Dentsply Tooth Arrangement Manual

Anterior & PosteriorTooth Arrangement Manual

Suggested procedures for the arrangement and articulation ofTRUBYTE® ANTERIOR and POSTERIOR TEETH

Table of ContentsAnterior Teeth . . . . . . . . . . . . . . . . . . . . . . . .

Lingualized Teeth . . . . . . . . . . . . . . . . . . . .

0° Posterior Teeth . . . . . . . . . . . . . . . . . . . .

10° Posterior Teeth . . . . . . . . . . . . . . . . . . .

20° Posterior Teeth . . . . . . . . . . . . . . . . . . .

22° Posterior Teeth . . . . . . . . . . . . . . . . . . .

30° Posterior Teeth . . . . . . . . . . . . . . . . . . .

33° Posterior Teeth . . . . . . . . . . . . . . . . . . .

40° Posterior Teeth . . . . . . . . . . . . . . . . . . . .

Appendix . . . . . . . . . . . . . . . . . . . . . . . . .

1

Pages

2-8

9-14

15-17

18-20

21-22

23-24

25-27

28-29

30-31

32-38

Contains guidelines for use, a glossary of key terms andsuggested arrangement and articulation procedures

©2005 DENTSPLY International Inc. All rights reserved.

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 cavity. 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 of whatmay be extreme changes in shape and size, a resorbed,residual ridge is a questionable landmark for eitherfunctional or esthetic tooth position.

Setting artificial teeth directly over the center of resorbedridges makes the development of natural estheticsextremely difficult to achieve. This is because naturalteeth seldom occupy the so-called “over the ridge” posi-tion. Dental restorations, complete dentures in particular,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 maxillaryridge 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.

When using IPN Denture teeth, prior to placing teethin wax, it is suggested the underside of the tooth beground (deglazed) to remove the polished surface toenhance retention.

Description:Exceptional esthetics, plus an infinitevariety of moulds to satisfy any need.

Indications For Use:Any full or partial denture case; alsoideal for use in implant prosthetics andprovisional restorations.

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Factors to Consider in theEsthetic Arrangement ofTrubyte®Anterior Teeth

Natural antero-posterior placement ofmaxillary anterior teeth

These matrix studies further demonstrate the relationshipbetween tooth position and ridge resorption, and properlip support.

Fig. 1 shows a cross-sectionof the matrix and cast madebefore natural teeth wereremoved.

In Fig. 2 the cast has beentrimmed to simulate a normalamount of ridge resorption inthe anterior area.

In Fig. 3 a graphic illustrationis provided of what happensto tooth positioning when theteeth are set “up and back”on the resorbed 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 lip and facial tissue support.

The measurements of 22 mm and 18 mm from the labialfold to the incisal edges of the maxillary and mandibularincisors respectively, are reasonable averages. These dis-tances may be used as a guide for the length of waxocclusal rims in the anterior area, and positioning of thecentral incisor teeth for preliminary tooth arrangements.

Proper vertical positioning of artificial teethaccording to averages.

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

3

For natural esthetics and phonetics, the artificial teethshould be placed as nearly as possible in the same positionantero-posteriorly, and be of the same length, as theoriginal natural teeth.

Natural Tooth Position

“A” illustrates the position ofthe natural central incisor andits relationship to the ridge.

Position AfterLoss/Removal

“B” illustrates the same ridgeimmediately after removal ofthe tooth. Dotted lines indicateposition of the natural root.

Direction of Resorption

The direction of resorption isup and back. In “C” the solidline identifies the resorbedridge; the dotted line, theoriginal contour of the ridge.

Improper Positioningof Teeth

“D” illustrates one of the mostcommon errors in anterior toothpositioning - positioning theteeth over the resorbed ridgewithout considering the originalposition of the natural teeth.

In “E,” with drawing “A”superimposed over drawing“D,” the denture with teeth setover the ridge is comparedto the original position of thenatural central. The loss ofvertical dimension and lipsupport, and resulting lossin esthetics, is the mostcommon result.

A

22 mm.

18 - 20 mm.

9 - 10 mm.

B

C

D

12 - 14 mm.

E

Figure 1

Figure 2

Figure 3

22 mm.

36, 37, 38 mm.

2, 3, 4 mm.

18 mm.

Figure 4

Ridge resorption is a major factor in theposition of anterior teeth.

Figure 7. Mould 22G is illustrated.

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Figure 6. Mould 44E is illustrated.

Nature 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.

Mandibular ridge is used to determine arch form due toresorption of maxillary ridge.

Tooth Arrangement in the Square Arch

In the Square Arch form, the two centrals are usually setto an almost straight line across the front of the arch. Thelaterals are also positioned with a nearly full labialaspect and exhibit very little 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.

Overall, in the Square arrangement the visual effect isfairly straight from canine to canine. The teeth also tendto be straight up and down, rather than sloping. The fullor nearly full labial surface presented by all six anteriorteeth gives a broad effect which is in harmony with abroad, square face.

Other appropriate mould forms are listed in the IPNMould Chart, Form #4343-A and in the IndividualizedAnterior Arrangement brochure, Form #3900.

Tooth Arrangement in the Tapering Arch

A 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.

In the Tapering arch, the central incisors are often foundto be a greater distance forward of the canines than inother types of arches.


A Tapering arrangement does not appear as wide asothers, 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.

A Tapering arrangement may also exhibit some “slope;”that is, the incisals of the centrals and laterals are projectedforward, and the cervical area of canines is brought out.

Tooth Arrangement in the Square Tapering Arch

The Square Tapering arrangement combines characteristicsof the Square and Tapering forms, modifying both. It has acharacteristic 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 exhibit moredistal rotation than in a Square arrangement.

The centrals are set prominently, with the laterals andcannines elevated. There may be little or no rotation ofthe centrals combined with a typical Tapering effect orrotation of laterals and canines.

Tooth Arrangement in the Ovoid Arch

The Ovoid arrangement exhibits definite curvature; rota-tion is seldom observed.

The central incisors in the Ovoid anterior arch are often setwell forward of the canines, in a position between that ofthe Square and the Tapering arches.

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.

The relationship of the arch form to tootharrangement

Figure 11

5

Figure 8A

5mm Square6mm Ovoid7mm Tapering

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

Five 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 center axis.5. Antero-posterior positioning - How far labially or

lingually (in or out) the anterior or posterior teethare located.

Proximal View - AnteriorSlope

On average, the central incisor,when set at approximately thesame angle as natural teeth,will be at an inclination slightlyoffset from vertical. Theincisal edge will contact theocclusal plane.

The slope of the lateral incisoris often slightly more accentuat-ed than that of the central. Theincisal edge of the lateral maybe slightly raised (superior to)about 1/2 mm from theocclusal plane.

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.

Frontal/Facial View - Mesiodistal Inclination

The desirable angulation to the median line may becorrelated to the form of the arch and of the tooth.Generally the Square Arch form and tooth, and the OvoidArch form and tooth, may be set to approximately thesame angulations.

The Tapering forms are often set to a slightly greaterangulation.

Any 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.

Figure 9ACentral

Lateral

1/2 mm

Figure 9B

Canine

Figure 9C

Occlusion Rims

A 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.

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


Procedures

Basic placement of anterior teeth

Figure 10ASquare Ovoid

Square-tapering Tapering

Figure 10B

More information regarding use of wax occlusion rims,waxing-up and general set-up guidelines are availablein the Appendix, page 32.

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

In 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 sizeof the lateral incisors and canines, and their straight boldarrangement, are important considerations in achievingthe effect of strength. Vigor and boldness are not necessar-ily solely masculine characteristics, since strong, boldfaces may be found in many female patients.

The following drawings illustrate the principle of toothpositioning for visual effect.

In drawing 16A, two central incisors are normallypositioned. Viewed from the front, these teeth would looknormal in their size or relation toeach other.

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.

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

Figure 13

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

3. Place the canines with the incisal tip close to or touchingthe occlusal plane, and tilt the cervical third buccally togive it prominence. Often, the mesiolabial aspect of thecanine is visible when viewed from the anterior.

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).

Figures 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 12

Figure 16A

Figure 16B

Factors of softness and vigor

Positioning of maxillary canines

Figure 17

7

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 illusion maybe made even stronger by grinding the teeth incisally toleave the distoincisal area prominent.

Figure 16C

Illustrations 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.

Figures 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 for thealignment of lower anterior teethmay be above the occlusal plane,a distance usually described asthe vertical overlap or overbite(Fig. 21). The vertical overlap ofthe teeth may be influenced bythe esthetic and phonetic needsof the patient. Anterior teethshould also be arranged in har-mony with various degrees ofincisal guide table angulation.

Fig. 22 shows aproximal view of thelower anteriors indi-cating their averageantero-posteriorinclinations to ahorizontal plane.

Although there are varying methods and guides in thearrangement of artificial anterior teeth, it is the overallvisual effect of the teeth in the mouth of the patient, createdby their shape, size, color, and position, that determinesacceptance or rejection. The teeth must fulfill the Esthetic,Phonetic and Functional requirements of the individualpatient. This is why a wax try-in and acceptance of thedenture arrangement by the patient is so important.

A wide variety of patient communication materials anddenture selection aids are available from DENTSPLY tohelp educate patients and assist in the delivery of essentialinformation from the dentist to the laboratory.

DENTSPLY TruRx™ Digital Denture Prescription is one ofthese tools. DENTSPLY TruRx is an interactive software thatprovides a custom denture consultation showing the patientstheir post-therapy image during their first visit, easing fearsand setting the stage for a more positive appointment. Theprescription generated from the DENTSPLY TruRx digitaldenture prescription is easy-to-read and provides thelaboratory with the post-therapy image, face shape, mouldform, arrangement, denture base and more. For moreinformation, visit trurx.dentsply.com.

Vertical Overlap

Horizontal Overlap

Figure 21

VerticalOverlap(Overbite)

HorizontalOverlap (Over jet)

Central Lateral Canine

Figure 22

Central Lateral Canine

Figure 19

Figure 18

Figure 20

Overall evaluation of anterior tootharrangement

Procedures to be observed in arranging themandibular anterior teeth

8

Another 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 first 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,

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

or 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.

Asymmetry and its influence on tootharrangement

9

Lingualized occlusion* was first documented in dentalliterature in 1927 by one of the founding-fathers ofarticulation, Dr. Alfred Gysi, of Switzerland. It is definedas, “setting the upper posterior teeth in a turned-outposition (cusps toward the cheeks), so that only the lingualcusps of the maxillary teeth contact the center of theocclusal table (the fossa) of the mandibular posterior teeth”(see Figure 1 below).

The focus of this posterior arrangement method is onelimination of the tooth contact points on the buccal cusps.Thus, the occlusal contacts are moved as far lingually aspractical, while still maintaining the physiologic positioningof the prosthetic teeth. Preservation of the lingual contactsassures seating and minimizes tipping of the lower dentureupon tooth contact and during function.

Within practical limits, it is esthetically optimal whendenture teeth are arranged close, to where the naturalteeth were 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 neutral zones(the channel where the teeth are located that should notbe affected by tongue, lip and cheek forces which couldunseat the denture) may determine the extent to whichesthetics will be sacrificed for functional improvements.In such cases, lingualized occlusion minimizes estheticcompromises and optimizes functionality.

Balancing Side

Working Side

CentricWorking/Non-Working

Movement

Mandibular Movement

Figure 1. Lingualized Set-Up

Background and Objective

*Glossary Prosthodontic Terms 1999 (S. Howard Payne, 1941; Earl Pound, 1970’s)

Description:A posterior arrangement method that eliminatestooth contact points on the buccal cusps toassure seating and minimize tipping of thelower denture upon contact.

Indications For Use:Ideal for use with full dentures.

Ridge Type:30˚ or 33˚ – Healthy ridge with minor resorption.

22˚ – Moderately resorbed ridge.0˚ or 10˚ – Advanced ridge resorption.

10

For a lingualized occlusion, select a higher degree cuspangle on the upper posterior teeth than the degree of cuspangle of the lower posteriotr teeth.

We 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 combinationof teeth will function properly.

The following is Trubyte’s suggested process for lingualizedarticulation and arrangement of posterior teeth to achievefunction, comfort, and esthetics for a fully edentulous patient.

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 physiologicposition for esthetic and phonetic reasons. Posteriorteeth can be set over the resorbed ridge when adequatetongue space exists, or facial to the ridge when estheticsrequire facial placement of the teeth (Figure 2).

2. If a lingualized arrangement is desired, when all maxillaryteeth have been set insert an object the approximatethickness of a 2mm ruler between the buccal cusps ofthe posterior teeth and the table while the set-up wax isstill soft (Figure 3). Apply pressure. This technique willelevate the maxillary buccal cusps to the right positionfor proper contact between the opposing stamp cusps.This also eliminates any contact between the maxillarybuccal cusp and the opposing mandibular buccal cuspin the working movement.

Lingualized Set-up Techniques

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, whichoccludes into a fossa in the opposing dentition. Inlingualized occlusion the maxillary stamp cusps arepreserved. No grinding should occur on these teeth.Use the rule of BULL for 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, open thearticulator pin 1mm. Grind a saucer shape approximately2mm wide to accommodate the stamp cusps. Thesaucer shape is developed by marking both centricand eccentric occlusion with articulating paper.Continue to develop the saucers until the pin contactsthe incisal guide table.

Figure 2. Posterior Resorption

Figure. 3

Figure 4. Mandibular first molar - Buccal View

Figure 5. Mandibular first molar - Lingual View

Relationship of upper Portrait IPN Posteriors to lower Portrait IPN Posteriors

Figure 8

Arranging Portrait IPN Posteriors(33° Maxillary Posteriors with 22°Mandibular Posteriors)

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 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 angleor plane of the first molar. The distolingual cusp isapproximately 1-1/2 mm above the plane, and thedistobuccal cusp is approximately 2 mm above theplane (Figs. 6 and 7).

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

6. Occlude the central fossae area of the mandibular 22°teeth 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 12.

Figure 7

Figure 6

Arranging Portrait IPN 33° MaxillaryPosteriors with Portrait IPN 0° MandibularPosteriors

1. Place the 33° maxillary premolars with their longaxes at right angles to the occlusal plane (Fig. 6). Thelingual cusps should touch the plane and the buccalcusps should be raised approximately 1/2 mm abovethe plane (Figs. 6 and 7). A straight edge may beused to align the lingual cusps as shown previously.

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

MINUS

10˚30˚ 12 -̊15˚BENNETT

30˚ 0˚ 12 -̊15˚BENNETT

11

7. Occlude the central fossae area of the mandibular 0°teeth to the lingual cusps of the maxillary 33° teeth. Atypical relationship of upper to lower is illustrated in Fig.8. The relationships of the completed arrangement areshown in Figs. 18-26 on page 13.

If a “deeper” or “tighter” occlusion is desired, some slightgrinding modification in the developmental groove areasof the 0° lower posteriors will permit a more intimatelingualized relationship with the lingual cusps of the upper33° posteriors. The modification may be done with small,mounted points.

12

Tooth Arrangement in All Relations

Figure 9. Portrait® IPN® Lingualized balancedarrangement in centric occlusion, buccal view.

Figure 12. Working occlusion, buccal view.

Figure 11. Centric occlusion, lingual view.

Figure 15. Balancing occlusion, buccal view.

Figure 14. Working occlusion, lingual view.

Figure 17. Balancing occlusion, lingual view.

Note: Arrangements shown are average. Modifications may be made as needed for a given situation.

Mandibular Movement

WorkingSide

Mandibular Movement

Balancing Side

Portrait® IPN® Teeth - 33˚/ 22˚ Example for Lingualized Occlusion

Figure 10. Cross sectionof centric occlusion.

Figure 13. Cross sectionof working occlusion.

Figure 16. Cross sectionof balancing occlusion.

A simplified approach to tooth selection, ordering and set-up.

Figure 18. Centric occlusion, buccal view. Figure 20. Centric occlusion, lingual view.

Figure 21. Working occlusion, buccal view. Figure 23. Working occlusion, lingual view.

Figure 24. Balancing occlusion, buccal view. Figure 26. Balancing occlusion, lingual view.

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Portrait® IPN® Teeth - 33˚/ 0˚ Example for Unlingualized Occlusion

Tooth Arrangement in All Relations


Mandibular Movement

Working Side


Mandibular Movement

Balancing Side


An alternative for lingualized cases requiring flat mandibular occlusion.

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Lingualized Occlusal Options fromDENTSPLY Trubyte

DENTSPLY Trubyte’s multiple posterior tooth options assuresthat technicians will have a variety of predictable ways toapproach lingualized occlusion – with the cutting edge on

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

For more detailed tooth arrangement options, contactyour Trubyte Representative or call Customer Service at1-800-786-0085 to receive a free copy of“Individualized Anterior Arrangements of Trubyte Teeth”(form #3900).

Trubyte® Portrait® IPN® 0° 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 0°teeth resemble well-worn natural teeth. A modified rationalocclusal 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 lingualized set-up with semi or fully anatomicalupper posteriors, especially “even-dimensioned” 10° and33° posteriors. To aid in arrangement, the maxillary teethmay be positioned with the lingual surfaces set to astraight edge. This positioning automatically provides aproper degree of buccal contour for good esthetic appear-ance and function.

All Trubyte® 0° Posterior teeth follow the same suggestedarrangement and articulation guidelines as Portrait IPN 0°Posterior teeth.

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.

15

Figure 1

Figure 2

Description: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.

Ridge Type:Advanced ridge resorption.

Recommended Technique:Bilateral Balanced, Linear Occlusion, andLingualized Occlusion.

Arranging Trubyte Flat Plane IPN Posteriorsin linear occlusion

30˚ 0˚ 12 -̊15˚BENNETT

(Monoline®)

3. 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. Portrait® IPN® 0˚ flat linear type tootharrangement in centric occlusion, buccal view.


Figure9. Centric occlusion, lingual view.

Figure 13. Balancing position, buccal view.


Figure 15. Balancing position, lingual view.

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Figure 3

Figure 5

Figure 4

The arrangement illustrated here was done with a 30°condylar inclination and a 0° incisal inclination. Otherguidance factors may be used as individual conditionsindicate. In this type occlusion with 0° Posteriors, there willnormally 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




MandibularMovement

Working Side

MandibularMovement

Balancing Side

0˚ PosteriorsThe Completed Tooth Arrangement In All Relations in Linear Occlusion

1. 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).

A 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 inclined 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).

Figure 18. Portrait® IPN® 0° balancingarrangement, in centric occlusion, buccal view.


17





Arranging Flat Plane Posteriors in bilateralbalanced occlusion

4. The second molar is set to follow the same angle or planeof the first molar. The mesiolingual cusp should be about1 mm above the plane, and the mesiobuccal and dis-tolingual cusp areas approximately 2 mm off the plane.

5. Follow the same procedure in placing the posterior teethon the opposite side.

6. Then occlude the mandibular teeth to the maxillary teeth(Figs. 15-20). A 30° condylar inclination and 0° incisalinclination were used in this arrangement. Other guid-ance factors may be used as individual conditions 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 from thelingual as well as the buccal.

Figure 17Figure 16




MandibularMovement

Working Side

Mandibular Movement

Balancing Side

0˚ PosteriorsThe Completed Tooth Arrangement In All Relations in Bilateral Balanced Occlusion

Trubyte IPN® 10° Posterior teeth are a beautifullycarved tooth form with moderately inclined cuspal slopes.Their natural anatomic form makes them estheticallyand functionally well suited for use in complete andpartial dentures.

10° Posteriors resemble well-worn natural teeth, but withwell-defined sluiceways and ridges to promote goodchewing efficiency without packing - important for patientcomfort. Cusps are shallow and non-interfering to facilitatefreedom in excursions. A slight protrusive lift allows anterioroverbite for improved esthetics.

These teeth may be arranged in a linear type occlusion orwith a compensating curve for continuous bilateral balancedocclusion. For convenience in tooth arrangement in bothconfigurations, when viewed from the occlusal aspect, themaxillary teeth may be set with the lingual surfaces set toa straight edge. This automatically provides a properdegree of buccal curvature.

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).

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

18

Figure 3

Figure 1

Figure 2

Figure 1

Figure 2

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.”

Ridge Type:Semi to fully resorbed ridge.

Recommended Technique:Bilateral Balanced, Lingualized and LinearOcclusion.

Arranging 10° posteriors in linear occlusion

10˚30˚ 12 -̊15˚BENNETT

(Anatolinee/Functionale)

1. Place the maxillary 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).

19

Figure 5. 10° linear arrangement in centricocclusion, buccal view.

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

Figure 7. The linear arrangement in centricocclusion, lingual view.

Figure 11. The linear arrangement in balanc-ing position, buccal view.

Figure 10. The linear arrangement in workingocclusion, lingual view.

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

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

This also aligns the lingual cusps to, in effect, form a lingualknife for exceptional cutting efficiency.

3. Follow the same procedure in placing the posteriorson the opposite side.

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

Arranging 10° posteriors in bilateralbalanced occlusion

Figure 14

Figure 15

Figure 4

Proximal view

Buccal view

10˚30˚ 12 -̊15˚BENNETT




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

10˚ PosteriorsThe Completed Tooth Arrangement In All Relations

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 slightlyabove the plane, and the distobuccal cusp isapproximately 1 mm above the plane (Figs. 14 and 15).

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

20

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

Figure 19. In working occlusion, buccal view.

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

Figure 22. In balancing position, buccal view.

Figure 21. In working occlusion, lingual view.

Figure 24. In balancing position, lingual view.

mately 1-1/2 mm above the plane, and the distobuccalcusp is approximately 2 mm above the plane (Figs. 14and 15).

5. Follow the same procedure in placing the posterior teethon the opposite side.

6. Then occlude mandibular teeth to the maxillary teeth (Figs.16-24). A 30° condylar inclination and a 10° incisalinclination are recommended. However, other guidancefactors may be used as individual conditions indicate.


Figure 17. Cross sec-tion of centric occlusion.



Mandibular Movement

Working Side

Mandibular Movement

Balancing Side


Figure 2. Interproximal view

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

1. Place the maxillary first premolar with its long axisat right angles to the occlusal plane. The buccal andlingual cusps are placed on the plane.

2. Place the maxillary second premolar in a similar manner.

3. 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 be about1 mm from the occlusal plane (see Figure 2 below).

Trubyte 20° Posteriors are designed to overcome certainproblems of the edentulous patient by utilizing shallowcusp angles as an aid in reducing lateral thrust forces.Because the occlusal surfaces have interacting ridges andintercommunicating clearance spaces, masticating efficiencyis greatly enhanced. Trubyte 20° Posteriors will be founddesirable for use whenever a semi-anatomical cuspaldesign 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 stability and retention of the den-ture.

� SELF-CLEANSING SULCI to help prevent food packingon chewing surfaces and to maintain a high degree ofmasticating efficiency.

� READILY ADAPTABLE to both steep and shallow condylepaths without destructive change in the occlusal surface.

21

Figure 1. Buccal view

Description:Semi-anatomical, shallow 20˚ cusps offerminimal interference and interactingridges with clearance spaces to enhancechewing efficiency.

Indications For Use:Ideal for use with full dentures, whenease of set-up and uninterrupted functionis desired.

Ridge Type:Semi-resorbed ridge.

Recommended Technique:Bilateral Balanced and/or LingualizedOcclusion.

Arranging Trubyte 20° maxillary posteriors

10˚ 15˚BENNETT

BioStabil®

22

Articulation of mandibular first molar

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 aligned,but angled slightly inward (see Fig. 3).

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

Bilateral balanced occlusion contributes greatly to the comfortand efficiency of complete dentures. Without balanced occlu-sion there may be greater resorption, less mastication efficiency,and a recurrence of sore spots. This can be accomplished witha minimum of effort if each tooth is brought into function.

If careful attention is paid to the positioning of the mandibularfirst molar, articulation of the remaining posteriors will begreatly facilitated.

Centric Occlusion,Buccal View.Note: Generous overjetof maxillary molar overthe mandibular molar.

Note: Seating of uppermesiolingual cusp inlower central fossa.

Centric Occlusion,Lingual View.

Working Occlusion,Buccal View.

Working Occlusion,Lingual View.

Working Occlusion,Distal View.

Balancing Position,Buccal View.

Relation of the maxillary and mandibular first molarThe first molars are the keystone to posterior occlusion. Illustrated here are ideal relationships.


The remaining teeth are inter-digitated in a similar manner. Check the centric and lateral relationships of each tooth as it ispositioned - as well as the completed tooth arrangement in all relations.

Figure 4. In centric occlusion, buccal view

Figure 7. In working occlusion, buccal view Figure 9. In working occlusion, lingual view

Figure 10. In balancing relation, buccal view Figure 12. In balancing relation, lingual view

Figure 6. In centric occlusion, lingual view

20˚Posteriors - The Completed Tooth Arrangement in all Relations

Figure 3. Use of straight edge, occlusal view.




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

Trubyte 22° Posterior teeth are a beautifully carved toothform with moderately inclined cuspal slopes. Their naturalanatomic form makes them esthetically and functionallywell suited for use in complete dentures, as well as forremovable partial dentures.

The 22° 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-interferingto facilitate freedom in excursions, yet provide a definitepoint of centric contact. A slight protrusive lift allowsanterior overbite for improved esthetics.

These teeth may be arranged with a compensatingcurve for continuous bilateral balanced occlusion. Forconvenience in tooth arrangement, when viewed from theocclusal aspect, the maxillary teeth may be set with thelingual surfaces set to a straight edge. This automaticallyprovides a proper degree of buccal curvature.

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).

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).

23

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

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

Ridge Type:Moderately resorbed ridge.



Figure 2. Proximal view

Arranging 22° PosteriorsIn Bilateral Balanced Occlusion

10˚30˚ 12 -̊15˚BENNETT

(BioStabil®)

24

Figure 4. Centric occlusion, buccal view.

Figure7. Working occlusion, buccal view.


Figure10. Balancing position, buccal view.




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 the

distobuccal cusp are approximately 1-1/2 mm abovethe plane (Figs.1 and 2).


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

For the lingualized occlusion technique using 33˚posteriors over 22˚ posteriors, and 33˚ over 0˚, seepages 9-14.

Figure 3




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side


The 30° Posteriors are designed with a 5° buccal slope ofthe maxillary premolars, which follows nature’s plan andgreatly improves the esthetics of finished dentures. Studiesof thousands of natural teeth reveal the importance of this5° slope in esthetics. Fig. 1 below shows two representativenatural maxillary pre-molars compared with the 30°premolars. Note how closely the 5° buccal slope followsnature’s plan.

An important feature of the 30° Posteriors is the adequatefood table and narrow occlusal contact. Greater stabilityof the denture is provided by the shallow transverse orlateral angle of the teeth. Mastication is made easier andmore efficient, assuring a new and greater degree ofcomfort to the patient.

25

Trubyte 30° Posteriors are designed to meet the anatomi-cal requirements of the mandibular movements of themajority of patients. They are particularly suitable for par-tial and complete dentures which oppose natural teeth,and for complete dentures in which a cuspal form is pre-ferred.

When the teeth are properly occluded, they will have bilat-eral balance without cuspal interference. The 5° buccalslope and the engineered buccal overjet protects thecheeks and helps to virtually eliminate cheek biting.

Description:Fully anatomical, long crown forms andlong buccal-short bite moulds available.


Ridge Type:Healthy ridge with minor resorption.


A greater degree of comfort and efficiencyfor the patient

30˚30˚ 15˚BENNETT

The natural form and function of the 5°buccal slope

Figure 1.

(Pilkington-Turner®)

30° Posteriors - Articulation of mandibular first molarBalanced 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 witha minimum of effort if each tooth is brought into function.

Bear in mind that the mandibular first molar is a key toothin articulation. If careful attention is paid to the positioningof this tooth, articulation of the remaining posteriors willbe greatly facilitated.

Bilateral balanced occlusion is an important element insecuring maximum comfort and efficiency in completedentures. Without balance, there may be more resorptionof the ridges, lessening of masticating efficiency andgreater recurrence of tender, sore tissue.

Balanced occlusion can be accomplished by emphasison two factors:

A. The correct positioning 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 the 30° Posteriors lies in their adaptability to mosttechniques and the ease with which balanced occlusionmay be obtained.

Following are suggestions for the arrangement andarticulation of the 30° Posteriors. These suggestedprocedures follow generally observed principles.

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 premolars

Natural conformation and sizeare ideal for removable partialdentures30° Posteriors conform closely in size and shape to natur-al teeth. Buccolingually, their width closely approximatesthat of natural teeth. Mesiodisally, they are provided insizes harmonious with natural teeth which they mayreplace.

Fig. 2 shows theample food tableprovided in theocclusal designof the premolarsand molars.

and the mesiolingual cusp of the first molar touch theocclusal plane. The buccal cusps are raised approximately1/2 mm. The molars also follow this proportionaterelation. 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.

26

Procedures to be observed in arranging 30° Posteriors

Buccolingual view.

Buccal view.

Occlusal view.

Figure 2.

27




Figure 12. Balancing occlusion, buccal view.


Figure 14. Balancing occlusion, lingual view.






Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

Figure 15. Centric. Figure 16. Working.No Cuspal Disclussion.

Trubyte® 33° Posteriors are ideally designed for completedentures and removable partial dentures which opposenatural teeth. They are a standard of excellence for maxil-lary and mandibular complete dentures where an anatomi-cal tooth form is preferred or indicated.

Cuspal contours are comparable to those of moderatelyworn natural teeth. Their inclinations and well defined sulciprovide pathways which are adaptable to most require-ments in complete and partial denture construction.

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 of 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.

1. 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 premolars andthe canine with the edge of an occlusal plane (seeFigure 3).

28

Description:Fully anatomical, long crown forms andlong buccal-short bite moulds available.






Arranging Trubyte® 33° maxillaryposterior teeth

Figure 3

Please note: Portrait® IPN® 33° posteriors canbe aligned with a straight edge on the lingualfor faster set-ups (see 10° page 18).

30˚30˚ 12 -̊15˚BENNETT

Figure 4. Centric occlusion, buccal view

Figure 9. Working occlusion, buccal view

Figure 10. Balancing contact, buccal view

Figure 6. Centric occlusion, lingual view

Figure 7. Working occlusion, lingual view

Figure 12. Balancing contact, lingual view


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

6. An occlusal view of the positioning of Trubyte 33°maxillary posteriors is illustrated in Fig. 3, Page 28.

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 arrangement,and modifications can be made as individual conditionsindicate.

33° PosteriorsThe Completed Tooth Arrangement In All Relations

For the lingualized occlusion technique using 33˚posteriors over 22˚ posteriors, see page 9 and 14.

29

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

Trubyte 33° Posteriors - Articulation of mandibular first molar

Buccal/Cheek

Lingual/Tongue

Step 3Buccal/Cheek

Lingual/Tongue

Step 4

Bilateral balanced occlusion contributes greatly to thecomfort and efficiency of complete dentures. Withoutbalance there may be greater resorption, less efficiency,and a recurrence of sore spots. Balanced occlusion can beaccomplished with a minimum of effort if each tooth isbrought into function.

Bear in mind that the mandibular first molar is a key toothin articulation. If careful attention is paid to the positioningof this tooth, articulation of the remaining posteriors willbe greatly facilitated.

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.




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

Trubyte® Portrait® IPN® 40° posterior teeth are fullyanatomical. They were designed by master dental techni-cians in Europe and are moulded in York, Pennsylvania.Their wider, deeper occlusal table and longer crown formintegrate more completely with natural dentition. Thisyoung anatomic form makes them ideally suited for use inremovable partial dentures and combination cases.

Portrait 40° Posteriors are similar to the 22° posteriors inbucco-lingual and ridge lap design. This full-form tooth willfill a space and fit on a natural ridge with more stabilityand will more easily interdigitate with opposing naturaldentition 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 pathwayprovide more freedom of movement in lateral excursions,as compared 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 first, use aTrubyte 20° Template.

The relationship of the cusps of the maxillary posteriorteeth may be related to a flat occlusal plane for easy initialpositioning and later occlusion and articulation with themandibular posterior teeth, if necessary. An illustration ofinitial positioning of each tooth and the relationship ofeach cusp to a flat plane are shown in Figs. 1 and 2.

30

Description:Fully anatomical, long crown form.




1/2 to3/4 mm

Figure 2B. Cusp view



Arranging Portrait 40° Posteriors in aBilateral Balanced Occlusion

30˚30˚ 12 -̊15˚BENNETT

(EuroLinee)

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 first molar (reddots) 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 approximately1-1/2 mm above the plane (Figs. 1,2, 2B and Step 4 illustration).


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).

The buccal ridges of the molars may be similarly aligned,but angled slightly inward. This is an average arrangementand modifications can be made as individual conditionsindicate.






Figure12. Balancing position, lingual view.


31

Figure 3. Occlusal surface view

Buccal/Cheek

Lingual/Tongue

Step 3

Buccal/Cheek

Lingual/Tongue

Step 4




Mandibular Movement

Working Side

Mandibular Movement

Balancing Side

40° PosteriorsThe Completed Tooth Arrangement In All Relations

32

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-tion 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 lip 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 amillimeter ruler to measure the distance from the mucobuc-cal fold to the occlusal plane: 22-mm on the upper and18-mm on the lower. (These measurements 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 tuberosity 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 dimensions.

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

Figure 3. The posteriorareas of the wax rims shouldbe trimmed at a 30˚ angle toeliminate potential interfer-ence during bite registrationprocedures.

Stabilized Baseplates

Wax Occlusion Rims

Tooth Morphology

33

*Supplied in sets of 1x8 only (consisting of 2 blocks of 4 right and left- upper or lower).

TRUBLEND® SLM® 0° Plastic (MONOLINE®) 429 TRUBLEND SLM Shade (All Shades)431 T1, T2, T3, T4, T5, T6,433 T7, T8, T9, T10, T11, T12,

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

PORTRAIT® IPN® 0° Plastic 630 PORTRAIT IPN Shades (All Shades)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

BIOFORM® IPN® 0° Plastic (MONOLINE®) 429 BIOFORM IPN Shades (All Shades)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, B96

VACUUM FIRED 0° Porcelain (RATIONAL®) 29M, L BIOFORM Shades (Limited Shades)31M, L B62, B65, B66, B67, B69,33M, L B77, B81

BIOTONE® 0° Plastic (RATIONAL®) 29M, L BIOTONE Shades (All Shades)31M, L 62P, 65P, 66P, 67P, 69P,33M, L 77P, 81P

BIOTONE® 0° Block (Plastic)* (RATIONAL®) 29M, L BIOTONE Shades (Limited Shades)31M, L 62P, 65P, 66P, 67P, 69P, 77P

NEW HUE® 0° Plastic 29M NEW HUE Shades (All Shades)31M 59, 61, 62, 65, 66, 67, 69, 77, 8133M

CLASSIC® 0° Plastic 29M CLASSIC Shades (All Shades)31M A1, A2, A3, A3.5, A4, B1, B2, B3, B4,33M C1, C2, C3, C4, D2, D3, D4,

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

Trubyte® 0˚ Non-Anatomical(Flat-Plane) Posteriors

Moulds ShadesMoulds and Shades

Posterior Mould/Shade Availability

34

TRUBLEND® SLM® 10° Plastic (ANATOLINE®) 330 TRUBLEND SLM Shades (All Shades)332 T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12,334 T13, T14, T15, T16, T17, T18, T19, T20, T21, T22,

T23, T24

PORTRAIT® IPN® 10° Plastic (ANATOLINE®) 330 PORTRAIT IPN Shades (All Shades)332 P1, P2, P3, P3.5, P4, P11, P12, P13, P14,334 P21, P22, P23, P24, P32, P33, P34, P77,336 P59, P62, P65, P66, P67, P81,

PW2, PW4, PW7

BIOFORM® IPN® 10° Plastic (ANATOLINE®) 330 BIOFORM IPN Shades (All Shades)332 B51, B52, B53, B54, B55, B56, B59, B62,B63, B65, B66,334 B67, B69, B77, B81, B83, B84, B85, B91, B92, B93,

B94, B95, B96

VACUUM FIRED 10° Porcelain (FUNCTIONAL®) F30, F32, BIOFORM Shades (Limited Shades)F33, F34 B62, B65, B66, B67,Medium Lengths B69, B77, B81

BIOTONE® 10° Plastic (FUNCTIONAL®) F30, F32 BIOTONE Shades (All Shades)F33, F34 59P, 62P, 65P, 66P,

67P, 69P, 77P, 81P

CLASSIC® 10° Plastic F30, F32, F33 CLASSIC SHADES (All Shades)A1, A2, A3, A3.5, A4, B1, B2, B3, B4,C1, C2, C3, C4, D2, D3, D4,59C, 62C, 65C, 66C, 67C, 69C, 77C, 81C,CW2

NEWHUE® 10° Plastic F30, F32, F33 NEWHUE Shades (All Shades)59, 61, 62, 65, 66, 67, 69, 77, 81, 87

Trubyte® 10˚ Semi-Anatomical Posteriors Moulds ShadesMoulds and Shades

35

TRUBLEND® SLM® 20° Plastic 29M, L TRUBLEND SLM Shades (All Shades)31M T1, T2, T3, T4, T5, T6,33M T7, T8, T9, T10, T11, T12,

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

PORTRAIT® IPN® 20° Plastic 29M, L PORTRAIT IPN Shades (All Shades)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,

PW2, PW4, PW7

BIOFORM® IPN® 20° Plastic* 29S, M, L BIOFORM Shades (All Shades)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 BIOFORM Shades (Limited Shades)31S, M, L B59, B62, B65, B66, B67,33S, M, L B69, B77, B81

NEW HUE® 20° Plastic 29M, L NEW HUE Shades (All Shades)31M, L 59, 61, 62, 65, 66,33M 67, 69, 77, 81, 87

CLASSIC® 20° Plastic 29M, L CLASSIC Shades (All Shades)31M, L A1, A2, A3, A3.5, A4, B1, B2, B3, B4,33M C1. C2, C3, C4, D2, D3, D4,

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

BIOFORM® 20° Plastic 29S, M, L BIOFORM Shades31S, M, L B59, B62, B65, B66,33M, L B67, B69, B77, B81

BIOTONE® 20° Plastic (DENTRON®) 29M, L BIOTONE Shades31M, L 59P, 62P, 65P, 66P,33M, L 67P, 69P, 77P, 81P

Figure 3: *TRUBLEND SLM 20° Plastic Moulds, BIOFORM 20° Plastic Moulds andBIOFORM IPN Plastic Moulds are long buccal-short lingual moulds. They are speciallydesigned for short bite and partical cases. They are engineered with a “scooped out”ridge lap which eliminates unnecessary bulk and reduces grinding to a minimum.

Trubyte® 20˚ Semi-Anatomical Posteriors Moulds ShadesMoulds and Shades

Figure 3.

36

TRUBLEND® SLM® 30° Plastic 230M, L TRUBLEND SLM Shades (All Shades)(PILKINGTON-TURNER®) 233M T1, T2, T3, T4, T5, T6,

T7, T8, T9, T10, T11, T12,T13, T14, T15, T16, T17, T18,T19, T20, T21, T22, T23, T24

BIOFORM® IPN® 30° Plastic 230S, M, L, LS* BIOFORM IPN Shades (Limited)(PILKINGTON-TURNER®) 233M, L B59, B62, B65, B66,

B67, B69, B77, B81

Figure 2. *Long Buccal-Short Bite MouldsMould 230LS is specially designed for short bite and partial cases. It is engi-neered with a “scooped-out” ridge lap which eliminates unnecessary bulk andreduces grinding to a minimum.

Trubyte® 22˚ Posteriors (BioStabil®) Moulds ShadesMoulds and Shades

TRUBLEND® SLM® 22° Plastic (BIOSTABIL®) 530 TRUBLEND SLM Shades (All Shades)532 T1, T2, T3, T4, T5, T6,533 T7, T8, T9, T10, T11, T12,536* T13, T14, T15, T16, T17, T18,

T19, T20, T21, T22, T23, T24

PORTRAIT® IPN® Plastic 530 PORTRAIT IPN Shades (All Shades)532 P1, P2, P3, P3.5, P4, P11, P12, P13, P14,533 P21, P22, P23, P24, P32, P33, P34,536* P59, P62, P65, P66, P67, P69, P77, P81

PW2, PW4, PW7

BIOSTABIL® IPN® 22° Plastic 530 BIOBLEND IPN Shades (All Shades)532 100, 102, 104,533 106, 108, 109,536* 110, 112, 113,

114, 116, 118

*Special large fully contoured mould ideal for implantand partial cases where indicated.

Trubyte® 30˚ Posteriors Moulds Shades

Figure 2.

37

PORTRAIT® IPN® 40° Posteriors (EUROLINE®) 730 PORTRAIT IPN Shades (All Shades)732 P1, P2, P3, P3.5, P4, P11, P12, P13, P14,734 P21, P22, P23, P24, P32, P33, P34,

P59, P62, P65, P66, P67, P69, P77, P81,PW2, PW4, PW7

Trubyte® 33˚ Posteriors Moulds ShadesMoulds and Shades

TRUBLEND® 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

PORTRAIT® IPN® 33° Plastic 30M, L PORTRAIT IPN Shades (All Shades)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® IPN® 33° 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 FIRED 33° 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 HUE® 33° Plastic 30M, L, LS NEW HUE Shades (All Shades)32M, L, LS 59, 61, 62, 65, 66,34M, L, LS 67, 69, 77, 81, 87

CLASSIC® 33° Plastic 30M, L, LS CLASSIC Shades (All Shades)32M, L, LS A1, A2, A3, A3.5, A4, B1, B2, B3, B4,34M, L, 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, 81P

Figure 1: *Long Buccal-Short Bite Moulds (available in plastic only)Moulds 30LS, 32LS, and 34LS are specially designed for short bite cases. They areengineered with a “scooped out” ridge lap which eliminates unnecessary bulk andreduces grinding to a minimum.

Trubyte® 40˚ Posteriors Moulds Shades

Figure 1.

38

Identification of Teeth and Tooth Surfaces

Anatomy of Natural Teeth

Notes

39

DENTSPLY ProstheticsDENTSPLY International Inc.York, PA 17405-0872www.trubyte.dentsply.com orwww.dentsply.com

©2005 DENTSPLY International, Inc. All rights reserved. Form No. 4087-A (06/10)

Distributed by:DENTSPLY Canada161 Vinyl CourtWoodbridge, OntarioLL A3

Documents

Dentsply Tooth Arrangement Manual