Are you an impulse buyer? If you are, it will probably pay to plan before you shop. Here are a few tips:
• Check the Web and local flyers for what’s on sale before you go to the store.
• Don’t go grocery shopping when you’re hungry.
• Stock up on non-perishables when they are on sale.
• Before you make your purchase, ask yourself if you really need what you’re buying, or is it just something you want?
—adapted from The Motely Fool Website, Fool.com |
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First of all, there should be a law against single central restorations! Having said that, we all know how common they are, predominately due to trauma to the mouth. Creating a single central restoration to match the surrounding teeth, especially the other central, is often the most difficult restoration for any technician to fabricate.
The odds are against us both that the crown will seat on the first try-in visit, however, here are a few suggestions to increase the probability of success:
 Photography by Becden client
Dr. Clif Harris, Charlottesville, VA |
Clear, detailed digital photography is essential. Close-up pictures taken from straight on as well as from right and left side views help the technician follow the contour and surface texture of the adjacent teeth.
To duplicate incisal translucency and mammelons, a photograph taken with a black surface placed behind the tooth provides us the best way to see existing characterization. PhotoMed International sells black metal Contrasters that can be autoclaved. Visit them at http://www.photomed.net/ or call 800-998-7765. You may also use ovals cut from black plastic folders to serve the same purpose on a disposable level.  Remember when choosing your shade, we can easily go darker with a minor 2 day repair, but to go lighter usually requires a full remake. Our entire laboratory has corrected lighting (like daylight) so be sure you are taking your shades in a corrected lighting environment. Involve your team members in shade selection (especially if you’re male) since women have a natural tendency to see color better than men. Each tooth has three zones; incisal, body, and gingival. Choose each shade zone separately, and you can use multiple shade guides – for example, you can use the incisal of a Vita® guide, the body of a Chromoscope, and the gingival of the 3D Master shade guide. Simply indicate your mix on the prescription.
 Photography by Becden client
Dr. Clif Harris, Charlottesville, VA |
Even though exact color may not be duplicated through digital photography, photos taken with shade tabs in place are still quite helpful. Be sure to hold the shade tab in the same plane as the tooth with the number on the tab clearly showing. A ring light will provide the best lighting for these photographs. Shooting these shots from a view slightly to the side helps eliminate the glare on the surface of the tooth, which occurs when shooting straight on. Also shooting a couple of shots without the flash can be helpful.
For all porcelain restorations, Authentic™ or Empress®, stump shade photographs are also essential. Often, as stated earlier, trauma is the reason for these restorations to be needed, and dark dentin adds even more of a challenge for the technician to overcome. Use any shade guide (it is not necessary to only use the Ivoclar stump guide) to find the closest match to the dentin and photograph it in the same manner as the main shade photographs, keeping the guide in the same plane as the prepared tooth. When fabricating the restoration, our technicians paint the die the exact color of the stump and then adjust the final porcelain shade to accommodate the stump color. Without this information, the restoration will be the correct shade but may not match in the mouth due to the color of the dentin.
Color-mapped drawings are also helpful in cases, especially where there is a lot of variation in colors or calcification.
Always tell your patient the next visit will be a try-in, so that if at first we don’t succeed, none of us look bad to the patient. Try in the restoration and cross your fingers! If any adjustments are needed, repeat the photography steps above, add any additional helpful information, and return the crown to us for go-around number two.
Lastly, if upon your initial diagnosis you identify a huge challenge to match the other central, either talk the patient into doing at least two teeth OR have the case done by your local lab so you can send the patient in for a custom shade appointment (not that we don’t want the business – we just want us both to operate profitably). As always, please call me with questions, comments, or suggestions. If you need help with your digital photography, plan to attend our photography seminar with Dr. Rhys Spoor, October 12th and 13th, 2007. If you need help with adding corrected lighting in your operatory, call me and I will connect you with a dealer.
 Dr. Harris' patient before |
 Dr. Harris' patient after |
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131 E. 13065 S.
Draper, UT 84020 |
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888-344-9991 toll-free
801-576-9991 phone |
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The editor of this newsletter is Emily Webb of Becden Dental Laboratory, Inc. Please send any questions or comments about this newsletter, or suggestions for articles to: emilyw@becdendental.com
©2007 BECDEN Dental Laboratory, Inc. |
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