arrangement of teeth Anterior and Posterior

Complete Denture Prosthodontics involves the replacement of the
lost natural dentition and associated structures of the maxilla and
mandible for patients who have lost all their remaining natural
teeth. Arrangement of teeth for a complete denture is a pivotal
step in fabrication of such a prosthesis.
So why do we need to provide a complete denture?
Introduction -

Natural v/s Artificial Occlusion
Type of support
Proprioception
Response to pressures of occlusion
Effect of malocclusion
Effect of non-vertical forces
Act of incision
Act of mastication
Necessity for a bilaterally balanced occlusion.

Review of Literature
Prior to 18th
century artificial teeth were made of wood , ivory,
animal teeth and human teeth.
In 19th
century – Ash Of England is believed to be the first to to
design teeth that occluded properly.
1678- 1761 - Pierre Fauchard used teeth made up
from hippopotamus or elephant ivory dentures .

In 1914 - Dr. Alfred Gysi of Switzerland – first
anatomic porcelain tooth , were called Trubyte .
- Geometric theory of tooth selection –
presented by Dr. J. Leon Williams.
In 1922 - Victor Sears – Chewing members Tooth .
In 1927 - Victor Sears – Channel Tooth .
Gysi – Crossbite posterior teeth .

In 1929 - Hall introduced Inverted Cusp teeth - first
flat plane teeth
Myerson shortly introduced Truecusp –
cuspless posterior teeth
In 1930 - Avery Brothers designed
the Scissor bite teeth.

In 1931 - Fish gave concept of a Neutral Zone in
complete denture construction .
In 1932 - Pilkington and Turner anatomic posterior tooth
In 1934 - Nelson described Chopping Blocks - flat occlusal
surfaces with numerous transverse ridges.
In 1935 - French designed severely modified teeth .
a
In 1936 - McGrane marketed Curved Cusp posterior tooth.

In 1937 - Max Pleasure proposed to modify the
occlusal surfaces of lower posterior
teeth to a Reverse Curve by tilting the
tooth buccally.
In 1939 Swenson designed Nonlock posteriors
with Sluice ways for shredding and allowing
food to clear the occlusal table.
a
In 1942 - John Vincent introduced a change in materials
by using metal inserts in resin posteriors.

In 1946 - Hardy designed metal insert upper and lower posterior -
Vitallium Occlusal - ‘VO’ .
In 1951 - Myerson Tooth Corporation introduced the first
cross-linked acrylic teeth in a flat occlusal scheme called the
Shear Cusp tooth.
- Schultz- Gold Occlusal surfaces.
In 1952 - Coe Masticators designed
by Cook.

In 1954 - Earl pound stressed on the principle of
esthetics – ‘replacing the teeth in the natural
position from which they came ’.
In 1956 - John P Frush And Roland D Fisher introduced the
word “Dentogenic” in prosthetic dentistry for
the selection of anterior teeth in complete
denture prosthodontics based on sex, age and
personality.

In 1957 - Bader introduced cutter bar scheme by
opposing upper porcelain cuspless teeth with a
metal cutting bar replacing 2nd
premolar,
molars .
in 1961 - Sosin replaced maxillary second bicuspid and
molars with cleat shaped vitallium forms called
cross-blades.

In 1961 - Wright et al believed that posterior mandibular
denture teeth should be arranged directly over the center of
the denture stress-bearing area.
In 1966 - Wright described tongue function and its relation
to the occlusal plane and mandibular denture stability.
In 1973 - Pound recommended that the lingual surfaces of
mandibular posterior denture teeth should occupy an
area called Pound’s Triangle.
Pound’s triangle

Basic principles of teeth
arrangement

Imaginary root of maxillary anterior teeth are expected to pass
through the crest of the ridge.
Overjet and Overbite
Arch form –curvature of upper anteriors
Alignment of posterior teeth
Orientation with the plane of occlusion
Incisive papilla
Soft- tissue reflection
}As a guide to placement of
anterior teeth

Labiolingual
inclination
Mesiodistal
inclination
Arch
relation
Plane
relation
Position
Slight incisal
tilt
Perpendicular Along curve
of arch-
85degree
In contact
with plane of
occlusion
(According to
type of arch)
Square arch ;
tapered arch ;
ovoid arch .
Arrangement Of Maxillary Central Incisor

Labiolingual
inclination
Mesiodistal
inclination
Arch
relation
Plane
relation
Position
Definite labial
tilt – neck is
depressed
Slight distal tilt Distal half
rotated
lingually 45-
55degree
Above the
plane
(According to
type of arch)
Square arch ;
tapered arch ;
ovoid arch .
Arrangement Of Maxillary Lateral Incisor

Labiolingual
inclination
Mesiodistal
inclination
Arch
relation
Plane
relation
Position
Upright,
perpendicular
-neck
prominent
Upright, parallel
to midline
Turning
point of arch
-30 degree
Tip of canine
contact plane
(According
to type of
arch)
Square arch ;
tapered
arch ; ovoid
arch .
Arrangement Of Maxillary Canine

Labiolingual
inclination
Mesiodistal
inclination
Arch
relation
Plane relation
Vertical , erect Perpendicular Parallel to
curve of
arch- 90
All teeth are slightly above
the plane of occlusion
and are placed lingual to
the maxillary anteriors.
Arrangement Of Mandibular Central Incisor
Labiolingual
inclination
Mesiodistal
inclination
Arch relation Plane relation
Vertical , erect Slight distal tilt
at the neck
Along the curve
of arch- 45-55
All teeth are slightly above
the plane of occlusion
and are placed lingual to
the maxillary anteriors.
Arrangement Of Mandibular lateral Incisor

Labiolingual
inclination
Mesiodistal
inclination
Arch relation Plane relation
Vertical ,
erect-
neck slightly
prominent
Distally tilted;
leans towards the
midline
Turning point of
arch -30
All teeth are slightly
above the plane of
occlusion and are
placed lingual to the
maxillary anteriors.
Arrangement Of Mandibular canine

Plane relation Relation with
vertical axis
Arch
relation
Position
Buccal cusp
contact plane of
occlusion ; palatal
cusp 1mm above .
Parallel to vertical
axis Along crest
of residual
alveolar ridge
.
The buccal surfaces of all
posterior teeth make
contact with a straight-
edge laid from the labial
surface of the canine
backwards
Arrangement Of Maxillary First premolar

vertical axis
Arch relation Position
Buccal and palatal
cusp contact plane
of occlusion
Parallel to
vertical axis Along crest of
residual alveolar
ridge .
backwards
Arrangement Of Maxillary second premolar

vertical axis
mesiopalatal cusp
contacts plane of
occlusion
Slopes Distally
and buccally Along crest of
residual
alveolar ridge .
posterior teeth make contact
with a straight-edge laid from
the labial surface of the
canine backwards
Arrangement Of Maxillary First molar

vertical axis
Position
All four cusps
are clear of
occlusal plane
but mesiopalatal
cusp is nearest .
Slopes more
steeply -distally
and buccally
backwards
Arrangement Of Maxillary second molar

vertical axis
All four cusps are
above of occlusal
plane - B,D cusps
higher than M,L
cusps
Slopes mesially
and lingually
Along crest of
residual alveolar
ridge .
with a straight-edge laid
from the labial surface of the
canine backwards
Arrangement Of Mandibular first molar

vertical axis
Buccal and palatal
cusp above plane
of occlusion -
2mm
Parallel to
vertical axis
Along crest of
residual alveolar
ridge .
contact with a straight-edge
laid from the labial surface
of the canine backwards
Arrangement Of Mandibular Second premolar

vertical axis
Buccal cusp above
plane of occlusion;
palatal cusp below.
Parallel to
vertical axis
Along crest of
residual alveolar
ridge .
with a straight-edge laid
from the labial surface of
the canine backwards
Arrangement Of Mandibular First premolar

Plane relation Relation with vertical axis Position
All four cusps are
above of occlusal plane,
more than first molar.
Slopes more steeply -mesially
and lingually
The buccal surfaces of
all posterior teeth make
edge laid from the
labial surface of the
canine backwards
Arrangement Of Mandibular second molar

Compensating curves
Compensating curves are the artificial curves introduced
into the denture in order to facilitate the production of
balanced articulation. They are the artificial counterparts
of the curve of spee and curve of monsoon which are
found in the natural dentition.
The curves that assist in producing balanced
occlusion are :
A) Anteroposterior curve – run in
anteroposterior direction and help in
obtaining protrusive balance.
B) Mediolateral curves – run in a lateral
direction from one side of the arch to the
other and help in obtaining lateral balance.

A) Anteroposterior curve
Compensates for the Curve Of Spee in natural dentition.
CURVE OF SPEE is defined as ‘Anatomic curvature of the occlusal
alignment of the natural teeth beginning at the tip of the lower canine and
following the buccal cusps of the natural premolars and molars ,
continuing to the anterior borders of the ramus is called Curve Of Spee’ .
- Graf Von Spee.
This will destabilize the upper
denture and causes damage to
the rugae area, increasing bone
resorption in this area.
Curve Of Spee

MedioLateral curves
These curves run transversely from one side of the arch to
the other .The following curves come in this category –
•Monsons curve
•Wilsons curve
•Reverse / Anti-monsoon curve
•Pleasure curve

MedioLateral curves
•Wilson curve
This is a curve that is convex downwards.
Wilson adopted this curve in setting the
artificial teeth in balanced occlusion for
complete dentures.
It is used to arrange the molars.
The lower teeth are inclined lingually,
giving prominence to the buccal cusps
It is named after George Wilson who
described it in 1911.

MedioLateral curves
•Reverse curve or anti-Monson curve
A curve of occlusion that is convex
upwards
This is usually used to arrange the first
premolars

MedioLateral curves
•Monson curve
Curve of occlusion in which
each cusp and incisal edge
touches or conforms to a
segment of the surface of a
sphere 8 inches in diameter
with its centre in the region of
the glabella
It was described by George S.
Monson, a US dentist. This
curve in three dimensions is a
combination of ‘curve of
Spee and curve of Wilson’

MedioLateral curves
•Pleasure curve
This is a combination of Monson and anti-Monson curves.
Hence, it is not a single curve but a combination of curves.
○ It was used for arranging nonanatomic teeth in balanced
occlusion.
○ The premolars and the first molars are set in a reverse curve
to prevent buccal tipping and seat the denture.
○ Second molars are set in a conventional Monson’s curve to
provide eccentric lateral balance

MedioLateral curves
•Pleasure curve
In excessive wear of the
teeth, the obliteration of
the cusps and formation of
either flat or cupped-out
occlusal surfaces,
associated with the
reversal of the occlusal
plane of the premolar, first
and second molar teeth
(the third molars being
generally unaffected),
whereby the occlusal
surfaces of the mandibular
teeth slope facially instead
of lingually and those of
the maxillary teeth incline
lingually

1. Anatomic Vs Non-anatomic teeth
2. Resin Vs porcelain teeth
3. Abnormal jaw relations
4. Neutral zone
5. Teeth arrangement and phonetics

Types Of Posterior Teeth
(based on anatomy of occlusal surface)
1. The anatomic teeth
2. The nonanatomic
3. Semi Anatomic teeth

Anatomic teeth
 Cuspal anatomy is similar to the natural tooth
 33 degree cusp angle
 In an edentulous mouth , situation differes
 Difficulty encountered in-
◦ Harmonious Balanced occlusion
◦ Horizontal forces generated
Feature – efficient in grinding food

Semi- Anatomic Teeth
PRIMARY OBJECTIVE – preservation of tissues
Main advantage-
 Freedom of movement
 Lack of interferences
 No horizontal forces
Indications -
 Flat ridges
 Knife edge ridge
 Large interridge space
 Milling type of chewing pattern with broad excursions
 Improper neuromuscular coordination.

Non - Anatomic Teeth
Advantages-
 Easy to setup
 Least lateral stresses
 Good for patients with poor muscular
control
 Good for poor ridges
Disadvantages -
 Difficult to obtain balanced
occlusion
 Less chewing efficiency for fibrous
foods
 Poor esthetics

Acrylic teeth Porcelain teeth
 Significant wear off
 Fracture toughness
 Retention – chemical bond
 Easily grind
 Silent on contact
 Minimal abrasion
 Discolours with time
 Dimensional change
 Insignificant Wear off
 Brittle
 Retention – Mechanical
 Difficult To Grind
 Sharp Impact Sound
 Abrasion Of Opposing
Natural Teeh
 Colour is stable
 Dimensionally Stable

Neutral zone
Position of each tooth
Outward force Vs inward force
Potential denture space
Neutral zone is the area between the tongue on one side and the
cheeks and lips on the other, where opposing soft tissue displacing
forces create a zone of neutral or minimal muscular force, the teeth
should be placed as far as possible with respect for these muscle
forces.
Neutral zone affects - 7

In 1931 - Fish gave concept of a Neutral Zone in
complete denture construction .
In 1966 - Wright described tongue function and its relation to
the occlusal plane and mandibular denture stability.
In 1973 - Pound recommended that the lingual surfaces of
mandibular posterior denture teeth should occupy an
area called Pound’s Triangle.
- Modification by Halperin
Pound’s triangle

Arrangement Of Teeth In Abnormal Jaw Relations
Class II jaw relation –
Maxillary protrusion
Wider upper arch
Class III jaw relation –
Mandibular protrusion
Wider upper lower arch

Teeth Arrangement and Phonetics
bilabial labiodental linguodental alveolar palatal
p F n t Sh
b v l d Ch
m s J
r z
SOUNDS -

Conclusion
The nature of the supporting structures for complete
dentures and the forces directed to them by occlusion
creates a special biomechanical problem . Therefore
considering the biologic, physiologic and mechanical
principles is of utmost importance while arranging teeth for
such a man-made occlusion.

References
-Zarb- Bolender’s Prosthodontic Treatment For Edentulous Patients
( 12th
edition, Chpt 19, pg379-426).
- Rahn AO, Heartwell CM Jr. Textbook of complete dentures. 5th ed. Philadelphia:
Lippincott,Williams & Wilkins; 1993. p. 352-6 41.
- Sharry JJ. Complete denture prosthodontics.3rd ed. New York: McGraw-Hill;
1974. p.241-65.
-Sheldon Winkler: Essentials of complete denture Prosthodontics,2nd edition
-Clinical dental prosthetics, A.Roy Mcgregor 3rd
edn; varghese publishing house.
- Wright CR. Evaluation of the factors necessary to develop stability in
mandibular dentures J Prosthet Dent 1966;16:414-30.
- Pound E. Lost--fine arts in the fallacy of the ridges. J Prosthet Dent 1954;4:6-16
-Payne AG. Factors influencing the position of artificial upper anterior teeth. J
Prosthet Dent 1971;26:26-32.
-Arrangement of artificial teeth in abnormal jaw relation: Maxillary protrusion
and wider upper arch.-B.K Goyal and k Bhargava J Prosthet. Dent. July 1974.
volume 32,no 1; 107 -111.
-Arrangement of artificial teeth in abnormal jaw relation: Maxillary protrusion
and wider upper arch.-B.K Goyal and k Bhargava J Prosthet. Dent. october 1974.
volume 32,no 1; 107 -111.

arrangement of teeth Anterior and Posterior

arrangement of teeth Anterior and Posterior

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arrangement of teeth Anterior and Posterior