Great Shading Depends on Great Dentist/Lab Communication
Success of cosmetic dentistry to a large degree depends on effective collaboration with the dental lab. Dentists should work closely, and communicate freely with their dental lab to get the ideal shading on their products. Patients trust their dentist for restorative work when they are dreaming of their perfect smile. Equipping the dental lab with the tools and data necessary to produce the perfect color match is one of the most vital steps in any type of cosmetic dentistry procedure.
By. William R. Mrazek B.Sc., CDT
The following information is designed to educate the technician, dentist, and dental assistant in the accuracy, predictability, and efficiency of the VITA 3D-Master Shade system. I have included a list of recommendations for shade taking technique to help reduce the variables and increase the accuracy and predictability of the shade taking process.
The utilization of the 3-D Master system over the traditional Classical system provides a more realistic approach and provides a greater selection of measurable shades based upon value, chroma, and hue.
While somewhat intimidating and confusing at first, the original 3D-Master guide has been redesigned in two newer formats, that make it much easier and understandable to anyone involved in the shade matching process. While I personally, as a ceramist, prefer the original design with all the shades on one holder, the newer designs certainly simplify the chairside shade taking process.
I hope that you find this information valuable and useful in your goal to achieve consistently accurate shades utilizing what is, in my opinion, the most accurate and predictable vision-based shade selection process available today.
Shade Taking Tips
- Make sure the patient is sitting in a normal upright position when the shade is being taken, NOT in the horizontal operative position. The angle at which light enters the mouth significantly influences how the shade is perceived. Do not use the chair operatory light as a light source for shade taking unless it has a 5500 degree color corrected light option.
- Install color corrected 5500 degree K. rating in the shade taking area, or utilize an accurate digital shade taking device, such as the VITA EASY SHADE.
- ALWAYS take the shade before prepping the tooth. Verify the shade after prepping only if the adjacent teeth have been kept completely hydrated during prepping.
- Position the shade tab in the same position (maxillary or mandibular) as the tooth being measured
- Always view the shade from both direct and slight indirect viewpoints.
- Allow the patient to review your choice in a sitting up position. Make sure they hold the mirror at arm’s length (speaker’s distance) from their face. This also applies when the patient is evaluating the restoration at delivery. Holding the mirror at arm’s length also allows for the proper amount of light to enter the mouth.
- View the shade of the restoration under natural daylight, incandescent, and fluorescent light if the restoration is supported by a metal coping or framework due to metamerism.
Proper Positioning of Shade Tabs for Dentin and Incisal Matching
- Educate the patient about metamerism, especially when a light or bleach shade PFM is being fabricated.
- Always take a shade of the preparation when prescribing an all-ceramic restoration. A dark colored prep will have a direct effect upon the final shade of the restoration, and must be compensated for by the laboratory.
- If you’ve narrowed your shade selection to two shades, select the lighter of the two. It is much easier to increase the chroma and/or lower the value of a restoration, than it is to make it lighter or brighter.
- Do not stare at a shade for more than 5-10 seconds. The longer you stare, the more similar the shades will appear. To help readjust your eyes for yellow and orange acuity, look at something blue for a few seconds before evaluating the shade again. A blue dental bib works very well, and is conveniently located under the patient’s face, as well.
- Remember that a single central incisor is the most difficult shade match there is, and advise the patient of this, as well. These restorations sometimes require additional adjustments and should be taken into consideration in the event the patient needs the restoration by a specific date (usually a wedding).
- If the patient is considering or in the process of bleaching, do not attempt to predict the final shade. This is a guaranteed remake!
- If the patient is bleaching at home, advise them to stop when their teeth match the whites of their eyes, therefore maintaining an esthetic balance of their face.
- If the patient has completed the bleaching process, do not take the shade until a week after the last bleaching application, as it is common for a slight ‘bounce back’ to occur immediately after bleaching is finished.