Podcast
Questions and Answers
What is Christensen’s phenomenon, and why is it unacceptable for complete denture patients?
What is Christensen’s phenomenon, and why is it unacceptable for complete denture patients?
Which anatomical landmark is primarily used to determine the position of the maxillary anterior teeth?
Which anatomical landmark is primarily used to determine the position of the maxillary anterior teeth?
What happens to the crest of the residual ridges as resorption progresses after tooth extraction?
What happens to the crest of the residual ridges as resorption progresses after tooth extraction?
Why is the antero-posterior positioning of anterior teeth crucial?
Why is the antero-posterior positioning of anterior teeth crucial?
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Which line is described as bisecting the anteroposterior position of the upper dental arch?
Which line is described as bisecting the anteroposterior position of the upper dental arch?
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What is the recommended position of the incisal edge of the maxillary anterior teeth for most patients?
What is the recommended position of the incisal edge of the maxillary anterior teeth for most patients?
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Where should the labial surfaces of the maxillary anterior teeth be placed?
Where should the labial surfaces of the maxillary anterior teeth be placed?
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What is the vertical overlap in terms of anterior teeth arrangement?
What is the vertical overlap in terms of anterior teeth arrangement?
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Why is horizontal and/or vertical separation of opposing anterior teeth generally desirable?
Why is horizontal and/or vertical separation of opposing anterior teeth generally desirable?
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What is the primary function of the midline of the teeth?
What is the primary function of the midline of the teeth?
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What is the consequence of arranging the anterior teeth with a steep incisal guidance?
What is the consequence of arranging the anterior teeth with a steep incisal guidance?
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What aids in determining the midline during tooth arrangement?
What aids in determining the midline during tooth arrangement?
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In tooth arrangement, what should not be indicated unless specified by the clinician?
In tooth arrangement, what should not be indicated unless specified by the clinician?
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What is the approximate distance from the center of the incisive papilla to the labial surface of the central incisors?
What is the approximate distance from the center of the incisive papilla to the labial surface of the central incisors?
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Which of the following factors is NOT considered in the arrangement of teeth?
Which of the following factors is NOT considered in the arrangement of teeth?
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Where should the incisal edges of the mandibular anterior teeth NOT be positioned?
Where should the incisal edges of the mandibular anterior teeth NOT be positioned?
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What is a common feature of the positioning of the central incisors in relation to the canine line?
What is a common feature of the positioning of the central incisors in relation to the canine line?
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What may happen if the incisal edges of the mandibular anterior teeth are positioned too far forward?
What may happen if the incisal edges of the mandibular anterior teeth are positioned too far forward?
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Which arrangement follows after setting the two central incisors?
Which arrangement follows after setting the two central incisors?
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What is a characteristic of the neck of the upper centrals in tooth arrangement?
What is a characteristic of the neck of the upper centrals in tooth arrangement?
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What is a key consideration for minimizing horizontal overlap of opposing anterior teeth?
What is a key consideration for minimizing horizontal overlap of opposing anterior teeth?
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What is the ideal position for the incisal edges of the central incisors and canines?
What is the ideal position for the incisal edges of the central incisors and canines?
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How should the cervical necks of anterior teeth be aligned from the central incisor to the canine?
How should the cervical necks of anterior teeth be aligned from the central incisor to the canine?
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In terms of bucco-lingual tilt, how should the maxillary central and canine teeth be positioned?
In terms of bucco-lingual tilt, how should the maxillary central and canine teeth be positioned?
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What is indicated by the relationship of the incisal cusp tip of maxillary canines to the central incisors?
What is indicated by the relationship of the incisal cusp tip of maxillary canines to the central incisors?
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How should the maxillary lateral incisors be positioned relative to the occlusal plane?
How should the maxillary lateral incisors be positioned relative to the occlusal plane?
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What is the desired overbite measurement in anterior tooth arrangement?
What is the desired overbite measurement in anterior tooth arrangement?
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Which of the following describes the lateral incisors in the mandibular arch?
Which of the following describes the lateral incisors in the mandibular arch?
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What should be avoided in anterior tooth setup for proper esthetics?
What should be avoided in anterior tooth setup for proper esthetics?
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What is recommended for the alignment of maxillary lateral incisors during denture setup?
What is recommended for the alignment of maxillary lateral incisors during denture setup?
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What positioning is indicated for the central incisors in respect to their arch shape?
What positioning is indicated for the central incisors in respect to their arch shape?
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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
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1mm away from the incisal plane
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Deviated distally
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Slightly depressed neck
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Same contour with the arch
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Mandibular central incisors are typically set first, then the canines, and laterals.
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Incisal edges of mandibular anterior teeth should not extend beyond a plane perpendicular to the center of the labial vestibule.
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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
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Maxillary central neck is slightly depressed.
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Maxillary lateral neck is depressed.
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Maxillary canine neck is prominent.
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Mandibular central is proclined.
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Mandibular lateral is more upright.
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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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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.