by Michael DiTolla, DDS, FAGD
Some of the most difficult clinical situations that dentists face in clinical practice are patients with severe tetracycline staining.
I treated a patient's twin sister a few years ago, and we placed a set of veneers that were a conservative but esthetic compromise. When we removed the veneers six months later, I prepped deeper to make the veneers thicker. But at the try-in appointment, it was clear that the esthetics had not improved much from the first set.
We ended up using IPS e.max crowns. The crowns gave us an improved result, but we still had some show-through. When the patient's brother came to see me, I knew I was going straight to crowns. But I wanted to see if BruxZir solid zirconia crowns could block the prep shade. While not as esthetic as IPS e.max crowns, I hoped to get an esthetic result by blocking out the stump shade.
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Michael DiTolla, DDS, FAGD, is the director of clinical research and education at Glidewell Laboratories in Newport Beach, Calif. He lectures nationwide on both restorative and cosmetic dentistry. Dr. DiTolla has several free clinical programs available on DVD through Glidewell Laboratories or online at www.glidewelldental.com.
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