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DENTOGENIC

CONCEPT

Dr. Brijesh Maskey


2nd Batch, P.G Resident,
Department Of Prosthodontics And Maxillofacial
Prosthetics PDCH,Nayabazaar

CONTENTS
1. Introduction
2. History
3. Dentogenic concept
A. sex factor
B. personality factor
C. age factor
4. Conclusion
5. References

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INTRODUCTION
In the recent years, patients awareness of the importance of dentofacial appearance has
dramatically increased, resulting in more demanding requests for improved treatment
outcomes.
A well made prosthesis may fail in the eyes of a patientVon Vich, 1963
Complete denture ,being one of the most commonly considered treatment option for an
edentulous patient may not bear the same esthetic outcome though functional.
Esthetics in complete denture can be restored by characterization in the form of:
artificial teeth (selection,arrangement,modifications)
denture bases

HISTORY
700 B.C.: Tooth replacements included wood, bone, ivory teeth (carved by skilled
artisans) and artificial teeth attached to natural dentitions with ligature or fixed to the
metal plate held in the mouth.

15th century: 1st known european denture set included hinge device with upper and lower
teeth set carved from a single material rather than individual unit.

18th century: use of porcelain for denture construction

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1884: J.W. White proposed temperamental theory in dentistry to aid tooth selection and
improve aesthetics. Temperamental tooth forms were known as named sets. Teeth were
selected according to the individuals body size, body form, colour of eyes and hair,
disposition and character.
1887: W.R. Hall projected Typal form concept (initiation of geometric theory later)
1905: Berry highlighted a need for better harmony between face form and tooth form. He
was probably the first one to project that outline form of the inverted central incisor tooth
closely approximated the outline form of face.
1914: Geometric theory by Leon Williams.

He did extensive study in extracted human teeth and skulls in 1914 to give
three basic typal forms.

Typal anterior tooth forms in orangutan


This three typal or basic forms of teeth included square, tapering and
ovoid, as well as some intermediate and composite forms.

Square
Square
Tapering
Oval
tapering
He believed that a relationship existed between the face form and the inverted form of the
maxillary central incisor.

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DENTOGENIC CONCEPT
It was introduced by Frush and Fisher in the mid nineteen fifties (1955-59). The
term dentogenic in relation to prosthetic dentistry conveys the same meaning as the
suffix genic imparts to photograph in the word photogenic. These are guidelines for
tooth selection, arrangement, and characterization to enhance the natural appearance of
the individual.
WILHEHN ZECH, a sculptor in Switzerland observed that it was possible for a sculptor
to express vigor & delicacy in his arts of work. So, it should be possible for the dentist
also to do so in his artificial denture. this was an integral part of thinking that led to the
whole concept of dentogenic restorations.
Factors influencing dentogenic include sex, personality, and age which was collectively
called the SPA factor.
Sex: There are only two sexes immediately identifiable upon sight, but they can be
identified in dress, hair style, and all other visible features.
Personality: is a bit more complex, but, again it can be of three types i.e. vigorous,
medium and delicate.
Age: can be easily separated into young, middle or elderly and no patient in any group
deserves the tooth form or tooth color of either of the other classifications.

Sex factor (John P Frush, Roland D Fischer, 1956)


A woman is a woman from her finger tips to her smile and a man
from his fists to his smiles. Keeping a woman a woman and man a
man, after each looses the natural teeth has become so important a
problem that modern day thinking emphasizes that a dentist must be
an artist and a sculptor with highly developed perceptive qualities.
The procedure was basically selecting a feminine or
masculine mould and then harmonizing it to the individual patient
depending upon the other factors i.e. personality and age factors by
modifying individual teeth

Interpretation by mould shape:


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Femininity is expressed by roundness,


smoothness and softness that is typical of women.
Therefore the selection of basic shape which has the
soft lines expression of the feminine form, together
with effective personality characteristics is particularly
helpful.
A typical masculine form is described as
(cuboidal) hard muscular, vigorous appearance beyond
the evaluation of physical appearance. A basic tooth
form, which expresses masculine characteristic show
big or, boldness and hardness.
Interpretation by mould size:
Femininity is generally associated with smaller teeth i.e. narrower central and laterals
incisors while large sized teeth i.e. large centrals, prominent canine and broad laterals are
associated with masculinity.

Interpretation by tooth position:


Positioning of the teeth is necessary in further conveying sex characteristics to a denture.
However, definite positions cannot be assigned to one sex or the other, as other factors
other than sex must be taken into consideration. The anterior teeth should be arranged in a
lively position.
Central incisors
It can be arranged in four different harmonious lively positions to create the effect of
hardness, and a more vigorous look:
1. One of the central incisor bodily anterior to the other.
2. One of the central incisor from the starting position out at the cervical end.
3. Combined rotation of two central incisors with distal surface forward.
4. One incisor depressed at the cervical end and the other depressed incisally.

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Softness can be highlighted by:


1. Slight overlapping of central incisors.
2. One of the central incisor is moved out at the base but leaving the incisal edge
together.

These positions can be treated either softly or more vigorously as it is


for men or women.
Lateral incisors is referred to as the sex tooth or it imparts effect of hardness or softness to
anterior tooth by its position.
1. If lateral incisor is rotated mesially, the effect of the smile is
hardened which is best for vigorous man. The soft position of
the lateral incisor is produced by rotating its mesial surface
outward and inward rotation produces hard position.
2. Lateral incisor rotated to shape its mesial surface, slightly over
lapping the central incisor imparts softness and youth fullness to
smile.
Canine: A prominence in the canine tooth imparts great importance.
Prominent cuspids that are rotated to show about 2/3rd of the labial surface as
seen from the front with neck in line with the incisal tip gives the smile a vigorous
look while rotated canine to show only mesial 1/3rd of the labial surface with neck
more prominent than incisal tip imparts softness in a smile.
Interpretation by shade: Darker shades are associated with males while females are
associated with lighter shades.
Interpretation by smile line:
The incisal edges of maxillary anterior teeth follow the curve of lower lip in females while
the incisal edges of maxillary anteriors form a flat smile line.

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Interpretation by depth grinding:


It involves the accentuation of the three dimensional depth to
eliminate the flat appearance of the artificial upper anterior
teeth. It is done only on mesial surface of central incisors since
they are the widest, almost always the longest, and therefore,
the most noticeable of the six anterior teeth.
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,
moving the deepest visible point of the tooth further lingually. As a result depth grinding
reduces the width of the central incisors.
A flat thin narrow tooth, involving little depth grinding (spheroidal shape) fits
delicate women.
A thick bony big sized tooth heavily carved on its labial surface, involving severe
depth grinding (cuboidal shape) is vigorous and is to be used exclusively for men.
For the average patient, the depth grinding will be an average between delicate
and vigorous.
Depth grinding reduces the width of the central incisor according to the severity of
grinding to be accomplished.

Personality factor (John P Frush , Roland D Fischer,1956)


Personality holds the foundation for the dentogenic restoration. They devised the
personality spectrum and explained the precise prosthodontic application of the otherwise
abstract word personality by three divisions of personality spectrum.
Personality spectrum division:
a) Delicate fragile, frail, opposite to robust.
b) Medium normal, moderately robust, healthy and of intelligent appearance.
c) Vigorous - opposite of delicate, hard and aggressive in appearance,
the extreme male animal, muscular type almost primitive, ugly
It provides a working tool for dentists regarding the personality
factor in dentogenic restorations. They have conceived the
personality spectrum, which has color-band or vertical rainbow hues extending from
red to violet.
1. The rugged, extrovert, bold, most men could fit into the red end of
the spectrum or vigorous end.
2. Most women would fall to the right end of the spectrum or delicate
end (green to violet band) - 5%
3. The medium, normal type, male or female lies somewhere in between (orange to
yellow band) - 80%
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Personality of denture depends on the selection of tooth moulds, tooth colours, tooth
position, and the matrix of the teeth (denture base)
Interpretation by tooth mould
More squarish and large teeth are selected for vigorous people.
For executives, the anteriors should be in a flat plane and the teeth should be
relatively smaller and more symmetrically arranged.
Round incisal edges and corners imparts a delicate personality.

Vigorous personality

Interpretation by tooth color


Lighter shades to highlight delicate personality while darker shades for vigorous
personality.

Age factor (John P Frush , Roland D Fischer,1956)


The dignity of advancing age must be appropriately portrayed in the
denture by careful tooth color selection and by mold refinement, also
by the intervention of such characterization, as would be fitting for the
personality and sex of the patient.
Mould refinement
Incisal edge:
1. Incorporating wear
Young: The mamelons are present at the incisal edge of the
central and lateral incisors.The cuspid presents a pointed tip,
which is very sharp in appearance. The mamelon is soon
abraded away, and the tooth assumes the youthful adult form
evidenced by the enamel incisal edge of visible depth and of
bluish hue.

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Elderly: Later the sharp tip of the cuspid wears down to a more
mature form i.e. (centrals and laterals-straight;cuspids-curve)

2. Translucency
Youths have more incisal translucency than an elderly.
Shade
Darker shades for elderly and lighter shades for youth.
Smile line:
Long axis of teeth is accentuated with age.
A teeth loses their curves with aging in fermales.

Spacing and Diastemas:


Wearing away of the natural teeth between lateral and central incisor creates spacings
with advancing age. Diastemas of not measuring less than 2-3mm and wider at incisal
edge than the base (v-shaped) is incorporated to depict an elderly. The width of the
diastemas should be controlled so as not to appear unsightly. These diastemas should be
asymmetrically placed on either side of the dental arch. Placing a diastema whilst making
the denture can give it a successful illusion of reality.

Recession due to loss of attachment


To create illusion of a recession, longer tooth are selected. In addition, the adjoining the
gingival margin can be recontoured. Stains can be added to enchance the natural
appearance.
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These changes can be reproduced in complete dentures and will help


to improve the esthetics, especially if the gingival tissues and flanges
are visible on speaking or smiling widely.

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Change in interdental papilla:


In youth interdental papillae are freely stippled and
pointed tight against the tooth. As age increases,
Massler says, "the attached gingiva lose their
stippled appearance and appear edematous and
smooth, buccal mucosa is dry, inelastic and often
wrinkled.
Advancing age, can be indicated appropriately
by shortening the papillae and by raising gingival
gum line, selecting long tooth, contouring the wax and positioning the
tooth properly to suggest recession.
Other methods for characterization:
Incorporation of stain.
Red pigments to imitate paan stains.
Brown pigments subtly placed around the margins of restorations for
coffee/food stains.
Incorporation of restorations
Incorporating composites in the anteriors and silver amalgam in the posteriors
can serve two purposes:
Provides a more natural look.
Distracts the onlookers mind from the fact that the patient has an artificial
denture.

CONCLUSION
The dentogenic concept is an esthetic philosophy that considers gender, age and
personality to restore the patients dignity and unique individuality that has been missing
in far too many prosthesis.
Outstanding esthetics can be achieved by simple guidelines using tooth molds
specifically sculpted for males and females, arranging prosthetic teeth to correspond the
sex, personality and age and sculpting the matrix (visible denture base) with more natural
contours.
It guides dentists by translating esthetic concepts (optimum tooth selection and
their arrangement) into techniques and not a compulsion. Thus, our artistic perception
must be given more freedom. However, a patient cannot be expected to desire or even to
be willing to submit to the innovations of dentogenics.

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REFERENCES
1. Prosthodontics treatment for edentulous patients- Zarb Bolender, 12 th
edition
2. Textbook of complete denture- Arthur o. Rahn, Charles M. Heartwell
jr.,5th edition
3. Essentials of complete denture prosthodontics- Sheldon Winkler,2nd
edition
4. William S. Jameson: Dynesthetic and dentogenic concept revisited.
journal of esthetic and resorative dentistry 2002; 14(3)
5. Frush Jp. & Fisher Rd.: the dynesthetic interpretation of dentogenic
concept. J. Prostho. dent. 1958; 8(4): 558 581
6. Frush Jp. & Fisher Rd.: How dentogenic restorations interpret the sex
factor. J. Prostho. dent. 1956; 6: 160 172
7. Frush Jp. & Fisher Rd.: How dentogenic interprets the personality factor.
J.Prostho. Dent. 1956; 6: 441 - 449
8. Frush Jp. & Fisher Rd.: Age factor in dentogenics. J. Prostho. dent. 1957;
7:5 13
9. Omkar Shetty, Sabita Ram: Dentogenic concept- part 1. scientific
journal 2007; 1
10. Omkar Shetty, Sabita Ram: Dentogenic concept- part 2. scientific
journal 2008; 2
11. Dr. Brijesh Shetty, Dr. Pranav V Mody, Dr. Manish Kumar, Dr. Girish
Kumar, Dr. Kalpesh K. Revankar Bhat: Personalized denturelets make
a difference!!-a clinical case report on characterized denture journal of
orofacial research 2011; 1(1)
12. Rajeev Srivastava, Vivek Choukse: Characterization of complete denture
international journal of dental clinics, 2011:3(1):56-59
13. Himanshu Aeran, Rubina Gupta, Mukesh Dhanda: Dynsthetic
interpretation of esthetics in compete denture(review article) Indian
Journal of dental sciences.

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