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TECHNIQUES

Engineering meets aesthetics - Part 2

BY RAY SHARKEY, RDT

evelopment of a new concept Matrix kit we need to look at a tooth from but the influence of ultra violet light on the

D ceramic is a tall order in a day


where just about everybody has
their own unique system. Using the nat-
a different perspective (Figure 3).
As always, one of the first and most
important factors to be identified in a
fluorescence and thus the value is often
also overlooked (Figures 6a and 6b).
The ultra violet light spectrum is usually
ural tooth as a model, Heraeus Kulzer tooth is the Value. It has been shown in excluded from most fluorescent light tubes
(HK) set about reverse engineering a tooth many circumstances that if the value is (otherwise we would get sunburnt inside).
and identified some of nature’s building correct, then even slight mistakes in hue The absence of this part of the spectrum
blocks; they call this technique “Gradient and chroma can be disguised, because the can cause the incorrect identification of the
Engineered Ceramics”. With the aid of the crown will blend in better (Figure 4). tooth’s value range. I’m not suggesting
world’s most sophisticated production The problem we often encounter is that that we rush out and install UV lights in
facility for quartz glass, they created a frit what we see in the lab and in the surgery our offices (or mirror balls!), but we need
that closely resembles natural enamel and are often different from what is seen in to look at fluorescence and value in the
dentine (Figure 1). natural daylight (Figures 5a and 5b). presence of some source of UV, preferably

Figure 1. A Heraceram frit

With the basic components closely


resembling nature in opalescence and fluo-
rescence, it then became the job of Figure 2. Paul Feichter ZTM. Figure 3. The subtle influence of Value,
experienced master ceramists to help HK Translucency and Chroma can be seen in
to fine tune this raw material into a ceramic The light sources we use in the surgery this example of natural aesthetics. (Paul
that was both easy to use and able to pro- and lab do need to be the correct colour Feichter ZTM).
duce truly realistic crowns. Paul Feichter temperature and saturation, but even when
(Figure 2) was instrumental in this we go to great lengths to match the lights diffused daylight. Remember the amount
endeavour and designed a system called we still often encounter inconsistencies. I of visible daylight is not so important, just
the Matrix. With this kit, in addition to the believe the cause of this phenomenon is some light that contains UV.
normal dentine and incisal kit, those of us ultra violet light. Many surgeries and labs Back to Heraceram: the system has
who like to experiment with techniques have exposure to natural day light but the been designed very much to take UV and
and materials are able to let our hair down. amount can vary during different times of fluroescence into account. Firstly, we have
As I said in the previous instalment, the day, or can be influenced by weather fluroesence provided at the opaque layer,
Heraceram has the great ability to interact and atmospheric conditions eg. smoke where it should be, since in natural teeth
with the “Dance of Light” and enable us to haze or pollution. As a consequence, there the fluorescence is manifest in the pulp
create natural effects in crowns without a has been a tendency to ignore daylight in and dentine (Figure 7).
great deal of effort. However, as we know, the equation when we take a shade, by only Secondly, to account for those teeth
every tooth is different and identifying the using artificial light or new age digital with varied fluorescence and brighter
differences and then translating that to our shade taking machines. The amount of nat- areas, they have developed the Value pow-
ceramic has been the goal of every techni- ural visible daylight probably should be ders. These are supplied to correlate
cian. To successfully use the Heraceram ignored, due to the variations mentioned, loosely to the Vita Classic shade guide.
34 - eLABORATE November/December 2005
Figure 4. This example shows a tooth that Figure 5a and 5b. The two shade guides in artificial light appear similar the shade of
perfectly blends in with the surrounding the tooth on the left looks to be slightly lighter. However when we look at these with
dentition, even when there is a slight differ- just Ultra Violet light there is a clear difference in fluorescence. This effect is due to
ence in the Chroma. The addition of char- the lack of XXXX in the ceramic material used to create the shade guide. How can we
acteristics like crack lines and interdental expect to see correct value when the shade guide and the ceramic do not present ade-
shading along with careful surface texture quate fluorescence?
and contour complete the invisible crown.
Included in the range of fluorescent pow-
ders in the Matrix kit are mamelon powders
or MD, used just as the name suggests in
the mamelon region near the incisal edge.
These can be applied directly or mixed with
the dentine powders to increase the chroma
and fluorescence in the cervical area as
well. To increase chroma only, we can use
the SD or secondary dentine powders. The
SD powders do not contain as much fluo-
Figures 6a and 6b. This example shows a crown that is obviously the wrong shade rescence however they have much stronger
(oops), but look at the difference when we take the picture in diffused daylight only. chroma (Figure 9).
Almost an acceptable match (but not quite, back the lab for a remake!). The opalescence in a tooth is also some-
thing that is almost impossible to quantify
unless the ceramist takes the shade
(always recommended for anterior teeth)
and then they must rely on their judgment
and experience. However, since the base
frit used in Heraceram displays a certain
amount of opalescence, it is able to
recreate a natural appearance without
much modification (Figure 10).
Figure 8. From right to left are V1, V2, However, when we want to have more
V3 and V4 - decreasing in fluorescence control over this opalescence and
and increasing in translucency.. translucency, the matrix kit provides us
with some unique tools. Firstly, there is
the inclusion of Opal incisal or OS pow-
For instance, V1 should be used in con- ders - four powders to correlate to the
junction with A1, B1 or C1; V2 with A2 usual incisal powders, e.g. OS1 instead
and so on. or in conjunction with S1 for brighter
But, if we see a shade that seems to look shades, and OS4 and S4 for darker
like, say an A3, but just seems a bit shades inclusive. These powders can
brighter, then perhaps you could slightly appear brighter than the usual enamel
increase the value by using a slightly powders due to the inclusion of opal
brighter Value powder. Say use V2 with A3 material so should not be applied too
to achieve a brighter A3. This technique thick or the result may be a crown that
needs to be used carefully but with a little looks too white. Next, there are the opal
experience (and a few rebuilds), it does not translucent powders. These powders are
take long to understand how much powder arranged according to the amount of
to use to change the value without opalescence thus: OT1 is translucent
changing the base shade (Figure 8). powder with one part opalescence. OT2
Figure 7. Fluorescence is evident in the Always remember to use the value has two parts, OT5 has 5 parts and OT 10
sectioned tooth, in the underlying dentine material deep in the build up close to the ten parts (Figure 11).
and pulp, and also in the layered ceramic opaque layer to make subtle changes in This results in the ceramic appearing
on the crown. the value. slightly whiter as we increase the opales-
November/December 2005 eLABORATE - 35
TECHNIQUES

cence. An important thing to consider with


these powders is that while the increased
Mamelon powder in the opalescence may look whiter, it still man-
incisal tip ifests the wondrous effect of colour
change with a change in incident light
position. Also included are some coloured
Different value powders
opal powders to increase certain effects in
vary fluorescence
the incisal edges that may need further
chroma enhancement These colours are
Blue (use sparingly), Amber, Yellow and
Grey. Small amounts of these can add
lovely subtle colour changes where we see
Highly fluorescent them in natural teeth (Figure 12).
margin All of the techniques I have tried to
describe are applicable to the complete
range of Heraeus ceramics, including the
Zirconia and the soon to be released Alu-
mina veneering ceramics. The system is
enhanced by the inclusion of a pressable
Secondary Dentine pow- material that has the same CTE as the
der will give the illusion normal Heraceram, allowing us to do
of low value and shadow. combination work including all ceramic
crowns, veneers and bonded work with the
same veneering material. At the moment
Figure 9. Highly fluorescent margin powders in the cervical area and various Value Heraceram (bonding only) is also avail-
powders change the brightness or fluorescence of the underlying substructure. The able in the modified 3-dimensional
inclusion of two different Mamelon powders can be seen in the incisal tip, while shading technique enabling us to accu-
Secondary Dentine powder gives the illusion of shadow in the interproximal area. rately match almost all shading systems.

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36 - eLABORATE November/December 2005


Figure 10. Natural tooth on the right and Figure 11. The shade guide. Note Figure 12. Shown here is an illustration
Heraceram opalescent enamels or OS Secondary Dentine powder will give the of the many wonderful effects that can be
ceramic material on the left show identi- illusion of low value and shadow. created easily using the many combina-
cal amounts of opalescence. tions of powders of the matrix kit.

Heraceram, the new material designed Heraceram material helps us to master the
by Heraeus Kulzer, can be used to steps in the dance of light and enhances Ray Sharkey has owned his own
create truly natural effects in every our skill to recreate nature in everyday dental laboratory on Queensland’s
day ceramic restorations. With a little ceramic restorations. sunshine coast, north of Brisbane, since
practice and a slightly different 1985 and has lectured on various aspects
perspective, we can use simple modifica- Part 1 of this article appeared in of dental technology since 1992.
tions to our build up technique and eLABORATE July/August 2005. In 1994, he was hand picked by
improve the quality of our work. All famous Swiss ceramist Willi Geller to
new materials require a little perseverance Heraceram is available from Heraeus be the first Australian member of the
and practice to master, however with Kulzer in Australia. For more info, contact Oral Design® group. Recently he has
this material I believe it is made easier, Jeff Lauretti on (02) 9417-8411 or taught hands on technique courses in
since the ceramic itself more closely 0432-327-848. In New Zealand, call China, Korea and New Zealand for
resembles natural tooth structures. The Oraltec on (09) 478-2229. Heraeus Kulzer on Heraceram.

November/December 2005 eLABORATE - 37

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