We, as dentists, always think of life-like esthetics pertaining to ceramics, veneers, and crown and bridge restorations. Dentures often are excluded when it comes to creating a true, natural look for the patient. However, there is an increasing demand for high quality dentures because of the increase in demand of implant-supported dentures and higher expectancy in the complete denture outcome results. This presentation includes characterisation in complete dentures, with respect to both, denture teeth and acryllic denture bases, thus creating the concept of Prosthodontic privacy.

1. CHARACTERIZATION
IN
COMPLETE DENTURES
DR. SONALI HARJANI
II YEAR M.D.S.

2. Introduction:
We, as dentists, always think of lifelike esthetics
pertaining to ceramics, veneers, and crown and bridge
restorations.
Dentures often are excluded when it comes to
creating a true, natural look for the patient.
However, there is an increasing demand for high
quality dentures because of the increase in demand of
implant-supported dentures and higher expectancy in the
complete denture outcome results.

3. The success of complete dentures can be interpreted by the
patient from two distinct view points: function and appearance.
Most often the dentist’s primary concern is with the function
in the oral environment (e.g. stability, fit, retention and
mastication), and aesthetic considerations such as the size, shade,
and shape of the teeth, tooth position, denture base contours and
colour become secondary.
The patient, however, may view their relative importance
quite differently, and in recent years a more ‘patient-centered’
treatment regime has evolved.

4. In the 1950’s the American Dr. Earl Pound
innovated many techniques for creating natural looking
dentures.
Adopting Frank Lloyd Wright’s working philosophy
that “FORM AND FUNCTION ARE ONE”, Pound
advanced the concept that function in the oral
environment should not exist without aesthetic form,
as is often seen in dentures.
Hence, the concept of Characterization and
Prosthodontic privacy was evolved.

5. CHARACTERIZATION:
• Characterization is a procedure in which the character or
collective qualities of a person are introduced in the
complete denture, either by modification of teeth or
denture bases, to make it appear more natural for that
particular person.
• Characterization of the complete dentures is necessary to
give the dentures a life like appearance, and to make it
appear more natural.

6. According to the glossary of prosthodontics terms- 9:
“Denture characterization is modification of the form
and color of the denture base and teeth to produce a more
lifelike appearance.”
As said by Frush and Fisher, “the environment of the
teeth is as important as the tooth itself”.
Thus the two elements that must be considered in
denture esthetics are teeth and their supporting denture
base.

7. Complete dentures must be esthetic as well as
functional.
Hardy stated that, “To meet the esthetic needs of
the denture patient, we should make the (denture)
teeth look like (the patient’s) natural teeth.”

8. 1. Characterization
by selection,
arrangement and
modification of
artificial teeth
2. Characterization
by tinting the
denture bases
Complete dentures can
be characterized by
two basic methods:

9. CHARACTERIZATION BY SELECTION,
ARRANGEMENT AND MODIFICATION OF
ARTIFICIAL TEETH

10. TEETH SELECTION:
•Choosing the correct size and mould of teeth for the
denture is very important.
•Patient should be consulted, if at all possible, to find
out their views, or by viewing old photograph albums,
to ensure best results.

11. The teeth can be modified to harmonize with the
patient's age, sex, and personality to provide subjective
unity.
Fisher said that gender, personality, and age can be
used as guidelines for tooth selection, arrangement, and
characterization to "enhance the natural appearance of
the individual”.
This is the established Dentogenic concept of denture
construction.

12. • In the case of partial denture
wearers, the patient should be seen
first to match the artificial teeth to
the colour variation of their own
natural teeth.
• When choosing artificial teeth, look
for features that one would expect
to see in natural teeth; almost life-
like, with good characterization such
as strong surface detail, enamel
striation, mamellons, and natural
translucency and fluorescence.

13. TEETH ARRANGEMENT:
• The long axis of teeth can be varied.
• An eccentric midline or diastema can be produced.

14. •Masculine features: Boldness
i. Angular outlines
ii. Sharp lateral contours
iii. Larger laterals and canines
•Feminine features: Softness
i. Rounder outlines
ii. Smooth lateral contours
iii. Smaller laterals and canines.

15. • Lateral incisors “Personality
teeth”
and can be tipped accordingly
i. For Males: Labioversion
i. For Females: Linguoversion

16. •Crowing or overlapping
of teeth.
•Incisal wear in patients
of advanced ages.

17. MODIFICATION OF TEETH:
• Often, gold or alloy restorations
can be placed in the teeth to
create the illusion of naturalness.
• The use of direct gold fillings on
labial surfaces can be made.
• Amalgam fillings can be given on
posterior teeth.
• Cast crowns can be given on
posterior teeth

18. TEETH SHADE CHARACTERIZATION:
•Even after selection of a tooth shade, as close to that of
the patient’s natural dentition, it is possible that the shade
of the acrylic teeth may still not harmonize with that of the
patient’s natural dentition.
•Stock artificial teeth as provided by manufacturers have a
uniformity of color and shade, inherent to their production
that does not impart a natural esthetic result to dentures.

19. • In such cases, an in-office teeth
shade characterization protocol can
be applied; that is economical,
efficient, and predictable.
Eg: OptiGlaze Color (GC America)
• These stains can also be used to
produced characterized staining at
the gingival areas of the teeth or on
attrited incisal edges.

20. The staining kit consists of 15 2.6-mL bottles containing
a liquid light-cured, nano-filled protective surface coating in
various colors, which allows the dentist to perform rapid and
immediate characterization of all resins, PMMA provisionals,
acrylics, and denture-base materials.

21. PROCEDURE:
i. Denture teeth need to have their glossy coating removed
prior to application of the stains.
ii. Each tooth is sandblasted with 25- to 50-μm aluminum
oxide powder to gently create a uniform surface texture
and to prime the material for application of the colorants.

22. PROCEDURE:
iii. Alternatively, the surface coating can be ground off
with a bur, although this method is not much preferred.
iv. To rid the tooth of any debris following sandblasting,
steam cleaning the surface with hot water is
recommended, as opposed to using an alcohol-based
agent, such as ethanol, which may desiccate the acrylic
and lead to microcrack formation.

23. PROCEDURE:
v. The tooth anatomy may be further enhanced or
embellished with a variety of carbide and diamond burs
and/or a sharp scalpel blade, which is an excellent option
for creating crack lines.
vi. An endodontic file, can assist in adding color in fine
detail to each tooth.

24. PROCEDURE:
vii. Following characterization, a thin layer of OptiGlaze
clear is applied to the entire surface of the tooth. A final
light-curing step is required and can be accomplished
with a variety of devices, such as The Light 405 LED
from GC America.
viii. For best results, an incremental light cure of each
staining application is recommended before application
of the final glaze layer.

29. CHARACTERIZATION BY TINTING THE
DENTURE BASES

30. •An attractive, lifelike denture does not consist of teeth
alone.
•Needless to say, gingiva has a part to play in the overall
impression.
•By characterizing the visible areas of the gingiva in the
denture bases, a more lifelike appearance can be achieved.
Ideally, the denture should no longer be recognized as such
by other people.

31. A STANDARD MONOTONED
DENTURE
A CHARACTERIZED DENTURE

32. •Realism in complete dentures requires gum imitation,
especially with features found in natural gingiva, such
as muscle attachments and root detail.
•It is also worth paying attention to characterising the
colouring of the gum so that it simulates living tissue.

33. When the acrylic resins first appeared, they were
such an esthetic improvement over vulcanite bases that
most dentists felt that the final goal had been reached.
However, Pound pointed out the fact that the
“shiny pink” of the acrylic resins did not reproduce the
color and contour of the natural gingivae.
He and others hence suggested techniques for
staining of denture bases for over-coming this difficulty.

34. INDICATIONS FOR CHARACTERIZATION OF
DENTURE BASE:
1. Patients with an active upper lip.
2. Patients with a prominent pre-maxillary process.
3. Actors, singers and others who may expose gum tissues areas
during their performances.
4. The psychological acceptance of the dentures by the patient.

35. IDEAL REQUIREMENTS OF A DENTURE BASE
TINTING MATERIAL:
1. It should be readily miscible with methyl methacrylate
resin.
2. It should be non-toxic.
3. It should not add appreciable bulk to denture bases.

36. IDEAL REQUIREMENTS OF A DENTURE BASE
TINTING MATERIAL:
4. It should be stable and non-fading.
5. It should be resistant to loss from abrasion in cleaning and
in normal function.
6. It should not alter the properties of the denture base resins.

37. • Pound in 1951 incorporated the racial and individual colour
peculiarities, of the gingiva in artificial denture.
• He was the first to suggest a method of tinting acrylic denture
bases to simulate the gingival colour.
• Pound’s procedure was later modified by Hardy.

38. • Dr. Pound introduced Replident surface stains along with a
staining technique that applied the pigmentation onto the surface
layer of the denture base and was processed as an integral part of
the denture.
• This became one of the most widely used of all the documented
systems and later became known universally as Dr. Earl Pound’s
Kayon Staining Kit.
• Though the system Pound described was the most universally
accepted, its colour range was inadequate for rendering darker
pigmentations.

39. • Thus a new product for internal
staining that includes darker
pigmentation colours was
developed.
• This resulted in the creation of
the Enigma Colour Tone System,
which is widely used today.

40. I. IVORY PINK: The lightest colour and is used mostly to mix custom colours
or where an opaque layer is needed.
II. LIGHT PINK: For root eminences and the thin layer over the gingival roll
III. MEDIUM PINK: Places where bony buccal prominences transition from
the roots on pale healthy gums
IV. NATURAL PINK: Places where bony buccal prominences transition from
the roots on pale healthy gums. Used as base canvas.

41. V. DARK PINK: Used specifically for vascularity in areas of attached gingivae,
and inflammation in papillae
VI. BLUE PINK: Accent vascularity or inflammation on patients with darker
red tones
VII. LIGHT BROWN: Used when natural gums have brownish patches
VIII. DARK BROWN: Used for heavier pigmentation to show greater
vascularity

42. The colour of the acrylic base can also affect the
overall colour of the resulting denture.
Enigma High-Base acrylic is available in 3 shades:
Translucent,
Translucent Veined and
Pink Veined.
The Pink Veined acrylic enhances light pink shades,
while the Translucent Veined enhances blue shades.

43. POUND’S TECHNIQUE FOR DENTURE BASE
CHARACTERIZATION:
• Stains are applied on the stone investment surfaces
before packing is done.
• All the stains must be applied in reverse order, the
one representing the outer surface being applied
first.

44. TECHNIQUE:

45. TECHNIQUE:
• After boil out of the waxed
denture base, Acrylic
separator is applied in the
usual manner and allowed
to dry.
• Be sure not to allow any
accumulation of separator
to puddle around the
invested teeth.

46. • The base of the teeth are lightly ground utilizing a course, round
diamond bur. Any excess dust created by grinding is removed with
a light blast of air.
• The colour tones are applied to a completely cool flask by
sprinkling the various acrylic polymer beads into areas
surrounding the teeth.
• If the flask is warm, the surface monomer evaporates when it
contacts the stone. In turn the Colour Tones are set in place
prematurely and become difficult to manipulate.
• Drops of monomer should be applied whenever enough loose
polymer powder has accumulated to warrant holding it in place.

49. • The denture base monomer and polymer is measured and mixed. It is
packed in the usual manner. The flask is then assembled and secured
before being press-packed.

50. FINISHED DENTURE SHOWING COLOR, AND
INTEGRITY OF SURFACE DETAIL

51. JOHNSON’S TECHNIQUE:
• The technique allows the operator to observe his results while he
is staining the resin, and it avoids the danger of crazing acrylic
resin teeth by the monomer as the stains are applied.
• Also, it prevents the difficulty of having the stone core adhere to
the acrylic resin teeth at the gingival crevice if the monomer
contacts the teeth.
• A technique for tinting a denture base has been described in
which the acrylic resin is separated from the teeth during the
packing and staining procedure. The stains are applied to the
uncured resin after trial packing and before processing.

52. TECHNIQUE:
• After the flask has cooled to room temperature, a quarter-
inch groove is cut around the labial portion of the land,
about 3 mm. from the pattern of the flange. This moat is to
allow any excess acrylic resin to press into it, rather than to
prevent complete closure of the flask.

58. DENTURE SURFACE TEXTURE
CHARACTERIZATION:
• The smooth, pink, polished surface
of an average acrylic denture can
quickly reveal it’s false.
• Therefore, the surface texture of the
denture base can be modified by:
Alveolar eminences
Stippling

59. ALVEOLAR EMINENCES:
• To further enhance the natural effect, it
is necessary to imitate the anatomy the
gingivae and alveolus.
• The labial flange of a complete denture
should not be a smooth curved sheet of
acrylic, but instead should show a series
of swellings corresponding to the
alveolar eminencies over the roots of the
teeth.

60. • These are most marked anteriorly
and become progressively less
marked in the premolar and molar
region.
• In the upper anterior region, the
canine eminence is most marked.
The lateral incisor eminence is
small.
• In the lower jaw, again the canine
eminence is most marked and a
series of smaller ridges mark the
presence of the incisor roots.

61. GINGIVAL SULCUS:
Is produced by inserting
a No. 23 explorer tip or a
similar sharp instrument
between the teeth and the
wax at the gingival margin
and moving it mesiodistally
along this junction.

62. STIPPLING:
Suresh Nayar and Nicholas W. Craik had stated that
gingival stippling is a characteristic of the healthy
attached gingiva.
Copying gingival texture and contours contributes
to the natural appearance of labial flanges in complete
dentures by causing uneven reflection of light.
This, in turn, reduces the shine and reflection
typically seen in highly polished denture flanges and
provides a more natural appearance.

63. STIPPLING:
• Stippling of the areas representing
the attached gingiva may be
accomplished in a variety of ways.
• Various methods are used popular
methods are
i. Toothbrush technique.
ii. Offset bur technique.
iii. Sponge technique.

64. TOOTHBRUSH TECHNIQUE:
• press the bristles of toothbrush against the surface of wax
denture pattern prior to it’s investment.
• This produces a large number of holes in the wax. The wax is
then lightly flamed so the holes become less pronounced and
form dimples.

65. Limitations:
•Investment material may trapped within the pits, and
this is difficult to clean out.
•The most difficult problem with a toothbrush technique
is polishing to the depth of dimples, which is practically
impossible.
•As a result, it is difficult for the patient to keep the
dentures completely clean. Plaque and calculus form
rapidly, giving the dentures an odor.

66. Offset bur technique:
•This technique utilizes a bur which has been offset
bending the shank of the round bur (size Nos. 4 to 8),
placing it in a handpiece, and wiping the bur over the
denture in somewhat circular movement while the
handpiece is running.

67. Limitations:
•It is difficult to control the depth of the bur cuts.
•The dimples are usually linear in shape, rather than
rounded.
•The bur tends to scratch the surface of the denture
base making it difficult to polish.
•This technique results in the same kind of problems
for the patient as produced in the toothbrush
technique.

68. SPONGE TECHNIQUE:
Lynn C. Dirksen described a procedure which provides
an inexpensive means of obtaining more natural appearing
buccal and labial contours for complete dentures.
Procedure:
1. Wax the anterior flange and perform gingival
characterization (festooning).
2. 2. Flame the wax and press a synthetic sponge made
from low-density polyurethane foam over the flamed
region. Emboss the roughness of the sponge onto the
softened wax.

69. 3. Gently flame the anterior flange again to reduce the
roughness, the gingival stippling becomes self evident.
4. Invest and process the prosthesis, polish with pumice
and finish with rag wheel and polishing compound.

70. CONCLUSION:
Esthetics plays a vital role in rehabilitation of complete
dentures to achieve a pleasant smile. Each complete denture
patient should be evaluated individually, and the dentist
should strive to make the complete denture unique to that
person. Combination of dynesthetics with artistic effort will
help in achieving the ultimate esthetic goal. This can be used
as a guideline for tooth selection, arrangement and
characterization. It helps to illuminate a new pathway and a
new procedure to bring more mental comfort, satisfaction
and well-being to the denture wearers.

71. REFERENCES:
• Individual characterization of pre-fabricated prosthetic teeth, and soft
tissue areas. Bernd van der Heyd. QJDT 3, 1, 36-48 (2005)
• Dirksen, Lynn C.: A Natural Esthetic Buccal and Labial Anatomic Form for
Complete Dentures, J. PROS. DEN. 5:368-374, 1955.
• Characterization of complete denture - 11 Case reports. Joseph, et al. SRM
Journal of Research in Dental Sciences | Vol. 6 | Issue 1 | January-March
2015
• Quinlivan JT. Characterization of denture bases. Dent Clin North Am
1975;19: 321-32

72. • “Review: Characterization of Denture Bases -Redefining Complete
Denture Esthetics”
• Choudhary SC, Craig JF, Suls FJ. Characterizing the denture base for
noncaucasian patients. J Prosthet Dent 1975;33:73-9
• Johnson HD. Technique for packing and staining complete or partial
denture bases. J Prosthet Dent 1956;6:154-9

73. THANK YOU!!