A newer approach in positioning teeth for dental prosthetics using lateral cephalometric, trans-cranial radiographs, and the Denar-Witzig articulator: a case of hypodontia in an adolescent patient

Traditionally in full denture prosthetics, anterior teeth are set on the models, independent of the effects on the face. More enlightened dentists, will then adjust the wax-up for speech, and some effects on the lips. Consideration is infrequently given to restoring the face by repositioning the teeth and mandible. Rarely is thought given to the effects of occlusion on the posture of the body. This report uses several techniques to restore facial esthetics and body posture. The techniques used include a cephalometric radiograph, transcranial radiographs, an articulator that has an adjustable “TMJ” (Denar-Witzig), and Symmetrigraf Posture ChartR.

This clinical report describes a newer approach in the positioning of maxillary anterior teeth for a patient with hypodontia and nail dysplasia syndrome, and the overall effect of this approach on the face and posture of the patient.

Conventionally the precise form of the maxillary wax rim is fabricated with considerable variation from technician to another, based on the technicians training. This variation is evident on the position of the labial aspect of the rim horizontally and vertically. The wax rim is then further adjusted chair side based on subjective evaluation of the face. The maxillary anterior teeth position is established without considering that the lip position is not yet accustomed to the wax rim.

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