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Topics for Today Closing Diastemata Shade Matching with Composite

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Diastema Diastemata (pl) A space between two adjacent

teeth in the same arch 25% of american population have a

midline diastema (McVay 1984)

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Etiologic factors Prominent labial frenum Congenitally missing teeth Undersized or malformed teeth Tooth/arch discrepancies Habits Periodontal disease

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Treatment Options Orthodontics Direct composite Porcelain labial veneers Full crowns

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Advantages of Direct Composite Minimal preparation Good optical match Relative cost low Easily repaired

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Disadvantages of Direct Composite Skill dependent Potential repairs Potential staining Surface finish and abrasion

resistance

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Requirements of Composite Strength (hybrids) Translucency (hybrids) Excellent finish (microfills) Margin integrity (microfills)

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Translucency Composite type

MicrofilledMicro-hybrid

1mMore TranslucentLess Translucent

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Matching the Appearance of Teeth Symmetry and proportionality Shape and form Position and alignment Surface texture Color Translucency

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Criteria

Color Midline centered Facial contours Incisal contours

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Matching the Appearance of Teeth Color Translucency

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Shade Guides

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Shade Guides Vita Lumin

A=red-brown B=red-yellow C=greyish D= red-grey

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3 Dimensions of Color Hue

Value Chroma

A=red-brown B=red-yellow C=grayish D= red-gray

Squint to evaluate

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Why do shade tabs look natural? Layered Color Translucency

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Shade selection and matching Educate patient Remove lipstick Clean teeth Wet teeth Dont stare

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Shade selection and matching Rest eyes (medium blues) Use assistants and patients Look at total tooth then specific

areas Use different light sources

(metamerism)

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Final Resin Shade Color of underlying tooth Thickness of resin Polymerization

Yellow-blue Opaque -translucent

Finish and polish

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Other Alterations of Teethwith Composites Incisal edge wear Embrasure closings Minor tooth rotations Reshaping teeth

Canines in lateral position

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Symmetry and Proportionality

Golden proportions - 62% Width/length - .75-.80%

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Not a perfect world

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Shape and Form Wider or narrower

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Shape and Form

Shorter or taller

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End of Story