Aesthetic possibilities in removable prosthodontics. Part 3: Photometric tooth selection, tooth setting, try-in, fitting, reviewing and trouble-shooting

Key Points

  • Perfect imperfection – making dentures look like natural teeth and gums.

  • Being brave with tooth positioning and copying nature - selecting the right size and shape of artificial teeth using photometric calculation and assessment.

  • Patient led decision-making at rehearsal – the complete denture “try- in”.

  • Handling the delivery and review stages of complete denture provision.


This final article in a series of three on producing complete dentures which the patient considers attractive, describes selecting the denture teeth, setting the front teeth at the chairside, the try-in visits, processing, fitting and reviewing the dentures. The role of the patient as captain of the ship, the dental nurse as the patient's support and liaison officer, and the clinician as the first technical officer is outlined. The use of immediate replay video technology in allowing a patient to see what the trial denture really looks like is described. It is vital that the patient is completely happy with its appearance in every detail before any denture is finished. Dealing with post-fitting aesthetic problems is considered.

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Figure 1: Photometric method for calculating the width of the two upper central incisors.
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Figure 3: Tooth mould charts can be used to select the most suitable sizes and shapes of the upper anterior teeth, when used in conjunction with the photometric method of calculation of the upper central incisor width.
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Figure 7: Each tooth is added in turn and sealed down with a heated wax instrument at the neck (ridgelap) only.
Figure 8: A lower silicone putty matrix has been made to record the labial contour of the upper rim sent to the lab.
Figure 9: Classic Class II/div.
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Figure 21: The patient assessing the try-in with the dental nurse, looking at her dentate photograph comparing this with the try in on a video.
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Figure 15: Photograph of a natural dentition of a 30-year-old woman.
Figure 16: The natural dentition of a 30-year-old woman.
Figure 17: The natural dentition of an 81-year-old white man.
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Figure 20: The process of producing natural looking gums starts with waxing up.
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Figure 33: Incisors too long.
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Figure 35: Blackened incisal edges in situ (JB) Note a little soreness at the corners of the mouth.
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Figure 43: Upper complete denture made with almost total disregard to the appearance of the lower natural teeth.
Figure 44: Replacement upper complete denture made to appear compatible with the lower natural teeth.
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Figure 49: Real amalgam fillings in a denture ten years old.
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Figure 42: Finished smile in Fig.41, viewed from a distance.


  1. 1

    Glantz P O . Personal communication to John Besford. 1981.

  2. 2

    Ibrahimagić L, Jerolimov V, Ćelebić A . The Choice of Tooth Form for Removable Dentures. Acta Stomat Croat 2001; 35: 237–244.

    Google Scholar 

  3. 3

    Kumar M V, Ahila S C, Devi S S . The Science of Anterior Teeth Selection for a Completely Edentulous Patient: A Literature Review. J Ind Pros Soc 2011; 11: 7–13.

    Google Scholar 

  4. 4

    Williams J L . A new classification of human tooth forms with special reference to a new system of artificial teeth. Dent Cosmos 1914; 56: 627–628.

    Google Scholar 

  5. 5

    McCord J F, Grant A A . Prosthetics: Registration: Stage I — Creating and outlining the form of the upper denture. Br Dent J 2000; 188: 529–536.

    Article  Google Scholar 

  6. 6

    Wright W H, Selection and arrangement of artificial teeth for complete prosthetic dentures. J Am Dent Assoc 1936; 23: 2291–2307.

    Google Scholar 

  7. 7

    Bindra B, Basker R M, Besford, J N, A study of the use of photographs for denture tooth selection. Int J Prosthodont 2001; 14: 173–177.

    PubMed  Google Scholar 

  8. 8

    Magne P, Gallucci G, Belser U . Anatomic crown width/length ratios of unworn and worn maxillary teeth in white subjects. J Pros Dent 2003; 89: 453–461.

    Article  Google Scholar 

  9. 9

    Hyde T P, McCord, J F, Macfarlane T, Smith J . Gender aesthetics in the natural dentition. Eur J Prosthodont Restor Dent 1999; 7: 27–30.

    PubMed  Google Scholar 

  10. 10

    Frush J, Fisher R . Introduction to dentogenic restorations. J Pros Dent 1955; 5: 586–595.

    Article  Google Scholar 

  11. 11

    Brisman A H, Paige H H, Hamburg M, Gelb M . Tooth shade preferences in older patients, Gerodontics 1985; 1: 130–133.

    PubMed  Google Scholar 

  12. 12

    Carlsson G . Facts and Fallacies: An Evidence Base for Complete Dentures. Dent Update 2006; 33: 134.

    Article  Google Scholar 

  13. 13

    Hajtó J . Anteriores. Fuchstal: Teamwork Media, 2006, Reprint 2015.

    Google Scholar 

  14. 14

    Schottlander. Enigma Colour Tones: Part of the Enigma Denture System. A professional guide to custom matching of gingival tissue. 2004. Available at (accessed March 2018).

  15. 15

    Schottlander. Enigma Gingival Composite. Available at (accessed March 2018).

  16. 16

    Anxadent. Anaxgum. Available at (accessed March 2018).

  17. 17

    Ivoclar Vivadent. SR Nexco Paste. Available at (accessed March 2018).

  18. 18

    Avadent. Homepage. Available at (accessed March 2018).

  19. 19

    Ivoclar Vivadent. Wieland Digital Denture. Available at (accessed March 2018).

  20. 20

    Dentca. Homepage. Available at (accessed March 2018).

  21. 21

    Allen L . Improved phonetics in denture construction. J Prosth Dent 1958; 8: 753.

    Article  Google Scholar 

  22. 22

    Zaki Mahross H, Baroudi K . Spectrogram Analysis of Complete Dentures with Different Thickness and Palatal Rugae Materials on Speech Production. Int J Dent 2015; 2015: 1–5.

    Article  Google Scholar 

  23. 23

    Clive James . I got used to Hollywood, but never got used to the teeth. The Guardian 2016. Available at (accessed March 2018).

  24. 24

    Pound E . Personalized Denture Procedures. Anaheim: Denar Corporation, 1973.

    Google Scholar 

  25. 25

    Scott S E, Newton J T . Body dysmorphic disorder. Dent Update 2011; 38: 112–118.

    Article  Google Scholar 

  26. 26

    Juniper A . Wabi Sabi: the Japanese art of impermanence. Tuttle, 2003.

    Google Scholar 

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Special thanks are due to Rowan Garstang and Matt Wilde and John Wibberley for their technical advice with these three articles.

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Correspondence to J. N. Besford.

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Besford, J., Sutton, A. Aesthetic possibilities in removable prosthodontics. Part 3: Photometric tooth selection, tooth setting, try-in, fitting, reviewing and trouble-shooting. Br Dent J 224, 491–506 (2018).

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