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Simplifying the Dilemma of Shade Matching

Categories: Restorative Dentistry

Author(s): Robert Rosenfeld, DDS

Date: 01-15-2020 06:12:14 am

Case Presentation:
Since the dawn of adhesive dentistry, composite resin materials have been considered the state-of-the-art standard for direct restorations. Advancements in the materials have improved features like wear resistance and polishability, but a product’s ability to mimic the surrounding tooth has depended upon the operator’s ability to correctly choose from the available shades to obtain a good match. This has required doctors to keep a large inventory of costly products. Sometimes, an otherwise perfect restoration is deemed unsatisfactory if the selected shade fails to match the surrounding tooth.

Interproximal decay on distal surface of premolar The goal of obtaining a perfect match has been simplified by the introduction of OMNICHROMA (Tokuyama Dental America). It is described as the first dental composite that matches every tooth with a single shade. This case presentation illustrates its use.

A 74-year-old male patient presented with interproximal decay on the distal surface of his lower right second premolar. The treatment plan required a disto-occlusal composite resin filling. After administering local anesthetic, I made a conservative preparation and excavated all decay. I then used Ultra-Etch 35% phosphoric acid (Ultradent) to selectively etch the enamel cavosurface margins. Using Composi-Tight 3D Fusion (Garrison Dental), I placed a sectional matrix band, wedge, and separating ring to ensure optimal contour and contact. A 2-step self-etching adhesive (CLEARFIL SE PROTECT, Kuraray America) was applied, followed by light-curing with VALO Cordless (Ultradent).

Having recently received OMNICHROMA, I was excited to evaluate its ability to match any shade. When I dispensed and placed the material, it was initially opaque white. However, after light curing, the material took on the color of the adjacent tooth structure. After removing any flash, improving the occlusal anatomy, checking the occlusion, and polishing with Enhance Finishing Points (Dentsply Sirona) and GROOVY Diamond Polishing Brushes (Clinician’s Choice), I was immediately impressed with the results.

The elimination of the shade-matching process will reduce chair time for all practitioners, and many will see cost savings by reducing their inventory of shades. Doctors—even those who stock numerous materials in dozens of shades—occasionally encounter a tooth that doesn’t match any shade in the VITA classical shade guide (VITA North America). Using a material that simplifies or eliminates the shade-matching dilemma can streamline the procedure and yield a result that satisfies even the most particular patient and doctor.

Composite filling using Omnichroma for shade matching

Omnichroma composite resin restoration

Go-To Product Used in this Case 

Omnichroma Composite best product

 

Tokuyama Dental America’s OMNICHROMA simplifies the restoration process by helping clinicians match the color of any tooth. Featuring high polishability and ideal physical-mechanical properties, OMNICHROMA is the first dental composite to use structural color as its main color mechanism; this helps it match the surrounding tooth color every time. Eliminating the shade-matching process streamlines clinical procedures and reduces chair time.

 

 

 

About the Doctor

Dr. Rosenfeld is a graduate of Cornell University and Northwestern University Dental School. He served a 1-year General Practice Residency and a second year as Chief Resident at Long Island Jewish Medical Center. He practices privately in Westwood, NJ, and is a Clinical Attending in the general residency program at Hackensack University Medical Center. Dr. Rosenfeld has advanced training in esthetic dentistry and is on faculty at the Nash Institute for Dental Learning. He is a member of the American Dental Association, American Academy of Cosmetic Dentistry, International Team for Implantology, and several dental study clubs.

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