Custom Shade-Matching Made Simple
Adapting new and efficient methods for patient satisfaction.
By Luke S. Kahng, CDT
When compared to matching the central teeth, custom shade-matching the laterals is much simpler. To identify the shade for the laterals, the author first looks at the value—is it high or low? How much opacity is present? He then checks for dentin translucency and color transparency and then the overlay from the incisal to the gingival areas. With his own personally fabricated ceramic custom shade tabs, the author can identify translucency modifications easily because they are included in the enamel overlay color. He is able to match the color and apply his porcelain build-up accordingly.
This article will illustrate how to create laterals and make their appearance as esthetically pleasing as possible using GC Initial™ One Body materials and slightly different techniques than what is traditionally used. The GC Initial Lustre paste can be applied very lightly or with a thicker layer depending on the brush size and technique.
Our case study analysis involves two different patients and examinations of their unique situations.
With LSK121 ceramic fabricated shade tabs, the author was able to focus and compare more on translucency and depth of color (Figure 1) as he recorded the first patient’s custom shade. The tabs were created using an enamel and dentin layering method, making it easy to match the patient’s particular shade because the color is more suitable to that of natural dentition. The gingival area is slightly darker, but the incisal is brighter.
In the GC Initial IQ One Body ZR System (Figure 2), there are five available colors from which to choose: BL, A, B, C and D. If we need to create different chroma colors from the inside, we can choose to layer on the GC Initial Reflection Liner, with seven colors available. If the technician is looking for more color possibilities for a patient whose teeth do not match traditional colors, the Liners will definitely help (Figure 3).
Custom ceramic shade tabs will provide a more intense color for matching the zirconia crown colors (Figure 4) with A, C, D, and B color possibilities (pictured left to right). Once received, the white zirconia coping was checked on the model for fit (Figure 5).
Next, One Body build-up color was chosen from the “A” group (Figure 6) with no enamel or translucency powder coloring necessary. The first bake was a complished at 810°C with a full vacuum (Figure 7). Consistent oven temperature is very important to the quality of the baking appearance. To that end, an Ibex Dental Technologies Summit Porcelain and Press oven is the choice of author (Figure 8).
After firing, the restoration’s appearance was eggshell with subtle translucency already in place (Figure 9) for the incisal one-third area. A fit check was again performed on the cast model.
Surface texture was next created using mesial-distal line angles narrowly drawn for the illusion of subtle texture (Figure 10). To create subtle translucency, the author applied GC’s Lustre Paste in L3 to the incisal area (Figure 11). Figure 12 is a mirror image of the restoration. The crown was later fitted (Figure 13) and approved by the patient. Lastly, it was polished and cemented (Figure 14) providing a very happy patient a reason to smile for the camera.
For the author, the first case was easier than the second because he did not have the pressure of a 27-year-old woman whose wedding date was quickly approaching. He also noticed during the custom-shading appointment that she dehydrated quickly and had a high smile line, which made it hard to match her shine. He used a rubber polish to create the gingival to mesial and distal corner color, as well as for the incisal third.
As a technician, the author knows the difficulty in making people understand that sometimes change and adaptation is needed in our methods. People like their habits and they do not want to change what they are familiar with. With the newer GC Initial porcelain products available, he would like to demonstrate how much more efficiently porcelain work could be a complished if a new system is learned. In accepting new ideas, we are learning to think outside the box.
Luke Kahng, CDT, is the owner and founder of LSK121 Oral Prosthetics in Naperville, Illinois.
This case is courtesy of Dr. Anthony LaVacca, Naperville, IL.
The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dental Technology.