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Color characterization of provisional restorations
Color characterization Loren C. Christensen, Letterman
Army
of provisional
D. D. S. *
Medical Center,
San Francisco,
Calif.
E
sthetics and color control in prosthodontics are often as necessary during the provisional phase of treatment as in the final restoration. Cohn’ described a technique where portions of acrylic resin were cut out of the restoration. The site was then stained and refilled with autopolymerizing acrylic resin. Other methods of custom shading, such as adding stains to the acrylic resin polymer or adding finely shaved colored chalk to either the powder or base portions of temporary cements, have also been reported.‘. .I Commercial staining kits (Minute-stain, George Taub Products, Jersey City, N.J.) are available and designed for use in shade alteration and color characterization of acrylic resin restorations. These stains are pigments dispersed in fast-curing liquid plastic. They are fast setting, easily applied at chairside, and available in several shades.
DISCUSSION Chairside autopolymerizing acrylic resins are usually available with a choice of several shades. While, the range of choices is usually adequate, it sometimes falls short in achieving the exact effect sought by the dentist and desired by the patient. When a problem with color occurs, acrylic resin stains can be helpful; they do, however, present limitations. Because the hues are saturated, they tend to give an unrealistic painted-on effect when added to the surface of acrylic resin restorations. This article describes a technique using shade guide tabs to aid the dentist in achieving a more acceptable shade-match of acrylic resin restorations to natural teeth.
FABRICATION
restorations
OF SHADE GUIDE TABS
Two shade guides are prepared from two different mold guides taken from a polycarbonate crown kit
(Ion Crowns, 3M Co., St. Paul, Minn.). Each acrylic resin stain is applied to the gingival portion of the external surface of the first guide and then to the inner surface of the gingival portion of the second guide (Fig. 1). Other shade guide tabs may be formulated by mixing various pigments. Tab construction with different surface characterization is limited only by the dentist’s imagination. The custom shade guides should be kept with the stain kit for comparison and quick reference.
TECHNIQUE Select the pigment to be used from the custom shade guide. Determine whether external or internal staining is required to achieve the proper shade match.
External staining 1. Fabricate, contour, and polish the acrylic resin restoration (Fig. 2). 2. Select shade from the guide. 3. Add the stain to the restoration using a fine sable or camel hair brush. Do not brush over the stain more than three or four times as the stains set very fast and streaking may result. 4. If the proper effect is not achieved, more stain may be added; or, the stains may be polished off, and the above procedure repeated (Figs. 3 and 4).
Internal staining 1. Select and contour a preformed shell crown. 2. Apply the stain to the inner portion of the selected shell crown to achieve the desired effect. 3. Reline the crown with autopolymerizing acrylic resin and trim to the margins.’ 4. Characterize, polish, and cement the restoration (Figs. 5 and 6).
SUMMARY The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. *Major, DC, USA.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
Esthetics is required for some provisional restorations. Acrylic resin stains can be used to develop natural appearing restorations with external and internal techniques. The use of a custom-made shade
631
CHRISTENSEN
Fig. 1. Custom shade guide tabs. Top row, left to right, external staining: white, gray, blue, pink, brown, cervical blend, and yellow. Boffom row, left to right, shows internal staining: yellow, cervical blend, brown, pink, blue, gray, and white. Fig. 2. Preformed relined provisional restorations placed on mandibular central incisors. Fig. 3. Stained crown contrasted with unstained crown. Fig. 4. Both provisional crowns completed for more desirable final effect. Fig. 5. Provisional crown on upper left lateral incisor was unacceptable to patient. Fig. 6. Provisional crown for upper left lateral incisor was remade using internal staining to lower value and small amount of external staining for characterization.
632
DECEMBER
1981
VOWME
46
NUMBER
6
COLOR CHARACTERIZATION
3.
guide aids the dentist in selecting the desired pigment, and determining the need for external or internal staining.
4.
REFERENCES 1. ‘2.
Cohn, L. A.: DENT 7:400, Cleveland, J. shading for DENT 32:425,
Staining acrylic resin restorations. J PROSTHET 1957. L., King, C. J., and Contino, S. H.: Custom temporary-coverage restorations. J PROSTHET 1974.
Oliva, R. A.: Custom shading of temporary acrylic resin jacket crowns. J PROSTHET DENT 44:154, 1980. Nayyar, A., and Wallace, W. S.: Fabricalion of a single anterior intermediate restoration. J PROSTHET DENT 39:574, 1978.
Reprint requeststo: DR. LOREN C. CHRISTENSEN Box 190 LAMC PRESIDIO SAN FRANCISCO, CA 94129
ARTICLES TO APPEAR IN FUTURE ISSUES A technique
for quadrant interocclusal
records
Harmon F. Adams, D.D.S.
A modification
of the altered cast technique
Richard Bauman, D.D.S., and James DeBoer, D.D.S.
Ceramic shade work authorizations R. B. Blackman, D.D.S., M.S.D.
Analysis of the posterior palatal seal and the palatal form as related to the retention of complete dentures Antolino Colon, D.M.D., Keki Kotwal, B.D.S., D.M.D., Ph.D.
Effect of oxidation
MS., and A. David Mangelsdorff,
on ceramometal bond strength
Robert J. Dent, D.D.S., Jack D. Preston, D.D.S., Joseph P. Moffa, D.D.S., M.S.D., and Angelo Caputo, Ph.D.
The casting accuracy of nickel-chromium
alloys for fixed prostheses
J. David Duncan, D.D.S., M.S.D.
Effect of self-curing fluid volume
acrylic resin treatment restorations on the crevicular
Patrick H. Garvin, D.D.S., M.S., William F. P. Malone, D.D.S., MS., Ph.D., Patrick D. Toto, D.D.S., M.S., and Boleslaw Mazur, D.D.S., MS.
A comparison of gingival
inflammation
related to retraction cords
G. G. de Gennaro, D.D.S., M.S.Ed., H. M. Landesman, D.D.S., M.Ed., J. E. Calhoun, D.D.S., and J. T. Martinoff, M.Ed., M.A., Ph.D.
In vitro tarnish measurements on fixed prosthodontic
alloys
Randall M. German, Ph.D., David C. Wright, M.S., and Robert F. Gallant, M.S.
Technical and biophysical aspects of fixed partial dentures for patients with reduced periodontal support Per-Olof Glantz, D.D.S., Ph.D., and Sture Nyman, D.D.S., Ph.D.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
633
Army
of provisional
D. D. S. *
Medical Center,
San Francisco,
Calif.
E
sthetics and color control in prosthodontics are often as necessary during the provisional phase of treatment as in the final restoration. Cohn’ described a technique where portions of acrylic resin were cut out of the restoration. The site was then stained and refilled with autopolymerizing acrylic resin. Other methods of custom shading, such as adding stains to the acrylic resin polymer or adding finely shaved colored chalk to either the powder or base portions of temporary cements, have also been reported.‘. .I Commercial staining kits (Minute-stain, George Taub Products, Jersey City, N.J.) are available and designed for use in shade alteration and color characterization of acrylic resin restorations. These stains are pigments dispersed in fast-curing liquid plastic. They are fast setting, easily applied at chairside, and available in several shades.
DISCUSSION Chairside autopolymerizing acrylic resins are usually available with a choice of several shades. While, the range of choices is usually adequate, it sometimes falls short in achieving the exact effect sought by the dentist and desired by the patient. When a problem with color occurs, acrylic resin stains can be helpful; they do, however, present limitations. Because the hues are saturated, they tend to give an unrealistic painted-on effect when added to the surface of acrylic resin restorations. This article describes a technique using shade guide tabs to aid the dentist in achieving a more acceptable shade-match of acrylic resin restorations to natural teeth.
FABRICATION
restorations
OF SHADE GUIDE TABS
Two shade guides are prepared from two different mold guides taken from a polycarbonate crown kit
(Ion Crowns, 3M Co., St. Paul, Minn.). Each acrylic resin stain is applied to the gingival portion of the external surface of the first guide and then to the inner surface of the gingival portion of the second guide (Fig. 1). Other shade guide tabs may be formulated by mixing various pigments. Tab construction with different surface characterization is limited only by the dentist’s imagination. The custom shade guides should be kept with the stain kit for comparison and quick reference.
TECHNIQUE Select the pigment to be used from the custom shade guide. Determine whether external or internal staining is required to achieve the proper shade match.
External staining 1. Fabricate, contour, and polish the acrylic resin restoration (Fig. 2). 2. Select shade from the guide. 3. Add the stain to the restoration using a fine sable or camel hair brush. Do not brush over the stain more than three or four times as the stains set very fast and streaking may result. 4. If the proper effect is not achieved, more stain may be added; or, the stains may be polished off, and the above procedure repeated (Figs. 3 and 4).
Internal staining 1. Select and contour a preformed shell crown. 2. Apply the stain to the inner portion of the selected shell crown to achieve the desired effect. 3. Reline the crown with autopolymerizing acrylic resin and trim to the margins.’ 4. Characterize, polish, and cement the restoration (Figs. 5 and 6).
SUMMARY The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. *Major, DC, USA.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
Esthetics is required for some provisional restorations. Acrylic resin stains can be used to develop natural appearing restorations with external and internal techniques. The use of a custom-made shade
631
CHRISTENSEN
Fig. 1. Custom shade guide tabs. Top row, left to right, external staining: white, gray, blue, pink, brown, cervical blend, and yellow. Boffom row, left to right, shows internal staining: yellow, cervical blend, brown, pink, blue, gray, and white. Fig. 2. Preformed relined provisional restorations placed on mandibular central incisors. Fig. 3. Stained crown contrasted with unstained crown. Fig. 4. Both provisional crowns completed for more desirable final effect. Fig. 5. Provisional crown on upper left lateral incisor was unacceptable to patient. Fig. 6. Provisional crown for upper left lateral incisor was remade using internal staining to lower value and small amount of external staining for characterization.
632
DECEMBER
1981
VOWME
46
NUMBER
6
COLOR CHARACTERIZATION
3.
guide aids the dentist in selecting the desired pigment, and determining the need for external or internal staining.
4.
REFERENCES 1. ‘2.
Cohn, L. A.: DENT 7:400, Cleveland, J. shading for DENT 32:425,
Staining acrylic resin restorations. J PROSTHET 1957. L., King, C. J., and Contino, S. H.: Custom temporary-coverage restorations. J PROSTHET 1974.
Oliva, R. A.: Custom shading of temporary acrylic resin jacket crowns. J PROSTHET DENT 44:154, 1980. Nayyar, A., and Wallace, W. S.: Fabricalion of a single anterior intermediate restoration. J PROSTHET DENT 39:574, 1978.
Reprint requeststo: DR. LOREN C. CHRISTENSEN Box 190 LAMC PRESIDIO SAN FRANCISCO, CA 94129
ARTICLES TO APPEAR IN FUTURE ISSUES A technique
for quadrant interocclusal
records
Harmon F. Adams, D.D.S.
A modification
of the altered cast technique
Richard Bauman, D.D.S., and James DeBoer, D.D.S.
Ceramic shade work authorizations R. B. Blackman, D.D.S., M.S.D.
Analysis of the posterior palatal seal and the palatal form as related to the retention of complete dentures Antolino Colon, D.M.D., Keki Kotwal, B.D.S., D.M.D., Ph.D.
Effect of oxidation
MS., and A. David Mangelsdorff,
on ceramometal bond strength
Robert J. Dent, D.D.S., Jack D. Preston, D.D.S., Joseph P. Moffa, D.D.S., M.S.D., and Angelo Caputo, Ph.D.
The casting accuracy of nickel-chromium
alloys for fixed prostheses
J. David Duncan, D.D.S., M.S.D.
Effect of self-curing fluid volume
acrylic resin treatment restorations on the crevicular
Patrick H. Garvin, D.D.S., M.S., William F. P. Malone, D.D.S., MS., Ph.D., Patrick D. Toto, D.D.S., M.S., and Boleslaw Mazur, D.D.S., MS.
A comparison of gingival
inflammation
related to retraction cords
G. G. de Gennaro, D.D.S., M.S.Ed., H. M. Landesman, D.D.S., M.Ed., J. E. Calhoun, D.D.S., and J. T. Martinoff, M.Ed., M.A., Ph.D.
In vitro tarnish measurements on fixed prosthodontic
alloys
Randall M. German, Ph.D., David C. Wright, M.S., and Robert F. Gallant, M.S.
Technical and biophysical aspects of fixed partial dentures for patients with reduced periodontal support Per-Olof Glantz, D.D.S., Ph.D., and Sture Nyman, D.D.S., Ph.D.
THE JOURNAL
OF PROSTHETIC
DENTISTRY
633