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Author: David M. Hern, D.M.D.

Guidelines for Properly Setting Maxillary and Mandibular Anterior Teeth – Laboratory Exercise When Using Ivoclar Ortholingual Maxillary and Mandibular Posterior Teeth Set on a 20 Degree Plane

  1. Mark the midline on the facial surface of the maxillary wax rim.
  2. Remove ¾ of the wax from the midline to the area where the middle of the left lateral incisor will be. Remove wax in the same manner as you set each tooth.
  3. Grind the lingual aspect of each tooth so that you can set it in place using the following guidelines.
    1. Place the mesial aspect of the left central incisor on the midline
    2. Place the incisal aspect of this incisor on the occlusal plane.
    3. Be sure that the facial surface of this central incisor is exactly 9mm. anterior to the distal aspect of the incisal papilla. View this dimension from the direct superior aspect using a straight edge from the left distro-incisal papilla line to that on the right. Using a second ruler, measure from the above ruler to the facial surface of the central incisor.
  4. The axial inclination of this incisor, as viewed from the facial, is slightly toward the distal (relative to the upright position the tooth tilts slightly to the left).
  5. The axial inclination of this central incisor is, as viewed from the distal, is slightly toward the lingual. (The neck of the tooth is slightly depressed.)
  6. The left lateral incisor is sex exactly as the central incisor from the aspects of being on the occlusal surface and having the same axial inclinations. View the residual maxillary ridge from the superior aspect and align the incisal edge of the lateral incisor according to this ridge outline (square, tapering, or ovoid).
  7. Set the left cuspid on the occlusal table, but with an upright axial inclination. Have the distal aspect of this tooth turned lingually. When viewed from an incisal aspect, the cuspid turns the corner.
  8. Have these three teeth evaluated by an instructor.
  9. Set the maxillary right anterior teeth using the same guidelines.

In order to properly setup denture teeth, they must be reduced in the linguo-cervical areas. While this must be done carefully and selectively, do not be afraid to reduce the teeth in these areas.

  1. The mandibular midline is the same as the maxillary midline.
  2. All of the mandibular anterior teeth are set with a 1mm. vertical overlap relative to the maxillary anteriors and on a flat plane left to right.
  3. All of the mandibular teeth are set with a 1mm. horizontal overlap relative to the maxillary teeth.
  4. The axial inclinations, both from the facial and the distal, are the same as the corresponding maxillary teeth.
  5. The arch form of the mandibular teeth as viewed toward the incisal follows that of maxillary set-up.
  6. The incisal 1/3 of mandibular anterior teeth are never set anterior to the depth of the mandibular muco-buccal fold.

Remember: You must grind the teeth.

Remember, when you set-up denture teeth for a patient, you will use the above as general guidelines. The midline will be determined by bisecting the patient’s face. The occlusal table will be developed using the patients low lip line, interpupillary and ala-tragus lines. The lateral incisals are frequently places slightly above the occlusal plane for esthetic purposes. We frequently use diastemas, tooth rotations, and varying axial inclinations to enhance esthetics or to meet special and/or functional requirements. Selective and careful grinding of the linguo-cervical aspect of the denture teeth is necessary in most set-ups.