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December 19, 2019
Dental Notes / Dentist
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Characterization of denture
Function
Speech
ESTHETICS
is observed that dental literature since 1973 revealed only 24 articles about dentate
appearance of edentulous patients. More focus has been given on the esthetics of dentate
patients.
Esthetics– the term is derived from the Greek word “Esthesia” which means sensibility or sensation.
Esthetics is the adjective form of it meaning ‘Responsive to the beautiful in art or nature.’
Importance of Denture Esthetics
to E. Pound phonetics is controlled by esthetics. But here he used the term for the proper
form of the denture base.
DENTOGENIC CONCEPT
Characterization means ‘Modification of the form & color of the denture base and the
teeth to produce more lifelike appearance.’
In simple words it means giving Individuality to the Denture.
Routinely dentures delivered to the patient by dentist are well finished and polished but
thy give ‘denture look’ or ‘false teeth look’ to the patient.
Prosthodontist, we should restore patient’ ‘natural look’ and should not provide dentures
with ‘artificial look’.
Characterization of denture
1) Teeth Positioning
By prominent positioning of one of the anterior tooth as it was before in patients’ natural
dentition.
By giving ‘Natural irregularity of tooth positioning’ that is proper angulations and
rotations of teeth.
By maintaining Diastema as in natural dentition.
2) Characterization by Restorations
– With the advancing age natural teeth will show some Changes as attrition, abrasion,
erosion.
– Incorporation of these changes in denture teeth will provide Natural look.
Freni
Free gingival margin
Stippling
Interdental papillae
Root prominences
In maxillary denture bases, we should include-
-Palatine Rugae
-Incisive papillae
a) Interdental Papillae
– Routine interdental papillae design not only produces mechanical ‘Denture Look’ but also
creates crevices & pockets that will lead to food Impaction, plaque accumulation, and bacterial
growth.
– In youth, the papillae are pointed tight against teeth; while with advancing age they can be
shortened.
– Similarly, papillae can be stained red to simulate the gingival irritation in advancing age.
– Massler said that “In old age, the attached gingivae lose their stippled appearance & appear
edematous & smooth.”
– Only the cuspid eminences are prominent & others are not much obvious.
– While Festooning, we should take care that the bulge is not formed at the borders. The root
prominences should merge with the borders.
c) Stippling
– The surface of the natural attached gingiva appears rough when it is wiped dry.
– In the denture, stippling can be produced with the help of a stiff-bristled toothbrush, which is
modified to have only a central row of bristles.
– The production of a free gingival margin as in the natural dentition gives better esthetic results.
– Gingival sulcus can be produced by inserting No. 23 explorer tip between the teeth and the
gingival margin.
e) Freni
– Labial, as well as buccal freni, can be produced in the denture to give a more natural appearance.
f) Palatine Rugae
Production of palatine rugae is very much important from comfort as well as phonetic point of view.
Technique
– A double thickness of 0.003 gauge tin foil is placed over the rugae area on the cast & swaged
with a pencil eraser to obtain adaptation over the cast.
– The pattern is removed & cut around the edge to separate the 2 foils.
– Outer foil is discarded as it may have imperfections due to direct contact with a pencil eraser.
– The inner foil is trimmed accurately & and it is kept aside until wax-up is carried out.
– The base plate with the teeth set up is waxed up to the cast when it is still on the articulator to
avoid errors in the occlusion.
– After buccal and palatal wax is done, the thickness of the wax is reduced in the palatal region
from where the baseplate is trimmed.
– Now the tin foil pattern that was made earlier is placed in that position accurately & its edges are
sealed with the wax spatula.
– Several methods have been used to tint the denture base that will produce a natural appearance.
– Skillful tinting procedures can produce excellent results, BUT it is equally true that poorly
executed tinting can give garish results that are worse than no tinting at all.
In 1951 Pound described ‘Sift In’ technique for denture base staining.
In this method Pound applied stains on the stone investment surface after flasking & dewaxing is
done but before any packing is carried out.
For staining he used a kit- ‘Replident’ having 8 dispenser bottles of different colored polymers.
Lighter shades are usually used in the first application followed by other colors and blends where
needed.
Problems:
He with the help of his technician a technique was developed whereby the natural contours &colors
could be fabricated by machine into a flexible acrylic veneer which can easily be adapted on denture
surfaces during the packing operation.
There are 2 methods for denture base tinting with heat cure resins.
These methods are based on the ‘Sift in’ technique described by Pound (1951).
Technique
B: brown
– After flasking and dewaxing, paint it with the tinfoil substitute and allow it to dry.
– Sift H resin over the facial aspect of the flasking stone in the region of attached gingiva & saturate
it with heat cure monomer.
– Sift a light coat of F over the H and extend F higher on the flange.
– Sift A higher on the flange to the borders. Use it with care as it is red.
– In this way do one side first and by taking it into consideration do the another side.
– Place a plastic sheet over the tinted flask & allow it to set for about 15-20 min. before the denture
base.
If pacing is carried out too soon, the tinting resin may be squeezed out of the mould or the
distribution may get modified.
The second method described by Rudd, Marrow & Putten involves use of brown & purple stains for
those with pigmented oral tissue.
– Sift F resin over the necks of the teeth but in a very thin layer. Saturate it with monomer.
– Place red fibers above the muco-gingival junction on attached mucosal region & sift A resin over
the fibers.
So all stains must be applied in reverse order, the one representing the outer surface being applied
first.
– In this technique packing is done with natural shade acrylic resin but the plastic or cellophane trial
pack sheets are placed between teeth and the acrylic resin being packed and not between the cast and
the resin.
– So the final trial pack separation finds the acrylic resin adapted to the cast.
– Then stains are applied.
The armamentarium-
It consists of neutral pink polymer. Long red Nylon fibers are added sparsely in one bottle &
in large amount in other.
– Blue, brown or a suitable combination of the two used for patients with melanotic
pigmentation.
TECHNIQUE
Yellow (pale) tones: applied over root prominences, rugae and hard palate.
Red (deep) tones: applied over freni, incisive papillae, soft palate, and mucobuccal fold.
Neutral (pink) tones: between root eminences, on lingual side of the lateral alveolar
processes.
After application of yellow & red tones to the specific areas finally the neutral polymer stains are
used.
– Neutral polymer having few fibers is applied liberally over all areas stained yellow or not stained at
all.
– Neutral polymer having many fibers is applied liberally over areas stained red.
It serves 2 purposes:
b) the nylon fibers will appear as blood vessels, denser in the areas where more fibers are added.
BRUSH-ON TECHNIQUE
In natural Coloring Of Cured Cross-Linked Acrylic: John L. Powers- JPD 1952; 3(3):351-354
-John L. Powers put forward this technique (1952)
-In this natural coloring is carried on processed denture.
Solution 1 – A clear liquid used to prepare the surface of the denture base
Solution2 & 3- Carry varying amounts of pigments for use on dentures of Caucasian
patients.
Solution 4 – Pigmented solution for dentures of Negro patients.
TECHNIQUE
-When a new denture is recovered from the flask, it should be shaped and cleaned but not polished. If
an old denture is to be tinted, the high polish is removed with pumice and rubber wheels.
– Paint the solution 1 on the outer surface. Allow it to soak into the denture for about 3 mins.
– Determine the pigmented solution to use by comparing the color guide with them. The location and
amount of pigment are determined by location and coloring in natural gum tissue.
– Two coats of Natur-tint are applied and allowed to dry for 10 mins.
– Clean and dry denture & apply 2 coats of solution no.1. This solution will cover the pigmented
coating with a protective layer of material.
– Remove the glaze which has formed when the solution is dried. The denture will look more natural
if it is not highly polished.
ADVANTAGES
1) Simple method
2) It will neither wear off by the patient’s brushing off the denture nor will it be dissolved by
chemicals that may go into the mouth.
3) It can be used in conjugation with the heat polymerized coloring techniques.
4) Can be used effectively on anterior fixed bridges & partial dentures where a labial veneer is
necessary to restore the lip line or lost tissue.
– Dummett called attention of dental profession toward characterizing denture bases for black
patients.
– In the described technique a product called Natural Coe-Lor is used. (It comes in 3 basic shades:
Heavy, Moderate, Mild)
TECHNIQUE
Office Procedures
– Take close-up photographs of the area to be characterized.
– Note the pigments of the gingiva for the location and placement of the pigmentation material.
This should be indicated on the preliminary cast.
– Write the work authorization & send the appropriate casts, waxed dentures, color prints to the
lab technician.
Laboratory Procedures
– Complete the wax pattern, festooning, stippling to simulate natural dentition.
-With a paintbrush, add blanching type acrylic resin powder around the necks of the teeth.
– Sprinkle the denture base acrylic resin on top of it . This will avoid displacement of during trial
packing.
– Use a small amount of polymer powder incorporated in the monomer and applies it over the
stained area.
– Pack rest of the flask with the appropriate basic color of acrylic resin.
Gingival shade guides are available for the purpose of selection of proper shades.
1) Lucitone 199 – 4 shades
• IPS Gingiva shade guide provides higher potential for more accurate visual shade matching.
REVIEW OF LITERATURE:
Earl Pound – Esthetic Dentures & Their Phonetic Values . JPD
1951; 1 (1):98-111
Earl Pound in 1952 described the importance of esthetic dentures in phonetics.
He stated that phonetics is 100% controlled by esthetics. Here he used ‘Esthetics’ in sense of accurate
reproduction of supporting structures that are denture base.
Donald F. Kemnitzer- Esthetics & the Denture Base – JPD Sept.1956; 6(5): 603-615
Donald F. Kemnitzer (1956) – He described esthetic wax up procedures as well as. Staining
method.
His staining technique for Characterization of denture is reverse of that of the Pound’s technique.
Dentogenic means the art, practice & technique used to achieve the esthetic goals in dentistry.
These factors should be taken into consideration during denture construction to avoid “Denture
Look”.
Suresh Choudhary, James Craig & Fredrick Characterizing denture for non
Caucasian patients. JPD, 1975; 33(1); 73-78.
– They described a method for staining denture base in patients with highly pigmented oral tissue.
Jerome c. strain -Coloring materials for denture base resins- suitability for use.
JPD JAN-1967; 17(1):54-59.
Jerome Strain (1961) in his study assembled 31 coloring agents to determine their suitability in
coloring denture base. Consideration was given to their toxicity, color, stability, coloring properties
& miscibility with the methyl methacrylate resin.
He finally selected 7 coloring materials for denture tinting.
He also did microscopic examination after these materials were added to methyl methacrylate &
observed that there is no reaction in the subcutaneous tissue.
REFERENCES
• Zarb GA, Bolender CL, Prosthodontic treatment for edentulous patients. 12th edition, Mosby
publications, 2004, 303-307.
• Rudd, Murrow- Dental Laboratory Procedures – 2nd edition, Mosby publications; 545-550.
• Earl Pound-Esthetic dentures & their phonetic values, JPD 1951; 1 (1): 98-111.
• John Power, Brush on technique in natural coloring of cured cross linked plastic artificial denture
materials. JPD, 1952; 3(3): 351-354.
• Hobert Procter, Characterization of Dentures. JPD, 1953; 3 (3): 339-349.
• Donald Kemnitzer, esthetics & the denture base, JPD Sept.1956; 6 (5):603-615.
• Choudhary S., James Craig, Frederic -Characterizing the denture bases for non Caucasian patients.
JPD, Jan 1975; 33 (1); 71-75.
• Jerome Strain, Coloring materials for denture base resins, JPD; 1961; 17(1): 54-59.
• Frush J., Fischer R., Introduction to dentogenic restorations, JPD; 955, 5 (5): 586-594.
• Frush J., Fischer R., The age factor in dentogenics, JPD 1956; 7 (1):5-12.
• Michael Waliszewski, Restoring dentate appearance: A literature review for modern complete
denture esthetics.
• Robert L.Engeleier, Complete denture Esthetics, Dental Council of North America, 71-84.
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