Jeffrey Caso I was committed, right from the start, to running just about every porcelain CEREC that I have made through the furnace to custom stain and glaze. I began my CEREC adventure before e.max required us to use the oven. I thought I was hot stuff right from the get-go as I had a Ney Miniglaze oven in the office and used it a great deal in the begining. It was a manual oven which required me to sit with a stopwatch and run the restoration through the cycle myself. I will say that they came out really well.
I bought a Vita oven within two years of CERECing and then, when e.max came out, I bought an Ivoclar oven with all the bells and whistles, plus dual-ramp capability and vacuum. I still use both ovens and like them very much.
In the beginning, for me it was all about the shine. The shinier the better. I have gone through a true evolution in terms of staining and now see things a whole lot differently. When doing multiple units in the anterior and not having to match the existing dentition, I like to use no stain or minimal stain. I think block shade is the most important criterion for success. Get that right and you have a happy patient. I also try hard not to go super-shiny. After firing, I will lightly polish the glaze down with a rubber wheel. This gives a more natural look. Teeth are just not that shiny.
When conforming to the patient’s natural dentition, proper block shade still reigns supreme. I was fond of going lighter and staining to match. It works, but eventually you will lose some stain and end up with a hopelessly mismatched restoration. For these anterior cases, I like to slightly over-stain the restoration, fire and then polish back some of the stain and dull out the glaze at the same time. That seems to work best in my hands and gives me a surface that is textured and wears nicely.
Part of the staining evolution that I was referring to is using bolder colors. I now use both black and white stains more than ever before. They can be mixed with other colors to easily give you what you need. Keep in mind that a little black goes a long way. In fact, I rarely use a stain right out of the package. Almost always I mix them to get a true custom color.
Posteriorly, I have had a shift as well. I was always accentuating the grooves with brown. Now, I rarely do that. A deep yellow, similar to a cervical stain and white on every cusp tip and incline really makes the occlusion pop. Blue mixed with a touch of black and blended in well gives a really nice translucent look both in the front and back of the mouth.
So, examine the adjacent teeth at some point and take note of how they look. Then, after the tough prep and design work is over, sit back and let your left brain take over. Don't be afraid to over-stain. You can remove it so well and in a controlled way. Enjoy this part of the process. Your patient can't tell if you have fantastic margins. What influences them most is how it looks. Make it look tooth like and it's a home run.
