Custom Shades...How do you do it?

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Brett Hansen CDT

Brett Hansen CDT

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We have been using Shadevision for years at our lab to take custom shades. Shadevision is no longer supported and I think ours is going out. How do you do custom shades at your lab? Is there a good system similar to Shadevision? Thanks!
 
BlakeHarting

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1. I start out by asking them how they like their temporary. I'm looking to pick up on any things they do/do-not like, so I can keep/fix any of those features.

2. Then I ask/note any difficulties with their case as to align their expectations with reality.

3, Then I use the Vita Easyshade to narrow down which Vita 3D master linear value shade cards I'm going to look at first.

4. Then I take each shade that I deem close to the tooth and put them onto a separate shade card.

5. Then I take polarized pictures of that shade card next to tooth being matched.

6. Then I take polarized filter off and take a close up of that tooth, and a smile picture.

7. Then while looking at the patients tooth with the shade card I made, I decide...
- at least 3 shades and draw basic representation (one gingiva, one dentin middle, and one enamel)
- note type of mamelon structure and draw basic representation
- note any other characteristics and colors and draw basic representation(crack lines, decalcification, etc..)

8. Then I tell them to have a nice day and nice to meet ya!
 
sndmn2

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I just look for the shade tabs that matches the best, Do some scribble on a tooth. Tell them that seldom does it come out to a perfect match that only the creator can do that but I will do my best to make sure it blends at a speaking distance.
 
A

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STEP 1 VALUE.. pick a shade closest for cervial 1/3, middle1/3, and incisal 1/3.. always helps to have your porcelain modifier tabs handy to map out the trans area (violet, sunset, opals, etc). Take photo records with tab in place and tab out of place. I prefer to use a blank white piece of paper near side of patients lip to use a reference of white.. Not sure why someone told me about it and i have always done it
 
TheLabGuy

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a3dl nailed it...I might add, we use Digital SLR with a ring flash and snap some pictures focusing on the three areas a3dl stated to refer back too. I have a large monitor at my ceramic bench...while building I'll throw the sd card from the patient photos up on the big screen and go to town.
 
Affinity

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1. I start out by asking them how they like their temporary. I'm looking to pick up on any things they do/do-not like, so I can keep/fix any of those features.

2. Then I ask/note any difficulties with their case as to align their expectations with reality.

3, Then I use the Vita Easyshade to narrow down which Vita 3D master linear value shade cards I'm going to look at first.

4. Then I take each shade that I deem close to the tooth and put them onto a separate shade card.

5. Then I take polarized pictures of that shade card next to tooth being matched.

6. Then I take polarized filter off and take a close up of that tooth, and a smile picture.

7. Then while looking at the patients tooth with the shade card I made, I decide...
- at least 3 shades and draw basic representation (one gingiva, one dentin middle, and one enamel)
- note type of mamelon structure and draw basic representation
- note any other characteristics and colors and draw basic representation(crack lines, decalcification, etc..)

8. Then I tell them to have a nice day and nice to meet ya!

Do you mind if I ask how you charge for this? Per appt. or per time involved?
 
Affinity

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I take the approach sndmn takes.. keep it simple, keep expectations low. There are situations where pics are necessary, but if Im honest, no one is requesting intricate layered porcelain anymore. Minimal translucency/cutback and paint by number. I have much better success with insync than I do with getting effect porcelain to do what I want.

When I was in europe the Dr reserved a 2nd seat appt. so that if adjustments needed made, the pt. expected it, if not great. I think trying the tooth in is the only way to truly do a shade match, anything else is an educated guess. If the Dr or PT are trying to achieve perfection, they need to realize its possible, but it may take several attempts. I explain that when I meet the Pt, that I can adjust it if necessary, and I almost never get anything back. I dont charge my core clients for this which also keeps expectations at a manageable level.. working ultimately for Pt satisfaction, not necessarily reduction of chair time, although that is certainly the goal and advantage of seeing the pt.

Another crucial step I take is making sure the Dr puts a 'base' shade on the script or sends pictures, , that way I can get the case started, and have their actual crown to do the custom shade with when they come, rather than only a shade guide reference or picture, that you then have to transfer to the crown. This is really the only advantage of seeing the Pt, sometimes they come by twice if its questionable. I find that the majority of people dont want to be bothered with coming to see me though, I match the ambition of the Pt.
 
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We charge $60 per custom shade. and yes Affinity sometimes these patients have to come back at day of delivery for a shade adjustment with the temp out. We also let the patient know upfront that this is a possibity we will need to see them again. TBH its a pain in the A$$ bc of all the moving parts of our techs and the patients schedule and all the different delivery times each week. but we manage to get it done and most our clients would probably pay more for custom shades. The short term clients we have that fight the fee we do not want to work with them anyway (we all know what type of clients those are; the faster better cheaper dr)
 
Polarmolar

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I use Elab. Patient sits down I take some pics to calibrate later. I show them the pics I took ask them what they like and don’t like or why they are changing it. Patient leaves. I check photos and calibrate later on and finish case. If I follow the protocol I don’t get a reshape , in fact when I’ve done single centrals this way. I’ve done over 20 single anterior this way in the last 5 months and I have not had a single reshade. I charge for my shade fees yes and now I get accounts because I am known to be able to do complex shades easily. Well if ya I follow the protocols it’s somewhat easy haha.


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Polarmolar

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I use Elab. Patient sits down I take some pics to calibrate later. I show them the pics I took ask them what they like and don’t like or why they are changing it. Patient leaves. I check photos and calibrate later on and finish case. If I follow the protocol I don’t get a reshape , in fact when I’ve done single centrals this way. I’ve done over 20 single anterior this way in the last 5 months and I have not had a single reshade. I charge for my shade fees yes and now I get accounts because I am known to be able to do complex shades easily. Well if ya I follow the protocols it’s somewhat easy haha.


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7c9491856544dee49789f2fd60b1eba2.jpg

Recent tricky one I did lately.



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Affinity

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Polar, how much do you charge for this effort? How long would you say it takes to photograph/upload/correlate per patient? I really like what elab is doing, looks like a great system.

Im thinking of offering this as a premium service, just not sure if it justifies the time it takes.. I dont really have an issue of crowns coming back, so not sure I want to rock the boat in that direction so that they 'get what they pay for'..
 
Polarmolar

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First time it took me 4 days for my crown. Now I can do it in a couple hours , but it’s more about going slow and I do other **** in the meantime. The shade process takes me about 2-5 mins per patient as I ain’t looking at shade guides, might throw a couple value shades but I rarely do now. The calibrate photos doesn’t they long like a few mins depending how fast your computer is also. The best part it that you feel confident you case will go in and you don’t have to do reshades that mess up my day. Right now we charge $75, but in reality it’s saves me time and I’ve started limiting my accounts who can send to me because it’s so high in demand. Chair time isn’t cheap so if you can get complex shades done quickly you can dictate you fee.


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Polarmolar

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First time it took me 4 days for my crown. Now I can do it in a couple hours , but it’s more about going slow and I do other **** in the meantime. The shade process takes me about 2-5 mins per patient as I ain’t looking at shade guides, might throw a couple value shades but I rarely do now. The calibrate photos doesn’t they long like a few mins depending how fast your computer is also. The best part it that you feel confident you case will go in and you don’t have to do reshades that mess up my day. Right now we charge $75, but in reality it’s saves me time and I’ve started limiting my accounts who can send to me because it’s so high in demand. Chair time isn’t cheap so if you can get complex shades done quickly you can dictate you fee.


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Anyway it’s a good system but complex. So you need to be prepared to have to learn photography and some computer software. Also to be humbled because there is no escaping a 30 inch monitor on your work.


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TheLabGuy

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So tell me more about this "eLab"? looks like you have to be somewhat pc savvy, use it on all your shade cases, and cost?
 
Polarmolar

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So tell me more about this "eLab"? looks like you have to be somewhat pc savvy, use it on all your shade cases, and cost?

I only use it on anterior cases. I joined the fb group and searched and watched the YouTube videos. I should make a post of it , I love the system.


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DentalTechTips

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1) Get told that there's a custom shade here
2) Sigh audibly and drop the 12 unit bridge I'm re-contouring
3) Shuffle into the custom shade area
4) Read script... (while mumbling to myself)
5) Count teeth and flip model around to face me (because even after 12 years I can't recognize which quadrant is which in the mouth)
6) Double check patient's first name
7) Call out patient's name... butcher it
8) As they're walking up, assess their age (Younger usually = A & B Shades, Older = C & D Shades)
9) Ask them how they are/ comment about the weather/ take a seat please
10) "looks like we're doing X for you, alright, let's take a look"
11) Dive in, elbows deep
12) Eyeball shade and grab the shade tab (usually A2)
13) F#@K... it's not A2
14) Try 3 more shade tabs
15) ...
16) Try A2 Shade Tab again... just for sh!ts and giggles
17) Bang on!
18) Start marking on script different characterizations
19) "gingival warming" "blue/grey incisal" "craze lines" "decalcification"
20) scribble it quickly in a language that can be likened to a chinese/arabic hybrid
21) "Can I see what shade you picked?"
22) ...o_O
23) Hand patient the mirror
24) "I was thinking about bleaching"
25) Banghead
26) Pull out 3D shade guide
27) "Okay... so here are our bleach shade options"
28) "What's the whitest one you've got?"
29) ...OM1
30) "Nothing whiter?"
31) "Ma'am... the only shade whiter is KKK" (Don't actually say that, just think it and chuckle to yourself)
32) Let's go with that!
33) "Are you sure? Bleaching will only bring you a shade or two lighter at best, You'll probably be an A1 when you're all done. In fact, I think you should do the bleaching first and book an appointment to come back so I can take your shade when you're done!"
34) "Nah... I don't want to have to drive all the way out here again, plus, I might end up getting veneers... and an implant! I want that hollywood smile"
35) Are you sure?
36) YES, I've been saving up for 5 years to get this crown done, it costs a lot of money y'know. Might as well get what I want since I'm paying for it!"
37) (Think to myself: She's never gonna get bleaching/veneers/or implants done... is she?)
38) ... Alright! OM1 it is then!
39) (Receptionist pops her head in) Your next patient is here, it's a shade adjust, doctor said the shade was too light...
40) Beer
 
Affinity

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What guides are everyone using? I have found myself almost solely relying on the 3d Master guide. I havent picked up the linear system yet though.
 
TheLabGuy

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1) Get told that there's a custom shade here
2) Sigh audibly and drop the 12 unit bridge I'm re-contouring
3) Shuffle into the custom shade area
4) Read script... (while mumbling to myself)
5) Count teeth and flip model around to face me (because even after 12 years I can't recognize which quadrant is which in the mouth)
6) Double check patient's first name
7) Call out patient's name... butcher it
8) As they're walking up, assess their age (Younger usually = A & B Shades, Older = C & D Shades)
9) Ask them how they are/ comment about the weather/ take a seat please
10) "looks like we're doing X for you, alright, let's take a look"
11) Dive in, elbows deep
12) Eyeball shade and grab the shade tab (usually A2)
13) F#@K... it's not A2
14) Try 3 more shade tabs
15) ...
16) Try A2 Shade Tab again... just for sh!ts and giggles
17) Bang on!
18) Start marking on script different characterizations
19) "gingival warming" "blue/grey incisal" "craze lines" "decalcification"
20) scribble it quickly in a language that can be likened to a chinese/arabic hybrid
21) "Can I see what shade you picked?"
22) ...o_O
23) Hand patient the mirror
24) "I was thinking about bleaching"
25) Banghead
26) Pull out 3D shade guide
27) "Okay... so here are our bleach shade options"
28) "What's the whitest one you've got?"
29) ...OM1
30) "Nothing whiter?"
31) "Ma'am... the only shade whiter is KKK" (Don't actually say that, just think it and chuckle to yourself)
32) Let's go with that!
33) "Are you sure? Bleaching will only bring you a shade or two lighter at best, You'll probably be an A1 when you're all done. In fact, I think you should do the bleaching first and book an appointment to come back so I can take your shade when you're done!"
34) "Nah... I don't want to have to drive all the way out here again, plus, I might end up getting veneers... and an implant! I want that hollywood smile"
35) Are you sure?
36) YES, I've been saving up for 5 years to get this crown done, it costs a lot of money y'know. Might as well get what I want since I'm paying for it!"
37) (Think to myself: She's never gonna get bleaching/veneers/or implants done... is she?)
38) ... Alright! OM1 it is then!
39) (Receptionist pops her head in) Your next patient is here, it's a shade adjust, doctor said the shade was too light...
40) Beer
Wow!!! That was friggin-awesome!!! I lost it a few times reading that....bwahahah....post of the week right there!!!! Thanks man/ma'am
 

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