Case Study By Michael Morris and Dr. Fred Arnold: Teamwork is the Key to Matching Single Central

January 2012--

A new female patient was disappointed in her crown on #9, and had been told by another dentist it was the best result she could expect. Although diagnostic waxups aren't commonly done for a single central, they are part of Morris and Dr. Arnold's routine and key to the success of this case. After studying the waxup model, which actually was a reduction carving of tooth #9, they decided that Dr. Arnold would have to bond the mesial of tooth #10. This allowed the fabrication of a new crown that would not only match the contra-lateral tooth in shade and texture, but also in size and contour.

As he does for all single central cases, and often for matching anterior teeth in general, Morris fabricated two all-ceramic feldspathic crowns with slightly different shading. After the first try-in, he and Dr. Arnold studied photos of the one that matched best, and discussed changes to get an even better result.

Morris then fabricated two more restorations, changing the opacity and chroma in the dentin and strength of the mammelons and halo, and adjusted the enamel layering to achieve more opalescence. At the second try-in, the team evaluated the newest restorations in terms of value, character, translucency and texture, and also got the patient's feedback. Dr. Arnold then seated the preferred restoration and performed the bonding on tooth #10.

Morris knows that most technicians don't have the luxury of fabricating multiple units for the same tooth, but says what really made the difference in this case is the collaboration. "We achieved beautiful results not simply because we were able to fabricate a few crowns and choose the best," he says. "Rather, it's the time we spent learning together to increase the skill level we offer as a team," says Morris.