Last week I had the pleasure in taking young Emma to visit a dental laboratory as part of broadening her experience before applying for dental school. We went to Castle Ceramics in Tamworth; a laboratory I have been working with closely for the past 10 years. Indeed in that time I have helped with presentations on photography and impression taking at the laboratory. Ian Taylor and I have worked together to give a combined lecture on Smile Design and Jeff Caddick is always a font of knowledge and advice. I was trying to stress to Emma the importance of working as a close team with the laboratory as, even though they never meet the patient, the technician has to produce what the patient and dentist want to ensure everyone is happy.
It is always interesting to see the lab in action and get a practical update on the new materials. For many years our choice of crowns was limited to either porcelain jacket crowns or porcelain-fused to metal crowns, where the metal substructure provides strength for the overlying porcelain. The inherent problem with this sort of crown is that the porcelain has to disguise the underlying metal and then attempt to match the appearance of the surrounding natural teeth; the net result is often a very opaque crown that lacks the vitality of the natural teeth and an unsightly black margin. Attempts to hide the metal margin below the gum usually means it is difficult to ensure a good fit; initially this results in gum inflammation which will never heal and eventually lead to gum recession, exposing the metal margins. Modern ceramic materials such as alumina and zirconium can provide a strong sub-structure; thereby allowing a more aesthetic and natural-looking all-ceramic crown to be constructed.
Many of the modern ceramics can be used in combination with a CAD CAM technique to ensure precision and accuracy. Emma was able to have a go at designing a crown and it was fascinating to see the process in action. It is so important to keep up to date with new materials and techniques, ensuring that our patients get the best outcome possible. The pace of change with dental materials is quite staggering, but the aim remains the same – we want to create natural looking teeth that enhance a patient’s smile and confidence.
Written By Dr Roy Dixon Clinical Director