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1. 12. Esthetics and Characterization Eleni Roumanas DDS Division of Advanced Prosthodontics, Biomaterials and Hospital Dentistry UCLA School of Dentistry Giulo Preti MD University of Turin and Frank Lauciello DDS Ivoclar Vivadent This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.

2. DENTURE ESTHETICS & CHARACTERIZATION

7. Characterization of Maxillary Anterior Teeth Lateral Rotations Diastema Incisal Wear labioversion linguoversion

9. Characterization of Lower Anterior Teeth Crowding & rotations Diastemas Staining Incisal Wear

11. Before After Improper Lip Support

12. Loss of VDO results in a more exaggerated class III occlusion Before After Loss of Vertical Dimension

15. Characterization

16. Anterior Tooth Characterization Central Lateral Canine Labial-palatal inclination Class 1 Perpendicular to ridge Class 2 Palatal inclination Class 3 Labial 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 Bold Follow 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

17. Anterior Tooth Characterization Soft Bold Central Labial-palatal inclination Class 1 Perpendicular to ridge Class 2 Palatal inclination Class 3 Labial inclination Mesial-distal inclination none Rotation Soft Bold Follow Distal arch flare Note: never mesial flare Length Same length as wax rim

18. Class 1 7mm Central incisors perpendicular to the ridge Centrals: Labial-palatal Inclination

19. Class 2 7mm Central incisors slightly palatally inclined Centrals: Labial-palatal Inclination

20. Class 3 7mm Central incisors slightly labially inclined Centrals: Labial-palatal Inclination

21. NO TILTING OF CENTRALS. Esthetically Unacceptable To Tilt Maxillary Centrals Mesial Or Distal. Centrals: Mesial-Distal Inclination

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

23. Distal flare- Creates a highlight on the center of the tooth, thereby giving boldness to a set up. Maxillary Centrals: Rotation

24. Mesial flare- Mesial flare is esthetically unacceptable for centrals. Maxillary Centrals: Rotation

25. DEFLECTION neck out REFLECTION neck in Maxillary Centrals: Neck Position Unacceptable characterization since it will make one central look light and other will look dark.

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

27. Anterior Tooth Characterization Soft Bold Lateral Labial-palatal inclination Soft Bold labial (neck in) perpendicular Mesial-distal inclination long axis of tooth inclined distally none Rotation Mesial flare Distal flare Length 1-2mm less than phonetic rim same length as phonetic rim

28. Perpendicular Neck in Maxillary Laterals: Labial-palatal Inclination - Neck tucked in toward the palatal is considered a soft characterization -Neck perpendicular to the palatal is a bold characterization

29. Distal Inclination Maxillary Laterals: Mesial-distal Inclination - Distal inclination of the long axis of the lateral is considered soft -Mesial inclination is considered not acceptable

30. Mesial flare (Mesioversion) Maxillary Laterals: Rotation - Considered a soft characteristics -Mesial flare of the lateral incisors is a characteristic most commonly seen in females, although it may occasionally be seen in natural male dentition.

31. Mesial Flair-Soft Effect Maxillary Laterals: Rotation

32. Distal flare Maxillary Laterals: Rotation -Considered a bold characteristic

33. Distal Flair-Bold Effect Maxillary Laterals: Rotation

34. Anterior Tooth Characterization Canine Labial-palatal inclination Palatal inclination (neck out) Note: never upright or labial inclination Mesial-distal inclination Long axis of tooth inclined slightly toward the distal Note: never to the mesial Rotation Mesial flare naturally created by following the arch form Note: never distal flare Length Same length as rim

35. Maxillary Canines: Labial-palatal Inclination Palatal inclination (neck out) - The 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

36. Maxillary Canines: Mesial-distal Inclination perpendicular 15 ° Distal Inclination - The long axis of the canine is inclined slightly toward the distal Note: never to the mesial

37. Canine Rotation-Mesial flare - Mesial flare is naturally created by following the arch form

38. Canine Rotation-Distal flare -Distal flare is not considered an acceptable characteristic and is not recommended in denture characterization.

39. Festooning: Denture Base Anatomy - The gingival heights of the various teeth in the arch vary and should never be waxed straight across. This a common mistake made in denture festooning. -The lateral is always shorter than the canine or central. -The canine is always longer then the premolar.

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

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

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

47. Smile!