Boris Jovanovic (Belgrade, Serbia) was satisfied with the lifelike nature of VITA MFT prefabricated teeth, but he did not like the way the denture base looked. For this reason, he was interested in learning everything about the different types of mucogingival anatomy, so he could reproduce it naturally in his partial and full denture work. He analyzed countless intraoral photographs to internalize the anatomical features and also studied a large amount of professional literature to explore the anatomical structure from the inside out. He then experimented for years in order to transform his findings into wax. Today he has developed his own procedure for quickly and accurately creating the red esthetic in wax. To do this, he works with instruments he has modified to meet his needs. In the following interview, he gives rare insights into his art and explains why the VITA MFT fits his mucogingival reproductions so well.
Lifelike environment for VITA MFT: The mucogingival art gallery of Boris Jovanovic
What are the characteristics of the natural mucogingival anatomy, and why is it so important to reproduce them individually for each patient?
The mucogingival anatomy consists of the interdental papillae, the gingival margins, the attached gingiva, the interdental furrows, the mucogingival border area, the cheek and labial frenulum, and it ends in the gingivobuccal fold. One question I have been asked countless times by dentists and dental technicians regarding mucogingival reproduction is: Why should they make dentures with all this detail if no one sees it when the patient speaks or smiles? The answer is simple. The patient is the one who sees it. Patients notice all of these details and the effort someone has put into it.
Even the modeling is a work of art that reproduces the natural anatomy.
The palatal anatomy is also reproduced in detail in wax.
After the implementation in resin, the palatal anatomy appears true to life.
How do patients react to your work? Are there noticeable positive effects after insertion?
They appreciate that something has been reconstructed that they once had, but unfortunately lost. This has a positive psychological effect on the patient and helps ensure that removable dentures are no longer a taboo subject. The moment patients take the prosthesis out of their mouth to clean it, they do not just see a piece of plastic that symbolizes aging. They see something that does more than just help them perform basic functions. They see something personal that they can accept much more easily, that helps them regain their confidence. Patients start smiling again, and this improves their quality of life.
A full denture restoration with biomimetic wax modeling in the articulator.
The upper denture after implementation in resin in the articulator.
In a close up, the reproduction cannot be differentiated from the original.
You normally only reveal the secret of your quick and natural-looking wax modeling during your courses. Can you give us any hints as to what is important?
If we want to imitate something, we have to understand it. In this case, nature is our greatest teacher! It is actually quite simple; we learn most of it in our professional schooling. The shape of the healthy alveolar ridge anatomy must be reproduced. When wax modeling, I start with a little more wax so that I have enough material for carving. That's really what I do to live up to my own expectations (laughs). First, I reduce the wax at the tooth neck to define the height of the clinical crown and the shape of the gingival margin.
The biomimetic esthetic zone of a denture in the macroscopic view.
Can you give us more basic details about your wax modeling? For example, how do you proceed with the attached gingiva?
I highlight the attached gingiva by reducing the wax in the free gingiva area and working out the mucogingival transition area. During this work step, I also bring out the alveolar processes. It is important to note that these never run in a straight line and that we have to orient ourselves to the tooth axis and the root length. In the front, the canines have the strongest root, which is therefore also more dominant than that of the incisors, especially in comparison to the more delicate roots of the lateral incisors. The concave shape of the movable alveolar mucosa is not only important for esthetic reasons, but it also supports the stability of the denture.
An additional piece for the gallery after implementation in resin, characterization and glazing.
How do you finish your biomimetic wax model? Which aspects have to be considered with regard to the coloring before the implementation in resin?
Stippled gums are only present on the attached gingiva. Finally, I model the marginal gingiva and the ligaments with an electronic wax knife. When implementing in resin, it is important to individualize based on ethnicity. I have noticed that the attached gingiva of Caucasian patients is always lighter – that is, light pink – than the mobile mucosa, which is reddish-pink. In addition, there is also a significant percentage of patients with gingival pigmentation and variable melanin distribution. Here too, the color must be determined in order to imitate the color effect in a manner appropriate to the patient.
The VITA MFT embedded in a completely natural environment.
How do you proceed with the implementation in resin in order to obtain the desired surface texture and different color nuances on the denture base?
The whole "magic" begins – as previously described – in the wax. I transfer the wax to acrylic in the conventional manner, embedding the dentures in Class III plaster flasks. Before I pour out the upper part of the flask, I carefully spread the plaster over the entire surface of the denture with a brush. This way I can be sure that the plaster penetrates even the finest details. After rinsing the flasks and insulating the entire plaster surface, I proceed to the internal characterization of the resin using the salt and pepper technique.
Labial frenulum and attached gingiva made of light pink resin.
That sounds interesting! What exactly do you mean by the salt and pepper technique? How do you do that?
In the first step, I apply light pink up to the visible mucogingival border. The negative spaces of the frenula are then filled with light pink. Details like deep red, violet, blue, orange or yellow can be added in small portions with a little brush. After inking, the base material is carefully inserted, being careful not to damage the characterizations. Pressing and finishing are done in the standard way. Since the vestibular surface of the dentures is made in layers, I do not recommended grinding it. I just seal it with light-curing glaze.
The VITA MFT denture tooth in an absolutely lifelike environment.
Why does the VITA MFT fit so well into the mucogingival environment you have created? Why can the gingiva around the prefabricated tooth be optimally designed?
I have been working as a dental technician for 23 years and have been able to test numerous brands and sets during this time. When we talk about denture teeth, I would like to highlight the VITA MFT teeth. They are multifunctional teeth that support every lingualized and balanced setup concept. Working with VITA MFT is easy and fun. I especially like the esthetics. The dentin and enamel portions provide a nice balance. The incisal third has a natural composition of translucency and underlying mamelons. The VITA MFT offer a good selection of beautiful shapes in different sizes, and the texture is accentuated just right. The width and shape of the tooth necks make it easy to create natural-looking gingiva.
The attention to detail is worth it – the restorations designed by Boris Jovanovic look completely natural in the mouth.
With regard to color, the individualized denture base fits completely harmoniously in the oral cavity.
Natural-looking papilla region and marginal gingiva around the VITA MFT denture tooth.