Teeth selection

Dr.Suresh V
 contents
 Introduction
 Evolution in anterior teeth selection
 Methods of teeth selection
 Dentogenics
 Golden proportion
 Evolution in posterior teeth selection
 Factors in selecting a posterior tooth
 Review of literature
 Conclusion
 References
 Introduction
An acceptable cosmetic effect in any dental restoration has always
been regarded as a important to good dentistry. A well made
prosthesis will fail if it is deficient in this respect.

Teeth selection in complete denture process plays a huge role in

great prosthetic success and a great patient – operator relationship.

Since ages various methods and guidelines are put forth to achieve
the best prosthetic out come.
 The evolution …
 During the ivory age and early porcelain period ,teeth were selected
or created mostly by dimensional measurements of the denture
space and arch size with little regard to esthetics.

 J W White in 1872 – projected correspondence and harmony theory,

temperamental theory was fading out of medicine but white
reached over and suggested that temperaments called for similarity
of form in faces and teeth.

 The temperamental theory is a theory of fluids of the body,

especially the blood ,the phlegm and the bile. It was conceived by
the Hippocrates in 5th century BC and was used by the medical
profession in diagnosis and treatment planning.
 Tempermental theory
 W.R. Hall in 1887 projected Typal form concept , this was the
initiation of geometric theory later. The basis of this classification
Major basis - a) labial surface curvature
b) outline form and neck width

Minor basis – labiolingual inclination of the upper incisors in

relation to the profile types.
 Berry’s biometric ratio method (1906); projected the outline form of
the inverted central incisor tooth closely approximated the outline
form of face . Hence the outline form of face indicated the outline
form of the anterior teeth to be chosen .
 Berry’s further investigation led to the finding of –

Maxillary central incisor was 1/16th width of the face and

1/20th its length.
 Since 1985 J. Leon Williams wanted revolution in teeth selection
process , later in 1909 he proposed the technique to build wax
occlusal rims of proper height and form, with patient’s lips at rest,
marked the location of corner of mouth ,high lip line, lower lip
line ,and after removing the occlusal rim the distal end of second
molar is marked.
 Using a fleximeter the distance between the markings were read.
 Although Hall had proposed earlier about Typal theory it was
neglected for twenty five years , williams did a extensive study in
1914 to give three basic typal forms – ovoid ,tapering, square.
 He studied in extracted human teeth and skulls .
 According to him it was “combination forms”
tapering or ovoid or both inblended into square
square or ovoid or both inblended into tapering
square or tapering or both inbleded into ovoid

The photograph were distributed among dentist and face form were
used as guide.
 Young emphasized on teeth selection based on emotion, mental
imagery and stored knowledge.

 Nelson in 1920 projected “palatal vault form” ,in this technique the
mid palatal shape was determined to select a tooth shape .

 In 1936 photometric method was proposed by wright, in this using

a
photograph of the patient with natural teeth and establishing a ratio
by comparative computation of measurements of like areas of the
face and photograph is done and using a simple mathematical
formulas the teeth is selected.
 “Anthropometric – cephalic index method” projected by sears in
1941, was based on the fact that the width of the upper central
incisor could be determined by dividing either the transverse
circumference of the head by 13 or by bizygomatic width by 3.3.

 “Bioform technique” proposed by the dentist ‘s supply company in

1950, was based on the geometric outline forms of face and teeth –
the ‘house’ classification for 4 basic , 3 combination typal forms and
3 dimensional harmony of tooth form and face form were
considered.
 The “Trybyte mould selector” method was advocated by the
dentist’s supply company.
 On the edentulous cast measurement in millimeters was made using
the incisive papilla as a focal point of triangle and the distance
measured from the papilla to the hamular notches and inter
distance between hamular notches were found .
 The total length in millimeters is input into
 Methods of teeth selection
Pre extraction records
 Diagnostic casts
 Recent photographs
 Radiographs of teeth

Post-extraction examination
– Size and form of edentulous foundation.
– Matching teeth to faceforms and arch forms. If patient is already a
denture wearer, mouth should be examined with the dentures in the
mouth giving importance to physiological and esthetic aspects.
 Form of anterior teeth
– Based on face form:
 Based on arch form
 – Based on profile of the face
 The labial surface of the tooth viewed from the mesial aspects
should show a contour similar to that when viewed in profile.

 The labial surface of the tooth viewed from the incisal aspect
should show a convexity or flatness similar to that seen when the
face is viewed from under the chin or from the top of the head.
 Based on anthropometric system
 Bizygomatic width = estimated width of maxillary central incisors.
16
 Bizygomatic width = approximate width of six anterior teeth
3.3

Based on marking on the corners of mouth

 Dentogenic concept

A woman is a woman from her finger tips to her smile , and a man is a man
from his fists to smile .

The purely mechanical and mathematical approach to tooth selection is

largely responsible for the neuter gender “denture look”
 Dentogenic and sex factor
 Frush and Fisher in 1955 were the first to introduce “dentogenic
restoration” to dental community.
 Dentogenics described a denture that is eminently suitable to the
wearer in that it adds to the person’s charm, character, dignity or
beauty in a fully expressive smile.
 According to the authors sex identity in dentures carried a greater
significance in achieving better esthetics.
 Feminine form is characteristically spherical with a roundness,
smoothness and softness, whereas the masculine form is cuboidal ,
with hard, muscular, vigorous.
 The procedure therefore is to select a basically feminine or
masculine mould and then harmonize it to the individual patient
depending upon the personality and age factors by modifying
individual teeth.
When the dentogenic concept evolved , the full meaning of esthetics
was carried into the 3rd dimension :

 The wearer of a dentogenic restoration must have inner sensibility of well

being.

 The viewer of the dentogenic restoration must perceive beauty or a

fulfillment of the wearer’s personality in his smile .

 Then the dentists who created the dentogenic restoration would feel deeply
rewarded.
 When the laterals are nearly as broad as the other front teeth the
denture is said to have strong or masculine appearance , when the
laterals are narrower then it depicts feminine or delicate.
 Lateral incisor – if rotated to show its mesial surface gives softness
and youthful appearance to the smile. If rotated mesially the effect
of smile is hardened.
 The authors described a procedure called depth girding, which
involves the accentuation of the third dimensional depth to
eliminate the flat appearance of the artificial upper anterior teeth.
 The depth grinding is done on the mesial surface of the central
incisors only .They are the widest , longest and most noticeable in
the six anterior teeth.
 With a soft stone , the mesiolabial line angle of the central incisor is
ground in a definite and flat cut , following the same curve as
mesial contour of the tooth in order to move the deepest visible
point of the tooth further lingually .after this cut has been made
careful rounding and smoothing of the sharp line angle is made.

 It is necessary to develop the desired effect in depth grinding by a

consideration of these main factors – a flat thin narrow tooth is
delicate looking and fits delicate woman and involves little depth
grinding , wheras a thick , bony , big sized tooth, heavily carved on
its labial face is vigorous and is to be used exclusively for men. this
involves rather severe depth grinding.

 Depth grinding reduces the width of the central incisors according to

the severity of grinding accomplished . Therefore to maintain, the
normal harmony of contrast in size between the six anterior teeth, a
larger central incisor of the same mold should be selected.
 Dentogenics and personality factor
 In 1956 , Frush and Fisher discussed another aspect of dentogenic
– the personality of the patient . They stated that foundation for
the dentogenic restoration is the personality of the patient – simply
because the male and female tooth form is a refinement of that
tooth form which has its inception in the personality factor.
 They devised the personality spectrum and explained the precise
prosthodontic application of the otherwise abstract word personality
– by 3 divisionsof the personality spectrum.
1. Delicate – fragile, frail , opposite of robust
2. Medium pleasing – normal, moderately robust, healthy and
intelligent appearing.
3. Vigorous- the opposite of delicate, hard , aggressive, muscular
type.
 The personality spectrum can be used in our artistic endeavor to
inject a variety of tooth form and tooth position, at the
comprehensive level of individual patient personality analysis.

 A small percentage of patients are delicate , slightly larger

percentage are vigorous, the remaining majority of the patients fall
into the medium section of the personality spectrum.

 The use of dentogenic concept has made easier, by considering the

smile as the primary objective . The smile, personality trait and the
personality spectrum is used in selection of the mould category.
 Dentogenic – age factor
 It was considered in 1957 by the same authors.
 The dignity of the advancing age must be appropriately portrayed in
the denture by careful tooth color selection and mould refinement

 Lighter shades are considered appropriate for young people and

darker shades are considered for older people.

 Also bluish incisal tinges are preferred for the young people and
greyish shades for the older.

 Mould refinement is done by producing worn incisal edges and

cuspid tips, attritional and abrasional facets, development of
diastemas to indicate tooth loss and subsequent drifting.
 The environment of the tooth were arranged is also important, the
matrix of the artificial tooth should be meaningful and not repetitive
and inartistic.
 With very life like material available ,we can even feature the
interdental papillae in a realistic manner.
 In youth interdental papillae are finely stippled and pointed and
tight against the tooth, as age increases the attached gingiva looses
stippled appearance and appear edematous and smooth, even
shortening of the papillae can be depicted by raising the gingival
line.
 Again in 1958 Frush and Fisher propounded the Dynesthetic
interpretation of the dentogenic concept.
 Dynesthetics is a compound word, ‘dyn’ is from the greek word
‘dynamis’ meaning power. It implies movement ,action ,change
,and progression in the esthetic phase of prosthodontics.
 The application of dynesthetics allows a denture to be a work of art
rather than an artifact.
 Rules that govern dynesthetics are:

1. The tooth
2. Its position
3. Its matrix (visible denture base)
 Dynesthetics outline:

Physiologic shade selection

Lip support
Midline
Labioversion
Speaking line
Smiling line
Position of incisors and cuspids
spaces between teeth
Buccal corridor
 Dynesthtics outline :
1. Physiologic shade selection-

As age advances there is accumulation of tobacco tar, food

pigments, and bacterial discoloration. as this occurs ,various degree
of color texture changes occur in the incisal edges, therefore in
creating the illusion of natural dentition for a older patient ,a darker
shade is preferred but this does not imply in all cases, since few
people might not smoke , take light pigmented foods, in such case
shade should be selected lighter.
 Midline : face usually slant one way or another and it is difficult to
see a true midline in a dentition. Therefore an eccentric midline is
acceptable in denture if it not to exaggerated.
 Labio version : most pleasing effect is obtained when the long axis
of the central incisors are either vertical or with slight labial
inclination, this determination is made when the patient is standing
in normal posture.

 Speaking line: it is the vertical composition of the anterior teeth, it

should be noticed when the patient is speaking .
A guide to vertical composition using the incisal edges in relation to
lip line is :
a) young woman 3 mm below lip line at rest
b) young man 2 mm below lip line at rest
c) middle age 1.5mm below the lip line at rest
d)old age ,senility o mmbelow lip line to
2 mm above lip line at rest
 Smiling line : the smiling line is the curve whose path follows the
incisal edges of the central incisors up and back to the incisal edges
of the lateral incisors to tips of the cuspids.its arc is determined by
the age of the patient and decreases as patient gets older.
 Central incisors position : these are the corner stones of the tooth
position, if this tooth position is right all the other teeth position will
be right.

 Their shape is controlled by the physical personality of the patient ,

and their position determines the strength and action of the
dentogenic composition.

 One central incisor is always placed bodily ahead or behind the

other, from this point a various degree of rotation ,labial inclination
and axial divergence will produce effects of additional strength,
activity, and vigor to entire dental composition.
 Lateral incisors : the position of this tooth is subordinated in
importance that of the central incisors. its rotation will either harden
or soften the dental composition.

 The right and left lateral incisors should have asymmetric long axes
and when positioned least portion of the tooth is seen while
speaking.

 In dentogenics , this is considered as the personality tooth, as sex

determination comes from either rounding incisal edge for feminine
and squaring incisal edge for masculine effect.
 The cuspid position : this tooth controls the size of the buccal
coridor, it should be carefully positioned so as to dominate the
lateral incisor and to complete the desired upward curve of the
smiling line.

 Basic requirements while placing the tooth are :

a) tooth should be rotated to show its mesial surface
b) the cervical end should be out
c) when observed from side , the long axis of the cuspids should
be vertical.
 Spaces : between the anterior and posterior teeth is extremely
effective , but their size must be artistically and hygenically formed
or they will become unsightly repositories for food , plaque and
calculus.
 Rules to be observed while giving spaces are :
a) all spaces must be V – shaped to shed food
b) a diastema between central incisors is unsightly and should be
avoided in aged patients.
c) diastemas should be asymmetrically placed on either side of the
dental arch.
d) the width of the diastema should be controlled , so as not to
appear unsightly at any instance.
 Buccal corridor : it is the space created between the buccal surface
of the posterior teeth and the corner of the lips when the patient
smiles.
 It begins at the cuspid , and its size and the shape are controlled by
the position and slant of the cuspid even though the actual corridor
exist posterior to the cuspid tooth.

 Buccal corridor present in the natural dentition, its inclusion in

dentogenics accomplishes an added illusion of reality.
Richard E. Lombardi (1973) stated about –
composition, unity,unity with variety,
dominance,mold requirements,colour in denture esthetics and shade
selection.
 As the amount of contrast increases , visibility increases and when
contrast decreases the visibility decreases, the study of relationship
existing between the objects made visible by the contrast is called
composition.
 The prime requisite of composition is unity means “one-ness”
 Two types of unity are static and dynamic
 If a denture is of static type placed on a dynamic living human
makes it unnatural and unpleasing esthetics.
 Segregating forces must be introduced into the dental composition
to produce dynamic unity.
 Hogarth’s line of beauty has been cosidered as outstanding example
of the unity with variety.

 Dominance is the prime requisite to provide unity.one shape, colour,

or line must dominate.
 The mouth is the dominant feature of the face, the central incisor
selected should be larger than the lateral incisor to dominate the
composition.
 The dominance of the dental composition may be increased by
making it more visible.
 Which may be done by -Increasing the mold size,using lighter
shade, placing teeth far anteriorly, and increasing the exposed
gingivoincisal length.
 The relationship of width to length of a tooth is important , because
if two teeth are of same width and different length, the longer the
tooth will appear to be narrower.
 Repeated ratio : The width of the golden mean rectangle is one
side of a square ;its length is one half the square plus the diagonal
of the half the square.
 This results in a rectangle in which the length / width ratio is
1.618/1.
 This ratio has been explored in relation to the mouth and as a
repeated ratio for the horizontal division of the area of the mouth, it
has proved to be too strong for the dental use.
 If the same ratio between the width of the central incisor and lateral
incisor is repeated between the lateral and the amount of cuspid
shown, and between the cuspid and bicuspid, each tooth size will be
different (variety) but related (unity) because of the same ratio.
 Golden proportion…

Dominance must be exhibited by using a central incisor of sufficient size to

dominate the composition, teeth must not be set on a static cure of circle
but on a dynamic line similar to Hogarth’s line and teeth must be set with
regard to repeated ratio to provide unity with variety .The teeth must be
modified to harmonize with the patient’s age, sex and personality to
provide subjective unity.
 According to Richard E. Lombardi – teeth selected on the premise of
face shape are as good as or better than those of any of the other
systems, but such selection is definitely not the exact science.

 The guide for selecting the size of the central incisors is

16:1head:tooth ratio

 Negative space : they provide the illusion of teeth by portraying the

dark space of the mouth behind the teeth.
 By altering the shape of the incisal edges, the contrast against the
black back ground brings the dynamism and realism to the smile.
 Color in denture esthetics
 Three main components :
Hue : characteristics of the color that gives the identity.
Intensity : describes how much of the actual pigment is in the
color been described.
Value : describes the lightness or the darkness of a color.

 Factors affecting color :

1. Lightness or darkness of the tooth is affected by the amount of light
striking the tooth that will be reflected to the eye of beholder.
2. The texture of the tooth (incisogingival angulation or smoothness of
surface)
3. The back ground against which the color is seen has a definite effect on
the color concerned( a darker background makes a color seems lighter than
the same color against a light back ground)
4. Lighter objects appear larger (closer) than the darker objects.
Unlike anterior teeth , posterior teeth are selected from

Occlusal schemes selected for each individual patients.

Bucco lingual width of tooth
Mesio distal length available
 Posterior teeth selection
History of development of posterior tooth forms :
 Alfred Gysi designed the 1st anatomic porcelian tooth.(1914)
 He studied numerous natural dentition and came to a conclusion
that anatomic posterior teeth should have 33°.
 In 1932 Pilkington and Turner anatomic tooth of 30° angulation.
 According to them the cusps are of tetrahedral form with transverse
grooves between them having the buccal and lingual portions in
alignment and the apices of the cusps all lying on the surface of
sphere.

 Gysi recognised that his anatomic tooth will not suite all type of
ridges , so he designed “cross bite”,in which maxillary cusp were
almost eliminated .

 He described this occlusal scheme as “mortar and pestle” action.

 Victor sears (1927) designed the “channel” tooth, in this the
maxillary occlusal suraces consisted of a deep channel that run
mesiodistally the entire length of the four posterior teeth.
 The lower posterior teeth were half the bucco- lingual width of the
standard anatomic teeth and were with single central ridge that ran
entire length of the occlusal table, they articulated with the central
channels of the maxillary teeth.
 This permitted unlimited protrusive glide and with limited lateral
guide.
 Avery brothers (1930) introduced the “scissors bite” technique.
 In this anteroposteriorly the occlusal surfaces were locked,the
occlusal surface was determined by the inclination of the condylar
path.
 They were free during latreal excursions and meant only for
shearing food.
 In 1937 Max Pleasure’s scheme proposed to modify
the lower posterior teeth occlusal surfaces to a
reverse curve by tilting the tooth buccally .

 John Vincent in 1942 introduced a change in

materials by using metal inserts in resin posteriors
 Sosin in 1961 replaced maxillary second bicuspid
and first & second molars with cleat shaped vitallium
forms called cross-blades.

 Levin modified this scheme by reducing the

size of the cross-blade to the maxillary
lingual cusp.
 Non anatomic or Cuspless teeth
 In 1929 Hall was the first to design cuspless teeth he called
inverted cusp tooth.

 Myerson also design cuspless posterior teeth called True-cusp. It

had a series of transverse buccal lingual ridges with sluice ways
between them.
 In 1934 Nelson described teeth as chopping blocks, which were flat
occlusal surfaces with numerous ridges
 In 1939 Swenson designed a posterior tooth
called nonlock.These were essentially flat teeth
with Sluice ways for shredding and allowing
food to clear the occlusal table.

 In 1946 Hardy designed a metal insert upper and

lower posterior which he called Vitallium occlusal.
 Three types of posterior teeth :
Anatomic – 33 °
Semianatomic - 20 °
Non anatomic - 0 °

Anatomical molds usually are selected for bilateral balanced articulation

Nonanatomical or cusp less teeth are generally the choice in the
nuetrocentric occlusion

lingualised concept utilises anatomic teeth for the maxillary and

monoplane or semianatomic teeth for the mandible
Anatomic teeth
Advantages
Penetrates food more easily
Resists the rotation of denture bases through cusp
interdigitation
Provides better esthetics
Acts as a guide for proper jaw closure

Disadvantages
More occlusal disharmony during settling and difficult to
correct by adjustment
Precise jaw closure and base stability required for
interdigitation
Increased horizontal forces
Difficult to adapt to abnormal jaw relationships
Non Anatomic teeth

Advantages
Does not lock the mandible in one position
Minimizes horizontal stress because of the absence of inclined planes
Adapts easily to Classes II and III jaw relations
More easily adjusted after changes in vertical and horizontal relations
Easier to arrange in cross bite

Disadvantages
Poor esthetics
Decreased masticatory efficiency
More difficult to obtained balanced occlusion
 There are four major patient factors to be considered, along with
their influence on the selection for anatomic, semianatomic,
nonanatomic and mold combinations of teeth.

 4 factors Neuromuscular control

Anteroposterior jaw relationship
Mediolateral jaw relationship
Esthetics
 Neuromuscular control
During the registering and transferring of entire jaw relation position
from the patient to the articulator, the dentist has the opportunity
to assess the muscle control capabilities of the patient. If little
difficulty is encountered during these procedures, use of the
anatomic or semianatomic molds are acceptable. If however the
muscle control of the patient is questioned and the dentist
experience great difficulty in registering transferring and verifying
the several jaw registration records, then molds with precise
interdigitation would not be indicated.
 Anteroposterior jaw relationships
Anatomic and semianatomic teeth are designed to interdigitate in
the normal class I skeletal and molar relationship. As long as the
patient presents clinically with an anteroposterior jaw relation
position that is a skeletal class I, the cusp teeth may be arranged
and adjusted to provide the balanced occlusal concept. Skeletal
class II patients may position the mandible in several
anteroposterior jaw positions . Even though the recording and
transfer of the retruded centric jaw relation position may be
reproducible, these patients bring their mandible forward to some
anterior position that usually is not repeatable. The patient will
experience multiple deflective occlusal contacts as he or she moves
to one of the anterior position.
 Midiolateral jaw relationships
The patient with a skeletal class III jaw relations will present similar
problems in tooth selection and arrangement as those observed
with class II skeletal relationship. Any attempt to arrange Anatomic
and Semianatomic teeth with a different mediolateral contacts other
than class I relation will usually cause multiple deflective occlusal
contacts.

 Esthetics: The cusp is a part that contributes to naturalness,

especially the buccal cusp. The “buccal corridor”, the region from
the maxillary premolars posteriorly enhances a patients smile. A
tooth mold with a buccal cusp form surely offers the greatest
potential for a pleasing natural appearance.
 Lingualized occlusion

Lingualized occlusion can be used in most denture combinations.

It is particularly helpful when the patient places high priority on esthetics

but nonanatomic occlusal scheme is indicated by oral conditions such as
severe alveolar resorption, a Class II jaw relationship, or displaceable
supporting tissue.

If the nonanatomic occlusal scheme is used, esthetics in the premolar

region are compromised.

With lingualized occlusion, the esthetic result is greatly improved while

still maintaining the advantages of a nonanatomic system
 The selection includes Shade Buccolingual width
Size Mesiodistal length
Number Vertical length
Form
 Shade:
 It should harmonize with the shade of the anterior teeth
 Bulk influences the shade of the teeth and for this reason it is
advisable to select a slightly lighter shade for the bicuspids if they
are to be arranged for esthetics. They may be slightly lighter than
the other posterior teeth but not lighter than anterior teeth.

Size and number of posterior teeth :

 The size and number of posterior teeth are closely related to usage.
These characteristics are dictated by the anatomy of the
surrounding oral environment and physiologic acceptance of
supporting tissues. The posterior teeth must support the cheeks and
tongue and function in harmony with the musculature in swallowing
and speaking as well as in mastication.
 Buccolingual width of posterior teeth
 The buccolingual width of artificial teeth should be greatly reduced
from the width of natural teeth they replace.
 Artificial posterior teeth that are narrow in buccolingual direction
enhance the development of the correct form of the polished
surfaces of the denture by allowing the buccal and lingual denture
flanges to slope away from the occlusal surfaces. This occlusal form
permits the tongue to maintain the dentures in position on their
residual ridges.
 Narrow occlusal surfaces with proper escapeways for food also
reduce the amount of stress applied on food during mastication to
the supporting tissues of the basal seat. On the other hand, the
posterior teeth should have sufficient width to act as table upon
which to hold food during trituration.
 Mesiodistal width of posterior teeth
 The mesiodistal width of the posterior teeth are determined by the
edentulous area between the distal of the mandibular cuspids and
the ascending area of the mandible. After the six mandibular
anterior teeth have been placed in their final position a point is
marked on the crest of the mandibular ridge at the anterior border
of the retromolar pad. This is the maximum extent posteriorly of
any artificial teeth on the mandibular ridge. In well formed ridge the
apex of retromolar pad is taken as posterior level and in resorbed
ridges the point where retromolar pad turns upward
 Vertical length of buccal surfaces of posterior teeth
 It is best to select posterior teeth corresponding to the interarch space and
to the length of the anterior teeth. The length of the maxillary first
premolars should be comparable to that of the maxillary canines to have
the proper esthetic effect.

Type of posterior teeth according to materials

 Most artificial teeth are made of acrylic, porcelain or a combination of
acrylic resin and metal occlusal surfaces.
 porcelain teeth are more resistant to abrasion and therefore maintain their
luster longer than acrylic resin teeth.
 Acrylic resin teeth can be altered and will bond with the denture base for
retention in instances of limited inter arch space.
 Acrylic resin teeth are preferred when the teeth in the opposing arch have
been restored with gold, as the porcelain has a higher coefficient of wear
than gold.
 Acrylic posterior teeth should never be used in combination with porcelain
anterior teeth. The rate of wear of resin teeth in relation to that of porcelain
teeth is such that the excessive forces from opposing tooth contact will
eventually be developed in the anterior part of residual alveolar ridges.
 Review of literature
 ByronE.Kern (1967) – Anthropometric parameters of tooth selection
He studied over 6000 skulls and documented over 509 of them, of
which he selected skulls had full complement of teeth and were
ages of 22 to 46 .
His analysis were on bizygomatic width,skull length,bigonial width,
internasal width, cranium circumference to that to the incisors
width.
Significant results were found in comparison between nasal width
of the skulls and cranium cicumference to that to widths of maxillary
central incisors width.
 Mavroskoufis (1980)- The face form as a guide for selection of
maxillary cetrl incisors.
His investigations were on 70 subjects, standardised photography
of full face and intra oral view of central incisors are recorded .

Then slides created were projected to measure “apparent” and

“actual” face form to that to incisors.
The results showed no relation between the face form and maxillary
central incisors form and its selection, instead dissimilarity of face
form and tooth form were detected.
 Fabiana Mansur Varjao (2005): Intercommissural width as a guide
for selection of maxillary anterior teeth.
cast were made from 160 subjects from 4 different racial groups ,
location of intercommisural width land marks were made on the
subjects and transffered to the cast .the distance between the
corners of the mouth and the distal of the canines were measured
on the cast and compared.
The result showed a weak correlation between them and the author
concluded that the use of corner of mouth for selection of artificial
teeth as inaccurate.
 Fabiana Mansur Varjao(2006):Nasal width as a guide in selecting
maxillary anterior teeth.
the author studied in 160 subjects in 4 different races, using a
sliding caliper the nasal width and the intercanine distance was
measured. A selection error in clinical application due to this method
was given as 0-2mm , 2-4mm, greater than 4mm.
The author concluded that intercanine distance and nasal width
comparison was not accurate.
 Conclusion
There are two worlds , the world we can measure with line and rule, and
the world that we feel with our heart and imagination.

Teeth selection is an important part of denture fabrication, although various

techniques is advised ,it is necessary to develop a esthetic sense by the
observer so as the artificial teeth will nearly look like a natural dentition
(living thing) rather than artifacts that are poor replicas of what has been
lost.
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