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Fig 22a-c: DSLR photographs of the initial situation served as a source of inspiration.

Fig 23-24: Before internal staining, the crown was slightly ground Fig 25-26: The darker areas were intensified, and cracks in the glaze were
into shape and moistened with glazing liquid. We began applying applied.
layers from the incisal edge, using white and cream towards the
center of the crown.
palatine sides with a 1:1:1 mixture of Light, Super Clear Glaze, and we apply the “makeup.”
Violet Glaze (Figures 18 and 19). A strip of Violet modifier dentin in The final ceramic application is more cosmetic, akin to applying
the middle third provided an absorption effect for the light (Figures makeup. However, it is a crucial step that helps achieve a depth effect,
20a and 20b). bringing out the underlying layers’ information, and gives the restoration
After the first firing, one could easily determine whether the basic its final shape (Figures 29a to 29c). Based on our observations, patient
structure was successful (Figure 21) or if further adjustments to the data, and the morphology and texture we identified on the working
internal structure were needed. Before internal characterization with model, we could now replicate these features purposefully and apply
super colors (Internal Live Staining), the crown was slightly ground to them to our restoration.
shape and moistened with glazing liquid. At this point, we revisited the
DSLR photographs of the initial situation and the neighboring teeth BISQUE BAKE TEST
to accurately capture and reproduce the relevant features (Figures 22a In the bisque bake test, we observed a slight difference in brightness
to 22c). between the restoration and our reference tooth 21. This difference
We began the Internal Staining by applying cracks, starting from the was more conspicuous in the incisal third and along the edges (Figures
incisal area with white and cream shades, moving towards the center of 30a to 30c). To document the color difference and the decisive choice
the crown (Figures 23 to 26). Before the fixation firing, the super colors of color, more photographs were taken as part of the bisque bake test.
were rapidly dried outside the kiln to prevent them from spreading In this case, the colors B4, A4, and D2 were the closest to the natural
during firing and to ensure that the applied effects remained in place teeth. The previously chosen enamel had to be changed because the
(Figure 27). Since the tooth being reconstructed had various internal brightness and translucency were incorrect, and the effects in the
and external features but needed to appear as a cohesive unit, layering incisal third were intensified (Figures 31a to 31c). The brightness and
posed a challenge. The solution was a combination of the Internal Live translucency were especially striking, as was the saturation of the red-
Staining technique by master dental technician Hitoshi Aoshima, along orange opalescence effect in the enamel mamelons of the natural teeth.
with Universal Stain and Glaze (Dentsply Sirona), applied in several Additionally, the “dreaded” enamel cracks in the reconstruction had to
layers. Proper layering is essential, as it enhances the internal staining be accounted for.
technique, and it is important to create a solid base with accurate color Enamel masses and glazes clarify the influence they have, as well as
rendering of the dentin and enamel, as we did in the basic body shape. their thickness, on the overall color effect of artificial teeth. The samples
On the base body, characterized by internal staining, we applied represent different enamel and glaze masses and their interaction.
opaque dentin B4 on the exposed root zone. In the cervical and middle Moreover, there are samples of our current enamel and glaze masses,
thirds, a 1:1 mixture of dentin A3.5 and Enamel Clear was applied, showing differences in brightness based on the type of glaze and
while the incisal third was completed with a 1:1 mixture of Enamel translucency relative to thickness. The samples are approximately 2.3
Light and Enamel Clear. Enamel Extra Light was applied on the edges mm at their thickest point and about 0.8 mm at the thinnest (Figure
to finish the layering (Figures 28a and 28b). Figure 28c shows the 32). In Figure 33a, the enamel mass samples are sorted from left to
baked implant crown’s basic body, marking the end of this intermediate right by decreasing brightness. The sample on the far left is practically
phase. To borrow terminology from the world of makeup, this phase pure white, and the brightness decreases progressively from one plate
could be likened to the application of foundation. This foundation coat to the next (Figure 33b).
already contains deep color information and characteristics, and now When only the platelets are photographed, the glaze mass sample

Dental Practice I November-December 2024 I Vol 20 No 5 59