Esthetics and anterior tooth selection

By Dr. Vishaal Bhat on Sunday 6 July 2008 with 0 comments



4 determinants of esthetics:

1. Shade

2. Size

3. Form (rectangular, triangular or ovoid)

4. Arrangement

Dentogenics: harmonizing the teeth with the patient’s sex, personality and age

-smile line should follow the line of the lower lip

-tooth support of the lip is by 2/3 of the incisal labial surface of the anteriors

-central incisors should be 8-10mm anterior to the midpoint of the incisive papilla

Phonetics:

-labial sounds: P & B

-insufficient support of lips = defective sounds

-labiodental sounds: F, Ph & V

-incisors too short: V sounds like F

-incisors too long: F sounds like V

-if upper teeth touch labial side of lower lip, incisors too far facially

-if lower lip drops away from lower teeth during speech, lower teeth are too far lingually.

-if imprints of the labial surfaces of the mandibular anterior teeth are on lingual of lower lip, mand ant teeth are too far labial.

-if max ant teeth are too far lingual, they’ll contact lingual side of mandibular lip with F & V sounds.

Linguodental sounds: Th

-if tongue does not protrude, maxillary ant teeth too far labially.

-if more than 6mm of tip of tongue protrudes, maxillary ant teeth too lingual.

Linguopalatal sounds: T & D

-T sounds like D if maxillary anterior teeth are too far lingual

-D sounds like T if maxillary anterior teeth are too far labial

Sibilants: Ch, J & S

-S sound has two tongue positions

-tip of tongue against the palate in ruggae area with a small space for the escape of air between the tongue and the palate.

-if opening is too small, a whistle develops

-if space is too broad or thin, a lisp results

-a whistle develops if posterior arch is too narrow

1/3 of people make the S sound with the tip of the tongue

contacting the lingual side of the mandibular ant teeth and the tongue itself up against the palate to form the desired shape and size of the airway.

Whistle sound: mand ant teeth too far lingually

-faulty S sounds: lingual flange of mand denture too thick

-S, C & Z sounds:

-if occlusal vertical dimension is too great, the teeth will come together

prematurely and they’ll click.

-rule of golden proportion: 1 to 0.618 or 3 to 5

Category: Prosthodontics Notes

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