August 15, 2018


unnatural pfm crown

This patient had an unlifelike porcelain-fused-to-metal crown on her front tooth. The opacity shadowed the root and gums, resulting in gum darkness around the tooth.

Translucency is a major component in how natural looking your cosmetic dentistry will look.  Teeth by their nature are translucent (or semitransparent), allowing a certain quantity of light to diffuse through it from your surrounding environment.  Much effort by the cosmetic dentist and the ceramist is placed into duplicating this natural looking physical characteristic of natural teeth in their porcelain veneers or all-ceramic non-metal crowns.

I’m sure you’ve noted seeing people with “bad looking caps”, unnatural and opaque “chicklet-looking”.  Most of the really unesthetic looking porcelain crowns that are quite obvious to us are usually not all-ceramic (which has

All-ceramic crowns and porcelain veneers

After replacing the porcelain-fused-to-metal crown with all-ceramic crown and porcelain veneers on the adjacent teeth, which had more natural translucency, this patient's gum shadowing was much improved.

translucency), but rather porcelain-on-metal crowns that have an inner thimble of gold that is covered with porcelain or very opaque porcelains.  Although the outside porcelain looks more natural than a metal crown, the underlying metal or porcelain is opaque and thus does not allow light to pass through the crown as it would in a natural tooth.   So understanding why translucency is such an important physical characteristic in cosmetic dentistry it is easy to appreciate why the much more natural translucent effect of porcelain veneers and all-ceramic crowns is preferred by most cosmetic dentists rather than porcelain-on-metal crowns for teeth in the front of the mouth.

teeth with dark roots pose special problems

Denise had a very dark root because of trauma sustained as a child. When this occurs on one of the front teeth treating it can create some special challenges.

One challenge that cosmetic dentists often face is treating one or more very dark teeth, usually because the teeth in question had been traumatized by a fall or blow to the face, had an abscessed tooth and waited too long for root canal treatment, or had a previous metal post and core placed prior to the crown.  When cosmetic dentists try  to restore dark teeth the usual preferred treatment using translucent porcelain veneers or all-ceramic crowns sometimes allows the underlying dark root color to show through.  This can produce an end result that is objectionable to many patients. Thus in those cases of dark underlying teeth the dentist will either have to change the color of the underlying tooth utilizing special techniques, or place a less-translucent (i.e. more opaque) porcelain crown to mask the underlying color of the dark tooth.

porcelain veneer on a dark rooted tooth

Denise chose to have porcelain veneers on her upper front teeth. The dark root was successfully masked and natural translucency was maintained.

The main concept of all this is that translucent porcelain veneers or crowns is generally preferred for the best esthetics and most natural overall results.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo and Rancho Santa Margarita
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