12.esthetics&characterization

12. Esthetics and Characterization12. Esthetics and CharacterizationEleni Roumanas DDSEleni Roumanas DDS

Division of Advanced Prosthodontics, Biomaterials and Division of Advanced Prosthodontics, Biomaterials and Hospital DentistryHospital Dentistry

UCLA School of DentistryUCLA School of Dentistry

Giulo Preti MDGiulo Preti MDUniversity of TurinUniversity of Turin

andand

Frank Lauciello DDSFrank Lauciello DDSIvoclar VivadentIvoclar Vivadent

This program of instruction is protected by copyright ©. No portion of This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.any information storage or retrieval system, without prior permission.

DENTURE ESTHETICS & DENTURE ESTHETICS & CHARACTERIZATIONCHARACTERIZATION

Tooth CharacterizationTooth CharacterizationDenture Base CharacterizationDenture Base Characterization

Denture EstheticsDenture Esthetics

Denture esthetics demands artistic skill in addition to scientific knowledgeDenture esthetics demands artistic skill in addition to scientific knowledgeThe best method of developing skills is by observing natural teethThe best method of developing skills is by observing natural teeth

Gingival ContourGingival Contour

Females-delicateFemales-delicate Males-ruggedMales-rugged

Tooth WearTooth Wear

Denture EstheticsDenture Esthetics

Carefully evaluation existing dentures

1)1) Patient’s perception of their appearance.Patient’s perception of their appearance.2)2) Your perception of the esthetic needs of the patient.Your perception of the esthetic needs of the patient.

1.1. With With ageage-grind incisal edges-grind incisal edges-grind proximal contacts-grind proximal contacts

2.2. MasculineMasculine-angular outlines-angular outlines-sharp lateral contours-sharp lateral contours-larger laterals and canines-larger laterals and canines

3.3. FeminineFeminine-rounder outlines-rounder outlines-smooth lateral contours-smooth lateral contours-smaller laterals and canines-smaller laterals and canines

4.4. Lateral incisorsLateral incisors “personality “personality tooth”tooth”-females - labioversion-females - labioversion-males - linguoversion-males - linguoversion

Individualized CharacterizationIndividualized Characterization

Characterization of Characterization of Maxillary Anterior TeethMaxillary Anterior Teeth

Lateral RotationsLateral Rotations

DiastemaDiastema

Incisal WearIncisal Wear

labioversionlabioversion

linguoversionlinguoversion

1.1. Vertical overlapVertical overlap2.2. Horizontal overlapHorizontal overlap3.3. Antero-posterior inclination Antero-posterior inclination

in proximal viewin proximal view4. Inclination of long axes4. Inclination of long axes

Mandibular Anterior Teeth: Mandibular Anterior Teeth: Arrangement ConsiderationsArrangement Considerations

Characterization of Characterization of Lower Anterior TeethLower Anterior Teeth

Crowding & rotationsCrowding & rotations Diastemas

StainingStaining Incisal Wear

Proper lip supportProper lip support

-The orbicularis oris and other facial The orbicularis oris and other facial musculature are supported by the musculature are supported by the alveolous and teeth. Loss of teethalveolous and teeth. Loss of teethand resorption of the alveolar ridge and resorption of the alveolar ridge results in facial collapse.results in facial collapse.-You cannot remove wrinkles which -You cannot remove wrinkles which are a part of the skin aging process.are a part of the skin aging process.

Lip SupportLip Support

Before

After

Improper Lip SupportImproper Lip Support

Loss of VDO results in a more exaggerated class III occlusion

BeforeBefore

AfterAfter

Loss of Vertical DimensionLoss of Vertical Dimension

Immediate DenturesImmediate Dentures

The patient’s few remaining teeth provideThe patient’s few remaining teeth providean excellent guide for selection of mold and an excellent guide for selection of mold and shade.shade.

Immediate DenturesImmediate Dentures

These immediate denture restore These immediate denture restore the natural appearance of the patient’s the natural appearance of the patient’s teeth as well as the gingival tissues.teeth as well as the gingival tissues.

Central Lateral Canine

Labial-palatal inclination

Class 1Perpendicular to ridge

Class 2Palatal inclination

Class 3Labial inclination

Soft Bold Palatal inclination

(neck out)

Note: never upright or labial inclination

labial (neck in)

perpendicular

Mesial-distal inclination

none long axis of

tooth inclined

distally

none Long axis of tooth inclined slightly toward the distal

Note: never to the mesial

Rotation Soft BoldFollow Distal

arch flare

Note: never mesial flare

Mesial flare

Distal

flare

Mesial flare naturally created by following the arch form

Note: never distal flare

Length Same length as wax rim

1-2mm less

than phonetic rim

same length

as phonetic

rim

Same length as rim

Anterior Tooth CharacterizationAnterior Tooth Characterization

Central


Class 1Perpendicular to ridge

Class 2Palatal inclination

Class 3Labial inclination


none

Rotation Soft BoldFollow Distal

arch flare

Note: never mesial flare

Length Same length as wax rim


Soft

Bold

7mm

Class 1Class 1

Central incisors perpendicular to the ridge

Centrals: Labial-palatal InclinationCentrals: Labial-palatal Inclination

7mm

Class 2Class 2

Central incisors slightly palatally inclined


Class 3Class 3

7mm

Central incisors slightly labially inclined


NO TILTING OF CENTRALS.

Esthetically Unacceptable

To Tilt Maxillary Centrals

Mesial Or Distal.

Centrals: Mesial-Distal InclinationCentrals: Mesial-Distal Inclination

Maxillary Centrals: RotationMaxillary Centrals: Rotation

Basic Set Up-Basic Set Up-The centrals follow the curve of the arch, gives a The centrals follow the curve of the arch, gives a soft look to the set up.soft look to the set up.

Distal flare-Distal flare-Creates a highlight on the center of the tooth, Creates a highlight on the center of the tooth, thereby giving boldness to a set up.thereby giving boldness to a set up.


Mesial flare-Mesial flare-Mesial flare is esthetically unacceptable for centrals.Mesial flare is esthetically unacceptable for centrals.


DEFLECTION DEFLECTION neck outneck out

REFLECTION REFLECTION neck inneck in

Maxillary Centrals: Neck PositionMaxillary Centrals: Neck Position

Unacceptable characterization since it will make one central look light Unacceptable characterization since it will make one central look light and other will look dark.and other will look dark.

Be careful, they don’t work for every patient.Be careful, they don’t work for every patient.

DiastemasDiastemas

Lateral


Soft Bold

labial (neck in)

perpendicular


long axis of

tooth inclined

distally

none

Rotation Mesial flare

Distal

flare

Length 1-2mm less

than phonetic rim

same length

as phonetic

rim


SoftSoft

BoldBold

PerpendicularPerpendicular Neck inNeck in

Maxillary Laterals: Labial-palatal InclinationMaxillary Laterals: Labial-palatal Inclination

-Neck tucked in toward the palatal is considered a soft characterizationNeck tucked in toward the palatal is considered a soft characterization-Neck perpendicular to the palatal is a bold characterization-Neck perpendicular to the palatal is a bold characterization

Distal Inclination

Maxillary Laterals: Mesial-distal InclinationMaxillary Laterals: Mesial-distal Inclination

--Distal inclination of the long axis of the lateral is considered softDistal inclination of the long axis of the lateral is considered soft-Mesial inclination is considered not acceptable-Mesial inclination is considered not acceptable

Mesial flare Mesial flare (Mesioversion)(Mesioversion)

Maxillary Laterals: RotationMaxillary Laterals: Rotation

-Considered a soft characteristicsConsidered a soft characteristics-Mesial flare of the lateral incisors-Mesial flare of the lateral incisorsis a characteristic most commonlyis a characteristic most commonlyseen in females, although it mayseen in females, although it mayoccasionally be seen in natural occasionally be seen in natural male dentition.male dentition.

Mesial Flair-Soft EffectMesial Flair-Soft Effect


Distal flare


-Considered a bold characteristic-Considered a bold characteristic

Distal Flair-Bold Effect


Canine


Palatal inclination

(neck out)

Note: never upright or labial inclination


Long axis of tooth inclined slightly toward the distal


Rotation Mesial flare naturally created by following the arch form

Note: never distal flare

Length Same length as rim


Maxillary Canines: Labial-palatal InclinationMaxillary Canines: Labial-palatal Inclination

Palatal Palatal inclination inclination (neck out)(neck out)

-The facial surface of the tooth should never be upright or labialy inclinedThe facial surface of the tooth should never be upright or labialy inclined

-The neck of the canine is out to create the curvature of the arch-The neck of the canine is out to create the curvature of the arch

Maxillary Canines: Mesial-distal InclinationMaxillary Canines: Mesial-distal Inclination

perpendicularperpendicular

1515° ° Distal Distal InclinationInclination

-The long axis of the canine is inclined

slightly toward the distal


Canine Rotation-Mesial flareCanine Rotation-Mesial flare

-Mesial flare is naturally Mesial flare is naturally created by following the created by following the arch formarch form

Canine Rotation-Distal flareCanine Rotation-Distal flare

-Distal flare is not consideredan acceptable characteristic andis not recommended in denturecharacterization.

Festooning: Denture Base AnatomyFestooning: Denture Base Anatomy

-The gingival heights of the various teethThe gingival heights of the various teethin the arch vary and should never be waxedin the arch vary and should never be waxedstraight across. This a common mistake straight across. This a common mistake made in denture festooning.made in denture festooning.-The lateral is always shorter than the -The lateral is always shorter than the canine or central.canine or central.-The canine is always longer then the -The canine is always longer then the premolar.premolar.

goldgoldamalgamamalgamCompositeCompositestainingstaining

Tooth CharacterizationTooth Characterization

Tooth Characterization-StainingTooth Characterization-Staining

-Staining kits may be used to further characterize denture teethand make them more age appropriate. The most common areasto be stained are incisal edges, craze lines, interproximal contacts and the roots at the gingival level.

Gingival CharacterizationGingival Characterization

-Acrylic of various shades can be used Acrylic of various shades can be used to mimic the patients gingival coloration.to mimic the patients gingival coloration.-These colors are layered into the flask -These colors are layered into the flask prior to packing.prior to packing.-Some discoloration/yellowing of the base-Some discoloration/yellowing of the baseoccurs as the denture base agesoccurs as the denture base ages.

Gingival stainingGingival staining

Gingival CharacterizationGingival Characterization

LAB PRESCRIPTIONLAB PRESCRIPTIONPatient demographicsPatient demographics

SexSexPersonalityPersonalityAgeAgePhotosPhotosPre-extraction castsPre-extraction castsExisting denturesExisting dentures

-Providing the laboratory with these specific patient demographics allows them to fabricate a denture that is more consistant with the patients age, sex and personality.

Lab CommunicationLab Communication

-An excellent means of communicating esthetics to the patient and the labAn excellent means of communicating esthetics to the patient and the labis with these anterior denture simulation models. They can be fabricatedis with these anterior denture simulation models. They can be fabricatedwith various tooth molds, shades and characterizations. Placed under the with various tooth molds, shades and characterizations. Placed under the patients lip they are very useful in helping determine the most appropriate patients lip they are very useful in helping determine the most appropriate look for that patient. look for that patient.

Smile!

12.esthetics&characterization

Health & Medicine