From Dark to Light

[PearlySweetKate]

Hi guys,

Pt is having two crowns replaced; 3& 30. Pt. bleaches her teeth, so the natural teeth are 1m1 lower, .5m1 upper, but crowns are darker and ugly, hence the replacement.

Problem is her ND shade under the crowns is ND8.

Emax. I could use an MO0 ingot, an MTBL2 ingot, but Ivoclar recommends HO0 ingot (I think that will be too bright).

What do you guys think?

 

[2thm8kr]

What is the thickness of the crowns?

 

[PearlySweetKate]

Really, I have a range of ingots to choose from, so if you have a different recommendation, it would be awesomely appreciated.

Help! Thank you thank you thank you!!!!

 

[PearlySweetKate]

Most areas are about .7 and up.

 

[PearlySweetKate]

Occlusals are slightly thinner, most notably in pits.

 

[Sda36]

Occlusals are slightly thinner, most notably in pits.

B1 HT is a good choice, depends on how much area beyond prep though. It's basically an enamel replacement ingot coice. If reduction is more substaintial you need to maybe look at LT, cut back & layer a bit, mid to Inc 1/3rdsm

 

[2thm8kr]

B1 HT is a good choice

Over an ND8? HT B1 is the most translucent.

 

[PDC]

Hi guys,

Pt is having two crowns replaced; 3& 30. Pt. bleaches her teeth, so the natural teeth are 1m1 lower, .5m1 upper, but crowns are darker and ugly, hence the replacement.

Problem is her ND shade under the crowns is ND8.

Emax. I could use an MO0 ingot, an MTBL2 ingot, but Ivoclar recommends HO0 ingot (I think that will be too bright).

What do you guys think?

I would probably use something similar to Argen's Esthetic zirconia and go with an OM2 for the 1M1 and C4 (maybe C3) for the 5M1. With .7 thickness you should be able to hide the stump color with this material. I would prefer this material over emax in the posterior region also.

Or there is the old tried and true PFM. No stump color will come through that and you can get the exact shade.

 

[PearlySweetKate]

Thanks for the suggestions, guys. I appreciate it.

PDC, the shades were 1m1 and (.)5m1. At first, I was like, how is this possible? But the dentist told me that this patient has been bleaching her teeth for a long time and obviously the stumps that were covered with a crown, the bleaching agent didn't affect.

I ended up chatting with one of my nearby resources, and I pressed in an MO0 ingot. HOLY REACTION LAYER!!! Does anyone else find that MO ingots have a heavy reaction layer?

I'll finish the crowns today and see how things turn out.

I will recommend a couple of things to the dentist as well, maybe going with a PFM next time or trying to bleach the stumps a bit? Any other recommendations for future situations?

Again, you guys are all awesome. As a newbie tech, I appreciate all of your wisdoms.

 

[PDC]

Thanks for the suggestions, guys. I appreciate it.

PDC, the shades were 1m1 and (.)5m1.

Sorry, I didn't catch that (.). I didn't have my loupes on!

 

[PearlySweetKate]

Okay, so, the restorations were too opaque. I've done some more reading on this, and will take the restorations, cut back, and layer porcelains on them for practice. I'm also going to redo the crowns, and press in LTBL2 after sitting chairside and taking shades and pictures with the doctor, and she said that she'd use a little more opaque of a cement to help block out the dark stump shade.

 

[JMN]

Did you wash the situation through this app that Mr. Patrick Coon pointed out to us? It does require a login, but this is what it was intended to help with.

https://play.google.com/store/apps/details?id=com.ivoclarvivadent.shadeselector

 

[PearlySweetKate]

Did you wash the situation through this app that Mr. Patrick Coon pointed out to us? It does require a login, but this is what it was intended to help with.

https://play.google.com/store/apps/details?id=com.ivoclarvivadent.shadeselector

Oh wow, I'm going to check this out. Thank you!