We recently processed a combination case of E-max crowns and veneers. The customer is very professional and demanding. She is surely a responsible dentist for her patients. Besides, she is a keen artist, who loves photography and paintings. I wonder this is why she is so picky about qualities for dental cases. Thankfully, she loves to communicate, which I think is essential for creating a nice case. Here please let me display the final work first.

E-max crowns and veneers

Now let’s look at the conversations between us. I am displaying important information of our emails, so everyone can have a better understanding of the whole process. All email information is highlighted in Blue.

 

1. Receiving instructions and making stone models

email content from dentist

Email content from dentist. She will send 10 units of Porcelain Veneers, and requires a similar polychromatic shading with high incisal translucency.

Once received this email, I immediately created Shipping documents and sent them to the dentist. About one week later (she waited until having more cases), she sent a package, and one of the cases was this combination work containing 4 porcelain veneers and 6 E-max crowns. 3 days later, we got the package.  Then I received instructions and photos from the dentist. The below in Blue is her email content.

 

Hi Steven, please construct the following:

1. Two Unit Fixed Bridge on tooth number: 11 & 12, and 21 and 22

2. Porcelain Veneer on tooth number 13 and 23

3. Porcelain Veneer with occlusal overlay on 14, 15, 24, 25

4. PORCELAIN: E-max

5. SHADE: Polychromatic OM1 with high incisal translucency.

6. DIMENSION IN MM      LENGHT                                            WIDTH

     Central                                 13 mm                                               9 mm

      Lateral                                 12 mm                                               8 mm

      Canine                                approximate 11-12 mm                   9 mm

      Premolars                          approximate 9-10 mm                    9 mm

GOAL OF RESTORATION: Teeth Lengthening.

I took impression of pre-op length of Central and Lateral. Please follow that length to the later.

SMILE DESIGN and SHADE CHARACTERIZATION: See attached images.

After finishing the work, could you take a picture with a ruler showing the length of each tooth as instructed?

Could you also send with this shipment your Lab form and plastic bags?

Any questions or issues, email me back.

photos from dentist

Photos from the dentist. The left photo shows the patient’s oral situation, while the right one shows what the dentist whats this case to be done.

 

It is good that we have detailed instructions about the case. Another good thing is that we have a photo to check the patient’s oral situation, and we have photos showing what the dentist whats it. Therefore, our technicians can learn what kind of anatomy and shade are the best. In fact, we suggest our customers to send clinical photos, if they need us to make dental restorations for front teeth.

We began to process the case. Once we had stone models and articulated those models, we found that the occlusion was too high. So I sent an email, including several photos, to the dentist. I tried to remind her of watching out for the occlusion, and later make adjustments.

high occlusion

2. Displaying unfinished dental work for approval

2 days later, we had this unfinished work. As requested, we had to send photos first, asking for the customer’s approval. We also took photos with a ruler showing the length of the teeth. Those pictures were just for giving an overview of the work, for the dentist to check occlusion and length.

unfinished all-ceramic case

The unglazed all-ceramic case. There is still not much details.

 

Doctors are often busy. I received no reply in 24 hours. After waiting for the whole day, I sent another email, hoping to get a response, so we could timely proceed with the work. About one hour later, I got an email requesting more photos for the labial aspect – the frontal and lateral view of all the veneers. This was my bad. I should have included more pictures showing all angles, so the dentist could know what was happening.

Within minutes, I received another email with a photo. The attached photo was a sample for reference. She asked us to take professional photos with a black background. Honestly, it is kind of hard for us, because we are just customer service people and technicians. We don’t know much about cameras. Besides, we actually have a lot of work to do. We would feel happy if we could finish a day’s work in 10 hours each day.

 

For all the future photos that you are going to take and send it to me, could you take it at an angle like on the attached photo and on the black background? One is frontal view like that of the attached image, then one right side and one left side view.

Could you resend me X’s case, with those angles of photos as requested. See attached photo. Thanks!

 

3. Taking more professional photos

In order to fully cater to our customer, we managed to take more professional pictures as instructed. We again articulated the case with AMANNGIRRBACH, hoping to show the right occlusion. But it did take us some time to make those pictures. I later sent 2 emails containing photos to the doctor.

articulated dental work

side views of the veneer case

all-ceramic work

 

I have to say this customer helped us to be more professional. As you can see, we are displaying the same case, but those photos can give a totally different effect. With high-resolution photos, the details (though not much) can clearly show up. We would love to take pictures of all our cases, if we had more time.

 

4. Requesting a change for a better anatomy

Soon I received an email, asking for pictures of occlusal view and the lingual view. As we were taking photos for these views, I got another email. We were asked to make a change for better anatomy – the customer even drew a picture indicating the changes that she wanted. Please check the email content and the photo as below.

 

Hi, please see attached photo for further instruction:

1. Could you make the distal incisal corner of central and lateral a bit rounder?

2. From the incisal aspect of incisors, make the central incisor 1.5 mm longer than the lateral incisor.

3. So the teeth does not look so long, create a horizontal characterizations on the cervical area and make the cervical area darker than the base shade

4. Starting from the distal cusp inclines of the canines, make the length of the PMs progressively getting shorter. So that the distal inclines of 2nd PM is the same length as the Molars

asking for a better arch

The left photo is a sample for reference, whereas the right picture is how we should make a change for a better result.

 

4. Making a change for a better arch

Please note that the work was not finished yet. Later we would definitely work on details. Besides, the 2 photos show different angles. The one from our customer has an angle from looking down, while our photo shows an angle from looking straight forward. That’s why our photo could not fully display too much of the beautiful arch.

Anyways, we could never argue with our customers, though most of them did not know how we normally operate. We made a slight change as requested, and sent new photos as below. This time, the photos could display virtually all angles.

side views of the dental work

labial view of the dental work

occlusal views of he dental case

 

5. Making a change for a better glazing

Not long after, I received an email saying “FINE”. The word was brief, but we had the customer’s approval. We finally could go and finish the case. It was not that we got annoyed. We were just happy that our customer was pleased with our work. Within hours, we had a glazed work. However, after we finished the work and sent those pictures to the doctor, we received a negative response as below.

glazed veneer case

Glazed E-max crown and veneer case. The customer said the shade at the cervical is too dark, and cannot match the rest of the shade.

What is the exact shade does your lab used on the cervical area? Looking at the picture, the shade difference is so abrupt and not subtle. It looks like on shade of A3. Some cervical areas are darker than the other and it varies on size. Some are smaller while some are big.

Is the technician who did X’s case the best one on your lab? The shade characterization looks awful. It is not smooth everywhere from the cervical to the mid-body and cervical.

I have sent you on my earlier instruction with X, a picture of what I would like it to accomplish in terms of shades. Tell your technician to review a study of it and follow it to the later.

 

What we originally thought was that the teeth were a bit too long, so we wanted to hide it with a darker shade at the cervical. Besides, we thought a darker shade at that area would give a more natural look. About one hour later, I received another email, giving us suggestions.

See photos attached. They have to make the transitions of different shade smooth. The base shade is OM1, which is very white. They can’t use a family of A3s or Cs shade, as it doesn’t work out aesthetically. If they have to create a darker cervical, they have to use the same darker family of the base shade like that OM3 or even B1.

What shade of incisal translucency have they used?

Two dental cases

Photo is from the dentist. She contrasts two dental cases, and tells us the kind of shade she wants.

 

6. Satisfied with our work

I got to admit that we made a mistake — we shouldn’t have put the teeth onto a white stone model while taking pictures. It made the dark areas look much darker. Also, I would have to say that we should improve our photo-taking skills, especially on how to create ideal lighting conditions. Our photos just could not completely display the real color. What’s more, the shade was indeed a bit too dark! As requested, we scrapped the glaze and changed to OM3, and the customer was finally happy with the work.

final dental work

Final all-ceramic dental work. We could not position all the teeth. As we were taking photos, some teeth were actually falling off (check margins of pre-molars).

In conclusion, creating beautiful cases is not easy. It requires deep communication. This customer is very patient and willing to tell us what she wants. That’s how we have can this work.

This case took about 2 weeks to complete. Normally, we can finish such a case in 4 days. However, during the process, we sent emails and pictures back and forth, which required time, but it was worth it. Therefore, if you ask for a high quality work, please consider giving us more time (6 days), and talk to us more.