The “Problematic” Single Central

One of the most difficult things we do as clinicians is trying to match a single central with an indirect crown. Determining proper dentinal and enamel translucencies, opacities, thickness, and shades all must be matched to the natural adjacent tooth to provide an ideal match.

The most important thing a clinician can do is provide excellent photos of the tooth to be matched along with shade tabs that most closely match the adjacent or contra-lateral tooth.

There are lots of shade guides available. My favorites are the Vita 3D Master (Vita), the Chromascop (Ivoclar) and the Vivodent PE (Ivoclar) Guides. When one of these shades from any of these guides, as well as many others that we have here at Keating, we have a much better chance to obtain a correct match.

When taking the photos of the shade tabs in place, try to keep the shade tab on the same two dimensional plane as the tooth you are trying to match so that it is the same distance from the light source.

Also, be sure that the shade tab # is always visible in the photo. Lastly, when your crown does come back from the lab, there is a high chance that it will not match perfectly, at least not the first time. Use this new crown as a custom shade tab and put it to place and photograph it again with different shade tabs. I always tell my patient that it may take several visits to obtain a shade that I am satisfied with.

For advice on cameras and set-ups, please give us a call at Keating Dental Lab. We can make some great recommendations.

David S. Hornbrook, DDS, FAACD

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