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Prosthodontics Dr.Thikra.M.Hachim

Waxing And Carving of complete denture

DEVELOPMENT OF THE PROPER FORMS OF THE POLISHED SURFACES

Three principal surfaces are involved in the functional stability of dentures:

1- the basal or impression surface.

2- the occlusal surface of the teeth.
3- the polished surfaces.

Waxing is defined as the contouring of the wax base of the trial denture into the desired form.

Carving is defined as restoring the anatomic forms of the lost tissues.

The form of the polished surfaces of a denture influences

1-stability.

2-retentive quality

3-denture esthetics.

Benefits of properly contoured dentures:-

1. Improved esthetic for patients especially those with a high smile line who display significant amounts of
gingiva.

2. Provides for appropriate support and contour of the lip and cheek.

3. Improved tolerance and comfort.

4. Facilitates denture stability and control.

5. Prevents chronic biting of the lip or cheek.

The polished surfaces are developed by contouring the wax. The wax surfaces around the teeth are known as
the "art portion" of the polished surfaces. It should imitate the form of the tissues around the natural teeth for
esthetic reasons.

The denture bases between the teeth and the border should be shaped in such a manner as to aid retention
by the mechanical directional forces of the muscles and tissues. The contours are full on the buccal aspect of
the denture but are quite concave on the palatal and lingual surfaces because of the functional and “at rest”
space requirements of the tongue.

The polished surface is defined by:-

1. The width of the border

2. The buccolingual position of teeth.

3. The fullness given to wax to obtain convexity and concavity both facially and lingually.

The width of the border

The borders of denture are rounded; the wax is contoured so that the width of the borders as recorded in the
impression is preserved in the denture. The muscles of the cheek and tongue have inclined plane action, which
exerted a horizontal force in the direction of the occlusal plane. This action can act as either a placing or
displacing agent, depending on the shape of the polished surface. The power of inclined plane forces on the
shape of polished surfaces as a mechanical aid, or detriment in retention.

For instance, when the lingual and buccal borders of a mandibular denture, are being shaped, they can be
made concave so the tongue and cheek will grip and tend to seat the denture. In the opposite case (in which
the lingual and buccal surfaces are made convex by waxing , the inclined plane forces resulting from pressure of
the tongue and cheeks will tend to unseat the denture
The development of the proper forms of the polished surfaces must be based on accurate impressions of the
tissues that limit the extent of the dentures, and the prosthetic teeth must be arranged in proper relation to
the ridges so the slopes of the polished surface can have a favorable angle with the cheeks, lips, and
tongue.The correct buccolingual position of the teeth is important because lateral forces also are exerted on
the dentition during function. Teeth positioned too buccally or too lingually allow the musculature of the cheek
or tongue to create unfavorable forces on the inclined plane of the surface of the teeth and the polished
denture. These forces will tend to unseat the denture. A buccal position of the teeth would likely not allow an
adequate concavity of the denture base between the gingival collar and denture border; the muscle action of
the cheeks would tend to unseat the mandibular denture.

The buccal surface of mandibular dentures in the first premolar region should be vertical to concave in shape
so as not to interfere with the action of the modiolus, (connecting the facial muscles with the orbicularis oris
muscle). This connecting point of muscles can displace the mandibular denture if the polished surface inclines
toward the cheek or if the dental arch in the premolar region is too wide. The lingual flange of the mandibular
denture should have the least possible amount of bulk, except at the border, which must be quite thick. This
thickness is under the narrower portion of the tongue, and it greatly enhances the seal by contacting the
mucolingual fold.

In the maxillary denture, the patient’s speech will be impaired unless a proper palatal contour is developed.
Additional care should be taken with the contours of the palatal alveolar surface in the area of the premolars
and canines. Airflow for speech sounds is greatly affected by the contact or approximation of the lateral tongue
in these areas. There should be a gentle concave contour of the denture base extending from the palatal
surface of these teeth to the horizontal shelf of the palate. If this contour is a deep concavity or a near right
angle between the vertical alveolar process and the horizontal shelf, the lateral border of the tongue will not
control air during speech. Particularly, the “s” sound will be distorted, sounding more like a “sh.” Fricative
sounds of “f” and “v” also may be distorted. Wax should be flowed along the junction of the alveolar ridge and
the horizontal shelves to create a gentle concave curve.

Once the speech-related palatal contour is properly developed, the rest of palatal surface of the maxillary
denture should be waxed to a uniform thickness of 2.5 mm. Thus when the processed resin is smoothed and
polished, the palate will be as thin as possible and yet sufficiently thick to provide adequate strength.
COMPLETION OF WAX-UP AND FESTOONING

Before the addition of wax to finalize the wax-up, it is important to evaluate the prosthetic occlusion. Wax
shrinks when it loses temperature; therefore it is not uncommon for teeth to move slightly out of occlusion.
This is particularly visible when viewing from the posterior of the articulator into the lingual aspect of the
dentition. Often the lingual aspect of the teeth needs to be lifted to meet the occlusal plane. Use of the metal
occlusal plane is useful to evaluate that the teeth are set in harmony with each other and the metal occlusal
plane.

The wax surfaces around the teeth are known as the art portion of the polished surface and should, for
esthetic reasons, imitate the form of the tissues around the natural teeth. Attentions to carving, stippling,
cervical exposure of teeth, and thickness of the palate and borders are the final touches before processing of
the dentures. After the proper occlusion is established and finalized, additional baseplate wax is added on the
buccal and labial surfaces of the mandibular and maxillary trial dentures and along the cervical collars of the
teeth. The excessive wax is removed first so the land area of the master cast is exposed, and then the small end
of a knife is held at a 45-degree angle to the tooth surface to form the wax gingival margin (A to C ).

Gingival outline form and contours must be reproduced. This is particularly useful in patients with a high smile
line who display significant amounts of gingiva (D ).
 D

Maxillary and mandibular canine eminences are reproduced to properly support the lips and the corners of the
mouth for esthetics and avoidance of lip biting( E )

Slight projection of the root to follow the individual tooth can be made by adding some wax at the root areas
and scraping out some wax at the interradicular areas. Creating gingiva rolls helps with deflecting the buccal
mucosa away from the biting surfaces. The interdental papilla must be flat or slightly concave so as to
provide a more natural appearance and to avoid food impaction.

Care should be taken to expose the complete clinical crown of the anterior teeth. This adds to the esthetics
because most adult natural dentition reveals the teeth to the cementoenamel junction (CEJ). Also, the less
acrylic resin that is visible around the teeth, the more natural the appearance is.
The lingual surface of the mandibular denture may be made slightly concave without extending the depth of
the concavity under the lingual surface of the teeth. A projection of the tooth beyond the polished surface acts
as an undercut into which the patient’s tongue will slip, thereby causing the denture to be unseated and also
allowing food to accumulate.

In the maxillary denture, palatal festooning restores part of the palatal surface of the tooth that is not supplied
in artificial teeth. Wax is added and carved on the artificial teeth to imitate the normal palatal contours of each
tooth .

Stippling of wax:

stippling refers to the orange peel like appearance of the attached gingiva. This can be observed in the mouth
after drying the gums. A denture with a stippled effect simulates natural gingiva and prevents light being
reflected from the denture base. Stippling in the wax is done by first lightly flaming the surface of the wax; the
wax base is then struck repeatedly with a stiff tooth brush. The bristles, being held in a vertical direction,
produce many small indentations in the wax. The wax base is then flamed in a light and fleeting manner with a
Hanau torch to smooth out the gross roughness caused by the toothbrush.

Benifite of stippling

• Esthetics – reflection of light

• Keeps food particles from traveling up to the periphery of the denture.

Establishing of posterior palatal seal area

POSTERIOR PALATAL SEAL AREA

It is the soft tissues along the junction of the hard and soft palates on which pressure within physiological limits
of the tissues can be applied by a denture to aid in the retention of the denture.

The posterior border of the denture is determined in the mouth and its location is transferred onto the cast.
The locations of the right and left hamular notches are marked with an indelible pencil. Then the location of
fovea palatinae near the median palatal suture is marked.

The vibrating line (the posterior part of the posterior palatal seal area) normally used as a guide to the ideal
posterior border of the denture, it may be slightly anterior to the fovea palatinae.

Procedure of carving the posterior palatal seal area

A V-shaped groove (1-1.5 mm) depth is carved into the cast at the location of the bead. A large sharp scraper is
used to carve it passing through the hamular notches and cross the palate of the cast. The groove will form a
bead on the denture that provides a posterior palatal seal. The bead will be (1-1.5 mm) height and (1.5 mm)
width at its base.

ADVANTAGES OF POSTERIOR PALATAL SEAL AREA

1- It helps to determine the posterior border of the maxillary denture.

2- It helps to compensate for the shrinkage of the acrylic resin in this area during processing.

3- Provide a good seal in the posterior area of the maxillary arch which increase retention.

4- It prevents food to enter under the maxillary denture.

5- Reduces the tendency for gag reflex

After wax-up and festooning are completed, seal the periphery of the denture flange to the inner edge of the
land of the cast. The wax should be flush with the land (A) . After soaking the master casts and mountings in
water for a few minutes, gently remove the casts from the mountings (B and C) and prepare for flasking and
processing.