Masking An Endodontically Treated Tooth

Historically, porcelain veneers have been an effective treatment option. In addition to preserving tooth structure, adhesive technologies offer excellent options to improve both the esthetic and restorative needs of the patient. As dental materials and techniques have improved, porcelain veneers provide durable, aesthetic, and structural improvements to a person’s smile. These dental restorations alone provide exceptional results and, when coupled with other treatment options, can provide patients with conservative options that are remarkable.

The following case study was sent in from Dr. Katie Sugar of Sugar Family Dental.

The patient presented with teeth crowding, overlapping, and irregularities. Tooth #9 had been endodontically treated and was very dark. The patient wanted to improve his smile, specifically wanting to achieve a straighter, whiter, and more balanced smile. However, the patient did not want to have any crown preparations and indicated that he would like to take as conservative an approach to his case as possible.

Dr. Katie Sugar, DMD
Sugar Family Dental

Dr. Sugar began the case using Invisalign to move the patient’s teeth to a more ideal position. Invisalign and other clear aligner therapies are excellent options for correcting malocclusions and aligning teeth to a more esthetic and functional place. This patient had some crowding which is a common issue involved in malocclusion. In most mild to moderate crowding cases, clear aligners work great to reposition the teeth. In addition, Dr. Sugar did some tooth whitening to lighten the teeth as much as possible to help with the final results.

Shade Selection

select the correct Emax ingots and provide the ideal shade match, the following information must be provided. This will ensure that the patient’s color expectations are met.

Specifically, the following should be provided:

1. The shade you desire (Figures 3 and 4)
2. The tooth shade after preparation (Figure 5)
3. Photos:
4. Full face
5. Lips retracted
6. Pictures with the shade tabs in the same position as the tooth
7. Natural smile

With this information in hand, the Smiles by Design team at Burbank Dental Lab was able to select the corresponding Emax ingot that provided the closest color match while masking the dark underlying stump shade present on tooth #9.

Burbank Dental Lab Fabrication

After the case was prepared with veneer preparations, the case was digitally scanned using an Itero scanner and uploaded to the digital portal on the website at Burbank Dental Lab.

The case fabrication process began with the following steps:

• Evaluate and comprehend the case requirements on the prescription
• Understand the patient’s desired end result
• Review the photos provided
• Analyze the issues concerning the underlying color of tooth #9
• Evaluate the digital scans
• Begin fabrication of veneers

Thank you Dr. Katie M. Sugar, DMD

Burbank Dental Lab is very grateful to Dr. Katie Sugar of Sugar Family Dental for giving us the opportunity to work with her on this case. The results of this case are outstanding, and this stems from planning and following the necessary communication steps to get a case like this right. Working with the patient’s desires to remain conservative provided for an excellent starting point with respect to tooth position and shade.

Successful cases follow proper preparation design, appropriate material selection, patient input, and knowledgeable technicians who can mimic the surrounding dentition with the given materials. If you have any questions regarding your next case, please call or chat with a Smiles by Design team member at Burbank Dental Lab.

Burbank Dental Lab would like to thank Dr. Katie Sugar for providing the notes and photos for this case and for giving us permission to use them.