help incisors

[pdrmoura]

Hello,
I have stumbled across this web site recently and found it really helpful and inspiring, so I thought it would probably be a good idea to introduce myself. I am dentist from Portugal. I run a practice that has a dental lab incorporated. My father, my sister and my uncle, they all work with me and they are all dental technicians. However, my father and uncle are only interested on dentures, so my sister does all my crowns and implants.
I have showed them some of the cases on this website and they were all very impressed with the quality. I would love to be able to provide my patients with that kind of quality treatment.
So, I will post a couple of cases here, and maybe, you could help me with some ideas. We just want to deliver a great product and we feel we are needing some expert help.
I will post two cases now. In both of these cases the ips d sign porcelain system was used.
In the firs case two extractions were performed followed by two immediate placed implants. Provisionalisation was made by means of a denture. Two ucla screw type restorations were made. The final result did not please the patient completely. His complaint was that the crowns did not match his teeth color.
In the second case the central incisor was extracted then immediately replaced by an implant. Provisionalisation was made by means of a temporary fixed restoration. The final crown was cemented.
Well, here it goes.
Please comment. What could have been done better?

initial picture


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after provisionals


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finished case


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Patient 2
shade taking. patient is wearing a fixed provisional


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after provisional


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finished case


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we are waiting for comments
thank you very much

 

[charles007]

Welcome to DLT and thanks for posting your work........Your patient wasn't happy with the shade, that a simple fix.
Order the Vita 3D shade guide, I would try the newer guide called the Linearguide-Master. This one cost more, aprox $225. US and is more intuitive. Secondly, print out Rob's 3d conversion chart, Rob uses dsign and this will help.. OR go one step up and use Vita porcelain on your 3D shades. The new Vita Master porcelain is less technique sensitive than the 900 or 13.....
And lastly, order the shade tabs from the dsign porcelain kit.........if your doing emax, order them also.. Al here on DLN says it helps a lot with emax !
If your not doing emax, now is a great time to jump in, this web site has some of the best emax techs with hundreds of ideas !

Your first case, if you had the enamel shade tabs, you could have given the tech the exact shade of translucent porcelain to use on the central... would need to map out the shade, or pictures for you tech to see the transition of enamel to dentin. Also, with the 3D guide, the chroma level could have been spot on.......Value level first and chroma level are what jumps out when the shade is off.........
Just a few ideas.

Charles