Dentaltown January 2020 - 49

Fig 2: The introduction of a white balance gray reference card (www.emulation.me) with a known color
coordinate facilitates the calibration of images.

Photographing in the RAW format with
the restoration on the virtual die, these images
can also be color corrected with the white
balance gray reference card.
The two images-the clinical condition
and the lab bench result-can then be overlaid
and determined if our goals of micro-aesthetics
have been met. Only then, with this quality
control in place, can the restorations be
forwarded to the clinician for try in and
delivery. The intention is to eliminate the
multiple chairside visits sometimes necessary
to dial in the shade for a single central incisor.

Case example

Fig. 3: The fabrication of color-correct dies by the laboratory technician simulates the clinical condition
on the lab bench to allow for interpolation of the underlying tooth structure.

Fig. 4: Clinical preoperative condition, requiring limited restoration within the smile zone.

Using the "virtual
try-in" technique
The technologies of dental materials
have evolved to the level of strength and
beauty that now rivals nature. These
restorations can be created in very thin
cross-section and can impart a high degree of
natural translucency. Our challenge involves
dealing with discolorations of underlying
tooth structure and the inf luence they
may have on the fi nal restoration once it's
delivered. This often requires interpolation
and guesswork by the ceramist. This can

be overcome and tested in the laboratory
by creating custom color dies. These dies
are fabricated from materials available to
the ceramist that replicate the shades of the
clinical preparations and are determined
once again from the photographs that
the restorative dentist provides of the
preparations.
With the color-correct dies in hand, the
newly fabricated indirect restorations can be
placed onto these dies with the same try-in
paste that the clinician will use to try the
restorations in chairside (Fig. 3).

This patient presented with a history of
traumatic injury to her anterior teeth. She
previously had bonding to correct the defects
of teeth #8 and #9; these restorations had
interproximal extensions to repair previous
caries and began to discolor with time. Her
end goal was to improve the appearance of
her anterior teeth with the most durable
option possible (Fig. 4).
In all aesthetic cases, it is critical to
follow our understanding of the criteria
of smile design. The American Academy
of Cosmetic Dentistry's Contemporary
Concepts in Smile Design provides us with
the gold standard of this commonly accepted
nomenclature. These criteria of smile
design are conceptually organized from
our broadest field of view and progressively
narrowed.
1. Global aesthetics. Those criteria that
focus on elements of smile design that
are observed in unretracted smiles and
how the smile orients to the face and
the lips that drape the smile.
2. Macro-aesthetics. Those criteria that
focus on the shapes and contours of
the teeth and their relationship to each
other.
3. Micro-aesthetics. Those criteria that
relate to the subtle intricacies of shade,
textures, translucencies and surface
effects that make teeth look like teeth.
By speaking the same language, both
restorative dentists and lab ceramists will
dentaltown.com \\ JANUARY 2020

49


http://www.emulation.me http://www.dentaltown.com

Dentaltown January 2020

Table of Contents for the Digital Edition of Dentaltown January 2020

Dentaltown January 2020 - Intro
Dentaltown January 2020 - Cover1
Dentaltown January 2020 - Cover2
Dentaltown January 2020 - 1
Dentaltown January 2020 - 2
Dentaltown January 2020 - 3
Dentaltown January 2020 - 4
Dentaltown January 2020 - 5
Dentaltown January 2020 - 6
Dentaltown January 2020 - 7
Dentaltown January 2020 - 8
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Dentaltown January 2020 - Cover3
Dentaltown January 2020 - Cover4
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