Why Doesn’t My Crown Match?

Why Doesn’t My Crown Match?

hi, this is Luke Kahng
thanks for watching my video today’s topic is: “Why Doesn’t My Crown
Match?” from my 30 years of experience, we all the
time struggle regarding the color for single tooth matching,
like that everybody struggles, but there’s a reason
in this video, we’re going to show you how we can match a single tooth perfectly
stay tuned ok, let’s talk about the problem
number one: communication like this, it’s fuzzy
it’s too bright, blurry, you cannot see clear definition
you have to take a good high-definition photo regardless of what kind of camera you have
and then I need the shade tab number if you do not communicate it correctly
then the result is like this okay, one other miscommunication is the photo
being taken too far away you know what I mean
it’s too far, I want it a little bit more closer
then it’s much better this is a miscommunication
I have no idea what they want please do not send them like this if you really want to take good communications from the patient
if the patient wears lipstick you have to have them remove it
because it irritates the teeth the patient must brush their teeth before
you take the color make sense? Otherwise, when the patient drinks
Starbucks Coffee the whole pot, guess what? The other side
is all brown hue so I’m using the brown hue, and when it
is delivered to the dentist’s office it’s not going to match
my restorations will be darker than the other teeth even though this is a good photo, I like the crack line
I like the translucency, dull texture but I don’t have any shade tab
the problem with this shade tab is, even though it has the number
and here it’s pretty close to it and the match looks good
these are fake restorations so here’s a big problem
we work with this Vita shade guide and 3D Vita shade guide
it’s not match the natural adjacent teeth enamel dentition at all
I’d say only 5% this is high value, right
now think about it, everybody wants natural teeth
you know what natural teeth means? medium value or kind of a little less value
but fake teeth shade tab …you get a high value
so whenever you say B1, I make it B1 for you so my question to you, if you choose B1
you send it out to A B C different labs so you prescribe B1, “I want a beautiful
cosmetic” even if you send it out to three different
labs you’ll get the same result from that shade
tab that is, a completely fake restoration like
that this is a great illustration
so, I don’t want to make fake-looking restorations like I mentioned earlier
everybody wants a natural tooth crown how? Do not follow the shade tab exactly
so here are the instructions I did not follow like this
I did not follow like this ok, it is the base color here, A2
but the other one is BO and I added calcification in order to match
this one make sense?
I’m talking about naturalism, ok? it’s not like a McDonald’s cheeseburger
it’s not like 1+1=2, it’s not how do I know? I wrote over 100 articles regarding
single tooth shade matching you can read all my old previous articles
if you have time this is good picture, that I took
and then I see really detailed color at the same time I wrote down my color’s
number and then here’s the high value
but I can see the same value, I can check except translucency, and with the character
this is a finger print which God created for us
you see the fingerprint you cannot see with your eyes
but we can see with our macro camera number two, preparations
the mistake here is that after they prepped, they took the color
that’s the problem because whenever they prep the teeth,
it takes probably 10 or 20 minutes, 30 minutes, depends on the prep
and then after they prep it, think about it, their mouth is open
and they give them anesthesia and then they take time to prep
the problem is adjacent teeth are getting dehydrated
which means, the teeth lose color you see the more white-ish color
because there is no saliva, there’s no moisture so what I’m saying is,
whenever they prep and then take the color usually it will not match the adjacent teeth
later it’s very important concept
so what should you do? you have to take the color before you prep
see it’s especially kinda like that here it’s more dark than the other
probably that’s why look at the dehydrated teeth, getting more
white-ish alright, so what they can do after they try
with the crowns and they close lips, have them hydrate their
teeth with their saliva and then wait about the 30 sec or 1 minute
to get moisture you need a proper shade guide
I know everybody has this, this is more popular, it’s Vita
this is a classic, this is 3D unfortunately, none of them match natural
teeth I’m telling you, only 5% match
Only matching completely any fake restorations in the patient’s mouth
so not only that, I can utilize these shade tabs
which is from the porcelain system by GC Initial porcelain system
they have their own shade tabs that are thin about 1 mm
they indicate enamel colors, and then i can prescribe it
so you make a better color internal color will effect my final restoration when I have lack of room
especially this, same size facially if I’m using LiSi Press or all ceramic restorations
you will see a slightly different color than the other
so the color differs so how can you solve?
easy, when you think there’s dark color then prep a little bit more than normal
that is more helpful this is LiSi Press, this is full contour
now this is a detailed indication of the thickness the thickness will change everything
so whenever you put the different coloring like i said, you put the low value, a lot
of enamel color then you can create that color exactly
so this much we are fighting about 5/10th 7/10ths
one millimeter porcelain layer you see we’re battling about 1mm layer concept
you cannot build thick, right? you cannot make the under contour
you have to make the proper contour in order to match adjacent teeth
and then apply this the porcelain layer look at this discoloration
so after they prepped the teeth the color will be different
guess what? you have to prep a little bit more than you think
in order to match adjacent teeth now we’re talking about the material selection
we have to use good materials zirconium and lithium disilicate,
and also, we can make them porcelain only, right?
But with this one you have to see that the color inside will effect the final aspect
too this is what i’m talking about, the black
post and core we need good communication
we need the color in order to make the all ceramic restorations
when we make porcelain fused metal which i don’t recommend it
this is a porcelain fused metal here you see the high value, and gum line is too
grey like this, another case is here, it’s all
black post and core this needs to really be indicated in order
to match adjacent teeth why? these are natural teeth
natural teeth are a medium value, there are a lot of layers on it
so it’s hard to match the other adjacent teeth
I’ll just admit that ok? not only do I indicate about surface texture
so whenever you said vertical ridge and here is a horizontal line
you know what vertical ridge means? reflection, whenever the patient’s teeth
are wet, then you can see the reflection
whenever you see a concave surface, you don’t get any reflection
now for material selection with fluorescence so high is good fluorescence, which is more
natural especially when the patient goes to the night
club with neon light and we see the same result
so that’s why we have to careful about that so I tested with all porcelain baking
which is in a blue, clear, and a white-ish color
we test it, that’s the material selection this is opaque so we have to really care about
that and then you have to write it down
just like on this custom shade chart we made what is this?
Information, just like the patient chart so whoever comes down to my office
we write down their information not only that, we have side view
and frontal view I just indicate it: hue, value, chroma
and then if it’s a 6 unit case I indicate little bit more detail along with the material
selection after that but I follow the A1 base, like I said
A1 base then I surround everything by chunk: translucency,
halo… I made this, so we call, this is my signature
line and… these are pretty expensive cases,
I’m telling you, it’s not going to work with your insurance
because with insurance you get $700… $500… whatever
and the laboratory only gets 10% maybe less, you cannot get a $99 crown, you cannot get
a $100 crown …you cannot get it
Here’s my background, we took the custom color with all these dental professionals
long time ago, there’s guideline for this and we have lots of communication with the
doctors, long time ago, I miss those days
so this is my the lab test, enamel testing I see the graduation, you cannot see much
but I see a little grey, and then tan, and with the pink and white-ish color
which is enamel, before I apply, just like that
so I took it out, peeled it off like this laid it down comparing together
and then you can see the different colors from blue, white
and then white and then clear clear, and then tan, you can see the different
colors so that’s why I can create naturalism
so this is one of the keys, to make it successfully so this is very important like i said
gold post and core and we have to know the proper materials selection
then we match the adjacent teeth like this, ok?
the single tooth, this is most toughest color to match in the world
let me tell you, I’m being honest with you this is mamelon, just like a cloud
you know what I mean by “cloud”? it disappears. Sometimes there, sometimes
gone, sometimes little but here’s another problem
the mamelon, I call the “disappearing cloud” with color of cloud
meaning that, whenever I see there’s light tan…
but after i dehydrate it, hydrate it, it changes subtly
this is God’s creation along with a little opalescence and with halo
and the tan here surrounded by… this is crazy
whenever I get cases like this… probably I have to spend about 8.. 10.. 12..
14 hours easily for one single crown this is just like that, slight difference
but this is the best I can do here’s my passion
trying to mimic the natural teeth as close as possible
I narrow down to 80 porcelain and then I fabricated a shade guide and then I put the number you have to make the good proper contour shape
you need the right thickness, and then you can apply the porcelain recipe
anyway, so this is all my effort, for best communication
dark and light like I said this changes everything
especially the veneers the color testing with the different patients
this is our guide so you know the translucency, you know the color,
I tested it, my own ceramic shade tabs with the discoloration, with the coloring
so here’s my Chairside Shade Guide so I can indicate it clearly, so that’s
why I can fabricate crowns like this now i’m going to conclude
like I said, I’ve 30 years experience I dedicated my life
I know what I’m doing I admit to you, it’s almost impossible for
us to match the natural teeth don’t give up, try the best you can
and then you get the final result and this is part one, see you part 2
thank you very much

Author: Kevin Mason

11 thoughts on “Why Doesn’t My Crown Match?

  1. Communication?
    Does a patient really need to tell you he or she wants a natural-looking crown that matches the other teeth?

  2. You need a new lab tech!!! The crown is too long, and the shape is poor, and the color is awful!!!!!

  3. So glad I came across this video. I run my own crown & bridge lab for 7 months now. This information you will not be able to read from some book or learn at school. Subscribed. Looking forward for part 2

  4. HAHA this is definitely one of those "Top annoying things dentists do to lab techs" videos. Seriously though, thank you for these tips so that we can have the best results for our patients.!

  5. I've experienced anxiety disorder for the past week. I have a crooked teeth but the dentist that I went to advice me for a bridge. 10 teeth for a bridge. Saddenly I agreed because since I was a kid, I have an insecurity and problem with socializing to everyone. Ever since I dreamed of having a nice teeth. But now that they put the temporary bridge, I am very disappointed of myself and I regret very much of loosing all my good teeth just because they were crooked. How I wish you are near and I am rich enough to go to a good dentist like you :'(

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