Wednesday, February 15, 2017

Selecting a Crown Shade


Selecting a Shade

Top: Ivoclar Vivadent Shade Guide
Bottom: Ivoclar Vivadent Prep Shade Guide

Selecting the appropriate shade for a patient's crown or bridge can sometimes by trying. There are many factors that contribute to the way a patient's teeth look, which can result in varied outcomes. To assist with obtaining an objective shade, take into consideration the following factors:
  • Light
    • Location
    • Color & Temperature
    • Source
  • Surrounding Objects
    • Operatory Walls​
    • Clothing of Patient
  • Shade-Taker
    • 2nd Opinion from Staff Member
  • Digital Camera
    • Shade Tabs​
    • Clarity
  • Prep Shade
    • Shade Tabs
Ensure the source of light is directed relative to the patient as they would normally be seen (i.e. have the patient sit up in the chair, and use passive light from above). When possible, use natural light, or use color-corrected bulbs.

If a patient is wearing a red shirt and pink lipstick in a room with yellow walls, the light will reflect off of these objects and onto the teeth, presenting a skewed shade.

Everyone's eyes interpret color differently. It never hurts to ask a second opinion.

When taking a shade photo to send to your dental lab, include the shade tabs in the photo, holding them up as they would read on adjacent teeth (match Gingival to Gingival, etc.). 
If an all-porcelain crown is requested, providing a stump/prep shade is extremely helpful to the dental lab technician in determining the material shade. Most all-porcelain materials are translucent, allowing light to shine through, reflect off the prepped tooth, and transmit it's shade back through the porcelain material. 

Referenced from: Charles J. Goodacre, DDS, MSD; Paul A. Sagel, BSChE "Dental Esthetics in Practice:
Part 3 - Understanding Color & Shade Selection" Crest® Oral-B®
at Continuing Education Course, Revised October 27, 2011