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