Crowns And Other Extra Coronal Restorations Aesthetic Control Flashcards
What are the steps of aesthetic control
Identification and definition if the pts aesthetic problem
Consideration of the balance between aesthetics and tooth destruction for conventional and adhesive Restorations
An awareness of the aesthetic limitations of Restorations and an attempt to ensure that the pts expectations are realistic
Incorporation of procedures leading to better aesthetics at each clinical stage
Confidence in determining shade and communicating effectively with the lab
What are the different types of lab made aesthetic Restorations
All porcelain All composite Ceramo metal crown Composite bonded to metal crown Partial coverage metal crown
What are the different types of all porcelain lab made aesthetic Restorations
Conventional porcelain jacket crown High strength porcelain jacket crown Full coverage porcelain veneer dentine bonded crown Porcelain labial veneer Porcelain onlay
Lab cam use composite to make what Restorations
All composite crown
Veneer
Onlay
What factors contribute to dental aesthetics
Dental
Mucogingival
Facial
General
What are the dental aspects of aesthetics compared to Mucogingival
Dental: shade contour texture shape position arrangement interproximal contacts incisal embrasures gingival embrasures incisal level posterior occlusal level
Mucogingival: margin level margin pattern shape of papilla colour thickness
What are the facial aspects of aesthetics
Lip levels are rest
Lip levels in function
Centre line
What are the general factors contributing to facia aesthetics
Age
Occupation
Gender
Personality
What is the scheme for shade determination
Determine shade at the start of the appointment before the risk of eye fatigue and tooth dehydration with resultant shade change especially after use of rubber dam
Use either natural light or colour corrected artificial light soyrce
Drape the pt with a neutral coloured cover if clothing is bright and have the pt remove brightly coloured makeup
Assess value by squinting the reduced amount of light entering the eye may allow the retinal rods to better distinguish degrees of lightness and darkness
Make rapid comparisons with sgadr tabs no more than 5 seconds each viewing gazing at a soft blue colour between attempts is said to reduce blue fatigue which can result in accentuatuon of yellow orange sensitivity
The canines have high chroma and may be a useful guide to assessing hue
Compare the dominant hue and chrome within the value range chosen
Compare selected tabs under different conditions Eg wet vs dry different lip positions artificial and natural light from different angles
Select a shade which is higher in value lighter if in doubt surface stains can reduce these dimensions but not easily increase them
Look carefully for colour characterisation such as stained imbrication lines white spots neck colouration incisal edge translucency and halo effect (a thin opaque line sometimes seen within a translucent incisal). Shade tabs exactly representing the pure porcelains and stains available can be useful for this task. Simple diagrams are invaluable
Determine surface lustre
What are the benefits and drawbacks of porcelain as a material
High cost
Removal of tooth tissue and potential for damage to the pulp and periodontium
Benefit of stunning porcelain work is easiest to achieve where a thick layer of material can be used to develop the optimum optical properties this requires more tooth tissue removal
So the choice is either
- sacrifice aesthetics for long term health
- take a risk with long term pulp health to maximise aesthetics
Name some adhesive Restorations and their drawbacks
Porcelain laminate veneer
Dentine bonded crown
Problem of masking the colour of darkly stained teeth
Problems with temporisation
Inability to cement Restorations provisionally
What is the advantage of a Conservative approach?
Less pulp mobility/risk of pulp damage
More tooth remaining should the need arise to remake the restoration
