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Dark Single Central Incisor

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One of the docs in my practice referred this younger woman to me to match her darker endo treated Central to the rest of her dentition

So the tooth wasn't that dark and she had previous attempts at some internal bleaching but obviously the previous dentist wasn't able to get it dark enough.  I was pretty conservative with my prep and didn't reduce the facial more than I typically prep.  My plan was to use an MT or Impulse block.

I ended up using a V3 Impulse block and used eMax stains for this case.  I actually added a little bit of composite on the mesial of #8 & 9 in order to close her gingival embrasure a little more and then biocopied what I had done.  I was pleased with this case and really happy that I didn't need to go with a lower translucency block.  With the pics blown up I may have put a little too much translucency on #8 but the patient was thrilled and didn't want me to change anything.   A few of these pics have some try in paste residue on the tissue.  I ended up needing to tone down the value a touch so I cemented with Variolink Esthetic Warm.


Very nice Daniel 

you only had one version of your crown to try in - and you varied the tryin paste?


Daniel,
Great work. One of the toughest things we do in dentistry. Patient of course was thrilled. And great eye to correct the gingival embrasure.
Tom


Daniel,

Great job. Agree with Tom, great eye!

Carrie


Great shading and result!!!!


That is a great case.

Nice work.


Excellent


Great job!  Single central on a young woman can definitely cause a little anxiety, but you nailed it. 


@Ken...not sure if I will answer your question or not but I only had milled one crown at this point and I felt it was a touch bright so I tried in with a neutral and warm try in pastes to see how the two looked. I felt I was close in other aspects so I was very comfortable with just using a slightly warmer shade of Variolink Esthetic


What an amazing service to your patient - Excellent execution.  How you we ever go back to sending this to a lab. (10 times)

Greg


That's a BEAUTIFUL case!  Matching a single central crown is the most challenging single crown case in the mouth. PERIOD.  

 

You nailed it!  Bravo!


On 1/8/2016 at 12:57 pm, Greg Heideman and Spencer Luth said...

What an amazing service to your patient - Excellent execution.  How you we ever go back to sending this to a lab. (10 times)

Greg

Thanks everyone!  5 years ago I would have never envisioned myself preferring to do Single Centrals in the office on the same day but it's what I do.  Sometimes I nail it first try sometimes it takes a few firings but fortunately I don't have to recement the provisional again, and send the patient back home hoping and praying that the lab gets it right the next time.  The journey has been a great one and thanks to CEREC doctors for showing me what's possible and Faculty like Skrammy and Sam for breaking it down and teaching us how to evaluate these cases before we start and how to execute them.

 


Wow,  that was great work.


This is an update of a case that I did almost 2 years ago.  The quality of my photography was not great back then, but I'm still really happy with this case.  The subtle imperfections were a by product of doing biocopy.  I had missed her on a few recalls so I couldn't get some better photos. I finally just had her come in to get some updated photos.  

 


Hey I know that profile shot! I stole the idea from Yao Lin :) Looks great!


Great work


Very nice Daniel.

 

 


That's a homerun to deep center, center fielder never even moved a foot.


Dear colleague

These cases do not need ANY restorative treatments!!
Just do an internal bleaching and in most cases this solves the problem.

best regards
Alessandro Devigus

Alessandro,

Thank you for the suggestion. I had stated in the post that internal bleaching was tried and did not work. She was looking for another solution. This was the option she elected to proceed with. Every treatment has its risks and benefits. She was well aware her risks and alternative solutions

Dan


Dear Dan

Sorry, I didn't see that! In this case it was the next option and you did it very well!!

best, Alessandro

Alessandro,

I would definitely say internal whitening is oftentimes the ideal treatment. I think many would agree that it is technique sensitive and results between clinicians will vary. Recently Dr YaoLin Tang posted a case where he got amazing results.

If you some cases showing what you did and how you did it, I definitely think there would be a lot of interest in a post showing that.

Dan


On 9/21/2017 at 8:08 am, Daniel Wilson said... Alessandro, I would definitely say internal whitening is oftentimes the ideal treatment. I think many would agree that it is technique sensitive and results between clinicians will vary. Recently Dr YaoLin Tang posted a case where he got amazing results. If you some cases showing what you did and how you did it, I definitely think there would be a lot of interest in a post showing that. Dan

Daniel,

Amazing result even after 21 months after.

Your patient must be still thrilled by the result.

Thank you for mentioning about my recent post regarding the  "internal bleaching"

Here are the before and after photos ...

 


On 9/20/2017 at 9:16 pm, Kristine Aadland said...

Hey I know that profile shot! I stole the idea from Yao Lin :) Looks great!

Kristine,

love that profile shot to show the contour and  texture.....

Daniel did not steal from me....we "share"......... 

:)

 

 


I have been taking this shot consistently now because it forces me to evaluate the contours from another dimension and make sure I'm paying attention to this too