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