Complete Dentures

The Try-In

Appointment 4

Introduction
Goals:
Evaluate and finalize the anterior esthetics. Evaluate and finalize the occlusion.

The student/practitioner should: Complete the wax-up/set-up. Patient evaluate set-up. Obtain patient approval.

Introduction

Esthetic Set-Up Factors:

Tooth Alignment Golden Mean Anatomic Contours

THINGS THAT SHOULD HAVE BEEN DONE PRIOR TO THIS APPOINTMENT

The occlusal rims contoure d to hold the lips in proper position.

The t eet h prope rly set in the wax t o mainta in de sired labial f ullne ss.

The t eet h set t oo f ar labially giving the lips a pouche d outappea rance.

The t eet h set t oo f ar lingually giving the lips a dished in appea rance.

Axial Inclination of Maxillary Anteriors in the Basic Arrangement.

A
Axial Alignment of Mandibular Anterior Denture Teeth

B
A. Facial View. B. Proximal View.

20 O CURV ED M ET AL PLATE

RET ROM OL AR PAD

Use of a Curved Plate for Balanced Occlusions.

Maximum Labial Placement of Lower Anterior Teeth.

Horizontal and Vertical Overlap.

The Mandibular Residual Ridge as a Landmark for Setting Teeth.

RELATIONSHIP OF CUSPED POSTERIOR TEETH IN CENTRIC OCCLUSION

MAX.
CREST OF THE RIDGE

CREST OF THE RIDGE

MAND. POSTERIOR HORIZONTAL OVERLAP OF FLAT PLANE TEETH.

UPPER MEMBER M0 VEMENT

MAXILLARY CAST BULK WAXING COMPLETE DENTURES

10MM

(APPROX.)

1.5 TO 2.0 MM THICK

Tooth Alignment
Centrals Laterals Canines

Three different approaches to providing a denture on the same patient. Note the differences in the setting of the teeth and the festooning. The same mold of teeth was used in each case.

Tooth Alignment
Midline:
Centered with the patients face/ Perpendicular with the eyes.

Midline

Should follow the contour of the lower lip.

Varies with each patient.

Smile Line

Smile Line
Positive Negative

Length of Centrals
Should lie just above the resting lip. Should contact the wet-dry line during speech.

Pronounce F,V sounds.

Length of Centrals

Maxillary anteriors are in harmony with lower lip.

Over-long maxillary anteriors collide with the lower lip.

Width of six anterior teeth

Width of Ant. Six

A. Two planes exist in setting maxilla posterior teeth.. B. There are at least ways of aligning the mandibular teeth with the ridge. C. The anterior teeth should not be placed further forward than a line drawn from the labial vestibule perpendicular to the occlusa plane.

Plane of Occlusion
Anterior-Posterior Horizontal Orientation. Parallel With Patients Eyes Anteriorly.

A. Right side working. B. Left side balancing.

A. Centric

B. Balancing

C. Working

D. Protrusive

Plane of Occlusion

Plane of Occlusion

Function
Evaluate:
Vertical dimension Space available for tongue, lip-support, etc.

Esthetic Try-In

Use of a small amount of denture adhesive is helpful in building patients confidence at the try-in stage.

Evaluate Facial Proportions

Observe the patient from every angle.

Observe Maximum Intercuspation

Centric occlusion should correspond with articulator.

Evaluate Anterior Teeth

The vermilian border should be supported by the teeth.

Evaluate The Relation Of Mandibular Teeth In Relation To Lower Lip.

Mandibular anterior teeth should be positioned to contact lower lip.

Evaluate Vertical Axis of Anterior Teeth Relative to Base of Denture.

Observe Lip Support

Lip Support Should Come From Labial Surfaces of Anterior Teeth.

Evaluate Cheek Contact.

Teeth Should Be in Muscular Balance Between Cheeks and Tongue.

Evaluate Position of the Teeth Relative to the Tongue.

Difficult to evaluate

Denture provides lip support in B as compared to A, leading to recovery of patients natural appearance.

Proper contouring of dentures can significantly improve the physical appearance of the patient.

Selective grinding of the teeth can provide a much more lively and more natural appearance.

Occlusion
Centric Relation Centric Occlusion Vertical Dimension of Occlusion Vertical Dimension of Rest

Occlusion

Centric Occlusion

Occlusion

Centric Occlusion

Occlusion

Occlusion

Occlusion

Centric Occlusion

Occlusion

Centric Occlusion

Golden Mean

Golden Mean

Golden Mean

Golden Mean

Esthetics

Esthetics

Esthetics

Esthetics

Wax-Up
Should be finished and neat before seating the patient.

Patient Approval/Acceptance

Esthetics

E s t h e t i c s

E s t h e t i c s

E s t h e t i c s

E s t h e t i c s

Esthetics
Place the denture. Evaluate esthetics. Correct problems. Let the patient see set-up.

Introduction
Factors: Texture Color Arrangement

Texture
Look closely at the texture of the gingiva. What do you see?

Texture
Attached gingiva
Orange peel texture

Attached mucosa
Smooth

Texture
Orange Peel

Smooth

Texture
Achieved by:
Waxing proper contours. Not over-polishing.
Minimal polish of areas around teeth.

Texture
Wax to ideal. Do not over polish.

Color
Attached gingiva is:
Lighter, pinker than mucosa. Darker, browner.
Pink in the light skin races.

Brown to purple in the dark skin races.

Color

Contrast the two colors.

Color

Notice the small blood vessels.

COLOR