Lloyd Miller

Harvard Medical School, Boston, Massachusetts, United States

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Publications (2)1.91 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Color matching of a natural maxillary central incisor is one of the most difficult challenges in clinical dentistry. Accurate color determination and interpretation of tooth color information in ceramic work is an important step in achieving success in ideal color reproduction. In this case study, factors that influence tooth color determination were analyzed, and the process of interpretation of tooth color information was assessed based on scientific color data using a novel dental spectrophotometer system. An all-ceramic crown for a maxillary right central incisor was the subject of this color assessment. The contralateral incisor was an intact natural tooth that was bleached and then used as the target shade for an all-ceramic crown. The dental spectrophotometer (Crystaleye, Olympus, Tokyo, Japan) was used for tooth color measurement and analysis. The target tooth, prepared tooth, maxillary arch, and face images were captured for color information. Tooth color stabilization related to tooth bleaching and tooth dehydration was assessed. Based on tooth color data obtained by the dental spectrophotometer, color was analyzed in several different areas of a tooth using CIELAB (Commission Internationale de l'Eclarirage) color coordinates L*, a*, b*, and color difference Delta E. Interpretation of the tooth color information was made in each of porcelain layers on a blue map, and its intensions for color reproduction were described. Throughout this spectrophotometric assessment, the process of stabilized tooth color determination, tooth color analysis, interpretations, and fabrication of a blue map for porcelain work was clarified with color data as scientific evidence. CLINICAL SIGNIFICANCE: The use of a dedicated dental spectrophotometer allows the evaluation and measurement of the color of a bleached tooth. This allows the laboratory technician to more precisely understand the bleached tooth shade as well as when the bleached tooth color has become stable enough to match to a contralateral all-ceramic crown restoration.
    Journal of Esthetic and Restorative Dentistry 02/2010; 22(1):42-52. · 0.96 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Color reproduction of an anterior tooth requires advanced laboratory techniques, talent, and artistic skills. Color matching in a laboratory requires the successful transfer from in vivo with careful considerations. The purpose of this study was to monitor and verify the color reproduction process for an anterior all-ceramic crown in a laboratory through spectrophotometric measurements. Furthermore, a crown insertion process using composite luting cements was assessed, and the final color match was measured and confirmed. An all-ceramic crown with a zirconia ceramic coping for the maxillary right central incisor was fabricated. There was a significant color difference between the prepared tooth and the die material. The die material selected was the closest match available. The ceramic coping filled with die material indicated a large color difference from the target tooth in both lightness and chromaticity. During the first bake, three different approaches were intentionally used corresponding with three different tooth regions (cervical, body, and incisal). The first bake created the fundamental color of the crown that allowed some color shifts in the enamel layer, which was added later. The color of the completed crown demonstrated an excellent color match, with Delta E 1.27 in the incisal and 1.71 in the body. In the cervical area, color match with Delta E 2.37 was fabricated with the expectation of a color effect from the underlying prepared tooth. The optimal use of composite luting cement adjusted the effect from the underlying prepared tooth color, and the color match fabricated at a laboratory was successfully transferred to the clinical setting. The precise color measurement system leads to an accurate verification of color reproduction and its transfer. CLINICAL SIGNIFICANCE The use of a dedicated dental spectrophotometer during the fabrication of an all-ceramic crown allows the dentist and the laboratory technician to accurately communicate important information to one another about the shade of the tooth preparation, the shade of the contralateral target tooth, and the influence of luting cement on the final restoration, thereby allowing the technician better control over the outcome of their tooth color matching efforts and the final color match of an all-ceramic restoration.
    Journal of Esthetic and Restorative Dentistry 02/2010; 22(1):53-63. · 0.96 Impact Factor