Dentsply Tooth Arrangement Manual

5/10/2018 Dentsply Tooth Arrangement Manual

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A n t e r i o r & P o s t e r i o rT o o t h A r r a n g e m e n t M a n u a l[):~y T. b 1Mli , r u e t o y o u r u s m e s s .R U B Y f E


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S u g g e s t e d p r o c e d u r e s f o r t h e a r r a n g e m e n t a n d a r t i c u l a t i o n o fT R U B Y T E @ A N T E R IO R a n d P O S T E R IO R T E E T HCon ta in s gu id e lin es fo r u se , a g lo ssa ry o f key te rm s andsu gg es ted a rran gem e nt and a rticu la tio n p ro ced ures

T a b l e o f C o n t e n t s PagesAnterior Teeth. . . . . . . .. . . . . . . . . . . 2-840 Posterior Teeth . . . . . . . . . . . . . . . . . .. 9- 1033 Posterior Teeth. . . . . . . .. . 1 1-1230 Posterior Teeth 13-1522 Posterior Teeth . . . . . . . . . . . . . 16-1720 Posterior Teeth . . . . . . . . . . . . . 18-1910 Posterior Teeth . . . . . . . . . . . . . . . . .. . 20-220 Posterior Teeth . . . . . . . . . . . . . . . . . . . . 23-25Lingualized Teeth. . . . . . . . . . . . .. . 26-31Appendix 32-38

2005 DENTSPLYInt er na ti onal I nc . A ll r ight s r ese rved.


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Desc r i p t i o n :Exc e p t io n a l e s the tic s , p lu s a n in f in ite va ri-e ty o f m o u ld s to s a t is fy a n y n e e d .In d ic a t io n s Fo r Us e :An y fu l l o r p ar t ia l d en tu re c a s e ; a ls o id ea lfo r u se in im p la n t p ro s the tic s a nd p ro vi-s io n a l r e s to r a tio n s .

F a c t o r s t o C o n s i d e r i n t h eE s t h e t i c A r r a n g e m e n t o fT r u b y t e A n t e r i o r T e e th

N a t u r a l a n te ro -p o s t e r i o r p la c em e n t 0 1m a x il l a r y a n te r i o r t e e t h

Antero-posterior positioning of anterior teeth is an impor-tant factor in esthetics since the teeth give support to thelips, cheeks, and other tissues of the oral cavi ty. Thereplacement of artificial teeth in the original position ofthe natural teeth is frequently not stressed or simply over-looked. Too often resorbed residual ridges are used asthe primary indicator for tooth position. Because ofwhat may be extreme changes in shape and size, aresorbed, residual ridge is a questionable landmark foreither functional or esthetic tooth position.Setting artificial teeth directly over the center of resorbedridges makes the development of natural estheticsextremely dif ficult to achieve. This is because naturalteeth seldom occupy the so-called "over the ridge" posi-t ion. Dental restorations, complete dentures in particu-lar, will not normally be esthetically pleasing if teeth areimproperly positioned.The loss of bone structure after tooth removal is usuallygreater on the buccal/labial aspects of the maxil laryridge than on the palatal aspect. Therefore, the ridgecenter is more palatal, smaller and different in shapethan it was previously.The overall heights may vary, depending on the anatomi-cal differences between individual patients and on thedegree of vertical overlap (overbite) incorporated intothe anterior tooth arrangement. An accepted rule-of-thumb is discussed on page 3, bottom of column 2.

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R id g e r eso rp tio n is a m a jo r fa cto r in th epos i t ion o f an t er io r t ee th .

F o r n a tu ra l e s th e tic s a n d p h o ne tic s , th e a rt i f ic ia l t e e ths ho u ld b e p la ce d a s n ea rly a s p os sib le in t h e s am e p os it io na nte ro -p os te rio rly , a nd b e o f th e s am e le ng th , a s th e o rig i-n a l n a tu ra l te e th .

Natural Tooth Position" A" i ll us tr at es t he p os it io n o f t hen at ur al c en tr al i nc is or a nd i tsr el at io ns hi p t o t he r id ge .Position AfterLoss/Removal'11" Illustrates the same rtdgeimmediately after removal ofthe tooth. Dotted lines indi-cate position of the naturalroot.

Direction of ResorptionThe d ir ec ti on o f r es or pt io n i s upand back. In "C" the solid linei de nt if ie s t he r es or be d r id ge ; t hed ot te d l in e, t he o ri gi na l c on to uro f th e r id ge .Improper Positioning ofTeeth"0" illustrates one of the m ostco mm on e rro rs in a nterio rt oo th p os it io ni ng - p os it io ni ngthe teeth over the resorbedridg e w itho ut co nside ring th eorig in al p ositio n of th e n atura lteeth.In "E," w ith drawing "A"su perim pose d o ve r d ra win g"0," the denture w ith teeth setover the ridge is compared tothe original position of thenatural central. The 1055 ofvertical dim ension and lip sup-p or t, a nd r es ultin g 1055 inesthetics, is the m ost com mon result.

a A/, Ii1 2 1 4 m m . , / / /i/ ,:/!, // B/,/

9 I O m m .

c

1 8 2 0 m m .

These matrix studies further demonstrate the relationshipbetween tooth position and ridge resorption, and properlip support.Fig. 1 shows a cross-sec-tion of the matrix and castmade before natural teethwere removed.In Fig. 2 the cast has beentrimmed to simulate a normalamount of ridge resorption inthe anterior area.In Fig. 3 a graphic illustra-tion is provided of whathappens to tooth position-ing when the teeth are set"up and back" on theresorbed ridge.These figures illustrate the extent to which an artificialtooth set on the resorbed ridge may deviate from its truenatural position. This "on the ridge" position of the teethcannot provide proper l ip and facial tissue support.

T h e m ea s u r e m en ts o f 2 2 m m a n d 1 8 m m fr o m th e la b ia lf o ld to t h e in cis al e dg es o f th e m a x il la ry a n d m a n dib ula rin c is ar s r es p ec tiv e ly , a re re as o na b le a v er ag e s. T h es e d is -t a n ce s m ay b e u s e d a s a g u id e f o r t h e le n g th o f w a xo cc lu sa l r im s in th e a nt e rio r a re a, a nd p o si t io n in g o f th ec en tr al in c is o r te e th fo r p re lim i na ry t oo th a rra n ge m e nts .

Proper vertical positioning of artificial teeth accord-ing to averages.

3 6, 3 7, 3 8 m r n .

(Note that the teeth in the schematic drawing above arelabial to the residual ridges.)

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T h e r e la t io n s h ip o f t h e a r c h f o r m to t o o t ha r r a n g e m e n tNature tends to harmonize the form of maxillary centralswith the form of the face, the dental arch, and thearrangement of anterior teeth. Persons with dominantlysquare faces often have mainly square arrangements ofmostly square-shaped teeth. In general these same har-monious principles also apply to the square tapering,tapering, and ovoid types.KIllYP M a n d ib u l a r r id g e i s u s e d t o d e t e rm i n e a rc h f o rm d u e t o

r e s o rp t i o n o f m a x i l la r y r id g e . .T o o th A r r a n g em e n t in t h e S q u a r e A rc hIn the Square Arch form, the two centrals are usually setto an almost straight line across the front of the arch.The laterals are also positioned with a nearly full labialaspect and exhibit very l ittle rotation. This helps giveprominence to the canines. The radius of square archestends to be wider than, for example, tapering arches.This provides sufficient room for placement of the incisorteeth without crowding or lapping.

O v e r a l l , i n t h e S q u a r e a r r a n g em e n t t h e v is u a l e f f ec t i sf a ir ly s tr a i g h t f r om c a n in e t o c a n in e . T h e t e e t h a ls o t e n dt o b e s t r a ig h t u p a n d d o w n , r a th e r t h a n s l o p i n g . T h e f u llo r n e a r ly f u l l l a b ia l s u r fa c e p r e s e n te d b y a ll s ix a n te r i o rt e e t h g iv e s a b ro a d e ff e c t w h ic h i s i n h a r m o n y w i t h ab r o a d , s q u a re f ac e .

Figure S. Mould 12G is illustrated.

S O U R C E S O th e r a p p r o p r ia te m o u l d f o rm s a re l i s te d i n t h e I P N !r::J, M o u ld ( h a r t , F o rm # 4 3 4 3 -A a n d i n t h e I n d iv id u a l i z e d . .1~ A n t e r i o r A r r a n g e m e n t b r o c h u r e , F o r m #3 9 0 0 . ) 1

~.~~..======"~=~===""~=====.===.... . = JT o o th A r r a n g em e n t i n t h e T a p e r i n g A rc hA common feature here is the rotation of the centrals ontheir long axis inward at the distal, which sets the twoteeth at an angle. Rotation and lapping of teeth is oftenobserved because there is less space in this arch than inany other type, and crowding is a result. This oftenreduces the amount of labial surface visible.

I n t h e T a p e r in g a r c h , t h e c e n t r a l i n c is o r s a r e o f t e n f o u n dt o b e a g re a t e r d is t a n c e f o rw a rd o f t h e c an in e s t h a n i no th e r t y p e s o f a r c h es .

A Tapering arrangement does not appear as wide as oth-ers, however, it is usually in harmony with the narrowingeffect visible in the lower third of the tapering face. Thelaterals are often raised from the occlusal plane anddepressed at the gingival. In addition, the necks of thecanines at the gingival are often quite prominent. Theincisal tips of the canines may be at the same height orslightly above the incisal edges of the laterals.

Figure 6. Mould 44E is illustrated.A Tapering arrangement may also exhibit some "slope;"that is, the incisals of the centrals and laterals are project-ed forward, and the cervical area of canines is broughtout.

T o o th A r r a n g em e n t i n t h e S q u a r e T a p e r i n g A rc hThe Square Tapering arrangement combines characteristicsof the Square and Tapering forms, modifying both. It hasa characteristic Square placement of the centrals, but is setin a "softer" arrangement. The Square Tapering arrange-ment may not exhibit the illusion of fullness or width asdoes the Square, and usually the canines exhibi t more dis-tal rotation than in a Square arrangement.

~ T h e 1, , '01, o r e s e t p r o m i n e n l l y , w i l li t h e 0 1 " . , o n d l1li1-n in e s e le v a te d . T h e r e m a y b e l i t t l e o r n o r o t a ti o n o f t h e c e n -t r a l s c om b in e d w i th a t y p ic a l T a p e r in g e f f ec t o r r o t a ti o n o fl a t e r a ls a n d c a n in e s .

Figure 7. Mould 22G is illustrated.

T o o th A rr a n g e m e n t i n t h e O v o id A rc hThe Ovoid arrangement exhibits definite curvature; rota-tion is seldom observed.~ T h e " n t r n l i a d se r s ; , m e O v o i d o n le r i o r " , h o r e o f t e n s e tw e l l f o rw a r d o f t h e c an in e s , i n a p o s it i o n b e t w e e n t h a t o f

t h e S q ua re a n d t h e T a p e r i n g a rc h e s .g

A typical Ovoid alignment shows a fullness of labial sur-face from canine to canine. This, in conjunction with set-ting the teeth to the curved arch, gives a broad effect thatis in harmony with a round Ovoid face.

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Figure 8. Mould 65G is illustrated.

Figure 8A illustrates the averageantero-posterior distance from thecenter of the incisive papilla to thelabial surface of the centrals, basedon the tooth form selected. 5mm Square6mm Ovoid7mm Tapering

B a s ; c p l a c e m e n t 0 1 a n t er io r t ee thFive important factors are involved in positioning anteriorteeth. They are:1. Anterior slope - Labial inclination.2. Mesiodistal inclination - Mesial or distal tilt.3. Inferior-superior positioning to a horizontal plane -Above/below plane of occlusion.

4. Rotation on a long axis - Turning tooth on its centeraxis.

5. AnteroJosterior positioning - How far labially or lin-gually in or out) the anterior or posterior teeth arelocate.

P r o x im a l V ie w - A n t e r i o rS l o p eOn average, the centralincisor, when set at approxi-mately the same angle as nat-ural teeth, will be at an inclina-tion slightly offset from vertical.The incisal edge will contactthe occlusal plane.

Figure 9A

The slope of the lateral incisoris often slightly more accentuat-ed than that of the central.The incisal edge of the lateralmay be slightly raised (superiorto) about 1/2 mm from theocclusal plane.

Figure 9B

The canine may be set promi-nently, often to a line at rightangles to the occlusal plane,with the incisal edge set on orslightly above the plane.

Figure 9C

F r o n t a l/ F a c i a l V ie w - M e s io d i s t a l I n c l i n a t i o nThe desirable angulation to the median line may be corre-lated to the form of the arch and of the tooth. Generallythe Square Arch form and tooth, and the Ovoid Arch formand tooth, may be set to approximately the same angula-tions.

t u : c t 1 Y Lquare OvoidFigure lOAThe Tapering forms are often set to a slightly greater angu-lation. u r u r t mquare-tapering Tapering

Figure lOBAny technique concerning the preliminary arrangement ofteeth is based upon average conditions. Many times prac-tical considerations dictate modifications in these methodsin order to cope with individual differences in oral andfacial anatomy. However, if basic principles are followed,they will be a workable foundation for a harmoniousarrangement.

P r o c e d u r e sO c c l u s i o n R im sA wax occlusion rim is fabricated and defines the position,size and shape of the teeth to be replaced. Critical infor-mation about the patient's correct vertical dimension ofocclusion, occlusal registration and the general arrange-ment of the denture teeth are indicated on the occlusionrims. From this wax "template," a technician can proceedto position and arrange the teeth in the initial set-up.

M o r e in fo rm a t io n r eg a r d in g u se o f w a x o cc l u sio n r im s ,w a xin g -u p a n d g en e r al s e t- u p g u id e l i n e s a re a v a il a b lein t h e A p pe nd ix , p a g e 3 2 .

1. Place the central incisors in position with incisal edgestouching the occlusal plane or a mandibular occlusionrim (Fig. 11).

Figure 11

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2. Position the laterals with the incisal edge raised approx-imately 1/2 to 1 mm (Fig. 12).

Figure 123. Place the canines with the incisal tip close to ortouching the occlusal plane, and ti lt the cervical thirdbuccally to give it prominence. Often, the mesiolabialaspect of the canine is visible when viewed from theanterior.

In nature, the position of the canine teeth plays an impor-tant part in the esthetic appearance of the dentition. In adenture they play an equally important role. They haveesthetic and functional influence on both the anterior andposterior tooth arrangements (Fig. 13).

Figure 13

P o s i t i o n i n g o f m a x il l a r y c a n in e sFigures 14 and 15 show the importance of the properpositioning of the upper canines.

Figure 14. Viewed from the anterior, the mesiolabial sur-face of the canine is prominent, and the gingival one-thirdis positioned more facially than the incisal one-third.

Figure 15. Profile or side view emphasizes the almostvertical long axis and position of the canine.

F a c t o r s o f s o ftn e s s a n d v i g o rIn nature there are a number of conditions which may beobserved that directly affect the individual arrangementand esthetic appearance of natural dentition.Softness in a tooth arrangement is a reduction of the labialsurface in terms of its visual appearance. A roundedmesiodistal curvature of the tooth combined with an ovoidoutline of the tooth appears softer than a flat tooth withmore angularity. A rounded form is far softer to the eyethan a straight line or a flat plane.A characteristic of the bold, vigorous face is the dominantsize and alignment of the teeth. The relatively larger sizeo f the lateral incisors and canines, and their straight boldarrangement, are important considerations in achievingthe effect o f strength. Vigor and boldness are not neces-sarily solely masculine characteristics, since strong, boldfaces may be found in many female patients.The following drawings illustrate the principle o f toothpositioning for visual effect.In drawing 16A, two central incisors are normally posi-tioned. Viewed from the front, these teeth would look nor-mal in their size or relation to eachother.In drawing 16B, the two centralshave been positioned with themesials slightly more prominentand with the distals rotated inward-ly so they are less prominent.Viewed from the front view, theteeth in "B" would look smallerthan those appearing in "A." Theillusion is created by merely rotat-ing the teeth, giving them a some-what smaller and softer look.

Figure 16A

To further soften this effect, a rub-ber wheel may be used to roundthe distoincisal surface o f eithertooth, thereby introducing a slightdegree of asymmetry.

Figure 16B

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In drawing 16C the same twocentral incisors are placed tomake the teeth look larger, creat-ing the illusion of boldness orstrength. This is accomplished byrotating the mesial in and the dis-tal out to show more facial surface. If the laterals are alsodepressed slightly behind the centrals, the boldness of thetooth arrangement is further accentuated. This illusionmay be made even stronger by grinding the teeth incisallyto leave the distoincisal area prominent.

Figure 16C

P r o c e d u r e s to b e o b s e rv ed in a rr a n g in g th em a n d ib u l a r a n t e r io r t e e th

Figure 17

Figure 18Illustrations 17 and 18 show an anterior view of the loweranterior teeth arranged in average horizontal alignment oftheir incisal edges. Note that the long axis of the centralincisors is perpendicular to the plane. The long axis of thelateral incisors is inclined slightly to the distal at the neck.The long axis of the canines is inclined more to the disto-buccal at the neck.

Figure 19

Figure 20Figures 19 and 20 illustrate how to achieve greater char-acterization; lower anteriors should be rotated and lappedwith no two long axes of the teeth parallel to each other.

The horizontal plane used forthe alignment of lower anteriorteeth may be above the occlusalplane, a distance usuallydescribed as the vert ical over-lap or overbite (Fig. 21). Thevertical overlap of the teeth maybe inf luenced by the estheticand phonetic needs of thepatient. Anterior teeth shouldalso be arranged in harmonywith various degrees of incisalguide table angulation.

V e r t i c a l11-"1'---"- Overlap(Overbite)

Hori zonta lOv e rl a p (O v er j e t)Figure 21

C e n t r a l lateral C a n i n e

Fig. 22 shows a proxi-mal view of the loweranteriors indicatingtheir average antero-posterior inclinations toa horizontal plane.

Figure 22

O v e r a l l e v a lu a tio n o f a n te r io r to o tha r r a n g e m e n tAlthough there are varying methods and guides in thearrangement of art if icial anterior teeth, in the final analysisit is the overall visual effect of the teeth in the mouth of thepatient, created by their shape, size, color, and position,that determines acceptance or rejection. The teeth mustfulfill the Esthetic, Phonetic and Functional requirements ofthe individual patient. This is why a wax try-in and accep-tance of the denture arrangement by the patient is soimportant.

A wide variety o f patient communication materials anddenture select ion aids are available from DENTSPlYTrubyte. These materials wil l help educate patients andassist in the delivery of essential information from the den-tist to the laboratory, that will ultimately improve case suc-cess.

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A sy mm etry a nd its in flu en ce o n to otha r r angemen tAnother aspect of interest in tooth arrangement is the rela-tionship of facial asymmetry. Few faces will be observedwith true symmetry of the left and right side. Many faceswhich appear on fi rst observation to be symmetrical, oncloser study will be found to have differences. Similarly,these differences may be observed in the arrangement ofthe teeth. (Compare Fig. 21 with Fig. 22.)Asymmetry may be brought about by as little as thedepression or rotation of a canine. At times it may beaccompanied by a difference in the size of the laterals, or

Figure 21. Smile created using only theright side of the natural smile in Fig. 22.

by positioning one central slightly anterior to the other.This is shown in natural dentition (Fig. 22).Characterization of artificial tooth arrangements - usingasymmetry, spacing, crowding, lapping, and grindingmodifications - should be approached with caution. Pre-extraction study casts and photographs are the best guidesfor these individualized touches. This is an area of com-plete denture treatment which is more in the realm of theartistic than the scientific and requires patient acceptance.

Figure 22. Natural smile showing asymmetry.

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POSter i o r sDescription:Fully anatomical, long crown form.

Indications For Use:Ideal for use with partial dentures, in com-bination cases and implant overdentures;also for use in full dentures.Ridge Type:Healthy ridge with minor resorption.

Recommended Tech

Trubyte" Portrait IPNEuroline" 40 posterior teeth areful ly anatomical. They were designed by master dentaltechnicians in Europe and are moulded in York,Pennsylvania. Their wider, deeper occlusal table andlonger crown form integrate more completely with naturaldentition. This young anatomic form makes them ideallysui ted for use in removable partial dentures and combine-tion cases.Portrait EuroLine Posteriors are similar to BioStabil posteri-ors in bucco-l ingual and ridge lap design. This ful l-formtooth will fill a space and fit on a natural ridge with morestabil ity and will more easily interdigitate with opposingnatural dentition and fixed bridge restorations.Using 30 incisal and condylar guidance, the deepcusp/fossa angles can be arranged to maximize efficiencyand minimize interference. A definite occlusal stop in thecentral fossa area and an open ridge-groove pathway pro-vide more freedom of movement in lateral excursions, ascompared to other European posterior designs.These teeth may be arranged with a compensating curvefor bilateral balanced occlusion with complete dentures.Balancing contacts may be achieved on all teeth exceptthe first bicuspid. Either the lowers or the uppers can beset first. When setting the upper teeth first, follow the direc-tions provided here. If setting the lower teeth fi rst, use aTrubyte 20 Template.A r r a n g in g P o r t r a it E u r o L in e P o s t e r i o rs i n aB i l a te ra l B a la n c e d O c c lu s i o n

The relat ionship of the cusps of the maxillary posteriorteeth may be related to a flat occlusal plane for easy ini-tial positioning and later occlusion and articulation withthe mandibular posterior teeth, if necessary. An illustrationof initial positioning of each tooth and the relationship ofeach cusp to a flat plane are shown in Figs. 1 and 2.

Figure 1. Buccalview

( \ J (Q(QwFigure 2. Proximal view

1/ 2 to3 /4 m m \ ~J)) \.


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1. Place the maxillary premolars with their long axes atright angles to the occlusal plane (Fig. 1). A slightmesial inclination is also acceptable. The buccal cuspsof the premolars should touch the plane and the lingualcusp of the maxillary 1st premolar should be raisedapproximately 1/2 to 1 mm above the plane (Figs. 1and 2).

2. The first and second molars may beset with their long axes inclinedslightly mesially.

3. The mesiobuccal cusp and the mesi-olingual cusp of the fi rst molar (red Lingual /Tonguedots) are approximately 1/2 to 3/4mm above the plane (Figs. 1, 2, 2Band Step 3 illustration).

4. The second molar is set to follow theposition of the first molar. The dis-tolingual cusp and the distobuccalcusps (green dots) are approximate- l ingual /TongueIy 1-1/2 mm above the plane (Figs. 1,2, 2B and Step 4 i llustration).

5. Follow the same procedure in placing the posteriorteeth on the opposite side.

A straight edge may be used on the facial to align thebuccal ridge of the first and second premolars and themesiobuccal ridge of the first molar (Fig. 3).

Figure 3. Occlusal surface view

The buccal ridges of the molars may be similarly aligned,but angled slightly inward. This is an average arrange-ment and modifications can be made as individual condi-tions indicate.

E u r o l i n e 4 0 P o s t e r i o r sT h e C o m p le t e d T o o th A r r a n g e m e n t I n A l l R e l a t i o n s

Figure 4. Centric occlusion, buccal view. Figure 5. Cross section Figure 6. Centric occlusion, lingual view.of centric occlusion.

Figure 7. Working occlusion, buccal view.+-- Mandibular

Movemenf

Figure 8. Cross section Figure 9. Working occlusion, l ingual view.of working occlusion .

Figure 10. Balancing position, buccal view. Mandibular

Movement

Figure 11. Cross section Figure12. Balancing position, lingual view.of balancing occlusion.N o le : A rr on g em e nl s s ho w n a re o ve ra ge . M o di fi co li on s m a y b e m o de a s n ee de d f or a g iv en s il uo li on .

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A n a t o m i c a l 3 3

T ruby te ' tenDescription:Fully anatomical, long crown forms andlong buccal-short bite moulds available.

Indications For Use:Ideal for use with partial dentures, in com-bination cases and implant overdentures;also for use in full dentures.

Ridge Type:Healthy ridge with minor resorption.

Trubyte" Anatomical 33 Posteriorsare ideally designedfor complete dentures and removable partial dentureswhich oppose natural teeth. They are a standard of excel-lence for maxillary and mandibular complete dentureswhere an anatomical tooth form is preferred or indicated.

Cuspal contours are comparable to those of moderatelyworn natural teeth. Their inclinations and well definedsulci provide pathways which are adaptable to mostrequirements in complete and partial denture construction.

A r ra n g in g T r u b y te 33 ' m a x i l l a r yp o st e ri o r t e e t h

The procedures described are normal methods.Occasionally, compromises must be made for mechanicalreasons dictated by the conditions present. It may benecessary, for the purpose of creating required tongueroom, to alter the position o f the posterior teeth.The master carvings of Trubyte" 33 posterior teeth wereplanned to simplify occlusion and articulation. The relation-ship of the various cusps of the maxillary posterior teethshould be related to a flat occlusal plane for easy initialpositioning and later occlusion and articulation with themandibular posterior teeth. An illustration of initial posi-tioning of each tooth and the relationship of each cusp toa flat occlusal plane is shown in Figs. 1 and 2.

~ Figure 1. Buccal view

Figure 2. Proximal view1. Place the maxillary first premolar with its long axis atright angles to the occlusal plane. The buccal andlingual cusps are placed on the plane.

2. Place the maxillary second premolar in a similarmanner. Align the buccal surfaces of the premolarsand the canine with the edge of an occlusal plane (seeFigure 3).

Figure 3Please note: Portrait" IPN 33" posteriors canbe aligned with a straight edge on the lingualfor faster set-ups (see Anatoline page 20).

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3. The mesiobuccal and mesiolingual cusps of the maxillaryfirst molar touch the occlusal plane (red dots in Step 3).

Lingual/Tongue Lingual/Tongue

5. Follow the same procedure in placing the posteriors onthe opposite side.

6. An occlusal view of the positioning of Trubyte 33maxillary posteriors is il lustrated in Fig. 3, Page 11.

A straight edge may be used to align the labial ridge ofthe canine, the buccal ridge of the first and second premo-lars, and the mesiobuccal ridge of the first molar.The buccal ridges of the molars may be similarly aligned,but angled slightly inward. This is an average arrange-ment, and modifications can be made as individual condi-tions indicate.

The distobuccal cusp (green dot) is raised about 1/2mm and the distolingual cusp (green circle) is raisedabout 1/2 to 3/4 mm above the plane.

4. All the cusps of the second molar are raised from theocclusal plane following the position of the first molar(red circles). The mesiobuccal cusp (red dot) should beabout 1 mm from the occlusal plane.

F o r th e l in g ua liz e d o cc lu s io n te ch n iq ue u s in g 3 3 "p os te rio rs o v e r 2 2 " B io S ta bil p os te rio rs , s ee p ag e 2 6a n d 3 1 .

T r u b y te 3 3 P o s te r i o r s A r t i c u la t i o n o f m a n d ib u la r f i r s t m o la rBilateral balanced occlusion contributes greatly to the com-fort and efficiency of complete dentures. Without balancethere may be greater resorption, less efficiency, and a recur-rence of sore spots. Balanced occlusion can be accom-plished with a minimum of effort if each tooth is brought intofunction.

Bear in mind that the mandibular first molar is a key tooth inarticulation. If careful attention is paid to the positioning of thitooth, articulation of the remaining posteriors will be greatly faitated.

A n a t o m i c a l 3 3 P o s te r i o r sT h e C o m p le t e d T o o t h A r r a n g e m e n t I n A l l R e l a t i o n s

Figure 4. Centric occlusion, buccal view

Figure 7. Working occlusion, l ingual view

Figure 10. Balancing contact, buccal view

Figure 5. Cross sectionof centric occlusion.

[~..,__ M andibular

MovementFigure 8. Cross sectionof working occlusion .

. .. M a n d i bu l a rMov eme n t

Figure 11. Cross sectionof balancing occlusion.

Figure 6. Centric occlusion, lingual view

Figure 9. Working occlusion, buccal view

12N ot e: Ar ra ng em en ts s ho w n a re a ve ra ge . M od if ic at io ns m a y b e m ad e a s n ee de d fo r a g ive n s it ua tio n.

Figure 12. Balancing contact, l ingual view


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P ilk in gto n -Turnet 3 0

R O S t e r i o r sDescription:Fully anatomical, long crown forms andlong buccal-short bite moulds available.


Ridge Type:Healthy ridge with minor resorption.

Trubyte Pilkington-Turner 30 Posteriors are designed tomeet the anatomical requirements of the mandibular move-ments of the majority of patients. They are particularlysuitable for partial and complete dentures which opposenatural teeth, and for complete dentures in which a cuspalform is preferred.When the teeth are properly occluded, they will have bilat-eral balance without cuspal interference. The SObuccalslope and the engineered buccal overjet protects thecheeks and helps to virtually eliminate cheek bit ing.

T h e natural form a n d f u n c t i o n o f t h e S b u c c a l s lo p e

Pilkington-Turner Posteriors are designed with a 5 buccalslope of the maxillary premolars, which follows nature'splan and greatly improves the esthetics of finished den-tures. Studies of thousands of natural teeth reveal theimportance of this SOslope in esthetics. Fig. 1 belowshows two representative natural maxillary pre-molarscompared with the Pilkington-Turner premolars. Note howclosely the SObuccal slope follows nature's plan.

Figure 1.

A g r e a t e r d e g r e e o f c om f o r t a n d e f f i c ie n c yf o r t h e p a t i e n t

An important feature of Pilkington-Turner 30 Posteriors isthe adequate food table and narrow occlusal contact.Greater stability of the denture is provided by the shallowtransverse or lateral angle of the teeth. Mastication ismade easier and more efficient, assuring a new andgreater degree of comfort to the patient.

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Fig. 2 shows theample food tableprovided in theocclusal design ofthepremolars andmolars.

Figure 2.

N atu ra l con fo rm ation and s ize areid ea l fo r rem ovable pa rtia l d en -turesPilkington-Turner 30 Posteriors conform closely in size andshape to natural teeth. Buccolingually, their width closelyapproximates that of natural teeth. Mesiodisally, they are pro-vided in sizes harmonious with natural teeth which they mayreplace.

P ro ce du re s to be o bse rve d in arra ng in g P ilk in gto n-T urn er 300 Poster io rsBilateral balanced occlusion is an important element insecuring maximum comfort and eff iciency in complete den-tures. Without balance, there may be more resorption ofthe ridges, lessening of masticating eff iciency and greaterrecurrence of tender, sore tissue.Balanced occlusion can be accomplished by emphasison two factors:A. The correct posi tioning of the upper teeth.B. The correct arrangement and individual positioning ofeach lower tooth in a functioning relationship to theuppers.

A major advantage in the arrangement and articulationof Pilkington-Turner 30 Posteriors lies in theiradaptabili ty to most techniques and the ease with whichbalanced occlusion may be obtained.Following are suggestions for the arrangement andarticulation of Pilkington-Turner 30 Posteriors. These sug-gested procedures follow generally observed principles.Buccolingual view.

Figure 3. This buccolingual sketch of each posterior toothshows the individual relationship to the occlusal plane.Note that the lingual cusp of the first and second premo-

lars and the mesiolingual cusp of the fi rst molar touch theocclusal plane. The buccal cusps are raised approximate-ly 1/2 mm. The molars also follow this proportionate rela-tion. The arrangement of posterior teeth in this mannerforms the compensating curve (Curve of Wilson), the coun-terpart of the Curve of Spee in a natural dentition.

Figure 4. The long axis of the premolars should be atright angles to the occlusal plane, while the molars inclinevery slightly toward the mesial.The mesiobuccal cusp of the first molar is raised 1/2 mmto position it out of contact with the occlusal plane. Themesiolingual cusp touches the plane. The distobuccal cuspshould be raised approximately 1 mm.The mesiobuccal cusp of the second molar should beraised about 1 mm, while the distobuccal cusp should beraised approximately 1-1/2 mm.Figure 5. Illustrated is an occlusal view of the setting ofthe maxillary posteriors.

P ilk in g to n -T u rn e r 30 P o s te rio rsArtic ula tio n o f m a nd ibu la r firs t m o la rBalanced articulation contributes greatly to the comfort andefficiency of complete dentures. Without balance there maybe greater resorption, less efficiency, and a recurrence ofsore spots. Balanced occlusion can be accomplished with aminimum of effort if each tooth is brought into function.

Bear in mind that the mandibular first molar is a key tooth in articlation. If careful attention is paid to the positioning of this tooth,articulation of the remaining posteriors will be greatly facilitated.

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P i lk ing ton -Tu rne r 300 Poster iorsT he C om p le ted T oo th Arran gem e nt In All R e la tio ns

Figure 6. Centric occlusion, buccal view.

Figure 9. Working occlusion, buccal view.

Figure 12. Balancing occlusion, buccal view.

Figure 15. Centric.

Figure 7. Cross section Figure 8. Centric occlusion, lingual view.of centric occlusion.

-+-----MandibularMovement


. . M a n d ib u la rMovement

Figure 13. Cross section Figure 14. Balancing occlusion, lingual view.of balancing occlusion.N o te : A r ra n ge m en ts s h ow n a re o v er ag e . M o d if ic at io n s m a y b e m o d e a s n e ed e d f or a g iv en s it ua ti on .

15

Figure 16. Working.No Cuspal Disclussion.


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B i o S t a b i r 2 2

Description:Semi-anatomical, long crown forms withmoderately inclined cuspal slopes.


Ridge Type:Moderately resorbed ridge.

Trubyte BioStabil Posterior teeth are a beautifully carvedtooth form with moderately inclined cuspal slopes. Theirnatural anatomic form makes them esthetically andfunctionally well suited for use in complete dentures, aswell as for removable part ial dentures.BioStabil Posteriors resemble well-worn natural teeth, butwith well defined sluiceways and ridges to promote goodchewing efficiency without packing food - important forpatient comfort. Cusps are shallow and non-interfering tofacil itate freedom in excursions, yet provide a definitepoint of centric contact. A slight protrusive lift allows ante-rior overbite for improved esthetics.These teeth may be arranged with a compensating curvefor continuous bilateral balanced occlusion. For conve-nience in tooth arrangement, when viewed from theocclusal aspect, the maxillary teeth may be set with the lin-gual surfaces set to a straight edge. This automaticallyprovides a proper degree of buccal curvature.

A r r a n g i n g B io S ta b il P o s te r i o r sI n B i la te ra l B a la n ce d O c c lu s i o n

1. Place the maxillary premolars with their long axes atright angles to the occlusal plane (Fig. 1). The buccalcusps should touch the plane and the lingual cusp ofthe maxillary 1st premolar should be raised approxi-mately 1/2 mm to 1 mm above the plane (Figs. 1and 2).

. Figure 1. Buccal view

D D C J C JFigure 2. Proximal view

A straight edge may be used to align the lingual cusps ofall four posteriors to a straight line. When this is done, aproper degree of buccal curvature results (Fig. 3).

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2. The first and second molars may be set with theirlong axes inclined slightly mesially.

3. The mesiobuccal cusp of the first molar is approxi-mately 1/2 to 3/4 mm above the plane. The mesi-olingual cusp of the first molar is approximately 3/4to 1 mm above the plane (Figs. 1 and 2).

4. The second molar is set to follow the same angle orplane of the first molar. The distolingual cusp and

( t Y X i K ~Figure 3

the distobuccal cusp are approximately 1-1/2 mmabove the plane (Figs.1 and 2).


6. Then occlude mandibular teeth to the maxil lary teeth(Figs. 4-9).

MORIE;?B i o S ta b i l 2 2 0 P o s t e r i o r sT h e C o m p le te d T o o th A r r a n g e m e n t I n A l l R e la ti o n s

Figure 4. Centric occlusion, buccal view.

Figure7. Working occlusion, buccal view.

Figure 10. Balancing position, buccal view.

F o r t h e l i n g u a l i z e d o c c lu s i o n t e c h n iq u e u s i n g 3 3 "p o s t e r i o r s o v e r 2 2" B i o S ta b i l p o s t e r i o r s , a n d 3 3 "o v e r 0 , s e e p a g e s 2 6 -3 1.

Figure 5. Cross section Figure 6. Centric occlusion, lingual view.of centric occlusion .

.. .,_ .. ._ M a nd ib ul arMovement


. .. M an d i bu l arMovement

Figure 11. Cross section Figure 12. Balancing position, l ingual view.of balancing occlusion.

N o te : A r ra n ge m en ts s h ow n a re a v er ag e . M o d if ic a ti on s m a y b e m a d e a s n e ed e d f or a g iv en s it ua ti on .

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Truby te" t e r tDescription:Semi-anatomical, shallow 20 cusps offerminimal interference and interacting ridgeswith clearance spaces to enhance chewingefficiency.

Indications For Use:Ideal for use with full dentures, when easeof set-up and uninterrupted function isdesired.

Ridge Type:Semi-resorbed ridge.

Trubyte 20 Posteriors are designed to overcome certainproblems of the edentulous patient by uti lizing shallowcusp angles as an aid in reducing lateral thrust forces.Because the occlusal surfaces have interacting ridges andintercommunicating clearance spaces, masticating efficien-cy is greatly enhanced. Trubyte 20 Posteriors wil l befound desirable for use whenever a semi-anatomical cus-pal design is preferred or indicated. DESIGNED to function in accordance with anatomicalrequirements of mandibular movements. ENGINEERED for increased masticating efficiencywith shallow cusp inclinations, interacting ridges andintercommunicating clearance ways. A CORRECT AXIS for each tooth to direct masticatingforces and to assist in stabi lity and retention of the den-ture. SELF-ClEANSING SULCI to help prevent food packingon chewing surfaces and to maintain a high degree ofmasticating efficiency. READILYADAPTABLEto both steep and shallow condylepaths without destructive change in the occlusal surface.

A r ra n g in g T r u b y t e 2 0 m a x i l l a r y p o s t e r i o r s

Theoretical positions of the upper posteriors are shown inthe following diagrams:

1. Place the maxillary first premolar with its long axis atright angles to the occlusal plane. The buccal and lin-gual cusps are placed on the plane.

2. Place the maxillary second premolar in a similarmanner.

Figure 1. Buccal view3. The mesiobuccal and mesiolingual cusps of the upperfirst molar touch the occlusal plane. The distobuccalcusp is raised about 1/2 mm and the distolingual cuspwill be raised accordingly (see Figure 2 below).

4. All the cusps of the second molar are raised from thelower occlusal plane following the same angle or planeof the first molar. The mesiobuccal cusp should beabout 1 mm from the occlusal plane (see Figure 2be lo w]. ~ AWW~~

Figure 2. Interproximal view18


20/

5. A straight edge may be used to align the labial ridgeof the canine, the buccal ridges of the first and secondpremolars, and the mesiobuccal ridge of the first molar.The buccal ridges of the molars are similarly al igned,but angled slightly inward (see Fig. 3).

6. Follow the same procedure in placing the posteriors onthe opposite side.

Figure 3. Use of straight edge, occlusal view.

R ela tio n o f the m a xilla ry a nd m a nd ibu la r firs t m o la rThe first molars are the keystone to posterior occlusion. Il lustrated here are ideal relat ionships.

Centric Occlusion,BuccalView.

c.~

No te : G en er ou s o ve rj et o f N ot e: S ea ti ng of up pe rmaxillary molar over the mesiolingual cusp inmandibular molar. lower central f ossa.

Centr icOcclusion, Working Occlusion, Working Occlusion, Working Occlusion, BalancingPosition,LingualView. BuccalView. LingualView. DistalView. BuccalView.

Artic ula tio n o f m a n dibu la r firs t m o la rBilateral balanced occlusion contributes greatly to the com-fort and efficiency of complete dentures. Without balancedocclusion there may be greater resorption, less masticationefficiency, and a recurrence of sore spots. This can beaccomplished with a minimum of effort if each tooth isbrought into function.

If careful attention is paid to the positioning of the mandibu-lar first molar, articulation of the remaining posteriors wi ll begreatly facilitated.

200 Pos ter iors - T he C om p le ted T oo th Arra ng em e nt in a ll R e la tio nsThe remaining teeth are inter-digitated in a similar manner. Check the centric and lateral relationships of each tooth as i t ispositioned - as wel l as the completed tooth arrangement in al l relations.

Figure 4. In centric occlusion, buccal view

)Figure S. Cross section Figure 6. In centric occlusion, lingual viewof centric occlusion.

Figure 7. In working occlusion, buccal view Figure 8. Cross section Figure 9. In working occlusion, lingual viewof working occlusion .

Figure 10. In balancing relation, buccal view

+--- Mandibu la rMov eme n t

.. MandibularMovement

Figure 11. Cross section Figure 12. In balancing relation, lingual viewot balancing occlusion.N o te : A r ra n ge m en ts s h ow n a re a ve ra ge . M o d if ic a ti on s m a y b e m a d e a s n e ed e d f or a g iv en s it ua ti on .

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Anato l ine ' &Func t iona l ' 1 0

Description:Semi-anatomical, with the look of well-worn natural teeth. Shallow cusps minimizeinterference, yet provide a definite centric.Indications For Use:Ideal for use with full dentures. In occlusionthe upper lingual cusps align to form anefficient lingual "cutting knife."

Trubyte IPN 10 Anatoline Posterior teeth are a beautifullycarved tooth form with moderately inclined cuspal slopes.Their natural anatomic form makes them esthetically andfunctionally well suited for use in complete and partialdentures.Anatoline Posteriors resemble well-worn natural teeth, butwith well-defined sluiceways and ridges to promote goodchewing efficiency without packing - important for patientcomfort. Cusps are shallow and non-interfering to facili-tate freedom in excursions. A slight protrusive lift allowsanterior overbite for improved esthetics.These teeth may be arranged in a linear type occlusion orwith a compensating curve for continuous bilateral bal-anced occlusion. For convenience in tooth arrangement inboth configurat ions, when viewed from the occlusalaspect, the maxillary teeth may be set with the lingual sur-faces set to a straight edge. This automatically provides aproper degree of buccal curvature.Trubyte 10 Functional Posterior teeth follow the same sug-gested arrangement and art iculation guidelines asAnatoline Posterior teeth.

A r r a n g in g A n a to li n e , 0 p o s t e rio rs i nl in e a r o c c lu s io n

1. Place the maxillary premolars and molars with theirlong axes at right angles to the occlusal plane (Fig. 1).The buccal and lingual cusps should touch the plane(Figs. 1 and 2).

Figure 1[\~~bFigure 2

2. A straight edge may be used to align the lingual cuspsof all four posteriors to a straight line (Fig. 3).

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When this is done, a proper degree of buccal curvatureresults (Fig. 4).

3. Follow the same procedure in placing the posteri-ors on the opposite side.

4. Then occlude the mandibular teeth to the maxi llaryteeth as shown in Figs. 5-10. This arrangementwas done with a 30 condylar inclination, and a10 incisal inclination. Other guidance factorsmay be used as conditions indicate.

This also aligns the lingual cusps to, in effect, form a lin-gual knife for exceptional cutt ing eff iciency.

A n a t o l i n e & F u n c t i o n a l 1 00 P o s t e r i o r sT h e C o m p le t e d T o o th A r r a n g e m e n t I n A l l R e l a t i o n s

r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~

Figure 4

Figure 5. Anatoline linear arrangement incentric occlusion, buccal view.

Figure 8. The linear arrangement in workingocclusion, buccal view.

Figure 11. The linear arrangement in bal-ancing posit ion, buccal view.

Figure 6. Cross sectionof centric occlusion.

.,.___ M andibularMovem en t

Figure 9. Cross sectionof working occlusion.

. . M a nd ib ul arMov emen t

Figure 12. Cross sectionof balancing occlusion.

A r ra n g in g A n a to li n e 1 0 p o s t e r i o r s i nb i l a t e r a l b a l a n c e d o c c lu s io n~. Figure 141. Place the maxi llary premolars with their long axes at rightangles to the occlusal plane (Fig. 14). The lingual cuspsshould touch the plane and the buccal cusps should beraised approximately 1/2 mm above the plane (Figs. 14and 15). A straight edge may be used to align the lin-gual cusps as shown previously (Figs. 3 and 4).

Figure 15

21

Figure 7. The linear arrangement in centricocclusion, l ingual view .

Figure 10. The linear arrangement in work-ing occlusion, lingual view .

Figure 13. The linear arrangement in balanc-ing position, l ingual view. Balancing contactsmay be minimal.

Buccalview

~

Proximal view


23/

2. The first and second molars may be set with their longaxes inclined slightly mesially (Fig. 14).

3. The mesiolingual cusp of the first molar touches theplane, and the mesiobuccal cusp is approximately 1/2mm above the plane. The distolingual cusp is sl ightlyabove the plane, and the distobuccal cusp isapproximately 1 mm above the plane (Figs. 14 and15).

4. The second molar is set to follow the same angle orplane of the first molar. The distolingual cusp is

Figure 16. The balancing arrangement incentric occlusion, buccal view.

Figure 19. In working occlusion, buccalview.

Figure 22. In balancing posit ion, buccalview.

approximately 1-1/2 mm above the plane, and the dis-tobuccal cusp is approximately 2 mm above the plane(Figs. 14 and 15).


6. Then occlude mandibular teeth to the maxil lary teeth(Figs. 16-24). A 30 condylar inclination and a 10incisal inclination are recommended. However, otherguidance factors may be used as individual conditionsindicate.

Ana to lin e Fu n ctio n al 100 Poster iorsT he C om p le ted T oo th Arra ng em e nt In All R e la tio nsr - - - - - - - - - - - - - - - - - ~ ~ ~ - -

Figure 17. Cross sec-tion of centric occlusion.

-+-- MandibularMov eme n t

Figure 18. The balancing arrangement incentric occlusion, lingual view.

Figure 20. Cross section Figure 21. In working occlusion, l ingual view.of working occlusion.

. .Mandibul arMovement

Figure 23. Cross section Figure 24. In balancing position, l ingual view.of balancing occlusion.

N o te : A r ra n ge m en ts s h ow n a re a ve ra ge . M o d if ic at io n s m a y b e m a d e a s n ee d ed f or a g iv en s it ua ti on .

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T r u b y t e osteri r sDescription:Non-anatomical, with the illusion of well-wornanatomical teeth. Zero degree cusps are non-interfering and provide complete freedom inlateral excursions.

Indications For Use:Ideal for use with full dentures. Open occlusalangles permit a lingualized set-up with semi orfully anatomical upper posteriors.

Trubyte" Portrait IPN0 Posterior teeth are the first flatplane posterior teeth to be rated superior in overall esthet-ic appearance. They are suitable for complete dentureswhere a zero degree tooth is indicated or preferred. Awider bucco-lingual table promotes efficient function andease of set-up. Zero degree cusp areas are non-interferingand provide complete freedom in lateral excursions. Whenviewed in the mouth, the mesiofacial appearance of 0teeth resemble wel l-worn natural teeth. A modified ratio-nal occlusal design gives the illusion of anatomical teeth.Portrait IPN 0 teeth may be arranged for continuousbilateral balanced occlusion with the proper compensatingcurve or in flat linear occlusion. Open occlusal angles areideal for l ingualized set-upwith semi or fully anatomicalupper posteriors, especially "even-dimensioned" Anatoline10 and 33 posteriors. To aid in arrangement, the maxil-lary teeth may be positioned with the lingual surfaces setto a straight edge. This positioning automatical ly providesa proper degree of buccal contour for good estheticappearance and function.All Truby t e " Rationaland IPNMonoline Posterior teethfollow the same suggested arrangement and art iculat ionguidelines as Portrait IPN 0 Posterior teeth.

A r r a n g in g T r u b y te F l a t P l a n e 'P H P o s te r i o rsin l i n e a r o c c lu s i o n

1. Place the maxillary premolars and molars with theirlong axes at right angles to the occlusal plane (Fig. 1).The buccal and lingual cusp areas should touch theplane (Figs. 1 and 2).

2. A straight edge may be used to align the lingual cuspsof all four posteriors to a straight line (Figs. 3 and 4).When this is done, a proper buccal contour results.

Figure 1

Figure 2

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Figure 3

Figure 43. Follow the same procedure in placing the posteriorson the opposite side.

4. Then occlude the mandibular teeth to the maxillaryteeth (Figs. 6-12). There should be approximately1.5 mm of buccal overjet by the maxillary teeth asshown in Fig. 5. This buccal over jet is essential toprevent "cheek biting".

Figure 7. Portrcit" IPN00 flat l inear type tootharrangement in centric occlusion, buccal view.

Figure 5The arrangement illustrated here was done with a 30condylar inclination and a 0 incisal inclination. Otherguidance factors may be used as individual condit ionsindicate. In this type occlusion with 0 Posteriors, therewill normally be no contact in balancing positions.Note: The maxillary and mandibular teeth do not interdigi-tate. They may be set end-to-end as shown in Fig. 6. It ispossible to position premolars to oppose molars becausethere is no interdigitation of the cusps.

Figure 6

Mo no lin e 0 P o ste rio rsThe C om le ted T oo th Arran em en t In All R ela tion s in L in ea r O cc lus io n

Figure 8. Cross section Figure9. Centric occlusion, lingual view.of centric occlusion.

-Figure 10. Working occlusion, buccal view.

..- M a nd ib ul arMovement

Figure11. Cross section Figure 12. Working occlusion, l ingual view.of working occlusion.

. .. . M and i bu la rMovement

Figure 13. Balancing position, buccal view. Figure 14. Cross section Figure 15. Balancing position, lingual view.of balancing occlusion.

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M o n o l i n e 0 0 P o s t e r i o r sT h e C o m p l e te d T o o th A r r a n g e m e n t I n A l l R e la t i o n s i n B i l a te ra l B a la n c e d O c c l u s i o n

A r ra n g in g F l a t P l a n e P o s t e ri o r s i n b il a te ra lb a la n c ed o c c l u s io n1. Place the maxillary premolars with their long axes atright angles to the occlusal plane (Fig. 13). The lingualcusp areas should touch the plane, and the buccal cuspareas of the premolars should be raised approximately1/2 mm above the plane (Figs. 13 and 14).

Figure 16 Figure 17A straight edge may be used to align the lingual toothsurfaces as shown previously (Figs. 3 and 4).

2. The first and second molars may be set with their longaxes incl ined very slightly toward the mesial (Fig. 13).

3. Position the first molar with the mesiolingual cusp areatouching the plane, and the mesiobuccal cusp areaapproximately 1/2 mm above the plane. The distobuc-cal cusp area should be approximately 1 mm abovethe plane (Figs. 13 and 14).

4. The second molar is set to follow the same angle orplane of the first molar. The mesiolingual cusp shouldbe about 1 mm above the plane, and the mesiobuccaland distolingual cusp areas approximately 2 mm offthe plane.

5. Fol low the same procedure in placing the posteriorteeth on the opposite side.

6. Then occlude the mandibular teeth to the maxillary teeth(Figs. 15-20). A 30 condylar inclination and 0incisal inclination were used in this arrangement.Other guidance factors may be used as individual con-ditions indicate.

When using flat plane posteriors, it is advisable to modifythe canines so that the incisal edges tend toward bluntnessrather than a sharp point. A somewhat blunted canineenhances the appearance of the contact area andembrasure between the canine and the first premolar.To ensure the best occlusal efficiency, there should beclose contact of the occlusal surfaces when viewed fromthe lingual as well as the buccal.

Figure 20. Centric occlusion, lingual view.igure 18. Portrcir" IPN0 balancing arrange- Figure 19. Cross sec-ment, in centric occlusion, buccal view. tion of centric occlusion .

.- M an di bu la rMovement

Figure 23. Working occlusion, l ingual view.Figure 21. Working occlusion, buccal view. Figure 22. Cross sec-tion of working occlusion.

. ,. _ Man d i bu l a r

Figure 24. Balancing position, buccal view.Movement

Figure 25. Cross section Figure 26. Balancing position, lingual view.of balancing occlusion.25


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L i n g u a l i z e dO c c l u s i o n

Description:Partner 33' fully anatomical uppers with eitherBioStabil 22' semi-anatomical or Monoline 0'non-anatomical lower posteriors.Indications For Use:Ideal for use with full dentures.Ridge Type:33' - Healthy ridge with minor resorption.22' - Moderately resorbed ridge.0' - Advanced ri

B a c k g ro u n d a n d O b j e c t i v eLingualized occlusion * was first documented in dental l iter-ature in 1927 by one of the founding-fathers of articula-tion, Dr. Alfred Gysi, of Switzerland. It is defined as, "set-ting the upper posterior teeth in a turned-out position(cusps toward the cheeks), so that only the lingual cusps ofthe maxillary teeth contact the center of the occlusal table(the fossa) of the mandibular posterior teeth" (see Figure 1below).The focus of this posterior arrangement method is on elimi-nation of the tooth contact points on the buccal cusps.Thus, the occlusal contacts are moved as far lingually aspractical, while sti ll maintaining the physiologic position-ing of the prosthetic teeth. Preservation o f the lingual con-tacts assures seating and minimizes tipping o f the lowerdenture upon tooth contact and during function.

M a n dib ul ar M o v em e nl _Figure 1. Lingualized Set-Up

Within pratical limits, it is esthetically optimal when den-ture teeth are arranged close,to where the natural teethwere originally located, prior to ridge resorption.Radiographs and pre-edentulous photographs of thepatient are important in determining this position.However, patients with resorbed ridges and restricted neu-tral zones (the channel where the teeth are located thatshould not be affected by tongue, lip and cheek forceswhich could unseat the denture) may determine the extentto which esthetics will be sacrificed for functional improve-ments. In such cases, l ingualized occlusion minimizesesthetic compromises and optimizes functionality.

'G lo ss ar y P ro sl ho do nl ic T er m s 1 9 99 ( S. H o w ar d P ay ne , 1 94 1; E ar l P o un d , 1 97 0 's )

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L i n g u a l i z ec l S e t- u p T e ch n iq u e sWe recommend that the maxillary posterior teeth be a 30'occlusal slope or greater and that the mandibular posteriorteeth be a 22' slope or less. However when proper lingual-ized articulation techniques are used almost any combina-tion of teeth will function properly.The following is Trubyte's suggested process for lingualizedart iculation and arrangement of posterior teeth to achievefunction, comfort, and esthetics for a fully edentulouspatient.1. Set the upper arch first with ideal Curve of Spee, Curveof Wilson, and lingual Curve except when a lineararrangement is desired.NOTE: Set the anterior denture teeth in their physiolog-ic position for esthetic and phonetic reasons. Posteriorteeth can be set over the resorbed ridge when adequatetongue space exists, or facial to the ridge when esthet-ics require facial placement of the teeth (Figure 2).

~dl.i:Figure 2. Posterior Resorption

2. If a lingualized arrangement is desired, when all maxil-lary teeth have been set insert an object the approxi-mate thickness of a 2mm ruler between the buccal cuspsof the posterior teeth and the table while the set-up waxis still soft (Figure 3). Apply pressure. This techniquewill elevate the maxil lary buccal cusps to the right posi-tion for proper contact between the opposing stampcusps. This also el iminates any contact between themaxillary buccal cusp and the opposing mandibularbuccal cusp in the working movement.

Figure. 3

Figure 4. Mandibular first molar- BuccalView

Figure 5. Mandibular first molar- Lingual View

3. Begin setting the mandibular arch with the first molars.The mandibular first molars are the "key to occlusion"(Figures 4, 5). Use the mesiolingual maxillary cusp asthe stamp cusp. A stamp cusp is a working cusp,which occludes into a fossa in the opposing dentition.In lingualized occlusion the maxillary stamp cusps arepreserved. No grinding should occur on these teeth.Use the rule of BULLfor adjustments: if needed,occlusal grinding should eliminate contact on theBuccal cusps of the Upper teeth and remove prematurecontact from Lingual cusps of the Lower teeth. Set theremaining mandibular posterior teeth.

4. Grind-in option: You also have the option to grind inocclusion. Prior to setting the mandibular teeth, openthe articulator pin 1mm. Grind a saucer shape approx-imately 2mm wide to accommodate the stamp cusps.The saucer shape is developed by marking both centricand eccentric occlusion with art iculat ing paper.Continue to develop the saucers unti l the pin contactsthe incisal guide table.

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A r r a n g in g P o r tr a i t I P N L i n g u a li z e dP o s t e r i o r s (33 M a x il l a r y P o s t e r i o r sw i t h 2 2 M a n d i b u l a r P o s t e r i o r s )

1. Place the 33 maxillary premolars with their longaxes at right angles to the occlusal plane (Fig. 6).The lingual cusps should touch the plane and the buc-cal cusps should be raised approximately 1/2 mmabove the plane (Figs. 6 and 7). A straight edgemay be used to align the lingual cusps as shown pre-viously.

2. The first and second molars may be set with their longaxes inclined slightly mesially (Fig. 6).

Figure 6

Figure 7

3. The mesiol ingual cusp of the first molar touches theplane, and the mesiobuccal cusp is approximately 1/2mm above the plane. The distolingual cusp is slightlyabove the plane, and the distobuccal cusp is approxi-mately 1 mm above (Figs. 6 and 7).

4. The second molar is set to follow the same angle orplane of the first molar. The distolingual cusp isapproximately 1-1/2 mm above the plane, and the dis-tobuccal cusp is approximately 2 mm above the plane(Figs. 6 and 7).

5. Fol low the same procedure in placing the posteriorteeth on the opposite side.6. Occlude the central fossae area of the mandibular 22teeth to the lingual cusps of the maxillary 33 teeth. Atypical relationship of upper to lower is illustrated inFig. 8. The relationships of the completed arrangementare shown in Figs. 9-17 on page 29.

A r ra n g in g P o r t r a it I P N 33 M a x i l l a r yP o s t e r i o r s w i th P o r t r a i t I P N 0 M a n d i b u l a rP o s t e r i o r s

MINUS~ J ! g 'Follow steps 1-5 for Portrait IPN lingualized Posteriors.7. Occlude the central fossae area of the mandibular 0teeth to the lingual cusps of the maxillary 33 teeth. Atypical relationship of upper to lower is illustrated inFig. 8. The relationships of the completed arrangementare shown in Figs. 18-26 on page 30.

,Relat ionship of upper

- - - - - - - Portrait IPN Posteriorsto lower Por tr ait IPNPosteriors,

Figure 8

I f a " d e e p e r" o r " t i g h t e r" o c c lu s i o n i s d e s i r e d , s o m e s li g h tg r i n d i n g m o d i f i c a t i o n i n t h e d e v e l o pm e n ta l g ro o v e a re aso f t h e 0 l o w e r p o s te ri o r s w i l l p e r m i t a m o re i n t im a t el i n g ua li z ed r e la ti o n s h i p w i t h t h e l i n g ua l c u s p s o f t h e u p p e r3 3 p o s t e r i o rs . T h e m o d if i c a t i o n m a y b e d o n e w i t h s m a l l ,m o u n t e d p o in t s .

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Portrnlt" I P N L ingua lized T ee th - 3 3 0 / 2 2 0A s im p lif ied app roach to too th se lec tion , o rde ring and se t-up .

T o o th A r ra n g e m e n t i n A l l R e la ti o n s

Figure 9. Portroit" IPNLingualized balancedarrangement in centric occlusion, buccal view.

Figure 12. Working occlusion, buccal view.

Figure 15. Balancing occlusion, buccal view.

Figure 10. Cross sec- Figure 11. Centric occlusion, lingual view.tion of centric occlusion.

-+-MandibularMovement

Figure 13. Cross section Figure 14. Working occlusion, l ingual view.of working occlusion.

~ MandibularMovement

Figure 16. Cross section Figure 17. Balancing occlusion, lingual view.o f balancing occlusion.

N o te : A rr an g em e n ts s h ow n a re a ve ra g e. M o d if ic at io n s m a y b e m a d e a s n e ed e d f or a g iv en s it ua ti on .

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Portrnlt" I P N T e e t h 3 3 0/ 0 0An a lte rn ative fo r lin g ua lize d c as es re qu ir in g fla t m a n dibu la r o cc lu sio n .

T o o th A r ra n g e m e n t i n A l l R e la ti o n s

Figure 18. Centric occlusion, buccal view. Figure 19. Cross sec- Figure 20. Centric occlusion, lingual view.tion of centric occlusion .

.. . M a nd ib ula rMovement

Figure 21. Working occlusion, buccal view. Figure 22. Cross section Figure 23. Working occlusion, l ingual view.of working occlusion .

. .. M a n d ib u la rMovement

Figure 24. Balancing occlusion, buccal view. Figure25. Cross section Figure 26. Balancing occlusion, lingual view.of balancing occlusion.

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L in gu a l i z e d O c c lu sa l O p ti o n s f r o mD E N T S P L Y T r u b y te

DENTSPLYTrubyte's multiple posterior tooth options assuresthat technicians will have a variety of predictable ways toapproach lingualized occlusion - with the cutting edge on

Portrait IPN EuroLine 40 Posteriors

IPN Pilkington- Turner" 30 Posteriors

Can be set in the fallowing: 30'/22', 30'/10' and 30'/Portrait 0'

IPN 20 Posteriors

Can be set in the following: 20'/Monoline

Portraif IPN 0 /IPN Monoline Posteriors

top and the food table below. Lingual ized arrangementscan be successfully accomplished for each of the mouldcombinations illustrated below.

IPN 33 Posteriors

IPN/SLM BioStabil 22 Posteriors

IPN 10 /IPN Anatoline Posteriors

F or m o re d e t a il e d t o o t h a r r a n g em e n t o pt io n s , c o n t a cty o u r T r u b yt e R e p re se nt a tiv e o r c a ll C u st o m er S er v ic e a t1 -8 00 - 7 8 6- 0 0 85 t o r e c e iv e a fr e e c o py o f" I nd iv id u a liz ed A n t e ria r A r ra n ge m e n ts o f T r ub y t e T e et h "( fo r m # 3 9 0 0 ) .

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t l p p e n d ix f o re I a t e d I n f o r m a t i o n

Stabilized Baseplates

This chapter contains selected information and proceduresthat are important to routinely achieving successful denturetooth arrangement.Stabilized Baseplate - The purpose of a stabilizedbaseplate is to provide a foundation representing the baseof a complete denture, which is used for making jaw rela-t ion records and arranging denture teeth. Baseplatesshould be strong and rigid, fit accurately, and be stablewithout rocking. The baseplate borders should be full androunded as in the finished denture. If desired, a post-damor posterior palatal seal can be added to the upper togive additional stability when placed in the mouth.Wax Occlusion Rims - The purpose of occlusion rimsis to define the position, size and shape of the teeth to bereplaced. They enable dental professionals to establishand record the correct vertical dimension of occlusion, theocclusal registration and provide a positioning template toset denture teeth for proper l ip support.In overall design, the wax occlusal rims should be smooth,centered buccolingually over and parallel to the residualridge crest, and properly contoured. In the anterior, use amill imeter ruler to measure the distance from the mucobuc-cal fold to the occlusal plane: 22-mm on the upper and18-mm on the lower. (Thesemeasurements are for the"average" patient and may be increased or decreased bythe dentist.) The anterior upper should extend horizontallyabout 6- to 8-mm from the middle of the incisive papilla.The posterior plane of occlusion should not exceed 2/3 ofthe retromolar pad height on the lower and 8-mm up fromthe tuberosi ty on the upper. The anterior occlusal widthshould be about 3- to 4-mm, and the posterior width at thefirst molar region should be between 8- to 10-mm.

Figure 1. Mark and smooth/trim the wax to these dimensio

Figure 2. The anterior por-tion of the maxil lary occlusalrim is labially oriented, ie itslants to the anterior.

Figure 3. The posterior areof the wax rims should betrimmed at a 30 angle toeliminate potential interferenduring bite registration procedures.

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P o s t e r i o r M o u ld / S h a d e A v a i l a b i l i tM o u l d s a n d S h a d e sT r u b y t e 4 0 P o s t e r i o r s M o u l d s S h a d e sPORTRAITIPNEUROLINE40 Posteriors 730

732734PORTRAITIPN Shades (All Shades)P1, P2, P3, P3.5, P4, P11, P12, P13, P14,P21, P22, P23, P24, P32, P33, P34,P59, P62, P65, P66, P67, P69, P77, P81,PW2, PW4, PW7

T r u b y t e 33 A n a t o m ic a l P o s t e r i o r s M o u l d s S h a d e sTRUBlEND SlM 33 Plastic 30M TRUBlEND SlM Shades (All Shades)

32M T1, T2, T3, T4, T5, T6,34M T7, T8, T9, T10, T11, T12,

T13, T14, T15, T16, T17, T18,T19, T20, T21, T22, T23, T24

PORTRAITIPN33 Plastic 30M, l PORTRAITIPN Shades (All Shades)PORTRAITIPN33 lingualized** 32M, l P1, P2, P3, P3.5, P4, P11, P12, P13, P14,

34M, l P21, P22, P23, P24, P32, P33, P34,P59, P62, P65, P66, P67, P69, P77, P81,PW2, PW4, PW7

BIOFORM IPN33 Hardened Plastic 30M, l BIOFORM IPN Shades (All Shades)32M, l B51, B52, B53, B54, B55, B56,34M, l B59, B62, B63, B65, B66, B67,

B69, B77, B81, B83, B84, B85,B91, B92, B93, B94, B95, B96

VACUUM FIRED33 Porcelain 28S, M, l BIOFORM Shades (limited)30S, M, l B62, B65, B66, B67,32S, M, l B69, B77, B8132X- Extra long Bicuspids34S, M, l

NEW HUE33 Plastic 30M, l, lS NEW HUE Shades (Al l Shades)32M, l, lS 59, 61, 62, 65, 66,34M, l, lS 67,69,77,81,87

CLASSIC33 Plastic 30M, l, lS CLASSIC Shades (All Shades)32M, t. lS A 1, A2, A3, A3.5, A4, B1, B2, B3, B4,34M, t. lS C1, C2, C3,C4, D2, D3, D4,

59C, 62C, 65C, 66C, 67C, 69C, 77C, 81C,CW2

BIOTONE Blended 33 Plastic 30M, L, lS* BIOTONE Shades (All Shades)32M, l, lS* 62P, 65P, 66P, 67P,34M, l, lS* 69P, 77P, 81 P

Figure 1: *Long Buccal-Short Bite Moulds (available in plast ic only)Moulds 30LS, 32LS, and 34LS are spec ially designed for short bite cases. They are engineered with a "scoopedout" ridge lap which eliminates unnecessary bulk and reduces grinding to a minimum.**Long mould forms only.

Figure 1.33


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M o u l d s a n d S h a d e sT r u b y t e 3 0 P o s t e r i o r s M o u l d s S h a d e sTRUBLENDSLMPILKINGTON-TURNER30 P la stic 230M , L233M

TRUB LEND SLM Shad es (A ll S h ad es )Tl, T2, T3, T4, T5, T6,T7, T8, T9, T l0, T Il, T12,T13, Tl4, Tl5 , T l6, T l7, Tl8,T19, T20, T21, T22, T23, T24

B IOFORM IPN PILK INGTON-TURNER30 P la stic

230S , M , L, LS * B IOFORM IPN S hades (Lim ited)233M , L B59, B62, B65, B66,

B67, B69, B77, B81

Figure 2. *Long Buccal-Short Bite MouldsMould 230L5 is specially des igned for short bite and partial cases. It iseng ineered with a "scooped-out" r idge lap which e liminates unnecessary bu lk and reduces grinding to am i n i m u m .

Figure 2.

T r u b y t e 2 2 B i o S t a b i P P o s t e r i o r s M o u l d s S h a d e sTRUBLENDSLMB IOSTAB IL22 P las ti c 53 053 2

53 3536*

TRUB LEND SLM Shad es (A ll S h ad es )Tl, T2, T3, T4, T5, T6,T7, T8, T9, T l0, TIl, T12,Tl3 , Tl4, T l5, T l6, Tl7 , Tl8,T19, T20, T21, T22, T23, T24

PORTRA ITIPN Plast icPORTRAITIPN22 L ingual ized 53053 2

53 3536*

PORTRA IT IPN Shades (Al l Shades )PI, P2, P3, P3.5, P4, P ll, P12, P13, P14,P21, P22, P23, P24, P32, P33, P34,P59, P62, P65, P66, P67, P69, P77, P81PW2, PW 4, PW7

B IOSTAB ILIPN22 P las ti c 53 0532533536*

B IO BL END IP N S ha de s (A ll S ha de s)100, 102, 104,106,108,109,110,112,113,114,116,118

* S p ec ia l la rg e fu lly c on to ure d m ou ld id ea l fo r im pla nta nd p artia l c as es w he re in dic ate d.

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M o u ld s a n d S h a d e sT ru b y t e 2 0 S em i - A n a t o m i c a lP o s t e r i o r s M o u l d s S h a d e s

TRUBLENOSLM20 P l as ti c 29M , L TRUBLENOSLM S hades (A ll S hades)31M T1, T2, T3, T4, T5, T6,33M T7, T8, T9, T10, T1 1, T12,

T13, T14, T15, T16, T17, T18,T19, T20, T21, T22, T23, T24PORTRAITPN20 P la st ic 29M , L Portrait IPN Shades (A ll S hades)

31M , L P1, P2, P3, P3.5, P4, P11, P12, P13, P14,33M , L P21, P22, P23, P24, P32, P33, P34,35M P59, P62, P65, P66, P67, P69, P77, P81,

PW 2, PW 4, PW 7B IOFORM IPN20 P la st ic * 29S , M , L B IOFORM Shades (A ll S hades)

31S , M , L B51, B52, B53, B54, B55, B56,33M , L B59, B62, B63, B65, B66, B67,

B69, B77, B81, B83, B84, B85,B91, B92, B93, B94, B95, B96

VACUUM FIRED 20 Porcelain 29S , M , L B IOFORM Shades (Lim ited Shades)31S , M , L B59, B62, B65, B66, B67,33S , M , L B 69, B 77, B 81NEW HUE20 P lastic 29M , L NEW HUE Shades (A ll S hades)

31M , L 59, 61, 62 , 65, 66,33M 67,69,77,81,87

CLASS IC20 P la st ic 29M , L CLASS IC S hades (A ll S hades)31M , L A 1, A2, A3, A3.5, A4, B 1, B 2, B3, B4,33M C1. C2,C3, C4, 02, 03, 04 ,59C , 62C, 65C, 66C, 67C , 69C, 77C, 81C ,

CW2B IOFORM 20 P la stic 29S , M , L B IOFORM Shades31S , M , L B59, B62, B65, B66,

33M , L B67, B69, B77, B81OENTRON 20 P la stic 29M , L B IOTONE Shades

31M , L 59P, 62P, 65P, 66P,33M , L 67P , 69P , 77 P, 81 P

Figure 3: *TRUBLEND SLM 20 Plastic Moulds, BIOFORM 20 PlasticMoulds and BIOFORM IPN Plastic Moulds are long bucca l-short l ingua l moulds. They arespecial ly designed for short bi te and par tica l cases. They are engineered with a "scoopedout" ridge lap which eliminates unnecessary bulk and reduces grinding to a minimum.

Figure 3.

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M o u ld s a n d S h a d e sT ro b y t e 1 0 S e m i - A n a to m ic a l o s t e r i o r s M o u l d s S h a d e s

TRUBLEN[)SlM ANATOLlNE 10 P las ti c 33 033 233 4

PORTRAIT' "PNANATOLlNE 10 P las ti c 33 033 233 433 6

BIOFORMIPNANATOLlNE 10 P las ti c 33 033 233 4

VACUUM FIREDFUNCTIONAL 10 Porcelain F30, F32,F 33 , F 34Medium Lengt hs

B IOTONE FUNCT IONAL 10 P last ic F 30 , F 32F33 , F 34

CLASSI( 10 Plastic F30, F32, F33

NEW HUE 10 Plastic F30, F32, F33

36

TRUBLENOS lM Shades (Al l Shades )T 1, T2, T3, T4 , T5, T 6, T7 , T8, T 9, T1 0, T 11, T 12,T 13, T1 4, T 15, T 16, T 17, T18, T19, T20, T21 , T2 2,T 23 , T 24POTRAIT IPN Shades (A ll Shades )P 1, P 2, P 3, P 3.5 , P 4, P 11 , P 12 , P 13 , P 14 ,P21, P22, P 23, P2 4, P32 , P33, P 34, P7 7,P 59 , P 62 , P 65 ,P 66 , P 67 , P 81 ,PW 2, PW 4, PW lB IOFORM IPN Shades (All Shades)B 51, B 52 , B 53, B 54, B 55, B 56, B 59, B 62,B 63 , B 65, B 66,B 67, B 69 , B 77, B 81, B 83, B 84,B 85, B 91, B 92,B 93,B94,B95,B96BIOFORM Shades (Lim itedShades)B 62,B 65, B 66, B 67,B 69,B 77, B 81B IOTONE Shades (Al l Shades )59p , 62P , 65P , 66p ,6 7p , 6 9P , 7 7p , 8 1PCLASSIC SHAOES (A ll Shades )A 1, A2, A3, A3.5, A4, B 1, B2, B3, B4,C1, C2, C3, C4, 02, 03, 04,59C, 62C, 65C, 66C, 67C, 69C, 77C, 81C,CW 2NEW HUE Shades (All S hades )59,61,62,65,66,67,69,77,81,87


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M o u ld s a n d S h a d e sT r u b y t e 0 N o n - A n a t o m ic a l M o u l d s S h a d e s( F l a t- P l a n e ) P o s te r io r s

TRUBLENDSLMMONOLlNE 0 P la stic 429 TRUBLEND SLM S hade (All Shades)431 T1, T2, T3, T4, T5, T6,433 T7, T8, T9, T1 0, T11, T12,

T13, T14, T15, T16, T17, T18,T19, T20, T21, T22, T23, T24PORTRAITIPN0 P las ti c 63 0 PORTRAIT I PN Shad es (A ll S h ad es )PORTRAITIPN 0 Lingualized 632 P1, P2, P3, P3.5, P4, P11, P12, P13, P14,

634 P21, P22, P23, P24, P32, P33, P34,P59, P62, P65, P66, P67, P69, P77, P81,PW2, PW4, PW7

B IO FORM IP N MONO LlN E 0 P la stic 429 BIOFORM IPN Shades (A ll S hades)431 B51, B52, B53, B54, B55, B56, B59, B62,433 B63, B65, B66, B67, B69, B77, B81, B83,

B84, B85, B91, B92, B93, B94, B95, B96VACUUM F IREDRATIONAL 0 P orc ela in 29M, L B IO FORM Shad es (L im ite d S ha de s)

31M, L B62, B65, B66, B67, B69,33M, L B77, B 81

B IOTONE RATIONAL 0 P la st ic 29M, L BIOTONE Shades (A ll Shades)31M, L 62P, 65P, 6 6P, 6 7P, 6 9P,33M, L 77P, 81 P

B IO TONE RAT IONAL 0 B lo ck (P la stic )* 29M, L BIOTONE Shades (Lim ited Shades)31M, L 62P, 65P, 66P, 6 7P, 6 9P, 77P

N EW HUE 0 P lastic 29M N EW HUE S hades (All S hade s)31M 59,61,62,65,66,67,69,77,8133M

CLASS IC 0 P la st ic 29M CLASSIC Shades (All Shades)31M A 1, A2, A3, A3.5, A4, B 1, B2, B3, B4,33M C1,C2,C3,C4, D2, D3, D 4,

59C, 62C, 65C, 66C, 67C, 69C, 77C, 81C,CW2

*S upplied in sets of 1x8 only (c onsisting of 2 bloc ks of 4 right and left - upper orlower).

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Id en tif ic atio n o f T ee th a nd T oo th S urfa ce s

Po s t e r i o rT e e t h

12 nd M ola r3 rd M o la r

(W is d o m T o o th )---------

Ante r io rT e e t h

U pp e r (M axi lla ry ) Arc h

Cen t r a l s

Po s t e r i o rT e e t h

2 nd M ola r ird M ola r

(W is d o m T o o th)---------

MES IA L: Tow ard the m edian line.The surface of the tooth that isto ward s th e m ed ia n line .

L ow e r (M an d ibu la r) Arc h.-:;;;00;;;:-"----- OCCLUSAL: P er ta in in gt o t he o cc lu si on .

U sed to des cribe themas tic atin g o r c hewin gs ur fa ce o f th e p os te rio rteeth.

B UCCA L S UR FACE :Pe rt ai nin g t o t he c hee k .U sed to d es crib e thef ac ia l s ur fa ce s o f t heposter io r tee th .

PRO XIM AL: The surface of at oo th a djo in in g a no th er t oo th ._)io,":"':'~---1 U su ally th e M es ia l o r D is ta lS urfa ce u nle ss th e to oth is ro tate d.

D IS TA L: The surfac e ofthe tooth that is aw ay fromthe m edian line (D istal of 1 st I----..;:::;z;;p remol ar shown) .

CUSPS :Tape ri ng p ro je ct io nsu po n th e o cc lu sa l s ur fa ce o f a to oth .

S ULC US : A depression in theo cc lu sal s urfa ce o f a to oth .

LA BIA L S UR FA CE : P ertaining tothe lip. U sed to describe the fronts urfa ce o f th e a nte rio r te eth .

I NC IS AL : T he b itin g e dg e o f an terio r te eth .

Ana tom y o f N atu ra l T ee th

R O O T

C R O W NC R O W N

R O O T

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Dentsply Tooth Arrangement Manual

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