By Kelley Brummett, DMD 

A situation occurred in my office when I was working with a patient who needed a 30-year-old PFM crown replaced on #8. I was struggling with the shade because the adjacent teeth were an in between color. What I did was take a shade photo of the brightest one, which was B1, and then I took a shade photo with A1–because those were the two shades that matched the best. They weren’t what we were looking for. So, I made a provisional out of the A1 shade and a a provisional out of the B1 shade. I took the extra time to place both of them onto the tooth and let the patient look with me and help me decide. The patient chose the A1 shade. 

After I placed the A1 provisional, we sent  photos to my lab. These photos included the first shade photos of B1 and A1 alongside the tooth, photos of the B1 and A1 provisionals, and photos of the provisional I placed on the tooth from various aesthetic views. I then talked to the lab over the phone while we viewed the photos together so they could create the right in-between shade.  

At the end of the process, my patient expressed gratitude for taking the extra steps and meeting her expectations for a beautifully blended smile. 

The dreaded single central crown… How many of us feel confident that we can deliver an acceptable restoration on the first try?

We even prepare our patients for the inevitable follow up appointments to “fine tune” the shade. Let’s not even start the discussion of how to charge for this. So, maybe we just veneer the other central for a better match, even if it didn’t need the restoration. If we are hoping to preserve as much natural tooth structure as possible, then obviously this is not ideal.

An Incredibly Technical Task

Shade matching in the anterior, especially for a single tooth, is one of the most difficult endeavors in dentistry. The level of accuracy has to be so high it can become frustrating for the dentist, ceramist and patient very quickly. The subjectivity of this incredibly technical task only serves to further complicate the results. If a picture is worth a thousand words, then it takes a novel to describe a single anterior tooth!

The eLab Alternative

What if we could quantify shade in a way that guided the technician in creating the restoration? What if we could perform a “digital try in” with a high level of accuracy? What if we could know with a higher level of certainty what truly isn’t right about the shade and make the correction in the lab? This is what the eLab protocol provides us: quantitative shade matching using calibrated polarized images, a digital try in and more success.

At the 2019 Annual Pankey Meeting in September, I will present the eLab protocol and describe image acquisition and calibration so the technician can use this information to aid in both fabrication and verification of the final restoration.

Wouldn’t you love to work more predictably with your technician, even when in different geographic locations? Join us from September 12-14 to see what’s possible!