CHARACTERIZATION THE ART OF CAMOUFLAGE

Dr Vikas Aggarwal Deptt. of Prosthodontics Crown and Bridge

No matters how ideal or perfect is your restoration if it doesn't blends with the surrounding hard and soft tissue, the concepts of esthetics are jeopardized

What is Characterization
To produce a life like restoration characterization is

necessary
As defined by G.P.T 8 It is to alter by application of unique markings,

indentations, coloration and similar custom means of delineation on a tooth or dental prosthesis thus enhancing natural appearance

Characterization in Removable Prosthesis

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, to make it appear more natural

Indications for Characterization

A life like restoration can be obtained by simulating the

anatomical characteristics of oral mucosa with various stains. It is of particular value in 1. Subjects with active upper lip 2. Persons with prominent pre maxilla 3. Persons like teachers & singers 4. Who expose more of denture base during talking and smiling. 5. Young edentulous patients

Methods of Characterization
It can be done by two methods 1. Characterization by selection, arrangement and

modification of artificial teeth. 2. Characterization of denture bases.

Various ways of characterization

Martone stated that, The key to esthetics lies in asymmetry.
1. 2. 3. 4. 5. 6. 7. 8.

Varying long axis of tooth Creating asymmetry Dissimilarities in rotation, inclinations Using eccentric midline Gingival recession Grinding of incisal edges Spacing and diastema Restoration ,silver fillings

long axes of teeth become accentuated with age.

Creating asymmetry

Creating rotations overlaps

broader curve of smiling line indicates an older dental composition.

 creating midline

shifts

 The progressive abrasion of

the artificial tooth as the age of the patient progresses. The cut made for normal abrasion to remove the artificial appearance of the incisal edge.
A posterior diatoric tooth

to be modified to simulate erosion.

Spacing and diastema

Characterization Of Denture Base

Natural appearance of denture can be enhanced by: An esthetic wax up which reproduces the contours of the normal anatomy Staining these contours to give them a vital appearance

Carving
Esthetic gingival margins

should be created. More facial tooth structure is exposed in aged patients to represent the normal physiologic gingival recession. The interdental papillae are left long and pointed for young patients and short and blunt for older patients Variations in levels of contact point will guide the height of the gum line of each tooth

Root carving
Minor root eminences are left over the

root areas of the incisor. Heavy root eminences are formed over the cuspid roots Continuous alveolar bulk or minor root contours formed in posterior region

Frenula
Wax labial frenum (between central

incisors) and buccal frenula (between 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

Stippling
The surface of natural attached gingiva shows

stippling effect.
Creation of minute pore-like depressions

on the attached gingiva portion of denture base to create this orange peel appearance is known as stippling.
Scalloping should be over accentuated

according to the age of the patient

Positive stippling & negative stippling.

Positive stippling is achieved by blow-wax technique while negative stippling is done by making pores in the wax pattern using a tooth brush. The result of positive stippling is more natural looking which seems to collect less debris and calculus, and is easier to clean than the indentations made by negative stippling techniques.

Tinting and staining

Staining of denture base depends on Thickness and density of the soft tissue. Extent of vascularity within the tissue Cellular components of the tissue.
Colour and hue may vary in one area from another

 Deep red are found in

mucobuccal fold, frenula, soft palate, incisive papilla, interdental papillae and the larger rugae. Pale yellow- in root eminences and the hard palate Neutral Pink which fall between extremes of deep and pale colour tones, facially between root eminences

Map diagram for staining denture base

1. Basic pink used over hard tissue as attached gingiva (H) 2. Light red used for papilla and muscle attachment (A) 3. Medium red used sparingly (F) 4. Purple & Brown is used in heavily pigmented gingiva (E) (B)

BROWN MATRIX WITH ISOLATED AREAS OF PIGMENTATION GINGIVAL HALO DEPICTED AROUNDTHE NECK

BLUISH PINK DENTURE BASE WITH MELANIN PIGMENTATION OF ALVEOLAR MUCOSA

BROWNISH PINK TEXTURED BASE WITH DARK PIGMENTATION OF ATTACHED GINGIVA &INTER DENTAL PAPPILA

Techniques
Kayon denture staining kit
Pound technique (1951) Here, stains are applied on the

stone investment surfaces before any packing is done. Since one has to work from the denture surface inward, all stains must be applied in reverse order, the one representing the outer surface being applied first. Kemnitzer Technique (1956) An important variation from Pound procedure is incorporated in packing the flask. Here staining is done after packing ie during trial closure

See the difference yourself !!

Life less appearance

Life like appearance

A very well characterized mandibular denture

Characterization in fixed prosthesis

Characterization is the art of reproducing natural defects,

and it can be particularly successful in making a crown blend with the adjacent natural teeth. In general, defects should be reproduced to a slightly lesser extent on the restoration than as they appear on the natural teeth. The temptation to overcharacterize is strong but must be resisted. Characterization looks slightly more natural and is more permanent if applied intrinsically during the build up of the restoration

Various characterizations
Hypocalcified areas produced with

white stains easiest of all

White stain is used to mimic hypocalcified area

Proximal coloration
By reproducing this in the

restoration, the dentist is able to create the illusion of depth and separation Able to tone down excessive opacity at the cervical area. The stains used are brown and orange

Incisal halo
More common on the incisors of

younger patients. A mixture of white and yellow stains in the ratio of 4 : 1 is placed in the linguoincisal area,

 Enamel cracks A linear vertical crack interrupts the light transmission across the tooth surface, causing a shadow. Thus, both the highlight and the shadow of the crack must be simulated for an authentic result. The highlight is developed with white and yellow mixed in the ratio of 4 : 1, and gray stain is used for the shadow. Stained crack line Cracked enamel stains quickly on natural teeth. An orange-brown mixture applied in as thin a line as possible will effectively simulate a crack.

Mamelons can be accentuated in young adults

Cervical abrasions and gingival recession can be depicted

Special illusions
An FDP pontic may be very

long because of loss of supporting bone. Simulating a root surface can partially improve the appearance. The root extension is contoured for length and width, and then an orange-brown mixture is placed over the extension.

Conclusion
Small subtle changes can create large differences in

esthetic outcome of treatment It is very well said beauty lies in the eye of beholder

Thank you