g maxillary Majid Dental
Bissasu,
DDS,
Center, Ministry
anterior
natural
tooth gositio
PhDa
of Public Health,
Kuwait
The natural teeth provide the optimal guide for the correct placement of artificial teeth. A stem is made on the patient’s maxillary preextraction diagnostic cast. The stent is transferred to the patient’s edentulous maxillary cast to help position the maxillary anterior artificial teeth in the same positions the maxillary natural teeth occupied before extraction. (J PROSTHET DENT 1992;67:668-9.)
he ideal role of artificial teeth in complete dentures is to duplicate the positions of the natural teeth.l, 2 Immediate dentures simplify the determination of this position, but in making complete dentures without previous records, the position of the anterior teeth must be determined by the dentist’s esthethic sense, by the relationship of the teeth to the ridges, by measurements relative to the lip length, and by the use of phonetics. All of these factors require experience before they can be effectively used by the dentist. Preextraction records can provide valuable guides for placement of the anterior teeth. They include diagnostic casts, photographs, moulages, and profile templates.3 The latter record the facial contour as well as the position of the incisal edgesof the maxillary incisors, but this is only in the midsagittal plane.3 The other preextraction records are useful for arranging the artificial anterior teeth, but they do not help in placing the maxillary teeth in the exact positions previously occupied by the natural teeth. This article presents a simple method that can precisely duplicate maxillary anterior natural tooth positions by using a clear vacuum-formed stent constructed on the patient’s maxillary preextraction diagnostic cast. PROCED This procedure may be adapted for making maxillary and mandibular complete dentures or for making a single maxillary complete denture opposing mandibular natural teeth. In the latter case, not only the positions occupied by the natural teeth are copied, but the vertical dimension of occlusion can also be maintained. In this article, a maxillary complete denture has been made against natural mandibular anterior teeth and a removable partial den-
CONCLUSION This procedure is a simple method for placing the maxillary anterior artificial teeth in the same position that the maxillary natural anterior teeth occupied before their removal. Moreover, in patients whose mandibular anterior teeth are present, the vertical dimension of occlusion can be maintained. REFERENCES
ture.
1.
lateral borders terminate 2 to 3 mm short of the sulcus, and the posterior border terminates just anterior to the postpalatal seal region. 2. Make the maxillary primary and final impressions in the usual manner (Fig. 3). Make the mandibular impression with irreversible hydrocolloid and pour both impressions in artificial stone. 3. Select the maxillary anterior teeth with respect to proper size and shade. If necessary, reshape the teeth to fit in the identations of the natural teeth on the stent. 4. Keep the maxillary final cast in water for a few minutes and then place the stent on the cast (Fig. 4). 5. Place the selected teeth in the identations of the natural teeth on the stent (Fig. 5). 6. Attach the teeth to the cast with baseplate wax, remove the stent, and make posterior wax occlusion rims (Fig. 6). 7. Record the patient’s horizontal jaw relationship. 8. Mount the cast in the articulator and arrange the posterior teeth (Fig. 7). 9. Try in and finish the denture in the conventional manner (Fig. 8).
Make a clear vacuum-formed stent on the patient’s maxillary preextraction record cast (Figs. 1 and 2). The anterior border of the stent terminates at the labioincisal edge of the maxillary anterior teeth. The
1. Winkler S. Essentials of complete denture prostbodontics. 1st ed. Philadelphia: WB Saunders Co, 1979:291-300. 2. Hickey JC, Zarb GA, Bolender CJ. Boucher’s prosthodontic treatment for edentulous patients. 9th ed. St. Louis: CV Mosby Co, 1985: 363-4. 3. Turner LC. The profile tracer: method for obtaining accurate preextraction records. J PROSTHET DENT 1977;38:490-3.
Reprint requests to: Y?rosthodontist, 10/1/35OSl
668
Department
of Removable
Prosthodontics.
DR. MAJID BISSASC P.O. Box 768 HOMS SYRIA MAY
1992
VOLUME
67
NUMBER
5
Fig. 1. Preextraction maxillary cast. Fig. 2. Clear vacuum-formed stent. Fig. 3. Final maxillary cast. Fig. 4. Sent on final cast. Fig. 6. Teeth in position ready for waxing. Fig. 6. Anterior teeth and occlusion rims. Fig. 7. Posterior teeth are arranged and ready for try-in. Fig. 8 Completed maxillary denture. THE
JOURNAL
OF PROSTIIETIC
DENTISTRY
669
Bissasu,
DDS,
Center, Ministry
anterior
natural
tooth gositio
PhDa
of Public Health,
Kuwait
The natural teeth provide the optimal guide for the correct placement of artificial teeth. A stem is made on the patient’s maxillary preextraction diagnostic cast. The stent is transferred to the patient’s edentulous maxillary cast to help position the maxillary anterior artificial teeth in the same positions the maxillary natural teeth occupied before extraction. (J PROSTHET DENT 1992;67:668-9.)
he ideal role of artificial teeth in complete dentures is to duplicate the positions of the natural teeth.l, 2 Immediate dentures simplify the determination of this position, but in making complete dentures without previous records, the position of the anterior teeth must be determined by the dentist’s esthethic sense, by the relationship of the teeth to the ridges, by measurements relative to the lip length, and by the use of phonetics. All of these factors require experience before they can be effectively used by the dentist. Preextraction records can provide valuable guides for placement of the anterior teeth. They include diagnostic casts, photographs, moulages, and profile templates.3 The latter record the facial contour as well as the position of the incisal edgesof the maxillary incisors, but this is only in the midsagittal plane.3 The other preextraction records are useful for arranging the artificial anterior teeth, but they do not help in placing the maxillary teeth in the exact positions previously occupied by the natural teeth. This article presents a simple method that can precisely duplicate maxillary anterior natural tooth positions by using a clear vacuum-formed stent constructed on the patient’s maxillary preextraction diagnostic cast. PROCED This procedure may be adapted for making maxillary and mandibular complete dentures or for making a single maxillary complete denture opposing mandibular natural teeth. In the latter case, not only the positions occupied by the natural teeth are copied, but the vertical dimension of occlusion can also be maintained. In this article, a maxillary complete denture has been made against natural mandibular anterior teeth and a removable partial den-
CONCLUSION This procedure is a simple method for placing the maxillary anterior artificial teeth in the same position that the maxillary natural anterior teeth occupied before their removal. Moreover, in patients whose mandibular anterior teeth are present, the vertical dimension of occlusion can be maintained. REFERENCES
ture.
1.
lateral borders terminate 2 to 3 mm short of the sulcus, and the posterior border terminates just anterior to the postpalatal seal region. 2. Make the maxillary primary and final impressions in the usual manner (Fig. 3). Make the mandibular impression with irreversible hydrocolloid and pour both impressions in artificial stone. 3. Select the maxillary anterior teeth with respect to proper size and shade. If necessary, reshape the teeth to fit in the identations of the natural teeth on the stent. 4. Keep the maxillary final cast in water for a few minutes and then place the stent on the cast (Fig. 4). 5. Place the selected teeth in the identations of the natural teeth on the stent (Fig. 5). 6. Attach the teeth to the cast with baseplate wax, remove the stent, and make posterior wax occlusion rims (Fig. 6). 7. Record the patient’s horizontal jaw relationship. 8. Mount the cast in the articulator and arrange the posterior teeth (Fig. 7). 9. Try in and finish the denture in the conventional manner (Fig. 8).
Make a clear vacuum-formed stent on the patient’s maxillary preextraction record cast (Figs. 1 and 2). The anterior border of the stent terminates at the labioincisal edge of the maxillary anterior teeth. The
1. Winkler S. Essentials of complete denture prostbodontics. 1st ed. Philadelphia: WB Saunders Co, 1979:291-300. 2. Hickey JC, Zarb GA, Bolender CJ. Boucher’s prosthodontic treatment for edentulous patients. 9th ed. St. Louis: CV Mosby Co, 1985: 363-4. 3. Turner LC. The profile tracer: method for obtaining accurate preextraction records. J PROSTHET DENT 1977;38:490-3.
Reprint requests to: Y?rosthodontist, 10/1/35OSl
668
Department
of Removable
Prosthodontics.
DR. MAJID BISSASC P.O. Box 768 HOMS SYRIA MAY
1992
VOLUME
67
NUMBER
5
Fig. 1. Preextraction maxillary cast. Fig. 2. Clear vacuum-formed stent. Fig. 3. Final maxillary cast. Fig. 4. Sent on final cast. Fig. 6. Teeth in position ready for waxing. Fig. 6. Anterior teeth and occlusion rims. Fig. 7. Posterior teeth are arranged and ready for try-in. Fig. 8 Completed maxillary denture. THE
JOURNAL
OF PROSTIIETIC
DENTISTRY
669
