Another Single Central

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paulg100

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Ok so heres another single central, this time a bonded marland bridge to replace 21.

This was my first case in In-Line when i got my kit last year, so took quite a bit of playing about with colours, but the overall result
turned out pretty well i think.

First the pre-op

aimg806.imageshack.us_img806_1708_preop.jpg
By paulg100 at 2010-07-17

Metal frame

frame1.jpg

By paulg100 at 2010-07-17

Then the first build.
Now there was quite alot of translucency on the mesial and distal portions of this tooth.
A2.5 deep dentine (DD) was used to form the pontic base and neck. A mix of A2.5 DD and A2.5 dentine (D) was used to cover the body of the pontic and finally
A2.5 D was used to complete the bulk of the pontic. To help the transition between the dentine and incisal a mix of A2.5 D and translucent incisal 1 (TI1) was
placed at the transition zone and a mixture of TI1 and Effect 15 were used on the mesial and distal aspects to simulate the depth of the natural tooth in these areas.
TI1 was used for the rest of the incisal region and extended approximately 1mm to allow for shrinkage.
Mamelon orange/yellow was placed over this in the incisal area then the build up was fired.

You will see on the final result that the mix of TI1 and E15 did no acheive the correct amount of translucency and this is not how i would approach this now.
Since buying Ubassy's book tricks and tips, the use of dentine absorbtion masses by mixing translucent neutral which has no pigments to alter the shade,
seems alot more effective at getting deep translucency.

aimg59.imageshack.us_img59_5215_build1.jpg
By paulg100 at 2010-07-17

First bisque bake.

aimg341.imageshack.us_img341_4402_bisque1.jpg
By paulg100 at 2010-07-17

Second enamel layer

Once the first build had been refitted to the model a small amount of A2.5 DD was placed under the pontic and compressed into place to complete the
form of the pontic base. A thin layer of cervical translucent orange was placed at the neck, some bands of Opalescent 3 were placed in the middle and
cervical thirds and a mixture of TI1 and translucent neutral (TN) were placed over the rest of the build up. Some small amounts of pure TN were also
added to the incisal mesial and distal corners. This was then fired at a slightly reduced temperature to avoid any further shrinkage of the previous build layer.

This 2 stage build up technique allows modification of any internal effects before the final enamel layer is applied, thus avoiding a complete restart of the
ceramics should the internal effects need intensifying or reducing.

aimg806.imageshack.us_img806_8666_build2.jpg
By paulg100 at 2010-07-17

Second bisque bake before texturing.

aimg94.imageshack.us_img94_7783_bisque2b4texture.jpg
By paulg100 at 2010-07-17

Now a cool trick! this is a filter i found in photoshop during the course of this case. Its the Bas Relief mode under the sketch filter.
As you can see this has excellent potential for highlighting surface texture. It appears to work from reflected light so you will get variable resluts depending on the photo used, but there is some potential here for sure.

I never get on with the silver powder thing as i just find it very messy, so if i can find alternative ways then thats great. The other method of switching off the room lights and using a light either side of the unit also works well in highlighting surface texture.

aimg291.imageshack.us_img291_7660_texturemap.jpg
By paulg100 at 2010-07-17

Almost complete crown on model
Once this was treid in, i was able to fine tune the crown with some stains whilist the patient waited.

finishonmodelb4stain.jpg

By paulg100 at 2010-07-17

And the fit!

aimg96.imageshack.us_img96_968_fitretracted.jpg
By paulg100 at 2010-07-17

Fit image 2 showing white bands.

aimg38.imageshack.us_img38_6017_fitsideview.jpg
By paulg100 at 2010-07-17

Fit close up
The surface texture was close! but could still be better.

aimg718.imageshack.us_img718_5281_fitcloseup.jpg
By paulg100 at 2010-07-17

Im getting much better with in-line since this case and its a great ceramic.

As well as the tips and tricks book, another great book for ceramists which helped with this case is
Shades: A World of Colour by August Brugera (excuse spelling).

Ive picked this case to pieces many times in my head, now your turn ;)
aimg806.imageshack.us_img806_1708_preop.jpg aimg59.imageshack.us_img59_5215_build1.jpg aimg341.imageshack.us_img341_4402_bisque1.jpg aimg806.imageshack.us_img806_8666_build2.jpg aimg94.imageshack.us_img94_7783_bisque2b4texture.jpg aimg291.imageshack.us_img291_7660_texturemap.jpg aimg96.imageshack.us_img96_968_fitretracted.jpg aimg38.imageshack.us_img38_6017_fitsideview.jpg aimg718.imageshack.us_img718_5281_fitcloseup.jpg
 
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rkm rdt

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Nice job on a tough case!
 
Al.

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That looks nice, I havnet read through your post yet but I will later.
I have a tough shade Maryland bridge replacing the same tooth to do next week.

Also I ordered and just recieved the gold and silver dust. I never used it before but I am going to try it this weekend on a couple of cases.

I find that when I see crowns I did that looked great on the model dont look right when I see them in stone casts later.
 
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charles007

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Paul, great looking crown in shape,texture and color! So sorry I can't find anything to bitch about when you did such an excellent job.... Maybe next time !!hehe

Charles
 
dmonwaxa

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Great job on that crown Paul, Maryland bridges are often a PITA especially with width and masking at the embrasures, Excellent!

PS: nice tip regarding PS, thanks; will have to give that a try.
 
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Clear Precision Dental

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Nice work, Paul! Your restoration is such a great improvement over what the patient started with.

There seemed to be a discrepancy of the gingival tissue of #8, when I compared the first photo to the stone casts. There is some root showing and some gingival clefting in the first photo Your photos at the end, however, show some nice "healing" of the tissue of #8... therefore everything looks better !!!

[I just looked again... perhaps some periodontal surgery to correct via a graft and prepared a better shape for the ovate pontic...]

I am sure you made someone real happy, and that is one of the great rewards !!!
 
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This is really inspiring. Thanks for putting this up.
 
amadent

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maryland bridge what maryland bridge :D
if not for the photo -you would never know
job well done
very nice match
amaxing how much 1 tooth can change a person
im sure they will be smiling a whole lot more
 
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user name

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very excellent work. In the first photo the abutments seem to really get gray from the wings showing through. With your bridge the gray is gone. Is there something youve done??
Very nice.
 
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paulg100

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Thanks for the positive comments.

If you mean the interim build then the Grey is not show through, its where i have applied blue/Grey stain.

When the second fire with enamel is then placed over the top the additional thickness of material and the fact that you are conducting a second fire will kill the translucency some, so it does not appear so Grey after wards.

The final translucency still came out slightly underdone compared to the natural tooth, but Ive changed my protocols and picked up some good tips since doing this case.

One day ill actually earn something from doing single centrals at this level i tell ya..one day :nod:
 
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I was talking about the amount of gray show-thru on the abutment teeth with the original bridge. < Im assuming that was a poor maryland in the first photo. With your bridge, the wings dont seem to affect the color of #9 & 11. What alloy did you use?
 
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paulg100

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Ah i see, yeah the trick with Maryland's is to make wings so they only go half way up the palatal of the tooth.

This applies to metal or zirconia. You don't wanna block light from behind in the incisal third.

A metal wing right up the palatal will obviously Grey the tooth, a zirconia one will kill the translucency/vitality.
 

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