Achieving highly esthetic anterior restorations with ideal assessment, communication, and technique

Although all cases should be approached comprehensively, restoring a limited segment in the esthetic zone presents challenges particularly related to microesthetics. Microesthetics are those criteria related to the subtle intricacies of shade, textures, translucencies, and surface effects that make teeth look like teeth. These are the criteria that aid dentists in fooling the eye and allowing restorations to blend invisibly into the smile. Completing a comprehensive assessment of a patient ensures that the restorative foundation will remain biologically and structurally predictable, durable, and above all, esthetically pleasing. Starting esthetic treatment without first doing a comprehensive assessment will result in a compromised result. Within the criteria of microesthetics, the utilization of a common nomenclature and quantitative means of communication between the restorative dentist and the laboratory ceramist are at the core of success. The use of prototypes during the provisionalization phase and progressive techniques in digital photography are invaluable tools. Along with traditional techniques in acquiring proper shade selection, the use of cross-polarization filters has been proven to be an effective way to eliminate spectral artifacts typically found in flash photography. Additionally, the use of a color-corrected master die system provides the ceramist a method to calibrate shades on the lab bench by capturing images--via the cross-polarization filters--that are similar to what is observed clinically.