Topics for Today

Diastema

Closing Diastemata
Shade Matching with Composite

Diastemata (pl)
A space between two adjacent
teeth in the same arch
25% of american population have a
midline diastema (McVay 1984)

Dent 538

Dent 538

Dent 538

Dent 538

Dent 538

Dent 538

Etiologic factors

Prominent labial frenum

Congenitally missing teeth
Undersized or malformed teeth
Tooth/arch discrepancies
Habits
Periodontal disease

Dent 538

Dent 538

Treatment Options

Orthodontics
Direct composite
Porcelain labial veneers
Full crowns

Dent 538

Advantages of Direct Composite

Minimal preparation
Good optical match
Relative cost low
Easily repaired

Dent 538

Disadvantages of Direct Composite

Dent 538

Skill dependent
Potential repairs
Potential staining
Surface finish and abrasion
resistance

Dent 538

Requirements of Composite

Translucency
Composite type

Strength (hybrids)
Translucency (hybrids)
Excellent finish (microfills)
Margin integrity (microfills)

Microfilled

Micro-hybrid

1m
Less Translucent

More Translucent

Dent 538

Matching the Appearance of Teeth

Dent 538

Criteria

Symmetry and proportionality

Shape and form
Position and alignment
Surface texture
Color
Translucency

Dent 538

Matching the Appearance of Teeth

Color
Midline centered
Facial contours
Incisal contours

Dent 538

Shade Guides

Color
Translucency

Dent 538

Dent 538

Shade Guides

3 Dimensions of Color

Vita Lumin
A=red-brown

B=red-yellow

Hue
C=greyish D= red-grey

A=red-brown

B=red-yellow

Value
Chroma

C=grayish D= red-gray

Squint to evaluate

Dent 538

Why do shade tabs look natural?

Layered
Color
Translucency

Dent 538

Shade selection and matching

Educate patient
Remove lipstick
Clean teeth
Wet teeth
Dont stare

Dent 538

Shade selection and matching

Rest eyes (medium blues)
Use assistants and patients
Look at total tooth then specific
areas
Use different light sources
(metamerism)
Dent 538

Dent 538

Final Resin Shade

Color of underlying tooth
Thickness of resin
Polymerization
Yellow-blue
Opaque -translucent

Finish and polish

Dent 538

Dent 538

Dent 538

Dent 538

Dent 538

12B

Dent 538

Dent 538

Dent 538

Dent 538

Other Alterations of Teeth

with Composites

Incisal edge wear

Embrasure closings
Minor tooth rotations
Reshaping teeth
Canines in lateral position

Dent 538

Symmetry and Proportionality

Golden proportions - 62%

Dent 538

Not a perfect world

Width/length - .75-.80%
Dent 538

Dent 538

Shape and Form

Wider or narrower

Dent 538

Dent 538

Dent 538

Dent 538

Shape and Form

Shorter or taller

End of Story

Dent 538

Dent 538