A little white goes a long way
Something that I've picked up through the years from Sam, Flem, Skramy and my wife, Kris, is that natural teeth have a lot of white in them. When used well, I've found that it can make teeth really look a lot more natural and will give a monolithic restoration a lot more depth. I use white to add decalcifications, mimick craze lines, enhance translucency and oftentimes, it is just what the case needs. I will say this takes a little practice and it is easy to not have enough or too much. For a few of the cases that I will show, I really think it adds a little extra and makes the restorations blend in better. For many of you that see my posts, I often will use the Empress Stain and Glaze Kit on my cases because of it's ease of use. (For IPS e.max, make sure you have the restoration crystallized first if you are going to use Empress Stain and Glaze).
1st Case: VITABLOCS TriLuxe 1M2-A little sunset color stain gingivally but the rest is subtle white striations
Before:
2nd Case: Empress Multi B1 #9-This is an off angle pic but really showcases using white enhance the restoration 
3rd Case: The before is the classic monolithic crown without anything. I used VITABLOCS Mark II 1M1 and just added glaze and some white to attempt to match the white spots
Before:
After:
Great result Daniel. This is not to criticize or detract from your accomplishment. But seeing your case reminds me of a similar one I did 10 years ago. The patient was a young woman with anodontia of her lateral incisors. Her Ortho was completed and I was restoring the implants replacing her lateral incisors. Her central incisors had the typical white mild fluorosis splotches so common in young people today. I did a fantastic job of matching the lateral incisor crowns to her central incisors. As soon as she saw her new crowns alligator tears started to flow immediately. She hated the white splotches on her central incisors and wanted no part of them on her brand new lateral incisors. Neither I or her parents could reason with her. I had to polish off all of my beautiful staining and glazing. I have not seen that woman since. We can please some of our patients some of the time, but we can't please all of our patients all of the time.
Really great point Dr Chuck! I’ve had it happen once. I polished it all off and she was happy. I thought it looked terrible but it is their decision.
Knock on wood, no one has complained about it yet but I honestly don’t tell them what I’m doing to their restorations. Simply tell them I’m enhancing it
Very beautiful job Dr. Wilson.
What's your opinion about the longevity of all those stains?? based upon your long time experience, after how many years the stains will wear off??
This is the question that always crosses my mind when i am staining those delicate characterizations and because of my short experience with ceramic staining ( almost 3 years), i still don't have the answer.
Thanks Harry. I’ve been using CEREC since 2014 and I haven’t seen these wear off. My wife, Kristine Aadland, has been using CEREC for 13 years and says that she seen any loss of stain and characterization on non functional areas during that time. Granted we both try to be proactive with our hygiene team about not using coarse prophy pastes. Ivoclar Vivadent makes a great product: Proxyt that works very well for cleaning and preserving the esthetics of our restorations.
On 4/14/2019 at 7:26 pm, Daniel Wilson said... Thanks Harry. I’ve been using CEREC since 2014 and I haven’t seen these wear off. My wife, Kristine Aadland, has been using CEREC for 13 years and says that she seen any loss of stain and characterization on non functional areas during that time. Granted we both try to be proactive with our hygiene team about not using coarse prophy pastes. Ivoclar Vivadent makes a great product: Proxyt that works very well for cleaning and preserving the esthetics of our restorations.Thank you very much
Just one more question:
There are ceramic specific stains and universal stains.
For example e.max cad (870°C) or empress cad(790°C) stains fire at higher temps compared to ivocolor (710°C) or vita akzent plus(700°C).
Does the higher temp help stains to fuse in a stronger way and so make them more durable??
Harry, I’m not a materials expert but I will ask a friend. But I can’t imagine that the firing temperatures would matter that much for longevity. Your last two examples are very nice stain and glazes that lab technicians routinely use.
Update on the ceramic stain and glazes. As long as you match the firing temps with what the manufacturer recommends, there isn’t a correlation between higher temps and the characterization holding up longer. This is from Sean Han who is a master ceramist and KOL for a number of companies. His stain and glaze system of choice is CZR from Kuraray Noritake. He likes CZR because the glaze itself is a ceramic so he doesn’t worry about the wear in these non functional esthetic regions.
Kris has the system but I have yet to buy it . Maybe she can chime in on her thoughts about it.
I hope that helps Harry.
Beautiful!!!!!!!!!! I love the added "little" touches you did to make it look the way you did. BTW, I'm a fan of Vita Triluxe and Triluxe Forte for anteriors.
