PDF Version - Glidewell Dental Labs
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Figure 4: This view of the mandibular arch shows the same type of<br />
destruction evident in the maxillary arch. The patient said no dentist<br />
had ever told him that he needed a nightguard, which surprised<br />
me. (Keep in mind, I’ve found patients to be wrong more than they<br />
are right when relaying clinical facts.) Again, the cast metal crown<br />
on the lower right is the only tooth — natural or restored — that is<br />
doing well in this oral environment.<br />
Figure 5: Just for fun, I take out my VITA Easyshade ® Compact<br />
(Vident; Brea, Calif.) and attempt to get a reading on the current<br />
shade of the patient’s teeth. I have to admit that I half expected<br />
smoke to come pouring out of the device as it attempted to match<br />
this shade. The device is programmed to give the closest shade<br />
as opposed to the exact shade, so it indicated a C4 as you might<br />
have guessed.<br />
Figure 6: When I place the C4 tab next to the teeth, it’s clear that<br />
the hue and the chroma are more intense, and the value is much<br />
lower. As the tetracycline staining is technically in the dentin, what<br />
we are seeing is the stains showing through the enamel. You know<br />
as well as I do that when we prep into the enamel, this discoloration<br />
will only intensify.<br />
Figure 7: A SeeMORE 4-way retractor (Discus <strong>Dental</strong>; Los Angeles,<br />
Calif.) is placed. I used to use these retractors only when filming,<br />
but then I realized they freed up a hand each for my assistant and<br />
me. The company stopped making them for a while, but rumor has<br />
it they are starting to again. Here I am placing PFG Light topical<br />
anesthetic (Steven’s Pharmacy; Costa Mesa, Calif.) onto moist<br />
mucosal tissue. (NOTE: Don’t dry the tissue beforehand.) We leave<br />
it in place for 45–60 seconds before rinsing. I love this topical gel<br />
because it is the only one I have found that keeps the patient from<br />
feeling the needle insertion.<br />
Another Use for Anterior BruxZir Solid Zirconia Restorations25