Enhancing esthetics in porcelain fused to metal through technique modifications

Three techniques have been discussed and illustrated, with diagrams and examples of clinical cases, that will aid the practitioner to achieve better esthetics when using porcelain fused to metal restorations. The labial butt joint preparation is particularly suitable for upper anterior teeth when the smile line exposes the gingival margin of the restoration and maximal esthetics are demanded. Clinically, the preparation has to be executed in such a way that technically the ceramist does not have to compromise the restoration. Wrong buccal shoulder preparations and too large a space between porcelain and shoulder are the most frequently observed errors. A porcelain sandwich technique in which a thin incisal porcelain layer is condensed between body and translucent porcelain enhances the translucency of the restoration and improves the natural appearance. This technique is particularly suitable for anterior teeth, yet posterior teeth benefit from this method as well, and particularly upper bicuspids are excellent candidates. The third technique uses a blend gold that is applied to the opaque and covered again with another layer of opaque. This method effectively blocks the graying effect often experienced at the gingival margin caused by the underlying metal. A deep chamfer offers the ideal preparation and accommodates the technical requirements best. In conclusion, it can be stated that dentists and dental technicians have available various techniques that make it easier to meet the theoretical and practical requirements of esthetics in dentistry.