Zirconia Suggestions to match a PMMA......

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UCan'tHandleTheTooth!

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Hello all. I've been doing a fair amount of full contour , all-on- four cases that we mill out of Cercon HT zirconia. I've been having some trouble hitting shades properly . On the case we tried in today, Im convinced that I cant hit this shade with full contour Cercon Ht.... This patient loves her upper PMMA. The PMMA looks relatively colorless next to an A1 or B1 tab. It exhibits none of the yellow or warmth that is in these shade tabs. The actual hue of the body shade looks to match an 0M2 body color; But it looks grayed down, to where the the value is closer to a 2M1 . Lets say 1m1 would even work ( The value looked in between these 2, BUT CLOSER TO THE 2m1) The Cercon Ht B1 is too tan or beige in color , The next step for me is the BL2 bleach shade, but the HT version of the Cercon will be very bright . Does anyone have any Zirconia suggestions for this type of situation full contour; or do you think that cutting back the whole labial and layering will be the only way to achieve desirable esthetics in your opinions? I have no experience infiltrating color into my zirconia ; the learning curve for this option seems impractical for me on this case. But , I'm open to any suggested options that will get me to the promised land here. Thanks!
Brandon
 
JMN

JMN

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I'm gonna guess that explaining material degradation changes the material's shade profile to one that that teeth do not ever become is out of the realm of possibilities?
 
Brett Hansen CDT

Brett Hansen CDT

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I haven't seen a preshaded Zirconia yet that actually matches a shade tab. The last one we tried was the Cercon HT A2. RenderedImage.jpg

The value is just never right. We infiltrate all our zirconia with stains prior to sintering. We get much better results with that technique.
IMG_3793.jpg

This was done with Zircad LT. We can do a better with the Zircad MT. Preshaded zirconias have worked well for cases where we are restoring a front 6 because you aren't matching natural teeth. I am surprised the patient is complaining about the shade on your case. If you just wanted to dip your toes in the water on infiltration, just putting on an incisal stain can really make the preshaded zirconia look a lot better.
 
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UCan'tHandleTheTooth!

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I have had mixed results with the Cercon XT and XTML..... I've managed pretty well , but still struggle to find a good puck for certain shades. On these large full arch or all on four cases, I'm stuck with only a couple of options that have the required MPa. B1 is a shade I seem to struggle to hit. Most pucks seems to have a dominate color that works against me when I'm trying to get the right hue. I appreciate the feedback.
 
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i know i talk a lot about zirkonzahn but i would look at their prettau 2 dispersive and maybe micro layer over the top i you need to customise the shade more. we are getting beautiful results with it.
 
rc75

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I have had mixed results with the Cercon XT and XTML..... I've managed pretty well , but still struggle to find a good puck for certain shades. On these large full arch or all on four cases, I'm stuck with only a couple of options that have the required MPa. B1 is a shade I seem to struggle to hit. Most pucks seems to have a dominate color that works against me when I'm trying to get the right hue. I appreciate the feedback.

Call me. I'll send you a sample of our Multilayer Zirconia we have several options.
 
JMN

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I haven't seen a preshaded Zirconia yet that actually matches a shade tab. The last one we tried was the Cercon HT A2. View attachment 37652

The value is just never right. We infiltrate all our zirconia with stains prior to sintering. We get much better results with that technique.
View attachment 37654

This was done with Zircad LT. We can do a better with the Zircad MT. Preshaded zirconias have worked well for cases where we are restoring a front 6 because you aren't matching natural teeth. I am surprised the patient is complaining about the shade on your case. If you just wanted to dip your toes in the water on infiltration, just putting on an incisal stain can really make the preshaded zirconia look a lot better.
I've gotta ask about the object used as the background. My sister had a jacket that looked like that in the 90s.
 
Brett Hansen CDT

Brett Hansen CDT

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I've gotta ask about the object used as the background. My sister had a jacket that looked like that in the 90s.
Its the countertop material of my desk where my design station is. :) I didn't notice how 90's it was until I zoomed in on it.
 
JohnWilson

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The easiest path is to use a quality PMMA that matches a guide so you have a larger window of opportunity and material choices to hit the final shade in Zirconia.

Many of the lower cost PMMA will not be as consistent to the guide or from lot to lot. We use Harvest multi and the shades are very close to what we can match with Argen HT+
 
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ztech

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The easiest path is to use a quality PMMA that matches a guide so you have a larger window of opportunity and material choices to hit the final shade in Zirconia.

Many of the lower cost PMMA will not be as consistent to the guide or from lot to lot. We use Harvest multi and the shades are very close to what we can match with Argen HT+
Don't start using the Harvest PMMA. Ir is difficult enough now to get some shades. If everyone starts using it, we will never get B1 again. JK. Great material, Polishes well and holds up as long term interim restorations.
 
Car 54

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Telio Cad is still one of my favorites. Even though it's not a gradient PMMA, it still has a nice look to it, without being low value. It also gives you and opportunity to end up with an accepted restoration, compared to some of the gradients that can look so good, it's hard to beat it when doing the final crown(s).
This is the shade tab I used to help with the slightly lighter PMMA temp (implant case) and the slightly to much chroma and low value 2M1 tab.


IMG_3498 - Copya.JPG.
 
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