T h e c o n to u rs o f p o lis h e d s u rfa c e s o f c o m p le te

d e n tu re s : a r e v ie w o f th e lite r a tu r e

In the theory and practice of complete denture con­

struction, much attention has been given to im­
pressions and the occlusion. Retention, stability,
function, and appearance have always been of
major concern. However, the importance of the
polished surfaces in achieving these objectives has
only recently been recognized.

Early re fe re n c e s in th e lite ra tu re

E d g a r N. Starcke, Jr., DDS, Birmingham, Ala
Polished surfaces play an important role in den­
ture retention, stability, esthetics, and phonetics.
In fact, the success of a denture may depend on
proper treatment of these surfaces. The literature
suggests that functionally and mechanically
formed contours are equally effective.
Fauchard1 made one of the earliest known refer­
ences to the polished surfaces in 1746 when he
wrote, “We must consider the form and the curva­
ture that the outside and the inside surfaces must
have to avoid discomfort of the tongue, the gingi­
vae, and the inside of both cheeks.”
In 1800, Gardette2 inserted dentures tempo­
rarily in a patient without the usual springs to
hold them apart and in place. He was surprised a
short time later when he went to supply the
springs, to find that the patient could retain both
dentures perfectly without the springs. Gardette
reported his experience, concluding that support
of the dentures was made by involuntary and in­
stinctive contractions of the oral muscles. A ppar­
ently, Gardette was the first to observe and record
the principle that a compatible, harmonious ex­
ternal form is an important factor in denture reten­
tion.

P rin c ip le s of s u rfa c e form d e v e lo p m e n t

It was not until the early 1930s, when Fish3 de­

fined and introduced his theories of the form of

155
the polished surfaces as necessary to stability and
retention, that proper consideration was given to
them as an integral part of the construction of com­
plete dentures. Fish says that the denture exhibits
three surfaces: the impression surface; the occlusal
surface; and the polished surface (which includes
the lingual, labial, and buccal surfaces of the
teeth, as well as the periphery and lingual, labial,
and buccal surfaces of the denture base).
M ore recently Brill and others4 described the
surfaces of the denture as the pressure-receiving,
surface or occlusal table; the pressure-transmitting
surface or basal seat; and the secondary support­
ing surfaces (which he divides into the polished
surfaces and the lingual and buccal surfaces of
the teeth).
According to Fish, the “fundamental principle
in the construction of full dentures is that every
part of every surface of the denture shall be mod­
elled to fit some part of the patient’s tissues, or
some part of the other denture.” It is necessary to
adapt the polished surface of the denture to the
movable muscular tissues of the tongue, cheeks,
and lips which not only move over the polished
surfaces but also keep changing their own shape.
H e reasoned that to fulfill these requirements the
form o f the polished surface must be that of a
series of inclined planes.
M artone,5 in support of the fundamental prin­
ciple set down by Fish, says that the development
of the impressions and the positioning of the
teeth constitute two thirds of this requirement.
The anatomic contouring and finishing of the
polished surfaces make up the remaining third.
The polished surfaces are nearly equal in area
to the impression and occlusal surfaces of the den­
tures for the average edentulous patient. The area
of the polished surfaces usually becomes larger in
proportion to the amount of resorption of the
alveolar ridges. A study of healthy dental arches
of patients with natural teeth, and observations of
contours and surface markings of diagnostic casts
aid in developing and incorporating natural con­
tours in dentures. Fish3 believed that the polished
surfaces must be modeled into a series of inclined
planes, each of which presents itself to the muscle
with which it comes in contact, at such an angle
that when the muscle moves it pushes the denture
into place. Specifically, the inclined planes sug­
gested by Fish are described in this manner:
Lingual surface of upper denture looks inward
and downward.
156 ■ JADA, Vol. 81, July 1970
Lingual surface of lower denture looks inward
and upward.
Buccal surface of upper denture looks outward
and downward.
Buccal surface of lower denture looks outward
and upward.
The position of the teeth must be such that the
tongue is pressed inward with just as much force
as the cheek is pressed outward. In this way the
dentures occupy a “dead space” o r state of equi­
librium.
Swenson6 observes that a force exerted in the
direction of the occlusal plane by the tongue and
cheek can act as either a placing or a displacing
agent, depending on the shape o f the polished
surface. For example, when the lingual and buccal
borders of a lower denture are being shaped, a
concavity tends to seat and a convexity tends to
unseat the denture. Nagle and Sears7 concur in
this.
Brill,4 in describing the inclined planes set forth
by Fish, suggests that narrow artificial teeth permit
automatic formation of the polished surfaces with
favorably inclined planes that can be wedged be­
low the tongue, lower lips, and cheeks. In this
way, these structures are brought to rest on the
polished surfaces and their weight will force the
denture to remain on its foundation. This kind of
passive muscular fixation is made more effective
by broadening the base of the denture because
increase in basal tissue means a corresponding
increase in the denture base and, therefore, the
tongue, cheeks, and lips have a greater contact
area on which they bring their weight to bear.
Moreover, the fixing component o f the pressure
increases as the vertical inclination of the polished
surface decreases.
Tuckfield,8 in describing the inclined planes of
the flanges of the lower denture, says that the
buccal flange must be extended from the premolar
region posteriorly to the physiologic limits; how­
ever, the buccal flange in the premolar region
must be appreciably narrowed instead of being
extended because the modiolus can readily dis­
lodge a denture. When the fibers of the buccinator
muscle contract to hold food between the teeth,
they do not reduce the depth of the sulcus in the
molar region as they do in the premolar region;
the buccal flange extended into this pouch forms
an inclined plane. The lingual flange should be
such that when the tongue exerts a lateral pressure
on food it will exert its component of force down­
ward. A common mistake, he concludes, is to
make the lingual surface concave.
Tillman,9 like Tuckfield, emphasizes that the
lingual flanges should have no concavity to allow
the tongue to spread laterally. However, he says
that the anterior part of the lingual flange should
demonstrate a gently formed concavity for the
tongue to gain additional stability. However,
Sussman10 believes that the lingual flange should
be concave, with a flat anterior lingual surface as
well as a concave buccal surface. Likewise, Black11
contends, in regard to the palatal and lingual sur­
faces, that the two dentures should form a circular
pattern— a lower concavity to accommodate the
tongue at rest and the upper concavity to allow
tongue space and to guide the pressure of the
tongue and food in an upward and lateral position.
F u n ctio n ally form ed p o lish ed su rfa c e
Lott and Levin12 describe a technic for forming
the external surface of complete dentures by
using a soft functional wax. This procedure in­
volves making functional impressions of the soft
structures of the mouth adjacent to the buccal,
labial, lingual, and palatal surfaces of dentures
and incorporating the resulting extensions into
the denture construction. The extensions are de­
scribed as flanges or flange modifications. They
are related to the anatomy and physiology in each
region.
Merkeley13 suggests that for determining the
occlusal plane, bilateral vestibular impressions
can be taken with a plastic impression material.
He has made a study of the action of the accessory
muscles of mastication by a series of vestibule
impressions. He observed these characteristics:
When the lips are protruded, a groove cut by
the buccinator muscle corresponds to the occlusal
plane.
With the modiolus tensed, the triangularis
muscle depression would suggest a narrowing in
the lower premolar area.
The technic for establishing the polished sur­
face contours involves relining the bases at the
trial denture stage with the teeth in light occlusion.
When the patient’s lips are forcibly protruded and
retruded, the excess impression material flows
onto the labial and buccal surfaces and can be
molded.
Raybin14 tells how to make simple soft wax
impressions of the cheeks, tongue, and lips, thus
developing individually contoured polished sur­
faces for both the mandibular and maxillary den­
Starcke: CONTOURS OF POLISHED SURFACES OF DENTURES ■ 157
tures. He points out that resultant shapes are
forms of whorls, convolutions, folds, and bulges
rather than the usual configurations.
Russell15 describes a mandibular acrylic resin
base with a superstructure of soft wax shaped
like an occlusal rim. Convexities and concavities
are formed in the soft wax by suitable exercises
of the buccinator muscles, modiolus, tongue,
and lips. The ensuing tooth arrangement and
polished surface comply with the contour of the
soft wax rim. He says, however, that only the
mandibular denture derives any benefit from this
technic.
Schiesser16 develops the functionally formed
polished surface in complete dentures to establish a
“neutral zone” by using an impression plaster at
the try-in, and this form is carried through into
the finished dentures.
There have been some investigations into the
functionally and mechanically formed polished
surfaces as they relate to stability and masticatory
efficiency. Other investigations have been made
of the influence of polished surface configuration
on efficiency and retention.
R e se a rc h co m p arin g fu n c tio n a lly a n d
m e c h a n ically form ed p o lish ed s u rfa c e s
K apur and Soman17 investigated the influence of
a number of individual mechanical factors on the
masticatory efficiency of complete dentures. The
two factors found to be most significant were the
presence of grooves on the occlusal surface of the
posterior teeth and the placement of the posterior
occlusal plane on the crest of the residual ridge.
They also investigated the influence of denture
base contour on masticatory efficiency.
Thirteen forms of the polished surface of upper
and lower dentures were studied in 840 perfor­
mance tests involving ten patients. There was no
significant difference in the ability of the group
of subjects to chew with the various denture forms.
However, evidence of decided improvement in
mastication performance appeared among indi­
vidual subjects with different denture forms.
This would suggest that the polished surface con­
tour may be an important factor influencing the
efficiency of the food transporting mechanism and
thereby affecting masticatory function.
Stromberg and Hickey18 made a study to devise
testing equipment to measure retention of both
maxillary and mandibular dentures accurately and
to compare the retention of similar dentures whose
external surfaces had been formed by manual and
physiologic procedures.
The functional procedure used was basically
that of L ott12— to determine the physiologic align­
ment of the teeth and the form of the polished
surface. In the manual procedure, the dentures
were contoured carefully with the correct incli­
nations so the resultant forces of the tongue,
cheeks, and lips would help maintain the dentures
in place. A special testing device was designed to
measure the force required to dislodge the den­
tures in a vertical direction. The device was de­
signed so that the subject’s head would be fixed
and the amount of jaw opening could be repeated
for successive tests. The dentures were tested for
retention after the subject had been edentulous
for 24 hours, after the subject had worn manually
formed dentures for 48 hours, and after the sub­
ject had worn functionally formed dentures for
48 hours.
An analysis of variance indicated that, statisti­
cally, there was no significant difference between
the two forms of maxillary and mandibular den­
tures or among the three testing conditions.
Weight was not a factor. All of the patients pre­
ferred the manually formed dentures. The conclu­
sion was that the functional technic is excellent for
determining facial support and tooth location.
Lott’s19 reply to Stromberg and the others was
that the application of the flange wax technic was
good but their use of it on patients with well-
formed ridges was an unfortunate misunderstand­
ing because the technic is contraindicated for such
patients. He said that the average dentist gets
good retention on well-formed ridges. However,
if there is severe ridge resorption, the function­
ally formed flanges increase the area of intimate
contact, particularly of a mandibular denture,
and there is a consequent increase in retention;
comfort and appearance are often improved too.
Gingival th ird of th e p o lish ed s u rfa c e s
Pound20 believes that natural esthetics plays a
dominant role because of the great influence it
has on phonetics. In fact, he says that phonetics
is controlled 100% by esthetics. The denture
base material should accurately reproduce the
correct form of the interdental papilla. He also
emphasizes the importance of the appearance of
the free gingival margin, and the effect of stipp­
158 ■ JADA, Vol. 81, July 1970
ling and the full buccal contours.
Frush and Fisher21 emphasize the importance
of a nonsmooth plastic surface with stippling, and
the individual molding of characterized teeth in
esthetics of upper and lower dentures.
Young22 points out that the denture base rep­
resents the gingival and mucosal tissue o f the arch.
The denture base, therefore, contributes to oral
and facial esthetics by means of bulk, color, and
facial characterization. Festooning, stippling,
and root carving are important. The base should
have a satiny finish and not a high luster.
Dirkson23 urges consideration of these ideas:
anterior and posterior teeth should be replaced in
the same natural position from which they came,
relative to the lips, cheeks, and tongue; the basic
anatomy of the dental arch in all its natural con­
tours should be fashioned about these teeth;
exposed surfaces of the denture should be tinted.
Form of th e p alata l su rfa c e
Schlosser and Gehl24 say that cingula, rugae, and
the incisive papillae should be placed on the
palatal surface of the denture. They add, however,
that excessive thickness of palate should be
avoided.
Walker and Orsinger25 concur in that they
believe the natural contours of the palatal surface
should be reproduced in minute detail.
Landa26 agrees that the palate should be thin
but says that rugae should be avoided as they
tend to make the palate too thick. He believes
that the palate should be smooth and highly
polished.
Swenson6 suggests that the form of the wax
surfaces around the teeth should imitate the form
of the tissues around the natural teeth. Any fancy
or artificial festooning is distinctly out of place.
There should be a slight root projection to follow
the individual tooth. The upper part of the surface
should be formed in such a way as to lose none of
the border width of the original impression. The
form between the gingiva and border should be
shaped to aid retention by mechanical directional
forces of muscle and-tissue. There should be mini­
mum uniform thickness throughout the palate.
The lingual aspect of the lower denture should
have the least amount of bulk except at the
peripheral border, which should be quite thick.
Rothman27 discusses the palatal form as it re­
lates to phonetics. He suggests that the primary
concern in phonetics is with the changes in the
stream of air as it passes through the oral cavity.
The tongue is the principal articulator of the
consonants and changes position and shape for
the pronunciation of each of the vowels. In pro­
nouncing each consonant, the tongue contacts a
specific part of the teeth, alveolar ridge, or hard
palate. It is important to know where the tongue
contacts them so they may be correctly restored in
the prosthesis.
H e suggests that excessive thickness of the den­
ture base in the anterior part of the palate is often
the cause o f lisping. Likewise, if the groove is too
deep, the patient may whistle. Therefore, he
recommends that a palatogram be made in the
trial denture to determine the correct thickness.
The palatogram is made by placing talc on the
palate; the talc is wiped away by the tongue when
desired sibilant sounds are pronounced. A sagit­
tal section diagram and a palatogram of the palat-
olingual consonant sounds demonstrate that the
rugae of the palate are critical to their formation.
Boghosian and Spangenberg,28 on the other
hand, have shown that after the insertion of a pros­
thesis, the greatest alteration occurs in the quality
of vowel sounds. Therefore, they suggest that rugae
should not be placed on dentures, so that the
anterior part of the denture base can be as thin as
possible.
Roberts29 relates the palatal form to stability.
The maxillary denture can be supported advan­
tageously by the tongue or dislodged by it. If the
palatal arch is made too wide, too high, or even
too smooth, and if no effort is made to copy the
contour of the patient’s palate as it was shaped
with his natural teeth in place, stabilization by
tongue action is difficult.
Snow:i0 used the reproduction of the reverse
curve in the palate to improve the s and sh sounds
whereas Allen,:il to develop the normal tongue
pattern for the s and sh sounds, thickened the
posterior parts of the maxillary denture that con­
tacts the tongue. This palatogram is done with the
wax trial denture; wax is added to the palate from
the molar region forward until the normal pattern
of contact with the tongue is reproduced for the
s and sh sounds.
Slaughter*2 suggests that a baffle, or ridge, 1 mm
wide and 1 mm thick should be placed on the
palate. It should curve toward the midline from
the lingual side of the first premolar, extending
opposite to the lingual side of the first molar.
This enables the tongue in most of its functions to
cut off and narrow the air volume as needed.
Starcke: CONTOURS OF POLISHED SURFACES OF DENTURES ■ 159
D iscussion
It is interesting to observe, in reviewing the liter­
ature on the form of the polished surfaces of com ­
plete dentures, that there are areas of both agree­
ment and disagreement.
It is generally recognized, for example, that the
form of polished surfaces should be such that the
structures with which they come in contact aid in
the retention and stability o f the denture. However,
two different methods are suggested: functional
and mechanical formation.
For the most part, the functional technics in­
clude a procedure for physiologic determination
of the “dead space” or “neutral zone”— a position
occupied by the teeth where all forces acting on
them are, for all practical purposes, equal. In
the mechanical technics, the teeth are manually
positioned according to commonly accepted prin­
ciples and procedures. Studies have shown no
appreciable difference in function and retention
between dentures with functionally formed con­
tours and those with mechanically formed contours.
From a practical standpoint, the dentist should
be aware that the polished surfaces play an impor­
tant role in retention, stability, esthetics, and
phonetics and that the success of a denture may
well depend on the proper treatment of these
surfaces.
Therefore, the dentist should assume respon­
sibility for determining the form and contour of
the polished surfaces as he does for determining
the impression surfaces, jaw relationships, and
teeth selections. Unfortunately, this aspect of com ­
plete denture construction is all too frequently
ignored or overlooked and is left in the hands of
ancillary personnel who, without guidelines, must
determine the contours of the dentures arbitrarily.
The method used for the establishment of
the polished surfaces, be it the mechanical or
functional technic, will probably be determined
by the individual situation or the dentist’s prefer­
ence. But regardless of the technic used, the
dentist should supply the laboratory with the
proper guidelines and instructions to ensure that
the form and contour he determined at the chair
are incorporated into the denture.
Doctor Starcke is a career resident in prosthodontics at
the Veterans Administration Hospital, 700 S 19th St, Bir­
mingham, Ala 35233, and postdoctoral student, School of
Dentistry, University of Alabama, Birmingham.
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160 ■ JADA, Vol. 8 1 , J u l y 1 9 7 0
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