help!!!!!!!!! need some guidance with a shade please.

[Randy Hill PhD]

Doc sends in #'s 12,13 with shade NOritake NW0 right. So I mixed up some opaque, mostly white opaque modifier, with white porcelain modifier basically serving as the dentine, covered with white enamel. Nailed the shade tab. I was happy.

Patient comes in and these two were headlights compared to her teeth. Doc snaps a pic with the NWO tab next to her teeth, and yup, way too opague. I strip the Pfm's (long story on why PFM's) and make more of a B-1 with white enamel and some Extra Light enamel for translucency. No other pics provided.

Get them back today ( joy, joy),with a new shade tab and a note saying this is the closest shade tab he could find. (why not send this the first time?) Shade is VF Harmonique A000!!!!!!!! WTF?

Any help any of you could provide on converting this. I'm over this crap of making chicken salad out of chicken ......! Her teeth are white with blueish translucency. I've never even seen this shade guide before.

Thanks in advance

 

[rkm rdt]

I would begin by eliminating the metal.
It may be a long story but that's where it begins.

Not many cases that I find fall out of the scope of the Vita 3D shade guide.It is designed to translate shades better than a direct composite guide.

 

[Car 54]

I've never heard of the last shade request he gave you. You do have the tab though, right, as well as some previous photos and what you used,
so you're not totally in the dark.

I think an issue is you were using to much "white on white", the opaque needs to be a warmer shade, like 1/2
step "darker" than the shade, to help to keep from getting the headlight look, to give it more depth. I've seen it happen to me before and heard
other lab gurus mention the same thing (Peter Pizzi?)

 

[user name]

Patient cant stop by the lab for a check?

 

[Randy Hill PhD]

I've never heard of the last shade request he gave you. You do have the tab though, right, as well as some previous photos and what you used,
so you're not totally in the dark.

I think an issue is you were using to much "white on white", the opaque needs to be a warmer shade, like 1/2
step "darker" than the shade, to help to keep from getting the headlight look, to give it more depth. I've seen it happen to me before and heard
other lab gurus mention the same thing (Peter Pizzi?)

I agree with the opaque being a half shade darker. Have you ever just put lustre paste on opaque and fired it just to test it for shade? This shade, according to the out of town Dr., has some blue/gray tones to it, so I'm contemplating knocking down just a touch of the white opaque with just a hint of lustre paste and almost building the whole crown with enamels.

 

[Randy Hill PhD]

Patient cant stop by the lab for a check?

out of town Doc/Patient, and all I have are some phone pics which aren't the best, but the pics I have include the Whole NWO and NW.5 holder! Messing with my eyes.

 

[Randy Hill PhD]

I would begin by eliminating the metal.
It may be a long story but that's where it begins.

Not many cases that I find fall out of the scope of the Vita 3D shade guide.It is designed to translate shades better than a direct composite guide.

Wish I could. This guy still does tons of PFMS with 360 degree metal collars. What a PITA to wax, finish and polish all that. Even on anteriors. taught this by his predecessor who sold him the practice. No extra cash for all that additional work either!

 

[rkm rdt]

Wish I could. This guy still does tons of PFMS with 360 degree metal collars. What a PITA to wax, finish and polish all that. Even on anteriors. taught this by his predecessor who sold him the practice. No extra cash for all that additional work either!

Too bad he won't let you take advantage of the core shade assuming it is not discoloured.

My sarcastic approach would be to point out that the shade is irrelevant considering the eyes will be directed towards the silver line at the gums.

Good luck,we will be monitoring your sanity level throughout the year.

 

[user name]

I agree with the opaque being a half shade darker. Have you ever just put lustre paste on opaque and fired it just to test it for shade? This shade, according to the out of town Dr., has some blue/gray tones to it, so I'm contemplating knocking down just a touch of the white opaque with just a hint of lustre paste and almost building the whole crown with enamels.

Id like to see the pics youre working with. Bleach is a b!tch. Convert your pics to black and white to get a better grasp of value.

PFMs be damned. Id send him some FCZ. Once designed, mill some out of a couple different white candidates. Shotgun approach, but better than back and forth.

 

[CatamountRob]

Id like to see the pics youre working with. Bleach is a b!tch. Convert your pics to black and white to get a better grasp of value.

PFMs be damned. Id send him some FCZ. Once designed, mill some out of a couple different white candidates. Shotgun approach, but better than back and forth.

If you make a crown that wasn’t prescribed and they place it and it goes bad, you’re on the hook for the liability and it’s not going to matter why it went bad. I’d get the Rx changed first.

 

[Randy Hill PhD]

Too bad he won't let you take advantage of the core shade assuming it is not discoloured.

My sarcastic approach would be to point out that the shade is irrelevant considering the eyes will be directed towards the silver line at the gums.

Good luck,we will be monitoring your sanity level throughout the year.

My sanity level is already on overload. This is one tough city to get accounts to even look at your portfolio. Gatekeepers!!!!!! It's been depressing as hell to go a year without a steady paycheck. After 44 years, may have to hang it up. We have a dental school here.......... sending to China. It's a joke and a good ol' boys club.
I've devoted a lifetime to this kinda crap. Six freakin degrees and putting up with this is nonsense!
I' try to take some pics of this before it goes out. This doc has one foot out the door anyway. He's only using me because I'm cheaper than Root Dental Lab.

 

[user name]

If you make a crown that wasn’t prescribed and they place it and it goes bad, you’re on the hook for the liability and it’s not going to matter why it went bad. I’d get the Rx changed first.

When I took on one of my biggest accounts, I said the conditions are: you prescribe what teeth we're doing and the shade. I decide what theyre made of. Makes things much easier. My point to them was, Im not doing cast crowns or pfms. If its esthetic and im expected to make it a winner, maybe Ill press it, maybe Ill mill it and layer. My choice.

 

[rkm rdt]

When I took on one of my biggest accounts, I said the conditions are: you prescribe what teeth we're doing and the shade. I decide what theyre made of. Makes things much easier. My point to them was, Im not doing cast crowns or pfms. If its esthetic and im expected to make it a winner, maybe Ill press it, maybe Ill mill it and layer. My choice.

I had to go that route as well.
Best advice I ever got from Al was to take better pictures.
Did I follow that advice? Well not really but it was still the best advice.

 

[user name]

out of town Doc/Patient, and all I have are some phone pics which aren't the best, but the pics I have include the Whole NWO and NW.5 holder! Messing with my eyes.

Sometimes its a tough choice.

 

[Randy Hill PhD]

I've never heard of the last shade request he gave you. You do have the tab though, right, as well as some previous photos and what you used,
so you're not totally in the dark.

I think an issue is you were using to much "white on white", the opaque needs to be a warmer shade, like 1/2
step "darker" than the shade, to help to keep from getting the headlight look, to give it more depth. I've seen it happen to me before and heard
other lab gurus mention the same thing (Peter Pizzi?)

I took your advice and "toned down" the whiteness on some old Vita metal tabs they used to sell for you to be able to mix porcelains on and try. Toning it down helped a lot! I've never done this before on a pfm, but I built the entire crown out of Extremely light enamel, and then covered it with a layer of the same porcelain, but with a 25% Blue Enamel. Looking at the shade tab, I think I have it pretty close. Still have those metal collars that just make you want to ask yourself why? Make a Lisi crown out of one of the enamel ingots and let it rip!

I lost my ass on this case! I hate to lose an account for any reason, but with this case and another 9 unit bridge I'm having to remake because he said it didn't fit the mouth, but fit great on the working and sold models, he gets his pants in a wad and another lab calls me and says they are looking for another lab. He doesn't want their work, for he is totally digital, but was kind enough to tell me the office manager had called him. This was right after I had talked with the office manager to see how things were going and I was assured things were fine.

I know crap like this happens, but we can't consistently make chicken salad out of chicken ****, but Lord knows if something goes south, we all know which way that turd will roll!

Thanks for all your help. Keeping my fingers crossed.

 

[rkm rdt]

That was decent of your other lab friend to give you the heads up.
I would start looking to replace this loser.

 

[Randy Hill PhD]

That was decent of your other lab friend to give you the heads up.
I would start looking to replace this loser.

It honestly has caused me doubt why I'm even in this business any longer. I saw work like Al's and was so inspired to give it more time, more practice, more energy, and each and every time I do, this kind of crap happens. It just leaves me feeling completely empty and useless. I know I'm not an Al Hodges, or any of you with such remarkable talent that I've seen on this site and Facebook. Yes, I realize Dr's still want PFM's with facial collars. I get it. I'm just sick of the ups and downs of this business. I'm not that super fast stacker with mad skills. I'm a one man band, which essentially paints me in my own corner.
Why do I want to invest in CAD/CAM at 62? So I can sell crowns cheaper, make them faster, and still have a majority of Drs bitch about the freaking sky being blue.?
Someone will always sell it cheaper, and cheap seems to be the catch all.
Thanks to all of you for your input.

 

[rkm rdt]

It honestly has caused me doubt why I'm even in this business any longer. I saw work like Al's and was so inspired to give it more time, more practice, more energy, and each and every time I do, this kind of crap happens. It just leaves me feeling completely empty and useless. I know I'm not an Al Hodges, or any of you with such remarkable talent that I've seen on this site and Facebook. Yes, I realize Dr's still want PFM's with facial collars. I get it. I'm just sick of the ups and downs of this business. I'm not that super fast stacker with mad skills. I'm a one man band, which essentially paints me in my own corner.
Why do I want to invest in CAD/CAM at 62? So I can sell crowns cheaper, make them faster, and still have a majority of Drs bitch about the freaking sky being blue.?
Someone will always sell it cheaper, and cheap seems to be the catch all.
Thanks to all of you for your input.

Just remember that you are not the only one going through this.

 

[Randy Hill PhD]

Just remember that you are not the only one going through this.

yes, but when the bill collectors, call, they only ask for me. lol

 

[Sda36]

It honestly has caused me doubt why I'm even in this business any longer. I saw work like Al's and was so inspired to give it more time, more practice, more energy, and each and every time I do, this kind of crap happens. It just leaves me feeling completely empty and useless. I know I'm not an Al Hodges, or any of you with such remarkable talent that I've seen on this site and Facebook. Yes, I realize Dr's still want PFM's with facial collars. I get it. I'm just sick of the ups and downs of this business. I'm not that super fast stacker with mad skills. I'm a one man band, which essentially paints me in my own corner.
Why do I want to invest in CAD/CAM at 62? So I can sell crowns cheaper, make them faster, and still have a majority of Drs bitch about the freaking sky being blue.?
Someone will always sell it cheaper, and cheap seems to be the catch all.
Thanks to all of you for your input.

Dave @ 60 yrs...tough grind for sure but adopting Cad Cam many years ago was my best decision. You know, always weighing this, that and the other becomes a massive brain drain. Having said that, realising and adopting the furture has kept me in the game for sure and...you're only a "step" behind at this point in time. You will see New avenues evolve before your eyes. Revenue generation is purely based on you're pursuit. If, you don't assimilate, you will be punished... Not meaning to joke At All, I have many a sleepless night still, with our industry, but, some new tools have been laid in our path, somewhat like "God and the rowboat" theme.

If your work is truly appreciated by your clients, you have Enormous worth!!! Never, ever forget 1 oz of all of the training, searching, practice and yes , time, often away from where you'd like to be.

Never Forget!

This really is a paridiam shift going on but hey, look at the printing industry afterwards and how they grasped and evolved. It's really only about delivering a product " In demand" at an affordable and profit generating equation.

You can do it!!! Do it you will [emoji6]

You will never be bored [emoji5]

Dave

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