cosmetic dentistry_ beauty & science

_When meeting someone for the first time, a dental technician or dentist automatically glancesattheperson’smouthandteeth.Generally, the unnatural grey- or purple-coloured gingiva attracts more attention then the quality of the crowns. As detailed in the following case report, anterior porcelain-fused-to-metal (PFM) crowns or bridges are the main reason for this unsightly gingiva. _Case report A female patient came to our office in February 2012 complaining about pain in the region of teeth 14 I I case report _ red-white aesthetic cosmeticdentistry 2_2013 Fig. 4Fig. 3 Fig. 2Fig. 1 Fig. 8Fig. 7 Fig. 1_Old PFM crowns in situ with surrounding grey-coloured gingiva. Fig. 2_Old PFM crowns, slightly exposed tooth necks of teeth 12–22 and an open margin on the crown on tooth 22. Fig. 3_View of the grey-coloured occlusal soft tissue around the anterior PFM crowns and around the PFM molars. Figs. 4a–d_Schematic diagram of the incidence of light. The cross- section of a tooth with a PFM crown shows that the light passes through the ceramic and is blocked by the more opaque surface of the metal coping and scattered back into the ceramic (a & b). The cross-section of a natural tooth shows that the light passes into the tooth and the mineral tooth structure scatters it in all directions (c & d). Owing to the thin alveolar bone and the thin soft tissue, the entire area around the tooth is lit up from the inside.1 Fig. 5_Occlusal view of the preparation with packed retraction cords. Fig. 6_The preparation with the same stump shade on all stumps. Figs. 7 & 8_Provisional in situ with cleared papillary areas. Fig. 9_The impression, taken with Aquasil Ultra. Fig. 10_Close-up image of the control model. Fig. 11_Occlusal checking on the model to ensure adequate space for the crowns. Fig. 12_The finished IPS e.max copings on the control model. Fig. 13_Close-up image of the coping margins. Figs. 14 & 15_Ready for the try-in. Fig. 16_Close-up image of Changing grey–white back to red–whiteAuthor_Jost P. Prestin, Germany Fig. 6Fig. 5