Manuals_files/CD Manual 12.pdf - Removable Prosthodontics

Selecting & Setting Teeth - 42
Selecting Anterior Teeth
Selection of anterior teeth requires a combination of science and artistic ability based on
observation. Measurement, formulas etc. are only a starting point – use your eyes and
common sense.
Size
- Use existing teeth as a guide:
! Too big or small? If so, use other means of establishing size
! Does patient like them? Do you?
! If acceptably close, use Boley gauge to measure width and length of central
incisors and check with the paper Trubyte mould guide chart (measurements for
central are given; pictures are life size).
- High Lip Line gives indication of inciso-gingival length (minimal gingival display)
- Mark the position of the commisures of mouth with patient relaxed, mouth closed
(position of distal of canines - use the Auto-Rule to pick a corresponding mould e.g.
C, D, E, F etc.)
- Bizygomatic width measured by facebow divided by 16= width of the central incisor;
divided by 3.3 = width of 6 anteriors
- Pre-extraction casts or photographs can be useful, if available
Shape
- Tooth shape does not correspond to facial shape, but the Trubyte system can be a good
starting point for experimenting; there are proven no male/female characteristics
- Use existing teeth as a guide — do they look to good to you?
- USE COMMON SENSE AND OBSERVATION
Shade
- Tooth shade darkens with age, but the suggestion that there is any correlation with skin
and hair colour is suspect
- We will use the Dentsply Trubyte shade guide for Portrait IPN acrylic teeth
- Don’t show a patient all shades in the shade guide outside of the mouth – patients will
almost always pick the whitest shade
- Instead show patient 2 or 3 shades under lip and ask their opinion (colour perception is
affected by background) – disinfect the tabs afterward