Two Keys For Matching A Single Implant Crown

I thought I would create a blog post to share with all of you the results of the implant case.

I placed the final crown a couple of months ago and I am pleased to report that the crown was inserted on the first attempt. I can’t really say that this happens to me all of the time with a single central incisor restoration. There are cases that I am not satisfied with the results and I return it to the lab to modify.

I think the key to nailing one of these restorations on the fist attempt lies with excellent lab communication. Harald Heidl, a master dental ceramist from Seattle, fabricated this case. The case consisted of a custom Etkon Zirconia abutment and an IPS e.max layered ceramic crown. In this case I also used some limited bonding to improve the shape and form of the adjacent central and lateral incisor and recommended a bite splint to protect the restorations from future attrition.

Due to the distance involved, Harald never was introduced to the patient in person so we communicated with digital photography. I have discovered over the years that excellent digital photography can replace the need for the patient to drive to the lab for a custom staining appointment. The system that I follow is to send a series of shade photos that I take using my Nikon D3s camera using the Nikon Micro 105mm lens and the Nikon RICI Micro flash kit.

I find that this body, lens, and flash system produces excellent results but I have also tested the Nikon D7000 body with this set up and it offers great results at a lower price point.

I will share with you two different tips for excellent shade photos.

The first tip is to pick the shade tab that you feel is closest to the tooth you are matching and photograph that tab as well as one with higher value and one with lower value. For an anterior tooth I typically shoot shade photos with 3 different shade tabs from two different angles but sometimes I can use 5 or 6 shade tabs if the tooth in question has a complicated shade map.

The second tip is that I would recommend that you angle the lens and flash of your camera so that it is not perpendicular to the teeth and shade tabs that you are photographing. With this tip, you will find that the teeth and the shade tabs have less reflection on the surface and you can diagnose the shade more effectively.

If you follow these two tips and set your camera up correctly with proper exposure and white balance you should have great results matching even the elusive central incisor.

If you would like more detailed photography training feel free to check out my Mastering Digital Dental Photography DVD set. As always if you have any questions or comments feel free to use the link above.

Remaining tooth before extraction and implant site development.

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Shade photo with the provisional implant crown and the surrounding dentition.

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Shade photo with the provisional implant crown and the surrounding dentition.

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Shade photo with the provisional implant crown and the surrounding dentition.

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Shade photo with the provisional implant crown and the surrounding dentition.

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Shade photo with the provisional implant crown and the surrounding dentition.

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Shade photo with the provisional implant crown and the surrounding dentition.

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Final crown and zirconia abutment.

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Final crown and zirconia abutment.

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Zirconia abutment seated on the dental implant

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Final restoration.

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Final restoration.

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Final restoration.

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Comments

  1. Excellent result ..for your dedication to look into the details
    Thank u for the post
    I enjoyed it very much

  2. carlos Rosa says

    .Excellent and highly aesthetic outcome. very good

  3. Nasser Emtyazi says

    Dear Dr.Stephan,
    Thamk you ,and an excellent job you made.

  4. Dr Stephan nice job!
    Questions
    1.What cement do you use when cementing allceramic crowns to zirconia abutments ?
    2.Is there a different procedure when cementing to titanium abutments?
    Take Care
    Mark Rotsaert

  5. Hi Stephen,Well done!!!
    Good job,aesthetically pleasing and beautiful
    Dr.M Fyra

  6. Randy Barbuio says

    Nice job! (as always). Part of the success of this case has to do with the provisional I’m sure. Was it an immediate implant placement with a provisional crown?

    Regards,
    Randy B

    • Stephen Phelan says

      Hi Randy,

      The case was a delayed implant placement with an immediate provisional. I grafted the extraction socket and let it mature about 3 months before I placed the implant and provisional. If you look at the blog history you can see the case details in previous posts.
      I hope all is well.
      Regards,
      Stephen

  7. Hi Stephen, As always, a beautiful result. Well done!!!
    Always good to hear from you.
    Warm regards,
    Alvin Sher

    • Stephen Phelan says

      Thanks Alvin, I am glad you liked the results.
      Great to hear from you and I hope all is well.
      Stephen

  8. Hello Dr. Phelan

    This is a spectacular result.

    wow

    Dr. Zvi Fudim

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