Вы находитесь на странице: 1из 4
TECHNIQUES Engineering meets aesthetics - Part 2 B Y R AY S HARKEY , RDT

TECHNIQUES

Engineering meets aesthetics - Part 2

TECHNIQUES Engineering meets aesthetics - Part 2 B Y R AY S HARKEY , RDT D

BY RAY SHARKEY, RDT

D evelopment of a new concept ceramic is a tall order in a day where just about everybody has

their own unique system. Using the nat- ural tooth as a model, Heraeus Kulzer (HK) set about reverse engineering a tooth and identified some of nature’s building blocks; they call this technique “Gradient Engineered Ceramics”. With the aid of the world’s most sophisticated production facility for quartz glass, they created a frit that closely resembles natural enamel and dentine (Figure 1).

closely resembles natural enamel and dentine (Figure 1). Figure 1. A Heraceram frit With the basic

Figure 1. A Heraceram frit

With the basic components closely resembling nature in opalescence and fluo- rescence, it then became the job of experienced master ceramists to help HK to fine tune this raw material into a ceramic that was both easy to use and able to pro- duce truly realistic crowns. Paul Feichter (Figure 2) was instrumental in this endeavour and designed a system called the Matrix. With this kit, in addition to the normal dentine and incisal kit, those of us who like to experiment with techniques and materials are able to let our hair down. As I said in the previous instalment, Heraceram has the great ability to interact with the “Dance of Light” and enable us to create natural effects in crowns without a great deal of effort. However, as we know, every tooth is different and identifying the differences and then translating that to our ceramic has been the goal of every techni- cian. To successfully use the Heraceram

Matrix kit we need to look at a tooth from a different perspective (Figure 3). As always, one of the first and most important factors to be identified in a tooth is the Value. It has been shown in many circumstances that if the value is correct, then even slight mistakes in hue and chroma can be disguised, because the crown will blend in better (Figure 4). The problem we often encounter is that what we see in the lab and in the surgery are often different from what is seen in natural daylight (Figures 5a and 5b).

but the influence of ultra violet light on the fluorescence and thus the value is often also overlooked (Figures 6a and 6b). The ultra violet light spectrum is usually excluded from most fluorescent light tubes (otherwise we would get sunburnt inside). The absence of this part of the spectrum can cause the incorrect identification of the tooth’s value range. I’m not suggesting that we rush out and install UV lights in our offices (or mirror balls!), but we need to look at fluorescence and value in the presence of some source of UV, preferably

and value in the presence of some source of UV, preferably Figure 2. Paul Feichter ZTM.
and value in the presence of some source of UV, preferably Figure 2. Paul Feichter ZTM.

Figure 2. Paul Feichter ZTM. Figure 3. The subtle influence of Value, Translucency and Chroma can be seen in

The light sources we use in the surgery and lab do need to be the correct colour temperature and saturation, but even when we go to great lengths to match the lights we still often encounter inconsistencies. I believe the cause of this phenomenon is ultra violet light. Many surgeries and labs have exposure to natural day light but the amount can vary during different times of the day, or can be influenced by weather and atmospheric conditions eg. smoke haze or pollution. As a consequence, there has been a tendency to ignore daylight in the equation when we take a shade, by only using artificial light or new age digital shade taking machines. The amount of nat- ural visible daylight probably should be ignored, due to the variations mentioned,

this example of natural aesthetics. (Paul Feichter ZTM).

diffused daylight. Remember the amount of visible daylight is not so important, just some light that contains UV. Back to Heraceram: the system has been designed very much to take UV and fluroescence into account. Firstly, we have fluroesence provided at the opaque layer, where it should be, since in natural teeth the fluorescence is manifest in the pulp and dentine (Figure 7). Secondly, to account for those teeth with varied fluorescence and brighter areas, they have developed the Value pow- ders. These are supplied to correlate loosely to the Vita Classic shade guide.

34 - eLABORATE

November/December 2005

Figure 4. This example shows a tooth that perfectly blends in with the surrounding dentition,

Figure 4. This example shows a tooth that perfectly blends in with the surrounding dentition, even when there is a slight differ- ence in the Chroma. The addition of char- acteristics like crack lines and interdental shading along with careful surface texture and contour complete the invisible crown.

surface texture and contour complete the invisible crown. Figure 5a and 5b. The two shade guides
surface texture and contour complete the invisible crown. Figure 5a and 5b. The two shade guides

Figure 5a and 5b. The two shade guides in artificial light appear similar the shade of the tooth on the left looks to be slightly lighter. However when we look at these with just Ultra Violet light there is a clear difference in fluorescence. This effect is due to the lack of XXXX in the ceramic material used to create the shade guide. How can we expect to see correct value when the shade guide and the ceramic do not present ade- quate fluorescence?

and the ceramic do not present ade- quate fluorescence? Figures 6a and 6b. This example shows
and the ceramic do not present ade- quate fluorescence? Figures 6a and 6b. This example shows

Figures 6a and 6b. This example shows a crown that is obviously the wrong shade (oops), but look at the difference when we take the picture in diffused daylight only. Almost an acceptable match (but not quite, back the lab for a remake!).

match (but not quite, back the lab for a remake!). Figure 7. Fluorescence is evident in

Figure 7. Fluorescence is evident in the sectioned tooth, in the underlying dentine and pulp, and also in the layered ceramic on the crown.

and pulp, and also in the layered ceramic on the crown. Figure 8. From right to

Figure 8. From right to left are V1, V2, V3 and V4 - decreasing in fluorescence and increasing in translucency

For instance, V1 should be used in con- junction with A1, B1 or C1; V2 with A2 and so on. But, if we see a shade that seems to look like, say an A3, but just seems a bit brighter, then perhaps you could slightly increase the value by using a slightly brighter Value powder. Say use V2 with A3 to achieve a brighter A3. This technique needs to be used carefully but with a little experience (and a few rebuilds), it does not take long to understand how much powder to use to change the value without changing the base shade (Figure 8). Always remember to use the value material deep in the build up close to the opaque layer to make subtle changes in the value.

Included in the range of fluorescent pow- ders in the Matrix kit are mamelon powders or MD, used just as the name suggests in the mamelon region near the incisal edge. These can be applied directly or mixed with the dentine powders to increase the chroma and fluorescence in the cervical area as well. To increase chroma only, we can use the SD or secondary dentine powders. The SD powders do not contain as much fluo- rescence however they have much stronger chroma (Figure 9). The opalescence in a tooth is also some- thing that is almost impossible to quantify unless the ceramist takes the shade (always recommended for anterior teeth) and then they must rely on their judgment and experience. However, since the base frit used in Heraceram displays a certain amount of opalescence, it is able to recreate a natural appearance without much modification (Figure 10). However, when we want to have more control over this opalescence and translucency, the matrix kit provides us with some unique tools. Firstly, there is the inclusion of Opal incisal or OS pow- ders - four powders to correlate to the usual incisal powders, e.g. OS1 instead or in conjunction with S1 for brighter shades, and OS4 and S4 for darker shades inclusive. These powders can appear brighter than the usual enamel powders due to the inclusion of opal material so should not be applied too thick or the result may be a crown that looks too white. Next, there are the opal translucent powders. These powders are arranged according to the amount of opalescence thus: OT1 is translucent powder with one part opalescence. OT2 has two parts, OT5 has 5 parts and OT 10 ten parts (Figure 11). This results in the ceramic appearing slightly whiter as we increase the opales-

November/December 2005

eLABORATE - 35

TECHNIQUES

TECHNIQUES
TECHNIQUES
TECHNIQUES Mamelon powder in the incisal tip Different value powders vary fluorescence Highly fluorescent margin

Mamelon powder in the incisal tip

Different value powders vary fluorescence

Highly fluorescent

margin

Secondary Dentine pow- der will give the illusion of low value and shadow.

Figure 9. Highly fluorescent margin powders in the cervical area and various Value powders change the brightness or fluorescence of the underlying substructure. The inclusion of two different Mamelon powders can be seen in the incisal tip, while Secondary Dentine powder gives the illusion of shadow in the interproximal area.

cence. An important thing to consider with these powders is that while the increased opalescence may look whiter, it still man- ifests the wondrous effect of colour change with a change in incident light position. Also included are some coloured opal powders to increase certain effects in the incisal edges that may need further chroma enhancement These colours are Blue (use sparingly), Amber, Yellow and Grey. Small amounts of these can add lovely subtle colour changes where we see them in natural teeth (Figure 12). All of the techniques I have tried to describe are applicable to the complete range of Heraeus ceramics, including the Zirconia and the soon to be released Alu- mina veneering ceramics. The system is enhanced by the inclusion of a pressable material that has the same CTE as the normal Heraceram, allowing us to do combination work including all ceramic crowns, veneers and bonded work with the same veneering material. At the moment Heraceram (bonding only) is also avail- able in the modified 3-dimensional shading technique enabling us to accu- rately match almost all shading systems.

us to accu- rately match almost all shading systems. ZIRCONFLEX With Zirconflex, reconstruction using zircon
ZIRCONFLEX With Zirconflex, reconstruction using zircon oxide, this increasingly valued high-tech material, is
ZIRCONFLEX
With Zirconflex, reconstruction using zircon oxide,
this increasingly valued high-tech material, is
unbelievably easy and extremely precise.
Zirconflex
• Sensitive, reliable and precise grinding
• No formation of micron cracks
during dry processing
• Ideal for dealing with edges
• Little heat development, no sparing
• Best cost-benefit ratio
• Best for high end finishing
Our Products your Success
ip-tek pty ltd
Sole Importer and Distributor
Tel: (07) 40939889
Fax: (07) 40939919
PO Box 833, Smithfield Qld 4878
Email: admin@ip-tek.com Website: www.jota.ch

36 - eLABORATE

November/December 2005

Figure 10. Natural tooth on the right and Heraceram opalescent enamels or OS ceramic material

Figure 10. Natural tooth on the right and Heraceram opalescent enamels or OS ceramic material on the left show identi- cal amounts of opalescence.

Heraceram, the new material designed by Heraeus Kulzer, can be used to create truly natural effects in every day ceramic restorations. With a little practice and a slightly different perspective, we can use simple modifica- tions to our build up technique and improve the quality of our work. All new materials require a little perseverance and practice to master, however with this material I believe it is made easier, since the ceramic itself more closely resembles natural tooth structures. The

itself more closely resembles natural tooth structures. The Figure 11. The shade guide. Note Secondary Dentine

Figure 11. The shade guide. Note Secondary Dentine powder will give the illusion of low value and shadow.

Heraceram material helps us to master the steps in the dance of light and enhances our skill to recreate nature in everyday ceramic restorations.

Part 1 of this article appeared in eLABORATE July/August 2005.

Heraceram is available from Heraeus Kulzer in Australia. For more info, contact Jeff Lauretti on (02) 9417-8411 or 0432-327-848. In New Zealand, call Oraltec on (09) 478-2229.

In New Zealand, call Oraltec on (09) 478-2229. Figure 12. Shown here is an illustration of

Figure 12. Shown here is an illustration of the many wonderful effects that can be created easily using the many combina- tions of powders of the matrix kit.

Ray Sharkey has owned his own dental laboratory on Queensland’s sunshine coast, north of Brisbane, since 1985 and has lectured on various aspects of dental technology since 1992. In 1994, he was hand picked by famous Swiss ceramist Willi Geller to be the first Australian member of the Oral Design ® group. Recently he has taught hands on technique courses in China, Korea and New Zealand for Heraeus Kulzer on Heraceram.

technique courses in China, Korea and New Zealand for Heraeus Kulzer on Heraceram. November/December 2005 eLABORATE

November/December 2005

eLABORATE - 37