GUIDELINES TO

LIP POSITION IN THE

CONSTRUCTION OF
COMPLETE DENTURES
BRUNTON & McCORD
QUINT. INT. 1994; 25: 121-124

INTRODUCTION
MORE NO. OF RPD : RETAIN MORE
NATURAL TEETH
ELDERLY PATIENTS : BETTER
EDUCATED
MORE REGARDS FOR ESTHETICS &
FUNCTION

PHYSIOLOGIC LIP SUPPORT &

CONTOUR
IN DENTATE :
1. INTRINSIC SUPPORT

SUPPORT FROM
UNDERLYING
STRUCTURES
(ANTERIOR
TEETH & ASSO.
ALVEOLAR
BONE)

RICKETTS (1957)
ESTHETIC PLANE
ELLINGER
(1968):POOR
REFERENCE PLANE

RESORPTIVE CHANGES
LOSS OF BUCCAL BONE &
AN ASSO. DECREASE IN RIDGE Ht. IN
ANTERIOR REGION OF MAXILLA

DENTOFACIAL PROFILOMETER
(SCHER,1979)
TO QUANTIFY FACIAL PROFILE
HELP TO PRESERVE NATURAL FACIAL
CONTOUR
IT MEASURED NASOLABIAL ANGLE,
LENGTH OF UPPER LIP & HORI. PART
OF NOSE AT THE PRE-EXTRACTION
PHASE

DENTOFACIAL PROFILOMETER

FRIEDMAN IN 1977
USE FACIAL MEASUREMENTS,
PROFILE PATTERNS & PHOTOGRAPHS
TO OBTAIN INDEX OF LIP CONTOURS
SERVE AS GUIDE TO POSITIONING
THE ANTERIOR TEETH

PHYSIOLOGIC LIP SUPPORT

IMPORTANT : NATURAL & PLEASING
APPEARANCE +
FROM FUNCTIONAL POINT OF VIEW
MUSCLES : FUNCTION MOST EFFICIENTLY
MAINTAINED & SUPPORTED
ESTHETIC CONSIDERATION : LIPS ARE IN
REPOSE + FUNCTION

AFTER RESORPTION: IF TEETH

ARE PLACED OVER RESI. ALV.
RIDGE
-- UNPHYSIOLOGIC LIP
SUPPORT
RESULTANT SPACE BETWEEN
UPPER LIP & INCISORS
PHONETIC PROBLEM

DENTURE : REPRODUCE NATURAL

ANATOMY AROUND TEETH TO
ENHANCE LIP SUPPORT
(PHYSIOLOGIC LIP SUPPORT )

SIGNS OF EXCESSIVE LIP

SUPPORT

TENSED, STRETCHED
APPEARANCE OF THE LIPS
TENSION LINES AROUND THE
MOUTH

DISTORTION OF PHILTRUM

OBLITERATION OF THE
MENTOLABIAL, NASOLABIAL &
LABIOMARGINAL SULCI

ERADICATION OF
NATURAL CONTOURS
OF LOWER PART OF FACE

SIGNS OF INSUFFICIENT LIP

SUPPORT

PERPETUATION OF GENERAL
APPEARANCE OF COLLAPSE
AROUND THE MOUTH

REDUCTION IN SIZE OF
VERMILION BORDERS OF THE
LIPS

DROOPING OF CORNERS OF
THE MOUTH

DEEPENING OF
MENTOLABIAL,
NASOLABIAL &
LABIOMARGINAL
SULCI

OBLITERATION OF PHILTRUM

WATT & MacGREGOR (1986)

AVG. SAGITTAL ANGLE BETWEEN
COLUMELLA & LIP : RIGHT ANGLE

WATT & MacGREGOR

HORI. NASOLABIAL ANGLE

WATT(1981) CONSTRUCTION & USE

OF BIOMETRIC TRAYS:
BUCCAL SULCI DEPTH & WIDTH
PRE-EXTRACTION RECORD

COMPARISION OF THE
EDENTULOUS &
DENTATE STATES

ISMAIL et al(1968) AND

CARLSSON & ERICSON(1967)
SOFT TISSUE PROFILE : DENTURES
RESTORED THE LIPS TO PRE-EXTRACTION
CONTOUR
GRADUAL REDUCTION IN VERT. & HORI.
DIMENSIONS OF LIP CONTOUR - PATTERN
OF ALVEOLAR RESORPTION

WATSON & BHATIA(1989) :

IN EDENTULOUS GROUP UPPER
LIP HAD CHANGED IN
CHARACTER &
FLATTENING OF PROFILE

TALLEGREN et al(1991)
IMMEDIATE DENTURE CASES :
MORE ANTERIOR POSITION OF THE
MAXILLARY LIP [DENTURE FLANGE]

DECREASE VDO & ANTERO-SUPERIOR

ROTATION OF MANDIBLE :
OUTWARD POSITIONING OF UPPER LIP

ANTERIOR TOOTH POSITION

FRUSH & FISHER :
NATURAL & PLEASING LIP
SUPPORT
INDEPENDENT, NOT
CONTROLLED BY CRANIAL
RELATION

ANTERIOR ANATOMIC
LANDMARK (OCCLUSAL PLANE)

ELLINGER(1968)
FAILURE TO PLACE THE
ANTERIORS
UNSUPPORTED LIPS,
IMPROPER MUSCLE TONE,
PREMATURE AGING,
ALTERED FACIAL
EXPRESSION & FAULTY
CONTOURS

PLACE ANTERIORS OVER

RESIDUAL RIDGES

VIG (1961)
IF LABIAL FLANGE IS THICKENED =
SUNKEN, UNCOSMETIC OVAL PROFILE
WITH INVERTED PROFILE

FORSBERG(1979):
LIP LENGTH [DENTATE],
UPPER LIP LENGTH INCREASES WITH
AGE
MAXILLARY INCISORS : AT OR
SUPERIOR TO THE UPPER LIP
AVOID DENTURE LOOK

REPLACEMENT OF CENTRAL
INCISORS
AVG : 12.5 mm
BIOMETRIC GUIDE

MAXILLARY & MANDIBULAR

INCISORS
SET TO A LOWER LEVEL
ACC TO LONGER EDENTULOUS
UPPER LIP
SO, 1-2 mm BELOW THE VERMILION
BORDER
FORSBERG, FRUSH & FISHER

SUMMARY

VARIETY OF METHODS :
TO ESTABLISH GUIDELINES
NO ONE METHOD CAN BE SAID TO BE
FOOLPROOF
INCISAL PAPILLA & PRE-EXTRACTION
PHOTOGRAPHS