12 Prosthetic Dentistry Complete dentures
Customizing Esthetic Complete dentures Dr. Nazem Assaad na.assaad@wwv.se Lebanese University, Beirut Arab University Beirut, Lebanon
Dr. Najib Abou Hamra
Dr. Maha Ghotmi
Fig.1 & 2 Regular arch form
Introduction and Background Esthetic is a predominant factor for complete denture success (Carlsson et al. 1967). It is the most frequent complaints among complete denture patients (Jeganathan, 1993). Comfortable but unaesthetic dentures seem to be unaccepted by patients (Brewer, 1967). Compensating alveolar bone loss, correctly supporting lips and reestablishing the correct vertical dimension of occlusion are basic steps for achieving patient normal appearance. However, this is not sufficient to achieve individual denture esthetics. Denture esthetics has been defined as the cosmetic effect produced by a dental prosthesis that affects the desirable beauty, attractiveness, character and dignity of the individual (Glossary of Prosthodontic terms) which means proper form and shade of denture teeth and also individual set up of the teeth in order to achieve individual esthetic. Classically, three esthetic concepts have been differentiated to achieve denture esthetics (Waliszewski et al. 2006) 1- The denture look: an esthetic concept developed mainly as a result of a functionally oriented tooth positioning as well as from common errors in fabrication and appearance for complete denture wearers (Fig. 1-2). Fig 1
2- The supernormal teeth: Shor and colleagues in 2005 defined the supernormal concept as “attractive, idealized, and above-average dental esthetics. A custom made look to please the body image of the patient (Fig. 3-4). Fig 3
Fig 4
3- The natural look : described by Frush and Fischer as a natural appearance related to anatomic determinants of gender, age and personality. It seeks to restore the most natural patient smile and its appearance (Fig. 5). Fig 5
Fig 2
Fig. 5: Male teeth setup based on criteria given by the natural look theory
There is limited evidence-based information available when achieving dentate appearance in Dental News, Volume XX, Number III, 2013