What material would you choose to mask a dark tooth?
Here is a patient that recently came to me frustrated because she had three different dentists try to fix her front tooth and the shade was "never quite right." She had pretty severe trauma that resulted in a root canal and it needed full coverage due to missing tooth structure.
Anytime I hear that a patient has gone to multiple dentists I get a little nervous. She was upset because the first dentist "cut down her tooth a lot" and "it turned black underneath." She lost trust in the first dentist and went to the next dentist where other problems kept happening. One of the other dentists referred her to me to see what I could do.
She liked the shape of the tooth, but the crown was definitely bright. Part of the problem I saw was that her teeth were pretty translucent and the previous dentists kept trying to use zirconia to mask the darkness of the prepped tooth. This is when opaquers come in so handy!
I applied the pink opaquer to mask the black and then used buildup material and A1 opaquer to make the substructure appear more natural.
I milled out both an e.max B1 MT block and a Vita Mark II, 1M1 block for this case and I ended up using the Vita block. I wasn't worried about strength as much as I was about the color. The Vita tended to have a little more warmth in it than the e.max.
I warned her ahead of time that I couldn't get rid of the greyness of her root showing slightly at the gums, but with her smile I think it masked pretty well. The opaquers were my saving grace for sure in this case.
On 4/3/2019 at 9:35 am, Tom Monahan said...Great work Kris.....but now you're on the VITA train, you aren't going back
Ha...the young Jedi is going to the dark side 
On 4/3/2019 at 10:16 am, Armin Giessmann said...Was internal bleaching and then using a stable post no option?
Armin, this isn't my case, but there was an old crown that was removed....
I think internal bleaching will not yield a stable result. Also, I just ordered some of the pink opaquer. Thanks for the tip!
On 4/3/2019 at 11:27 am, Armin Giessmann said...I saw that, but is that an argument against internal bleaching?
Great result!! like the plan to have 2 of them milled.
I bet the patient was excited, 100 times better. Good Job!!
