When you want to deliver an all-ceramic restoration, don’t overlook the Dentin shade as another tool for patient satisfaction. Making a crown without knowing about a dark Dentin shade can create a challenging situation. Before you send another case back for a remake, see how the overall esthetic result of an all-ceramic restoration is influenced by the shade of the preparation, shade of the restoration and shade of the cementation material.
Shade of the preparation
All-ceramic restorations pick up the shade attributes of the underlying Dentin. Determining the color of the prepped surface is a critical component to achieving a properly shade-matched restoration, especially in cases of severe discoloration. Only if the dentist determines the shade of the preparation and passes it onto the lab can the desired esthetics be achieved. Since certain shade ranges may not work with all-ceramic crowns, talk to the lab about materials that can achieve an esthetic result for your patient.
Use the Ivoclar shade guide to determine the color of the prepped surface.
Shade of the restoration
Along with the Dentin shade, the lab needs to know the shade of the final restoration. After tooth cleaning, the shade of the non-prepared tooth and/or the adjacent teeth can be determined. When the lab knows these two shades, they can build the final restoration to match all the other teeth. For difficult shades, you may want to send the patient to the lab for a custom shade. However, if that is not an option, you will want to provide your lab with pictures if possible. For more information on taking patient photos, read our secrets to taking better case pictures.
Use VITA shade management tools to determine the shade of the final restoration.
Shade of the cementation material
One of the most exciting aspects of newer cements is the ability to make small cosmetic shade adjustments simply by selecting the right cement. Adjusting the Dentin shade chairside can help prevent the need for another appointment, saving you valuable time and making your patient happy. You have the option of addressing the Dentin shade with a line of cements that shade-correct and help block out the color of a dark Dentin. Use washable try-in paste for color matching, and even try mixing colors to achieve the desired result.
Use these cements from Cosmodent, Ivoclar and 3M™ RelyX™ to make chairside shade adjustments.