufficient contact in centric position (D)</p> Signup and view all the answers

    What is recommended for the alignment of maxillary lateral incisors during denture setup?

    <p>Slight adjustments can create a natural appearance (A)</p> Signup and view all the answers

    What positioning is indicated for the central incisors in respect to their arch shape?

    <p>Curved along the arch (C)</p> Signup and view all the answers

    Flashcards

    Anterior tooth arrangement

    Placing artificial front teeth in a way that's aesthetically pleasing and functional.

    Midline alignment

    Positioning the teeth's center point with the face's center.

    Incisal edge position

    Placement of the front edge of the front teeth for esthetics and speech.

    Lip support

    The amount of tooth showing beyond the lower part of the denture to support the lip.

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    Horizontal overlap

    The horizontal space between the upper and lower front teeth.

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    Vertical overlap

    Amount of vertical overlap in front teeth.

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    Incisive papilla

    A soft tissue bump in the center of the gum ridge in front of teeth.

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    Centric occlusion

    The position of the jaws when the teeth are fully in contact in the normal position.

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    Anterior Tooth Positioning

    Placing artificial front teeth in a position similar to natural teeth for proper lip, cheek, and tissue support, and pleasing appearance.

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    Residual Ridge Crest

    The highest point of the gum ridge after tooth extraction. It's important for tooth placement, as bone loss can change its position.

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    Alveolar Bone Resorption

    The gradual loss of bone structure (alveolar) that happens after teeth are pulled, usually more on the cheeks/lips than the roof of the mouth.

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    Central Incisor Placement

    The central incisors are positioned so that the distance from the center of the incisive papilla to the labial surface of the central incisors is about 6-8 mm anterior to the middle of incisive papilla.

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    Tooth Extension Beyond Flange

    A small but consistent amount of tooth should extend beyond the denture flange when viewed from the tissue side of the denture.

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    Factors in Tooth Arrangement

    Factors considered in tooth arrangement include bone resorption, esthetics and phonetics, occlusal plane, and harmony with the contour of the ridge.

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    Upper Central Incisor Position

    The upper central incisors should be vertical, overlapping the lower centrals, with the incisal edges slightly deviated distally. The mesial incline of the upper canine should contact the distal incline of the lower canine.

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    Upper Lateral Incisor Position

    The upper lateral incisors should be 1mm away from the incisal plane, deviated distally, with a depressed neck and the same contour as the arch.

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    Upper Canine Position

    The upper canine should contact the incisal plane, be slightly deviated distally or perpendicular, have a prominent neck, and have the same contour as the arch, ending at the canine line.

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    Tooth Arrangement Sequence

    The 2 central incisors are usually set first, followed by the lateral incisors and cuspids on each side.

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    Mandibular Incisal Edge Position

    The incisal edges of the mandibular teeth should not be placed forward of a plane perpendicular to the center of the labial vestibule, and under no circumstances should they be positioned over the anterior land area of the cast.

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    Lower Anterior Tooth Alignment

    The arrangement of the lower front teeth (incisors and canines) in relation to each other and the occlusal plane.

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    Maxillary Canine Position

    The maxillary canine is positioned so that its incisal cusp tip is at the same level as the maxillary central incisors. The long axis of the canine should be vertical or inclined distally.

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    Lateral Incisor Placement

    The lateral incisors are placed approximately 1mm above the occlusal plane.

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    Cervical Neck Inclination

    The cervical necks of anterior teeth tilt posteriorly from the central incisor to the canine.

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    Bucco-Lingual Tilt - Maxillary

    The maxillary central incisor neck is slightly depressed, lateral is depressed, and canine is prominent.

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    Bucco-Lingual Tilt - Mandibular

    The mandibular central incisor is proclined, lateral is more upright, and canine has a prominent neck.

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    Anterior Tooth Setup - Jump

    Anterior teeth do not contact in centric position. Overbite is 0mm and overjet is 2mm.

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    Anterior Tooth Contact in Centric

    The correct amount of contact between anterior teeth in centric occlusion is essential for proper function and aesthetics.

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    Anterior Tooth Curvature

    Central and lateral incisors must start to turn along the curvature of the arch as they approach the canine.

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    Circumference Follows Arch Shape

    The circumference of the anterior teeth should follow the shape of the arch.

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    Study Notes

    Tooth Arrangement

    • The midline of the teeth should align with the facial midline.
    • For most patients, the incisal edge position of the maxillary anterior teeth affects aesthetics and phonetics. The necks of the teeth and the fullness of the maxillary denture base affect lip support.
    • The labial surfaces of maxillary anterior teeth should be placed slightly labial to the labial flange.
    • A small consistent amount of tooth should be visible beyond the denture flange when viewing from the tissue side.
    • Vertical overlap of anterior teeth is not typically needed unless specified by a clinician.

    Horizontal Positions of Anterior Teeth

    • The incisive papilla aids in determining the midline.
    • Labial surfaces of central incisors are typically 8mm anterior to the middle of the incisive papilla.

    Lip Position

    • The upper anterior teeth should be positioned anterior to the crest of the upper ridge.
    • The lower anterior teeth should be positioned over the crest of the lower ridge.

    Overbite and Overjet

    • Overbite is the vertical distance between the maxillary and mandibular incisal edges.
    • Overjet is the horizontal distance between the maxillary and mandibular incisal edges.

    Mandibular Anterior Teeth Arrangement

    • When arranging mandibular anterior teeth, it's usually desirable to have space/separation between the opposing anterior teeth in centric occlusion. This minimizes premature contact and excessive forces on the weaker anterior residual ridges.

    Vertical Overlap

    • Vertical overlap is important for aesthetics, phonetics and functionality

    Tooth Arrangement and Posterior Teeth

    • Teeth should not be arranged with a steep incisal guidance causing posterior teeth to disclude during excursive movements (Christensen's phenomena)
    • This is not desirable for complete dentures.

    Setting Upper Anterior Teeth

    • The upper central incisors should contact the incisal plane.
    • They are slightly deviated distally.
    • The neck of the upper central incisor is slightly depressed.
    • Upper anterior teeth should have the same contour as the arch.
    • The mesial incline of the upper canine should have a distal incline of the lower canine.

    Setting Mandibular Anterior Teeth

    • 1mm away from the incisal plane

    • Deviated distally

    • Slightly depressed neck

    • Same contour with the arch

    • Mandibular central incisors are typically set first, then the canines, and laterals.

    • Incisal edges of mandibular anterior teeth should not extend beyond a plane perpendicular to the center of the labial vestibule.

    • This positioning should not extend over the anterior land area of the cast.

    Canine Arrangement

    • Canines should contact the incisal plane.
    • Their crowns should be nearly perpendicular with a slight distal inclination.
    • The neck should be prominent.
    • Canines should have the same contour as the arch.
    • The maxillary canine incisal cusp tip should be placed at a same level as the maxillary central incisors. The long axis of the canine should be vertical or inclined distally. The cervical portion should be prominent because of the labial position in relation to the lateral incisor.

    Setting Anterior Teeth

    • Incisal edges of centrals and canines should be at the same level as the occlusal plane.
    • Laterals are positioned approximately 1mm above the occlusal plane.
    • Cervical necks tilt posteriorly from the central incisor to the canine.

    Setting Mandibular Anterior Teeth

    • Incisal edges are placed at the same level.
    • Positioned in line with the occlusal plane.

    Bucco-Lingual Tilt

    • Maxillary central neck is slightly depressed.

    • Maxillary lateral neck is depressed.

    • Maxillary canine neck is prominent.

    • Mandibular central is proclined.

    • Mandibular lateral is more upright.

    • Mandibular canine has a prominent neck .

    Anterior Tooth Setup

    • Anterior teeth generally do not contact each other in centric position.
    • Overbite = 0mm
    • Overjet = 2mm

    No Anterior Contact in Centric

    • Three different images showing different arrangements - correct, insufficient, and excessive contact.

    Canines and Incisors

    • Central and lateral incisors must curve along the arch.
    • The two canines should be at same level.

    Circumference Follows Arch Shape

    • The circumference of the teeth should follow the arch shape.

    Alignment of Maxillary Lateral Incisors

    • Alignment can be slightly altered to create a natural appearance.
    • Changes can include modifications of the inclination of the long axis ,relationship to the incisal edges of the centrals ,.tooth width ,levels of the gingival margins.,tooth shade, and shapes of incisal edges, angles and proximal surfaces.
    • Most patients prefer a symmetrical arrangement.

    Dental Technician Role

    • The dental technician should ensure that individual tooth orientations create a harmonious arrangement compatible with the shape and positions of residual ridges.

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    Tooth Arrangement - Presentation PDF

    Description

    Test your knowledge on the proper arrangement and positioning of anterior teeth for optimal aesthetics and functionality. This quiz covers essential concepts such as the midline alignment, the role of the incisive papilla, and lip support considerations in denture fitting.

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