Matching the surface morphology of an anterior tooth is a critical component in achieving exquisite esthetics. It doesn’t matter if we are restoring the tooth with composite, porcelain or simply sculpting a provisional. One of the challenges in being able to match the surface morphology to create symmetry on either side of the midline is how we document it. This weekend I learned a very neat way to see the existing surface morphology of the teeth or of my restorations during a lecture by Dr. Brian LeSage at the Heraeus 4th Annual Symposium. If you have ever played the game as a kid where you uncover what was written on the previous piece of paper by using a lead pencil, then this will be a cinch. With a pencil and a piece of paper you simply use the side of the lead to color the paper, and it leaves the depressions in the paper from the previous page white so now you can read them.
On teeth we can accomplish the same thing, and color the high spots, leaving the depressions in the labial surface uncolored so we may more easily see this texture. With the teeth dry, use a piece of articulating paper, and run the paper or silk across the facial surface of the teeth. When you step back and look it will be very easy to now see the surface morphology. You can photograph the teeth this way as part of your lab communication. it is also a great way as you are sculpting an anterior composite or provisional to match what you are creating to the natural teeth. I played with this several times since the lecture, and it works with multiple types of articulating paper. I have used the Bausch paper and Madam Butterfly Silk. What I find amazing is how easy it is to visualize both the macro-texture so I can match the lobes of the teeth, but also the mictotexture, the perikymata and imperfections in the enamel surface. This will now be a permanent piece of my technique and photography series.
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