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OM SAI RAM!!!
GOOD MORNING
Smiles are
contagious
HAPPINESS
SMILE
BEAUTY
HEALTH
complete denture prosthesisscientifically
psychologically
esthetically pleasing
What is Esthetics?
Branch of Psychology
Esthetics is the study of the mind and
emotions in relation to the sense of beauty...
DEFINITIONS
(GPT8)
1. Dental esthetics : the application of the
principles of esthetics to the natural or
artificial teeth...
DENTOGENIC CONCEPT IN
PROSTHODONTIC TREATMENT
Presented by:
GATTU ANUSHA
PG STUDENT
COLLEGE OF DENTAL SCIENCES
DAVANGERE,K...
Contents
• Dentogenics
• History of dentogenics
• SPA factor
• Dysesthetic principles of dentogenics
• Structural componen...
Dentogenic
• Dentogenics, means the art, practice and techniques used to
achieve esthetic goal in dentistry.
Dento + genic...
HISTORY OF DENTOGENICS
FORM OF ANTERIOR TEETH
Based on face form (J.leon williams)
Geometric theory 1914
INTRODUCTIONTODENTOGENICRESTORATIONS*
JOHNP.FRUSH,D.D.S.,ANDROLANDD.FISHER,D.D.S.
SanMa&o,Calif.,andGlendale,Calif.
JPD5:5...
INTERPRETATION OF SEX
Expression of feminine
characters
• Roundness, smoothness and
softness
Expression of masculine
chara...
Female Male
• Incisal edges of the
max anterior teeth of
female follow the
curve of the lower lip.
• Distal surfaces of th...
Mesial surface LI is often
seen in an anterior relation
to the distolabial surface of
the CI.
Distal surface is rotated
po...
Distal surfaces of the
canines are rotated in
posterior direction ..mesial
third of labial surface is
exposed when viewed
...
INTERPRETATION OF PERSONALITY
FACTOR
.
.
fragile, frail, the opposite of robust
normal, moderately robust, healthy and of
...
PERSONALITY AND MOLD CONSIDERATION
youthful, good looking “model” type
of patient.
“coarse” and would be adaptable to
ampl...
AGE
ABRASION
The sharp tip of the cuspid ,suggests youth,
and, as age increases, it should be judiciously shaped, not abru...
Characterization of anterior segment
Frush and Fisher
Sex, Age and Personality (SAP)
Rufenacht
Sexual type, Aggressivity a...
The depth grinding is done on the mesial surface of central
incisor only
Depth grinding accentuates the third
dimensional ...
THE DYNASTHETIC INTERPRETATION
OF THE DENTOGENIC CONCEPT
Dynasthetic Theory:
• It is the secondary factor of a dentogenic ...
DYNESTHETIC TECHNIQUES
Techniques includes
• Shade selection
• Depth grinding
• Abrasion
• Identification of masculinity o...
Esthetic principles
FUNDAMENTALS OF ESTHETICS
Principle of visual perception and their clinical
application to denture est...
ESTHETIC PRINCIPLES:-
COMPOSITION:
The relationship between object made visible by
CONTRAST is called Composition.
Termino...
COHESIVE FORCES SEGREGATIVE FORCES
• Elements that tend to unify Opposite of cohesive forces
a composition
• A border is a...
UNITY OR ONENESS:
• The prime requisite of composition is unity.
• It gives different parts of the composition the effect ...
• HOGARTHS line Of Beauty:
• Has long been considered an outstanding example of unity with variety.
• It is a line inscrib...
BALANCE:-
 It can be defined as the stabilization resulting from
exact adjustment of opposing forces.
 Our visual sense ...
Structural map- the most stable position of the disc is in the center
The proper midline location is a must for stability...
SYMMETRY:
Itreferstoregularityinthearrangementofformandobject.(Furtwangler,1964)
• HORIZONTAL SYMMETRY RADIATING SYMMETRY
...
Horizontal symmetry Radiating symmetry
DOMINANCE:-
• Just as unity is the prime requisite for a good composition, dominance is
prime requisite for providing unit...
LINES:-
It has been stated that many factors that have
been a part of structural or biologic beauty
depends on visualizati...
STRUCTURAL ESTHETIC COMPONENTS
1.Facial components
2. Components of smile
3. Dental components
4. Gingival components
Faci...
FACIAL COMPONENTS
A) FACIAL FEATURES
esthetics of anatomy ≈ physiology
Bulging lip
Impression stage
Role of esthetics is to develop labial and
buccal borders so that they are not only
retentiv...
ANTERIOR TOOTH POSITION
• Payne writes that, “teeth should be placed where they grew.”
Vertical tooth placement Horizontal...
HORIZONTAL TOOTH PLACEMENT WITH POSITION
RELATIVE TO THE LABIAL VESTIBULE
(
These surfaces of artificial teeth should be s...
B) TOOTH VISIBILITY:
It is more important for females than males as the average
exposure of teeth is twice in females as t...
SMILE COMPONENTS
A) LIP LINE - refers to height of the upper lip relative to the maxillary central incisors.
High lip line...
B) SMILE LINE line drawn along the edges of the four anterior maxillary
teeth that has to coincide or run parallel with th...
The anatomy of smile
(Matthews.T.G,JPD1978; 39:128-134)
UPPER LIP CURVATURE
Directed upwards Straight
Slightly downwards Pronounced downwards
D) NEGATIVE SPACE (buccal corridors)
Is the dark space that appears b/w jaws during
laughter and mouth opening.
Adequate r...
• Similar to a painting. the anterior and lateral negative spaces
act as a border to the dental elements, with the lips
re...
• Closest one  appear larger
• Other like structures are interposed inbetween size
reduction apper gradual
ILLUSION AND ...
DENTAL COMPONENTS
DENTAL MIDLINE
• Recommended protocol
a) Placing this midline precisely in
accordance with facial midlin...
To be able to give a certain mathematical representation of
beauty for numerically expressing the relationship of the vari...
Dental, Dentofacial, and Facial compositions,
contain a variety of relationships.
B) Golden proportion
• Pythagoras in 530 BC
found a mathematical
solution for what was
perceived as beautiful
or ugly
• Go...
Edwin I. Levin
“Dental esthetics and the golden proportion”. J. Prosthet. Dent., 1978; 40, 244-252.
The distance between the two medial
canthus of eye is in golden proportion
with the distance between two medial
canthi of ...
To create diversity and individuality, repeated or recurring
proportions are more significant than a specific ratio
the ra...
Recurring esthetic dental proportion
Dentist may use a proportion of his choice
but it should remain consistent while
movi...
C) AXIAL ALIGNMENT
Mesial inclination tends to be
more pronounced from the
central incisors to the canines
Bilateral axial...
GINGIVAL COMPONENTS
The location of the
gingival zenith in relation
to tooth axis is distal in the
maxillary central incis...
Frenula
• Wax labial frenum (b/w central incisors) and buccal frenula (b/w I and
II premolar) is placed with wax spatula.
...
Stippling& Scalloping
The surface of natural attached
gingiva shows stippling effect.
This stippled effect is produced on
...
GingivalSulcus
• The production of a slight bulk of
gingival margin and minute break
between it and the teeth affords
natu...
In staining the denture base to simulate
natural tissue, three factors must be
considered.
Greater density of the soft tis...
Custom Denture Tinting Pound’s technique
stains are applied on the stone
investment surfaces before
packing is done.
All s...
The Denture Tinting Chart
Denture tissue tinting chart with areas to be tinted and
shades selected
AG = Attached Gingiva
A...
Attached gingiva and root eminences-lighter in color
Interdental papilla and unattached mucosa are darker in color
Close-u...
Classification of errors in dental esthetics
(LombardiR.E,JPD;32:501-513,1974)
• Inharmonious dentofacial ratio
A)Shade di...
 Inharmonious dentofacial ratio
A) Shade disharmony
B) Compositional incompatibility
1. static denture in dynamic mouth
2...
Drawing looks incomplete there is not enough
mouth Same dental composition is too weak to
play its Proper role in the faci...
This drawing seems complete the strong dental
Composition is harmonious with strength of other
Facial features
Strong toot...
Inadequate vertical length of
dentalComposition,
composition is unreal and
Lacking in esthetic qualities
Excessive vertica...
Occlusal plane drops down as it
progresses Posteriorly.
An unnatural and unesthetic result
Bilateral asymmetry of the
occl...
Single –line errors
1. Vertical deviation
2. Horizontal deviation
3. Line conflict
Imbalance
1. Midline errors
2.Imbalance...
Direction of line must be balanced to
Avoid unplanned results
Placement of an artificial element o
Either side produce imb...
ESTHETICSIN OVERDENTUREAND
IMPLANTPROSTHETICS
ESTHETHICMANAGEMENTIN
TRANSITIONALPHASES
ESTHETICSAND ADVANCEDTECHNOLOGY
• COMPUTER IMAGING SYSTEMS
• The computer imaging system (CIS) has revolutionized
• diagno...
ESTHETICSAND PSYCHOLOGY
• 1937 House classified patients into four typesbased upon
psychologic assessment
• The philosophi...
References
Zarb,Bolender, Prosthodontic treatment for edentulous patients
.Twelfth edition
Sheldon Winkler, Essentials o...
John P. Frush, Ronald D Fisher :The Dynesthetic
interpretation of Dentogenic concept, Journal of
Prosthetic Dentistry. 8:...
Esthetics in complete dentures  dentogenic concept
Esthetics in complete dentures  dentogenic concept
Esthetics in complete dentures  dentogenic concept
Esthetics in complete dentures  dentogenic concept
Esthetics in complete dentures  dentogenic concept
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Esthetics in complete dentures dentogenic concept

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Factors affecting Esthetics in Complete denture prosthesis

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Esthetics in complete dentures dentogenic concept

  1. 1. OM SAI RAM!!! GOOD MORNING
  2. 2. Smiles are contagious
  3. 3. HAPPINESS SMILE BEAUTY HEALTH complete denture prosthesisscientifically psychologically esthetically pleasing
  4. 4. What is Esthetics? Branch of Psychology Esthetics is the study of the mind and emotions in relation to the sense of beauty. “A branch of philosophy dealing with the nature of beautiful and with judgement concerning with beauty”. (Oxford Dictionary)
  5. 5. DEFINITIONS (GPT8) 1. Dental esthetics : the application of the principles of esthetics to the natural or artificial teeth and restorations. 2. Denture esthetics : the effect produced by a dental prosthesis that affects the beauty and attractiveness of the person. Dr. Charles Pincus the Father of Esthetic Dentistry
  6. 6. DENTOGENIC CONCEPT IN PROSTHODONTIC TREATMENT Presented by: GATTU ANUSHA PG STUDENT COLLEGE OF DENTAL SCIENCES DAVANGERE,KARNATAKA
  7. 7. Contents • Dentogenics • History of dentogenics • SPA factor • Dysesthetic principles of dentogenics • Structural components of esthetics • Esthetic principles • Techniques for natural look in complete dentures • Errors in esthetics • Conclusion • References
  8. 8. Dentogenic • Dentogenics, means the art, practice and techniques used to achieve esthetic goal in dentistry. Dento + genic Photo + genic
  9. 9. HISTORY OF DENTOGENICS FORM OF ANTERIOR TEETH Based on face form (J.leon williams) Geometric theory 1914
  10. 10. INTRODUCTIONTODENTOGENICRESTORATIONS* JOHNP.FRUSH,D.D.S.,ANDROLANDD.FISHER,D.D.S. SanMa&o,Calif.,andGlendale,Calif. JPD5:586-595,1955 Sex, Personality and Age
  11. 11. INTERPRETATION OF SEX Expression of feminine characters • Roundness, smoothness and softness Expression of masculine characters  Masculine form illustrates cuboidal, hard, muscular , vigorous appearance which is typical of men John P. Frush and Roland D.Fisher “How Dentogenic Restorations Interpret The Sex Factor” J. Prosthet. Dent., 1956; 6 : 160-172.
  12. 12. Female Male • Incisal edges of the max anterior teeth of female follow the curve of the lower lip. • Distal surfaces of the centrals are usually rotated in posterior direction The max centrals and canine are on a plane parallel to the lip while laterals are above the plane Labial surfaces of centrals are usually not rotated Sex Interpretations by tooth positioning:
  13. 13. Mesial surface LI is often seen in an anterior relation to the distolabial surface of the CI. Distal surface is rotated posteriorly to give softness to smile Mesial surface of LI is hidden behind the distal surface of CI . Distal surface is rotated very slightly in a posterior direction by giving hardness to the smile
  14. 14. Distal surfaces of the canines are rotated in posterior direction ..mesial third of labial surface is exposed when viewed from front Rotated less in posterior direction ….the mesial two third of the labial surface is exposed
  15. 15. INTERPRETATION OF PERSONALITY FACTOR . . fragile, frail, the opposite of robust normal, moderately robust, healthy and of intelligent appearance. meaning opposite of delicate; hard and aggressive in appearance, muscular type John P. Frush and Roland D. Fisher “How Dentogenic Interprets the Personality Factor” J. Prosthet. Dent., 1956; 6 : 441-449.
  16. 16. PERSONALITY AND MOLD CONSIDERATION youthful, good looking “model” type of patient. “coarse” and would be adaptable to ample-bodied, obese woman. typically robust form hence indicated for men. Moderate vigorous Rugged vigorousMild vigorous Temperamental theory – personality influences morphology of teeth
  17. 17. AGE ABRASION The sharp tip of the cuspid ,suggests youth, and, as age increases, it should be judiciously shaped, not abruptly horizontally flattened, but artistically ground so as to imply abrasion against opposing teeth. This erosion imparted to the artificial tooth, by careful grinding and polishing very effectively, conveys the illusion of vigor and advanced age EROSION "softened" on the tips of the cusps to avoid the appearance of recently erupted teeth. grinding the incisal edges removing the incisal enamel John P. Frush and Roland D. Fisher “The Age Factor in Dentogenics” J. Prosthet. Dent., 1957; 7 : 5-13.
  18. 18. Characterization of anterior segment Frush and Fisher Sex, Age and Personality (SAP) Rufenacht Sexual type, Aggressivity and Personality (SAP)
  19. 19. The depth grinding is done on the mesial surface of central incisor only Depth grinding accentuates the third dimensional depth necessary For the delicate look -less depth grinding -vigorous look-severe depth Grinding -Average looK-should be between Delicate and vigrous THE THIRD DIMENSION-DEPTH GRINDING
  20. 20. THE DYNASTHETIC INTERPRETATION OF THE DENTOGENIC CONCEPT Dynasthetic Theory: • It is the secondary factor of a dentogenic restoration. Dynesthetics is a compound word. The prefix “dyn” is the combining form from the Greek word “dynamics”, meaning power. John P. Frush and Roland D. Fisher “The Dynesthetic Interpretation of the Dentogenic Concept” J. Prosthet. Dent., 1958; 8 : 558-581.
  21. 21. DYNESTHETIC TECHNIQUES Techniques includes • Shade selection • Depth grinding • Abrasion • Identification of masculinity or femininity • Embrasures and diastemas • Buccal corridor • Gum line denture base contouring and tissue stippling It concerns with three important divisions of denture fabrication. The tooth, its position, and its matrix Secondary factors of Dentogenics are called as dynesthetics
  22. 22. Esthetic principles FUNDAMENTALS OF ESTHETICS Principle of visual perception and their clinical application to denture esthetics( Richard E Lombardi , JPD .29:359-382, 1973.)
  23. 23. ESTHETIC PRINCIPLES:- COMPOSITION: The relationship between object made visible by CONTRAST is called Composition. Terminologies in our field of interest are dental,facial and dentofacial composition. Dentofacial composition Dental composition Contrast visibility α contrast.
  24. 24. COHESIVE FORCES SEGREGATIVE FORCES • Elements that tend to unify Opposite of cohesive forces a composition • A border is a cohesive force They provide variety in unity…. as well as arrangement of elements in a definite form or according to a principle. Naturalness =cohesive + segregate forces. variety to the composition dynamic and interesting
  25. 25. UNITY OR ONENESS: • The prime requisite of composition is unity. • It gives different parts of the composition the effect of the whole. • STATIC UNITY DYNAMIC UNITY - composed of irregular Plants and animals and geometric shapes E.g drops of water,snow Flake crystals - Is passive and inert Active,living and (without motion) growing
  26. 26. • HOGARTHS line Of Beauty: • Has long been considered an outstanding example of unity with variety. • It is a line inscribed around a cone. • The line is never the same at any point along its course yet it never leaves the surface of the cone. • This is absolute unity with absolute variety. neutral space appears evenly full of teeth, when the patient smiles Denture look
  27. 27. BALANCE:-  It can be defined as the stabilization resulting from exact adjustment of opposing forces.  Our visual sense is used to maintain or induce equilibrium-if not established leads to visual tension. Because of induced forces unbalanced things will look transitory, restless, unfinished, accidental, temporary, aggravating, and tense
  28. 28. Structural map- the most stable position of the disc is in the center The proper midline location is a must for stability Because of induced forces unbalanced things look transitory, restless, unfinished, accidental, temporary, aggravating, and tense. Proposed structural map of tooth area the most Stable position is at the intersection of the axes And indicates the critical role of the midline Improper midline A measured midline Balanced things look permanent, stable, completed, planned, peaceful, and in repose, because the visual tensions are eliminated.
  29. 29. SYMMETRY: Itreferstoregularityinthearrangementofformandobject.(Furtwangler,1964) • HORIZONTAL SYMMETRY RADIATING SYMMETRY • Occurs when a design contains Is a result of design of an object similar elements from left to extending from a central point and right in a regular sequence the right and left side are mirror images • Is psychologically predictable and Represents segregating forces that comfortable tends to be brings life and dynamism to a monotonous composition
  30. 30. Horizontal symmetry Radiating symmetry
  31. 31. DOMINANCE:- • Just as unity is the prime requisite for a good composition, dominance is prime requisite for providing unity • dominance provides Static unity Dynamic unity ( monotonous) (vigorous) Dominance Prime requisite unity Prime requisite composition A weak dominance takes place when Subsequent elements do not provide Sufficient factors of contrast. A strong dominance requires the Presence of subsequent elements Providing strong factors of contrast
  32. 32. LINES:- It has been stated that many factors that have been a part of structural or biologic beauty depends on visualization of lines. Parallel lines are most harmonious as they do not exhibit conflict Perpendicular suggest psychological relationship and strong segregative forces Various lines exists in dental composition: • occlusal plane • incisal plane • midline • tooth direction
  33. 33. STRUCTURAL ESTHETIC COMPONENTS 1.Facial components 2. Components of smile 3. Dental components 4. Gingival components Facial features Tooth visibility Lip line Smile line Upper lip curvature Negative space Smile symmetry Dental midline Golden rule Axial alignment Dental morphology Contact points Gingival morphology Gingival contour
  34. 34. FACIAL COMPONENTS A) FACIAL FEATURES esthetics of anatomy ≈ physiology
  35. 35. Bulging lip Impression stage Role of esthetics is to develop labial and buccal borders so that they are not only retentive but also support the lips and cheeks properly. Care must be taken not to over support these structures with borders that are too thick
  36. 36. ANTERIOR TOOTH POSITION • Payne writes that, “teeth should be placed where they grew.” Vertical tooth placement Horizontal tooth placement Payne,contouring and positioning , new york 1973, medcom,pp 50- 54) 8-10mm anterior to the center of the incisive papilla line extending between the middle of the upper cuspids in relation to the incisive fossa indicates proper location of the anterior teeth.
  37. 37. HORIZONTAL TOOTH PLACEMENT WITH POSITION RELATIVE TO THE LABIAL VESTIBULE ( These surfaces of artificial teeth should be set at that position with imaginary extension of the roots of these projected to a resorbed anterior alveolus. Hickey:esthetics of Anatomy,medcom,inc ,new york 64- 69,1973.) The labial surface of natural anterior teeth are found as far forward as the reflection of labial vestibule.
  38. 38. B) TOOTH VISIBILITY: It is more important for females than males as the average exposure of teeth is twice in females as that of males. AGE Young Woman 3 mm below the lip line Middle aged Woman 1.5 to 2 mm below the lipline Older Woman 1 mm below the lip line Young Man 2 mm below the lip line Middle aged Man 1 mm below the lip line Older Man 0 to 2 mm short of the lip line
  39. 39. SMILE COMPONENTS A) LIP LINE - refers to height of the upper lip relative to the maxillary central incisors. High lip line Medium lip line Low lip line Anterior low lip line
  40. 40. B) SMILE LINE line drawn along the edges of the four anterior maxillary teeth that has to coincide or run parallel with the curvature of the inner border of the lower lip sharp curve is youthful broader curve indicates older dental composition
  41. 41. The anatomy of smile (Matthews.T.G,JPD1978; 39:128-134)
  42. 42. UPPER LIP CURVATURE Directed upwards Straight Slightly downwards Pronounced downwards
  43. 43. D) NEGATIVE SPACE (buccal corridors) Is the dark space that appears b/w jaws during laughter and mouth opening. Adequate restoration of the lateral negative spaces will permit the characterization of the smile and enhances personality. The diminution of size and detail must occur gradually to increase buccal corridor space.
  44. 44. • Similar to a painting. the anterior and lateral negative spaces act as a border to the dental elements, with the lips representing the picture frame. • Anterior negative space is evident during both speech and laughter. while bilateral negative spaces should be evident during a relaxed smile. . • As the teeth passes posteriorly,the light is reduced and this gives a gradually darker shade and therefore a smaller appearance.
  45. 45. • Closest one  appear larger • Other like structures are interposed inbetween size reduction apper gradual ILLUSION AND GRADATION HOW TO RESTORE LATERAL NEGATIVE SPACE?? If two objects are of the same size,the lighter one appears larger, this is principle of illumination
  46. 46. DENTAL COMPONENTS DENTAL MIDLINE • Recommended protocol a) Placing this midline precisely in accordance with facial midline or in the middle of the mouth using the incisive papilla or labial frenum as landmarks. b) Never establish it in a precise midline because it may contribute to an artificial appearance. An eccentric midline if not too exaggerated is acceptable and may lend to the illusion of natural dentition
  47. 47. To be able to give a certain mathematical representation of beauty for numerically expressing the relationship of the various units that combine to make a composition, the term Proportion is used. PROPORTION The relationship of the various units which are associated with each other through a certain repetitive mathematical factor is the Repeated ratio.
  48. 48. Dental, Dentofacial, and Facial compositions, contain a variety of relationships.
  49. 49. B) Golden proportion • Pythagoras in 530 BC found a mathematical solution for what was perceived as beautiful or ugly • Golden Number, represented by the Greek symbol, ∆ [(∆5-1) ÷ 2]. • The reciprocal of ∆ is 0.618 termed the Golden or Divine Proportion. Roman statues based on golden proportion 0.618 + 1 = 1.618 1 + 1.618 = 2.618 1.618 + 2.618 = 4.236 1 x 1.618 = 1.618 1.618 x 1.618 = 2.618 2.618 x 1.618 = 4.236 1 / 0.618 = 1.618 1.618 / 0.618 = 2.618 2.618 / 0.618 = 4.236
  50. 50. Edwin I. Levin “Dental esthetics and the golden proportion”. J. Prosthet. Dent., 1978; 40, 244-252.
  51. 51. The distance between the two medial canthus of eye is in golden proportion with the distance between two medial canthi of an eye Golden proportion From trichion to eye & to chin Medial canthus of eye to nose & to chin In the relaxed face, the lip line divides the lower third of the face into the Golden Proportion
  52. 52. To create diversity and individuality, repeated or recurring proportions are more significant than a specific ratio the ratio for beauty of 0.618 signifies an ideal. other ratios, e.g. 0.577 or 0.8 are also perceived as aesthetic, with the provision that there is repetition in a given composition. So Lombardi suggested a continuous proportion or repeated proportion The ratio of width established between central & lateral must be used as we progress distally
  53. 53. Recurring esthetic dental proportion Dentist may use a proportion of his choice but it should remain consistent while moving distally More flexibility RED proportion should be modified to fit face, general body type of the patient Golden proportion + repeated ratio = Recurring esthetic dental (RED) proportion Daniel H. Ward “Proportional smile design using the recurring esthetic dental (RED) proportion” Dental Clinics of North America, 2002; 143-153.
  54. 54. C) AXIAL ALIGNMENT Mesial inclination tends to be more pronounced from the central incisors to the canines Bilateral axial alignment of the teeth of the posterior segment responds to the phenomenon of balance of lines around central fulcrum.
  55. 55. GINGIVAL COMPONENTS The location of the gingival zenith in relation to tooth axis is distal in the maxillary central incisors and canines and coincides on lateral incisors Short teeth made to appear longer by Moving the zenith point apically
  56. 56. Frenula • Wax labial frenum (b/w central incisors) and buccal frenula (b/w I and II premolar) is placed with wax spatula. • Labial frenum is usually narrow and thin at the margin whereas buccal frenum is broad thick or fan shaped. TECHNIQUES FOR CREATING NATURAL- LOOKING DENTURES
  57. 57. Stippling& Scalloping The surface of natural attached gingiva shows stippling effect. This stippled effect is produced on the denture by the use of a stiff- bristled tooth brush. Scalloping should be over accentuated according to the age of the patient. interdental papillae are left long and pointed for young patients and short and blunt for older patients.
  58. 58. GingivalSulcus • The production of a slight bulk of gingival margin and minute break between it and the teeth affords natural appearance. • The gingival sulcus is formed by inserting the tip of a No:23 explorer between the tooth and the wax, then carrying it mesio- distally along the cervical end of the tooth. More facial tooth structure is exposed in aged patients to represent the normal physiologic gingival recession
  59. 59. In staining the denture base to simulate natural tissue, three factors must be considered. Greater density of the soft tissue found in lighter tissue Deep red - are found in mucobuccal fold, frenula, incisive papilla, interdental papillae and the larger rugae Pale yellow - in root eminences and the hard palate Neutral Pink - which falls between extremes of deep and pale color tones Cellular components Vascularity Thickness of soft tissues
  60. 60. Custom Denture Tinting Pound’s technique stains are applied on the stone investment surfaces before packing is done. All stains must be applied in reverse order, the one representing the outer surface being applied first. Color characterization may be done after the denture has been processed.
  61. 61. The Denture Tinting Chart Denture tissue tinting chart with areas to be tinted and shades selected AG = Attached Gingiva AM = Alveolar Mucosa B = Blanched areas over roots F = Frenum Attachments P = Papillae Shade Light reddish pink Shade Reddish pink Shade Pale pink Shade Red stain Shade Light reddish pink Light pink - H Light red - F Medium red - A Purple - E Brown - B
  62. 62. Attached gingiva and root eminences-lighter in color Interdental papilla and unattached mucosa are darker in color Close-up of esthetic dentures. Full smile view of esthetic dentures
  63. 63. Classification of errors in dental esthetics (LombardiR.E,JPD;32:501-513,1974) • Inharmonious dentofacial ratio A)Shade disharmony B)Compositional incompatibility 1. static denture in dynamic mouth 2.Inharmonious strength or weakness of dental composition compared to background features a. Weak mouth with strong face b. strong mouth with weak face • Intrinsic dental disharmony 1. Space allocation error 1 Inadequate vertical space allocation 2 excessive vertical space allocation 3 excessive horizontal space allocation 2. Structural line errors 1 elevated occlusal plane 2 occlusal plane drops down posteriorly 3 asymmetrical occlusal plane 3. Unnatural lines 1 Reverse smiling line 2 unnatural axial inclination 3 cuspless posterior teeth 4 gradation errors 5 Age-Sex-Personality disharmony 4. Single –line errors 1. Vertical deviation 2. Horizontal deviation 3. Line conflict 5. Imbalance 1. Midline errors 2.Imbalance of direction 3. Artifact error 4. Diastema error
  64. 64.  Inharmonious dentofacial ratio A) Shade disharmony B) Compositional incompatibility 1. static denture in dynamic mouth 2.Inharmonious strength or weakness of dental composition compared to background features a. Weak mouth with strong face b. strong mouth with weak face A static denture Cardinal sin against the principle of visual perception
  65. 65. Drawing looks incomplete there is not enough mouth Same dental composition is too weak to play its Proper role in the facial composition because of The strength of other facial features Weak tooth arrangement =disharmony strong facial features Strong dental composition against a weak background features There is too much mouth Strong tooth arrangement =disharmony Weak facial features
  66. 66. This drawing seems complete the strong dental Composition is harmonious with strength of other Facial features Strong tooth arrangement= harmony Strong facial features In this drawing weak dental composition Seems harmonious because rest of the facial Features are also weak. A harmonious Relationship of all facial features exist, Because the weak dental composition is seen Against the background of weak facial features Weak tooth arrangement = harmony Weak facial features
  67. 67. Inadequate vertical length of dentalComposition, composition is unreal and Lacking in esthetic qualities Excessive vertical length, narrowSpace filled to overflowing Excessive horizontal space This is unnatural, primitive Coarse, lacking in human qualities Intrinsic dental disharmony Space allocation error
  68. 68. Occlusal plane drops down as it progresses Posteriorly. An unnatural and unesthetic result Bilateral asymmetry of the occlusal plane Incisal edges form a curve which is in Contrast to the curve of the smiling line Structural line errors
  69. 69. Single –line errors 1. Vertical deviation 2. Horizontal deviation 3. Line conflict Imbalance 1. Midline errors 2.Imbalance of direction 3. Artifact error 4. Diastema error Use of short posterior teeth destroys the illusionOf gradual reduction in the size, sin against the Principle of gradation Raising or lowering of one adjacent Line destroys the illusion
  70. 70. Direction of line must be balanced to Avoid unplanned results Placement of an artificial element o Either side produce imbalance A wide diastema divides the composition, and elements are not balanced
  71. 71. ESTHETICSIN OVERDENTUREAND IMPLANTPROSTHETICS
  72. 72. ESTHETHICMANAGEMENTIN TRANSITIONALPHASES
  73. 73. ESTHETICSAND ADVANCEDTECHNOLOGY • COMPUTER IMAGING SYSTEMS • The computer imaging system (CIS) has revolutionized • diagnosis, treatment planning, and case presentation. Intraoral • and extraoral images can be accessed, stored, and • manipulated, creating "what-if' scenarios • Patients see not only their current condition but also the • possible results of various treatment plans Computer-generated superimposed measurements predict the final dimensions of the teeth after proposed diastema closure.
  74. 74. ESTHETICSAND PSYCHOLOGY • 1937 House classified patients into four typesbased upon psychologic assessment • The philosophic patient • The exacting individual • The indifferent patient • The hysterical patient • 1. The patient has an unrealistic esthetic expectation that cannot be satisfied. • 2. The patient expects that an esthetic improvementwill remove or correct deep- seated psychologic problems. • 3. The patient is not satisfied with results that are technically and esthetically correct- in other words, the "it's not me" phenomenon. • 4. The patient is satisfied with the results, but family and friends are not. • 5. The patient does not wish to have esthetics enhanced, and the dentist does. The dentist should not promise more than can be delivered. The dentist should be sensitive to cues that the patients or those accompanying thepatients reveal during the initial examination and interviewprocess. Developing a Trusting Relationship Decision-Making Ability Cooperation and Follow-Through Abnormalities and Problem Patients(psychological)
  75. 75. References Zarb,Bolender, Prosthodontic treatment for edentulous patients .Twelfth edition Sheldon Winkler, Essentials of complete denture prosthodontics,second, edition 2000 Claude R. Rufenacht: Fundamentals of esthetics, Quintessence Publishing Co , 1992 Edwin I Levin :Dental Esthetics and the golden proportion , Journal of Prosthetic Dentistry . 40: 244-252 , 1978. Richard E. Lambarde : The Principle of visual perception and clinical application to denture esthetics , Journal of Prosthetic Dentistry . 29:359-381 ,1973. John P. Frush, Ronald D Fisher :Introduction to Dentogenic Restorations , Journal of Prosthetic Dentistry ,5:587-595,1955.
  76. 76. John P. Frush, Ronald D Fisher :The Dynesthetic interpretation of Dentogenic concept, Journal of Prosthetic Dentistry. 8:559-581, 1958. D J Lamb: Appearance and Aesthetics in denture practice, wright bristel, 1987. Bernard levin; Impression for complete dentures, Quintessence pub. co., 1984. Michael waliszwski ; Restoring Dentate Appearance : A Literature review for modern complete denture esthetics, Journal of Prosthetic Dentistry , 93 ; 386-393, 2005. Ascheim , Dale: Esthetic Dentistry , a clinical approach to techniques and materials.2nd edition , Mosby 2001 Ronald E. Goldstein:Esthetics in Dentistry,second edition, BC Decker 2002

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