U.S. patent application number 11/243897 was filed with the patent office on 2006-04-20 for method and apparatus for communicating tooth characteristics and tooth restoration produced thereby.
Invention is credited to Steven P. Weinstein.
Application Number | 20060084027 11/243897 |
Document ID | / |
Family ID | 29582368 |
Filed Date | 2006-04-20 |
United States Patent
Application |
20060084027 |
Kind Code |
A1 |
Weinstein; Steven P. |
April 20, 2006 |
Method and apparatus for communicating tooth characteristics and
tooth restoration produced thereby
Abstract
A method and apparatus for communicating specific idiosyncrasies
in tooth appearance to be replicated in the fabrication of tooth
restorations, as well as a method for creating reference images of
a tooth are disclosed. The apparatus contains images of a tooth,
wherein categories of specific features are displayed in the
images, and codes are assigned to the images according to
variations within the categories. The method of communication
utilizes the apparatus by allowing a first user to compare an
actual tooth to the images, record the codes for images with
features that most closely resemble the actual tooth, and transmit
the codes to a second user who may reference the same selected
images using the recorded codes. The reference images of a
particular type of tooth are created by separating and enhancing
specific features in photographs of an actual tooth.
Inventors: |
Weinstein; Steven P.;
(Englewood, CO) |
Correspondence
Address: |
HEIMBECHER & ASSOCIATES, LLC.
390 UNION BLVD
SUITE 650
LAKEWOOD
CO
80228-6512
US
|
Family ID: |
29582368 |
Appl. No.: |
11/243897 |
Filed: |
October 4, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10156968 |
May 28, 2002 |
6951459 |
|
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11243897 |
Oct 4, 2005 |
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Current U.S.
Class: |
433/26 |
Current CPC
Class: |
A61C 13/082 20130101;
A61C 19/10 20130101 |
Class at
Publication: |
433/026 |
International
Class: |
A61C 19/10 20060101
A61C019/10 |
Claims
1. A communication tool for communicating characteristics of
observable tooth appearance for replication in the fabrication of
tooth restorations, the communication tool comprising a plurality
of images of a tooth, wherein each of the plurality of images
depicts at least one specific color-independent feature of tooth
appearance:
2. A communication tool for communicating characteristics of
observable tooth appearance for replication in the fabrication of
tooth restorations, the communication tool comprising a plurality
of images of a tooth, wherein each of the plurality of images
depicts at least one single, isolated feature of observable tooth
appearance separated from a first image of a particular tooth and
applied to a second image of a constant tooth template.
3. A communication tool for communicating characteristics of
observable tooth appearance for replication in the fabrication of
tooth restorations, the communication tool comprising: a plurality
of images of a tooth, wherein each of the images depicts at least
one specific, isolated, color-independent feature of observable
tooth appearance; and a plurality of codes, wherein each of the
codes is assigned to a respective one of the plurality of images,
and each of the codes uniquely identifies the at least one
specific, isolated, color-independent feature of its respective
assigned one of the plurality of images.
4. The communication tool of claim 3, further comprising a
categorization of the images, wherein the plurality of images
comprises at least a first image and a second image; and a basis
for the categorization is a common relationship between the at
least one specific, isolated, color-independent feature of the
first image and the specific color-independent feature of the
second image.
5. The communication tool of claim 3, wherein the at least one
specific, isolated, color-independent feature is a single, isolated
feature of observable tooth appearance.
6. The communication tool of claim 3, wherein the at least one
specific, isolated, color-independent feature is a composite of a
plurality of single, isolated features of observable tooth
appearance.
7. The communication tool of claim 3 further comprising a schematic
drawing indicating a location and/or shape of the at least one
specific, isolated, color-independent feature in one of the
images.
8. The communication tool of claim 3 further comprising a means for
documenting at least one of the plurality of codes when an actual
feature similar to the at least one specific, isolated,
color-independent feature uniquely identified by the at least one
of the plurality of codes is observed in a subject tooth by a user
of the communication tool.
9. The communication tool of claim 3, wherein the at least one
specific, isolated, color-independent feature of tooth appearance
is depicted on a constant, unchanging tooth template.
10. The communication tool of claim 3, wherein each of the
plurality of images of the tooth is set into a template
representing attached gingival tissue.
11. The communication tool of claim 10, wherein each of the
plurality of images of the tooth and the template is set against a
high contrast background.
12. The communication tool of claim 3, wherein the categorization
of the plurality of images comprises at least one category selected
from the group comprising: translucency, translucency hues,
characterizations, hypocalcifications, brown discolorations, crack
lines, surface anatomy, chroma, value, and variations.
13. The communication tool of claim 3, further comprising a recipe
related to at least one of the plurality of codes for recreating
the at least one specific, isolated, color-independent feature on a
tooth restoration.
14. A booklet communicating characteristics of observable tooth
appearance for replication in the fabrication of tooth restorations
comprising: at least one page; a plurality of images of a tooth
displayed across the page, wherein each of the images depicts at
least one specific, isolated, color-independent feature of tooth
appearance; a plurality of codes displayed across the at least one
page, wherein each of the codes is assigned to a respective one of
the plurality of images, and each of the codes uniquely identifies
the at least one specific, isolated, color-independent feature of
its respective assigned one of the plurality of images.
15. The booklet of claim 14 further comprising a categorization of
the images using a plurality of categories, wherein the plurality
of images comprises at least a first image and a second image; and
a basis for the categorization is a common relationship between the
at least one specific, isolated, color-independent feature of the
first image and the at least one specific, isolated,
color-independent feature of the second image.
16. The booklet of claim 15, wherein the categorization is
displayed on the at least one page.
17. The booklet of claim 16, wherein the categorization is
displayed in a color coded manner.
18. The booklet of claim 15, wherein the categorization of the
images further comprises at least one category selected from the
group comprising: translucency, translucency hues,
characterizations, hypocalcifications, brown discolorations, crack
lines, surface anatomy, chroma, value, and variations.
19. The booklet of claim 14, wherein each of the codes is displayed
in association with its respective assigned one of the plurality of
images.
20. The booklet of claim 14, further comprising an index that
documents the categorization of the plurality of images as the
plurality of images appear on the at least one page of the
booklet.
21. The booklet of claim 14, wherein the at least one specific,
isolated, color-independent feature is a single, isolated feature
of observable tooth appearance.
22. The booklet of claim 14, wherein the at least one specific,
isolated, color-independent feature is a composite of a plurality
of single, isolated features of observable tooth appearance.
23. The booklet of claim 14 further comprising a schematic drawing
indicating a location and/or shape of the at least one specific,
isolated, color-independent feature in one of the images, wherein
the schematic drawing is displayed on the page.
24. The booklet of claim 14, wherein the plurality of images is
divided into a plurality of subsets of the plurality of images
according to the categorization and at least a portion of the
images of one of the subsets is printed together on the at least
one page.
25. The booklet of claim 14, wherein the at least one page
comprises a plurality of pages and at least two of the pages are
viewable simultaneously.
26. The booklet of claim 14, wherein the at least one page
comprises a plurality of pages; each of the pages contains an
aperture; and the booklet further comprises a binding ring, wherein
the binding ring passes through each of the apertures to attach the
plurality of pages together.
27. The booklet of claim 14, wherein the at least one page is
laminated.
28. The booklet of claim 14, wherein the at least one specific,
isolated, color-independent feature of tooth appearance is depicted
on a constant, unchanging tooth template.
29. The booklet of claim 14, wherein at least one of the plurality
of images is digitally enhanced to highlight the at least one
specific, isolated, color-independent feature depicted in the at
least one of the plurality of images.
30. The booklet of claim 14, wherein each of the plurality of
images of the tooth is set into a template representing attached
gingival tissue.
31. The booklet of claim 30, wherein each of the plurality of
images of the tooth and the template is set against a high contrast
background.
32. The booklet of claim 31, wherein the high contrast background
is matte black.
33. The booklet of claim 14 further comprising a prescription page
for documenting at least one of the codes when an actual feature,
similar to the at least one specific, isolated, color-independent
feature depicted in at least one of the plurality of images and
uniquely identified by the at least one of the codes, is observed
in a subject tooth by a user of the booklet.
34. The booklet of claim 14, wherein the plurality of images
comprises at least one of the images as shown in FIGS. 6A, 6B, 6C,
6D, 7, 8A, 8B, 8C, 9A, 9B, 9C, 10A, 10B, 11A, 11B, 12A, 12B, 12C,
12D, 13, 14, 15, 16A, 16B, 16C, 16D in this specification.
35. The booklet of claim 14, wherein the plurality of codes
comprises at least one of the codes as shown in FIGS. 6A, 6B, 6C,
6D, 7, 8A, 8B, 8C, 9A, 9B, 9C, 10A, 10B, 11A, 11B, 12A, 12B, 12C,
12D, 13, 14, 15, 16A, 16B, 16C, 16D in this specification.
36. The booklet of claim 14 further comprising at least one recipe
related to at least one of the plurality of codes, the recipe
providing instructions for recreating the at least one specific,
isolated, feature on a tooth restoration identified by the at least
one of the plurality of codes.
37-50. (canceled)
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 10/156,968, filed 28 May 2002 (the '968 application), now U.S.
Pat. No. 6,951,459 B2, issued 4 Oct. 2005 (the '459 patent). The
'968 application and the '459 patent are both hereby incorporated
by reference in their entirety as though fully set forth
herein.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] This invention relates to the communication between
dentists, dental auxiliaries, and laboratory technicians of
specific idiosyncrasies in tooth appearance to be replicated in the
fabrication of porcelain or ceramic restorations.
[0004] 2. Description of Related Art
[0005] Traditional methods of assigning features or
characterizations in tooth appearance for the purpose of accurate
and consistent communication of the appearances from a dentist or
dental auxiliary to a laboratory require a significant input of
information for a life-like output in a final restoration of a
patient's tooth. The dentist who provides greater detail in the
nature and intensity of desired tooth characteristics is much more
likely to have a positive result than the dentist who provides a
less specific description. Likewise, the laboratory technician who
is able to reference more detailed information has a much higher
potential to achieve a positive result than one who is provided
limited information. While traditional methods may sometimes be
successful, there are many variables that can complicate the
process, resulting in inadequate or misinterpreted communication,
which in turn lead to greater time demands for treatment.
[0006] Features relevant to tooth appearance can be communicated
from the dental office to the dental ceramist through several
different means. For instance, the dentist or dental auxiliary may
create a diagrammatic illustration depicting various specific
features of tooth appearance including narratives. Tooth appearance
may be communicated to the dental ceramist using photographic
technology, such as a 35 mm color print or a digital photo image
transmitted electronically. Alternatively, the ceramist may examine
the patient directly while simultaneously creating his or her own
schematic or recording tooth appearance using photographic
technology for later reference. Prescribing particular features and
fabricating restorations to fulfill these requirements is performed
on an individual basis requiring one or a combination of the
aforementioned methods of communication for each patient.
[0007] While current techniques may allow for successful
replication of particular features relevant to tooth appearance,
significant limitations exist leading to increased time and
equipment costs, as well as error that is introduced through the
subjectivity of interpretation and multiple steps in communicating
the desired results. For instance, the ability to adequately
identify and describe features of tooth appearance varies among
dentists and dental auxiliaries depending upon motivation,
experience, and skills. When using photography, multiple variables
are introduced that may compromise dependability, for example,
method of display, exposure, subject framing, film processing, and
loss of feature contrast or detail due to flash illumination
coupled with the fact that certain features are difficult to
consistently capture photographically. The use of photography also
requires additional expenses in equipment, film, and film
processing. The use of photographs, diagrams, and narratives
provided to the ceramist are subjectively interpreted and
susceptible to error when changing contexts from one case to the
next.
[0008] Presently there is no industry standardization in the
categorization and encoding of features in tooth appearance that
allow for accurate descriptions of the degree or intensity of
features in tooth appearance. Esthetic dentistry, by its very
nature, is a very visual endeavor wherein all parties are trying to
translate a visual impression of what they see and what they would
like to see in a completed dental restoration into words. There is
a need for a process of accurately matching a restoration to
natural definition that is less difficult, time consuming, and
expensive than traditional methods when considering varying degrees
in motivation and abilities of a dentist and a laboratory
technician. An improved process would reduce or eliminate the
inability to achieve an acceptable and anticipated result and the
subsequent need to re-make restorations. An improved process would
also reduce patient frustration and treatment time, as well as
uncompensated costs to the dentist and technician in time, effort,
and materials.
SUMMARY OF THE INVENTION
[0009] The present invention addresses the shortcomings of the
tooth restoration process by inexpensively creating a level of
standardization in the communication of specific idiosyncrasies in
tooth appearance to be replicated in the fabrication of porcelain
and/or ceramic restorations by significantly reducing the amount of
subjectivity associated with such communications. The invention
provides a communication tool for reference by the dentist and
dental laboratory in order to fabricate life-like restorations.
Repetitive use of the invention may also enable the dentist and
laboratory to provide consistent and predictable results.
Additionally, the present invention significantly reduces the
amount of expertise required to facilitate communications between
dentists, dental auxiliaries, and ceramists and further facilitates
such communications in a more consistent and objective manner.
[0010] In one embodiment, the present invention depicts,
categorizes, and encodes specific features of tooth appearance in a
communication tool to enable documentation of the features. The
array of features depicted may be sufficiently inclusive so as to
command applicability to tooth characterizations or features which
any patient may present. Categories representing features of tooth
appearance are presented with specific illustrations of variation
within each category. Illustrations representing variations in
degree and intensity of particular features are also provided.
Specific features diagnosed are transcribed on an accompanying
laboratory prescription and sent to the dental laboratory where the
restoration may be fabricated. The laboratory technician or
ceramist may refer to the same pictorial display in fabricating the
porcelain or ceramic portions of the restoration that have been
delineated on the laboratory prescription to accurately create the
prescribed presentation of the final restoration.
[0011] Basing communication on pictorial images eliminates the need
for complex diagrams or narratives, and fixed presentation of the
images reduces the negative impact of metamerism (i.e., the change
in appearance caused by different lighting conditions). Thus, the
error and potential error in current formats and methods of
communicating features may be minimized or eliminated.
Additionally, the dentist sets all technical parameters and directs
the laboratory technician to stay within the parameters in order to
support accountability of the technician in following direction of
the dentist. The content and format of the images support
recognition of individual features because, with repetitive use,
the user is trained to recognize these features both singly and in
composite. Therefore, the invention is conducive to use by dental
auxiliaries who may have less knowledge, training, or experience in
the field by improving the communication of these less skilled
practitioners.
[0012] The images presented in the present invention may be a
singularity on an unchanging template. Composite representations of
multiple specific features in context may also be presented as a
secondary reference. Displaying single features on a constant
template eliminates visual distractions inherent with changing
contexts. Displaying both single features and composite images
provides for immediate reference to verify the accuracy of selected
features. In either case, the dimensions of the gingival tissue
framing the tooth and the dimensions of the tooth template may
remain constant. Representative slides based on clinical
observations may be converted to a digital format and specific
features may be digitally separated from the original image and
applied to the respective template. All features depicted in the
present invention thus may be true representations of natural
phenomenon. In some cases, further digital manipulation of an image
may be used to heighten or enhance the respective feature in order
to maintain its natural appearance. The images may be sufficiently
large to enable deciphering of detail while not demanding
extraordinary perceptual interpolation or extrapolation by the user
for accuracy.
[0013] When using the present invention while examining a patient
in order to select specific features that occur in tooth
appearance, a dentist or dental auxiliary may first select a
category of feature. The dentist or dental auxiliary will then
compare the images displayed for the selected category to the
patient's tooth. The dentist or dental auxiliary will then document
the code for the image that most closely depicts the actual
features on the tooth on a prescription form. If the images are
displayed, for example, in a booklet, diagnosed features may be
transcribed on a laboratory prescription form that is consistent
with the booklet itself. The lab technician or ceramist will then
use the codes documented on the prescription form to cross
reference to identical images displayed using the present invention
in the laboratory in order to fabricate a porcelain and/or ceramic
restoration of the patient's tooth.
[0014] The invention may also utilize semi-transparent overlays of
various images displaying specific selected features of tooth
appearance in order to construct a composite image of the tooth.
However, when overlaying layers, for example, of acetate, one must
be sure that a lifelike image is attainable. In addition to
semi-transparent overlays, the invention may utilize a video
display to present composite images of the tooth for reference by
the dentist or technician, for example, through the use of image
morphing software on a computer. When using video displays, care
must be exercised to make sure the consistency of the images is not
compromised by such equipment variables as monitor calibration.
[0015] The foregoing and other aspects, features, details,
utilities, and advantages of the present invention will be apparent
from reading the following description and claims, and from
reviewing the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] This patent or application file contains at least one
drawing executed in color. Copies of this patent or patent
application publication with color drawings will be provided by the
United States Patent and Trademark Office upon request and payment
of the necessary fee.
[0017] FIGS. 1A and 1B are front isometric views of a communication
tool of the present invention in a booklet form.
[0018] FIG. 2 is a plan view of a single page of a communication
tool of the present invention in a booklet form.
[0019] FIG. 3A is a plan view of a diagnosis form for use with a
communication tool of the present invention in a booklet form.
[0020] FIGS. 3B-3E depict exemplary restoration recipes.
[0021] FIGS. 4A and 4B are flow diagrams depicting a method for
using a communication tool of the present invention in a booklet
form.
[0022] FIG. 5 is a plan view of an index of one embodiment of a
communication tool of the present invention in a booklet form.
[0023] FIG. 6A is a plan view of a Defined Translucency page of the
booklet of FIG. 5.
[0024] FIG. 6B is a plan view of a Brown Translucency page of the
booklet of FIG. 5.
[0025] FIG. 6C is a plan view of a Characterized Translucency page
of the booklet of FIG. 5.
[0026] FIG. 6D is a plan view of a Proximal Translucency page of
the booklet of FIG. 5.
[0027] FIG. 7 is a plan view of a Translucency Hues page of the
booklet of FIG. 5.
[0028] FIGS. 8A-8C are plan views of Translucency Format pages of
the booklet of FIG. 5.
[0029] FIGS. 9A-9C are plan views of Hypocalcifications of a
Characterization category pages of the booklet of FIG. 5.
[0030] FIGS. 10A and 10B are plan views of Brown Discolorations of
the Characterization category pages of the booklet of FIG. 5.
[0031] FIGS. 11A and 11B are plan views of Crack Lines of the
Characterization category pages of the booklet of FIG. 5.
[0032] FIGS. 12A-12D are plan views of subcategories of Surface
Anatomy category pages of the booklet of FIG. 5.
[0033] FIG. 13 is a plan view of a Chroma category page of the
booklet of FIG. 5.
[0034] FIG. 14 is a plan view of a Value category page of the
booklet of FIG. 5.
[0035] FIG. 15 is a plan view of a Variations category page of the
booklet of FIG. 5.
[0036] FIGS. 16A-16D are plan views of selected images from the
booklet of FIG. 5 superimposed on different shades of Vita.RTM.
porcelain.
[0037] FIG. 17 is a flow diagram of a method to create images of
dental characteristics for a communication tool according to the
present invention.
DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION
[0038] The present invention will now be described in detail with
reference to various embodiments thereof, with some aspects of the
invention being described in the accompanying drawings. Numerous
specific details are set forth in order to provide a thorough
understanding of the present invention. It will be apparent to
those skilled in the art that the present invention may be
practiced without some or all of the specific details, that
operations may be rearranged, that some operations may be
eliminated or performed in a different way, and that other changes
may be made without departing from the spirit and scope of the
present invention.
[0039] An exemplary embodiment of the present invention is referred
to herein as a Laboratory and Dentist Digitally Enhanced Reference
(LADDER). The LADDER is a pictorial reference guide displaying true
photographic images of features of tooth appearance. The scope,
intensity, coloration, contrast, and character of the features are
combined to simplify what would otherwise be a significantly more
involved means of communication into one universal pictorial and
encoded reference. Dentists, dental auxiliaries, and laboratory
technicians may use the LADDER to communicate these features
between the dental office and dental laboratory. The LADDER
depicts, categorizes, and encodes specific features that occur in
tooth appearance in the context of an unchanging template, enabling
the user to visualize the specific feature(s) and readily
communicate such onto a laboratory prescription for fabrication of
a porcelain or ceramic restoration. Samples of composite features
are also included in the LADDER to provide further reference. The
encoded prescription is then forwarded to the laboratory technician
or ceramist who references the same images to accurately replicate
the prescribed feature(s) in the porcelain or ceramic
restoration.
[0040] Respective tooth features are accurately depicted in the
LADDER on a constant template in both individual and composite
formats. The features and images depicted may be digitally
reconstructed to be accurate in reflecting a life-like appearance.
A constant template is maintained with only the respective tooth
feature changing. Specific tooth features are identified using the
LADDER and are added individually to create the final appearance.
The LADDER allows any user to identify specific features, and the
respective coding provides for exact communication of the
identified features to the laboratory. Once the specific features
are identified, the user can utilize the composite images provided
in the LADDER to verify and support the accuracy of his or her
selection(s) in a literal, photographic context.
[0041] In one embodiment, the LADDER utilizes a multi-page booklet
2, as depicted in FIGS. 1A and 1B, including front and back covers
with images 4 and schematics 6 displayed inside. A plurality of
images 4 may be displayed on each of the internal pages 8 of the
booklet 2. The embodiment depicted in FIGS. 1A and 1B displays four
images 4 per page 8. The pages may also be connected together to
allow for viewing of a single page with all others rotated under
and against the topmost page and for viewing multiple pages by
fanning the desired pages. For example, the pages of the booklet
may be connected in the upper left hand corner by a binding ring
10, as shown in FIGS. 1A and 1B. The binding ring 10 allows for
viewing a single page 8 with all others rotated under and against
the topmost page as shown in FIG. 1A and for viewing multiple pages
by rotating the pages 8 using the binding ring as a pivot point to
fan desired pages as shown in FIG. 1B.
[0042] FIG. 2 depicts a typical page 8 in one embodiment of the
LADDER booklet. The page 8 in FIG. 2 displays three images 4 of an
ideal maxillary left central incisor 12, set into a template
representing attached gingival tissue 14 that acts to mimic a
natural setting. The images are further printed on a matte black
background 16 for contrast. More or fewer than four images 4 may be
displayed on the page in various ways, and the LADDER booklet is
not limited to containing images 4 of ideal maxillary left central
incisor 12, but may contain images 4 of any type of tooth. The
images 4 may be printed on only one side of the page 8, or both
sides may also be utilized. Multiple categories delineating
multiple features of tooth appearance may be displayed on the pages
of the LADDER booklet. For example, the page 8 depicted in FIG. 2
displays a category name 18 vertically on the right hand side of
the page 8 and may also be color coded. The images 4 displayed on a
page 8 may represent variations within a specific category. For
example, the embodiment shown in FIG. 2 shows images 4 that
represent low, medium, and high translucency. The images 4 in FIG.
2 may also have designated codes 20: CIT-L, CIT-M, and CIT-H. The
page 8 may also display a schematic drawing 22 of the image 4
showing the geographic location 24 on the tooth of the referenced
feature. It may be desirable to include the number of images per
page that should support presentation of those categories that
display the degree or intensity of a particular feature. Presenting
multiple and defined images per page may assist the user in
discerning features by comparison within a category that otherwise
may be difficult to perceive.
[0043] When using a booklet to display images, the size may be
compact to make it convenient to use chair-side in referencing the
natural dentition of a patient, as well as on the work surface of
the laboratory technician when fabricating the final restoration.
All pages of the booklet may also be laminated so they may be
cleaned or disinfected without damaging the booklet. Images may be
displayed that are sufficiently large to enable the deciphering of
detail while maintaining proportion to the subject reference that
does not demand extraordinary perceptual interpolation or
extrapolation by the user for accuracy. For example, one embodiment
of the invention displays images that are approximately 1.5'' high
and 1'' wide.
[0044] When examining a patient to document how a particular tooth
restoration should appear, a dentist or dental auxiliary may use
the LADDER to effectively communicate the specific features of
tooth appearance to the laboratory technician. The specific
features of tooth appearance may be transcribed on a prescription
form. FIG. 3A shows one embodiment of a prescription form, which is
herein referred to as a LADDER Rx form 300. The LADDER Rx form 300
may contain blank spaces for information to be filled in by the
dentist or dental auxiliary, such as the dentist's name 302; the
dentist's license number 304; the date of the prescription 306; the
patient's name 308; the dentifrice material 310, i.e., the brand or
type of material to be used in making the tooth restoration, e.g.,
Vita.RTM. porcelain (Vita, Bad Sackingen, Germany); and the desired
return date 312. The LADDER Rx form 300 may also contain blank
schematic drawings 314 of a tooth, whereby the dentist may indicate
the types of specific features and their locations on the patient's
tooth, which are explained in further detail herein.
[0045] One method for using the LADDER is depicted in FIGS. 4A and
4B. At step 400, the dentist or dental auxiliary fills in the
dentist's name, the patient's name, the material from which the
restoration will be fabricated (e.g., porcelain to metal (gold), a
specific brand of ceramic, or a specific type of feldspathic
porcelain), and the return date on the LADDER Rx form. The dentist
or dental auxiliary may then, at step 410, choose to review an
index of categories of specific features of tooth appearance. An
index of categories for one embodiment of a LADDER booklet is
depicted in FIG. 5. Then, at step 420, the dentist or dental
auxiliary turns to the page, if using a booklet, containing the
images of the chosen category. The displayed images for the
specific category are then, at step 430, compared to the patient's
actual tooth. The dentist or dental auxiliary then selects the
image containing the specific feature of tooth appearance within
the chosen category that most accurately reflects the patient's
actual tooth (step 440). Once an image is selected, the dentist or
dental auxiliary then, at step 450, records the code corresponding
to the selected image on the prescription form and further
indicates the location and intensity of the feature on the actual
tooth by marking an area on the schematic drawings of the tooth on
the prescription form. Steps 410 though 450 are then repeated until
image codes have been selected and documented for each category
(step 460). Once all the image codes have been recorded, the
dentist or dental auxiliaries may then, at step 470, view composite
images of specific features of tooth appearance in order to verify
their code selections. At step 480, the prescription form is
forwarded to the laboratory technician or ceramist in charge of
creating the tooth restoration.
[0046] Referring to FIG. 4B, the laboratory technician or ceramist
receives the completed prescription form at step 490. While viewing
a LADDER reference guide that is duplicate to the one used by the
dentist or dental auxiliary, the laboratory technician or ceramist,
at step 500, uses the prescription form to guide him or her to
specific images during fabrication of the tooth restoration. At
step 510, the laboratory technician or ceramist views the image to
better understand the desired tooth restoration. Finally, at step
520, the laboratory technician or ceramist places the image so that
it may be viewed while preparing the tooth restoration and prepares
the tooth restoration based upon the features displayed in the
image.
[0047] FIGS. 5-15 depict one exemplary embodiment of a LADDER
booklet. FIG. 5 depicts an index 40 for this embodiment of the
LADDER booklet. The index 40 shows nine categories 42 depicting
multiple features of tooth appearance. The categories 42 depicted
in FIG. 5 are translucency 44, translucency hues 46,
hypocalcifications 48, brown discolorations 50, crack lines 52,
surface anatomy 54, chroma 56, value 58, and variations 60. The
hypocalcifications 48, brown discolorations 50, and crack lines 52
categories may be grouped under a heading of characterizations 62.
The categories 42 displayed on the index 40 may also be color coded
to identify images of like categories 42 for ease of locating a
specific category 42 when using the LADDER. For example,
translucency 44 and translucency hues 46 may be displayed in blue;
hypocalcifications 48, brown discolorations 50, and crack lines 52
may be displayed in gray; surface anatomy 54 may be displayed in
red; chroma 56 may be displayed in yellow; value 58 may be
displayed in white; and variations 60 may be displayed in violet.
The respective color coding 63 of the categories may also be
present as a background for narrative descriptions vertically
transcribed on the right-hand side of each page, as shown, for
example, in FIG. 6A. The embodiment of the LADDER described herein
is presented for use with a maxillary left incisor. However, the
LADDER may be used with any tooth, and the categories discussed
could vary in number, name, and detail.
[0048] Four translucency pages 64 (FIGS. 6A-6D) are presented in
the LADDER booklet: defined 66 (FIG. 6A); brown 68 (FIG. 6B);
characterized 70 (FIG. 6C); and proximal 72 (FIG. 6D). In the
embodiment depicted, each translucency page 64 displays three
images 4 depicting a low, moderate, and high degree of
translucency. A schematic drawing 22 of the image 4 showing the
geographic location 24 of the referenced feature may also be shown
on each of the translucency pages 64. Each image 4 is coded for the
type and degree of translucency. In FIG. 6A, the defined images 4
may be coded as follows: DIT-L 74 for defined incisal low, DIT-M 76
for defined incisal medium, and DIT-H 78 for defined incisal high.
As shown in FIG. 6A, the tooth in each image becomes more
translucent toward the bottom of the tooth from DIT-L to DIT-H. In
FIG. 6B, the brown images 68 may be coded as follows: BIT-L 80 for
brown incisal low, BIT-M 82 for brown incisal medium, and BIT-H 84
for brown incisal high. As shown in FIG. 6B, the tooth in each
image becomes darker brown toward the bottom of the tooth from
BIT-L to BIT-H. In FIG. 6C, the characterized images 70 may be
coded as follows: CIT-L 86 for characterized incisal low, CIT-M 88
for characterized incisal medium, and CIT-H 90 for characterized
incisal high. These images differ from the defined translucency
series of FIG. 6A in that the translucent area does not extend to
the bottom edge of the tooth. As shown in FIG. 6C, the translucent
area of the tooth in each image becomes more translucent toward the
bottom and the sides closer to the bottom of the tooth from CIT-L
to CIT-H. In FIG. 6D, the proximal images 72 may be coded as
follows: PT-L 92 for proximal translucency low, PT-M 94 for
proximal translucency medium, and PT-H 96 for proximal translucency
high. As shown in FIG. 6D, the tooth in each image becomes more
translucent at both sides of the tooth from PT-L to PT-H.
[0049] Translucency hues 46 (FIG. 5) is a sub-category of
translucency 44 and is described on a separate page 98 (FIG. 7),
utilizing four images 4. All aspects of the images 4 are constant
except for the hue or color of the referenced translucency. As
shown in FIG. 7, the tooth images are more translucent toward the
bottom of the tooth, and the translucency varies by color. In FIG.
7, each image 4 is coded as follows to describe the varying colors
of translucency on each image: VTH 100 for violet blue translucency
hue, CTH 102 for cyan/green translucency hue, MTH 104 for
magenta/red translucency hue, and GTH 106 for gray translucency
hue.
[0050] Referring to FIGS. 8A-8C, the twelve images displayed on the
three pages labeled as translucency format 108 depict translucency
in a composite format. The composite formats allow other features
to be included in a single image, for example, surface anatomy,
characterizations crack lines, and varying translucency hues. In
FIG. 8A, the images 4 are coded as follows: UT 110 for uniform
translucency, COHT 112 for common incisal halo translucency, CIHT
114 for characterized incisal halo translucency, and DT 116 for
defined translucency. As shown in FIG. 8A, the translucency is
uniform throughout the tooth in image UT 110. The translucency is
more concentrated in a region across the tooth toward the bottom,
but not including the bottom edge of the tooth in images COHT 112
and CIHT 114, whereas the translucency in image DT 116 is
concentrated in a region across the tooth toward the bottom
including the bottom edge of the tooth. In each of these images,
different surface anatomies or characterizations are simultaneously
imposed on the tooth as a composite image.
[0051] In FIG. 8B, the images 4 are coded as follows: BIHT 118 for
blue/incisal halo translucency, BRIHT 120 for brown incisal halo
translucency, PT 122 for proximal translucency, and MT 124 for
middle translucency. In addition to the surface anatomy, crack
lines, and characterizations imposed on the tooth in each of the
images, the translucency in images BIHT 118 and BRIHT 120 appears
in a region across the bottom half of the tooth, but not including
the bottom edge with the translucency taking on a blue tint in BIHT
118 and a brown tint in BRIHT 120. In image PT 122, the
translucency appears on both side edges and the bottom edge of the
tooth, whereas the translucency in image MT 124 appears across the
middle one-third of the tooth.
[0052] In FIG. 8C, the images 4 are coded as follows: IAT 126 for
incisal angles translucency, PGST 128 for progressive translucency,
PDBT 130 for progressed blue translucency, and PDGT 132 for
progressed gray translucency. Again, in addition to translucency
characteristics, several types of surface anatomy are variously
additionally imposed on the tooth to provide a reference for how a
composite of such features would appear. The translucency in image
IAT 126 appears concentrated toward the bottom corners of the
tooth. The translucency in image PGST 128 appears more concentrated
in the bottom corners of the tooth and becomes less defined toward
the center of the tooth, and the images PDBT 130 and PGDT 132 show
the translucency in blue and gray tints, respectively.
[0053] Four types of hypocalcifications 48 are depicted in FIG. 9A.
The images 4 may be coded as follows: LSH(T) 134 for localized
surface hypocalcification, LSSH(T) 136 for localized sub-surface
hypocalcification, DSH(T) 138 for diffuse surface
hypocalcification, and DSBH(T) 140 for diffuse sub-surface
hypocalcification. As shown in FIG. 9A, the hypocalcification is
depicted in the whiter portions of the images. In images LSH(T) 134
and LSSH(T) 136, the hypocalcification is concentrated in a few
locations on the tooth as opposed to being spread out over a
greater portion of the tooth as in images DSH(T) 138 and DSBH(T)
140. The hypocalcification also appears closer to the surface of
the tooth in images LSH(T) 134 and DSH(T) 138 as opposed to LSSH(T)
136 and DSBH(T) 140, wherein the hypocalcification appears just
beneath the surface of the tooth.
[0054] The coding for the images shown in FIG. 9A are designated
with a parenthesized "T"--T--which designates a template image.
This indicates that the individual feature is presented singularly
to prevent confusion with similar coding for composite images of
the same features. FIGS. 9B and 9C depict hypocalcifications 48 in
composite settings using a constant template in shape and outline.
In addition to the hypocalcifications 48, the composite images
additionally present various combinations of, for example, surface
anatomy, characterizations, chroma, and discolorations. The images
4 in FIG. 9B are coded as follows: LDSH 142 for localized distinct
surface hypocalcification, DDSH 144 for dispersed distinct surface
hypocalcification, DSH 146 for diffuse surface hypocalcification,
and DSBH 148 for diffuse sub-surface hypocalcification. As shown in
FIG. 9B, the hypocalcification in image LDSH 142 appears as defined
white regions localized near the bottom edge of the tooth. The
hypocalcification in image DDSH 144 appears as defined white spots
that are dispersed throughout the tooth, whereas the
hypocalcification in image DSH 146 appears as white areas which are
less defined and appear to occur toward the surface of the tooth.
The hypocalcification in image DSBH 148 appears as white areas that
are less defined and appear to occur below the surface of the
tooth.
[0055] In the FIG. 9C, the images are coded as follows: LDS 150 for
localized diffuse surface hypocalcification, LDBH 152 for localized
sub-surface hypocalcification, SSH 154 for striated surface
hypocalcification, and SSBH 156 for striated sub-surface
hypocalcification. As shown in FIG. 9C, the hypocalcification in
image LDS 150 appears as defined white surface spots that are
dispersed in a localized area toward the bottom one-third of the
tooth, whereas the hypocalcifications in image LDBH 152 appear
below the surface of the tooth. The hypocalcifications in SSH 154
appear in white surface spots that appear in elongated areas
running from the bottom to the upper half of the tooth, whereas the
hypocalcifications in image SSBH 156 appear below the surface of
the tooth.
[0056] Four types of brown discolorations 50 are depicted in FIG.
10A. The images 4 may be coded as follows: BH(T) 158 for brown
hypocalcification, MBS(T) 160 for middle brown stain, IBS(T) 162
for incisal brown stain, and SBS(T) 164 for surface brown stain. As
shown in FIG. 10A, the brown discoloration is depicted by a brown
or darker area on the tooth. For example, the brown discoloration
on BH(T) 158 is depicted as a brown spot toward the center bottom
of the tooth, the brown discoloration on MBS(T) 160 is depicted as
a brown spot in the center of the tooth, the brown discoloration in
IBS(T) 162 is depicted as a brown stain that covers most of the
bottom third of the tooth, and the brown discoloration in SBS(T)
164 is depicted as a brown stain that covers most of the center
third of the tooth and appears closer to the surface of the tooth.
The coding for the images 4 shown in FIG. 10A are designated with a
parenthesized "T"--T--which again designates a template image,
wherein the individual feature is presented singularly to prevent
confusion with similar coding for composite images including the
same features.
[0057] In FIG. 10B, the features shown are the same as those in
FIG. 10A, but they are depicted as brown discolorations 50 in a
composite setting using a constant template in shape and outline.
The images 4 in FIG. 10B may be coded as follows: BH 166 for brown
(hypocalcification), MBS 168 for middle brown stain, IBS 170 for
incisal brown stain, and SBS 172 for surface brown stain.
[0058] Four types of crack lines 52 are depicted in FIG. 11A. The
images 4 may be coded as follows: YCL(T) 174 for yellow stained
crack line, BCL(T) 176 brown stained crack lines, MDST 178 for
microfracture-distinct, and MDIF 180 for microfractures-diffuse. As
shown in FIG. 11A, image YCL(T) 174 depicts a darkened yellow crack
line running from the bottom to the upper third of the center of
the tooth, whereas BCL(T) 176 depicts two darkened brown crack
lines running parallel from the bottom to the upper third of the
tooth. The image MDST 178 depicts a small well-defined crack
running from the bottom of the tooth left of center vertically to
the center the tooth, whereas MDIF 180 depicts a small crack with
more amorphous features running from the bottom of the tooth right
of center vertically to the upper one-third of the tooth.
[0059] FIG. 11B depicts crack lines 52 in a composite setting using
a constant template in shape and outline. The images 4 in FIG. 11B
may be coded as follows: YCL 182 for yellow stained crack line, BCL
184 for brown stained crack lines, SM 186 for surface
microfractures, and SSM 188 for sub-surface microfracture. The
image YCL 182 depicts a single yellow-brown crack line in the
center of the tooth running from the bottom to the top, whereas the
image BCL 184 depicts multiple brown vertical crack lines. The
image SM 186 depicts small surface crack lines (microfractures)
running from the bottom of the tooth toward the top, whereas image
SSM 188 depicts small crack lines (microfractures), which appear
below the surface of the tooth.
[0060] The four pages shown in FIGS. 12A-12D depict sixteen
representations of surface anatomy 54. Because surface anatomy is
colorless, it may be advantageous to show the images in gray scale.
Surface anatomy 54 may be sub-categorized as low 190 (see FIG.
12A), moderate-high 192 (see FIG. 12B), and as having variations
194 (see FIGS. 12C and 12D). The four low surface anatomy images
are coded SA-1 196, SA-2 198, SA-3 200, and SA-4 202, which
correspond to increasing proportions of the surface over which the
anatomy presents. The four moderate-high surface anatomy images are
coded from SA-5 204, SA-6 206, SA-7 208, and SA-8 210, which
correspond to even greater and increasing proportions of the
surface over which the anatomy presents. Surface anatomy may be
described as random bumps and indentations located in a particular
area of a tooth. As shown in FIGS. 12A and 12B, the images depict
an increasing surface area characterized with random bumps and
indentations from SA-1 to SA-8.
[0061] Occasionally, surface anatomy takes on a more uniform
characteristic, as shown in the surface anatomy variations images
of FIGS. 12C and 12D. The eight surface anatomy variations images 4
are coded as follows: SA-9 212 for striated, SA-10 214 for waved,
SA-11 216 for orange peel, SA-12 218 for lemon peel, SA-13 220 for
perikymata, SA-14 222 for alternate texture, SA-15 224 for cervical
crease, and SA-16 226 for fissure. The image SA-9 212 depicts a
tooth with a surface anatomy that resembles a striated surface. The
surface anatomy in image SA-10 214 appears to have waves stacked
vertically and traversing laterally across the surface of the
tooth. The image SA-11 216 depicts surface anatomy that is rough
over most of the surface area, with the roughness taking on the
shape of the outer texture of an orange peel, whereas SA-12 218 has
a less rough surface anatomy taking on the shape of the outer
texture of a lemon peel. Image SA-13 220 depicts a perikymata
anatomy wherein minute transverse ridges are shown on the surface
of the tooth. Image SA-14 222 depicts a surface anatomy containing
more than one of the previously described characteristics. Image
SA-15 224 depicts a crease in the surface running vertically from
the top to the lower one-third of the tooth right of center,
whereas image SA-16 226 depicts a fissure in the surface running
from the upper one-third to the lower one-third of the tooth.
[0062] The category of chroma 56, or the degree of color
saturation, is depicted in the four images 4 shown in FIG. 13. The
chroma images may be coded as follows: CL 228 for low, CML 230 for
medium-low, CMH 232 for medium-high, and CH 234 for high. As shown
in FIG. 13, the images become progressively more yellow in color
from CL 228 to CH 234.
[0063] The category of value 58, or the degree of brightness, is
depicted in the four images 4 shown in FIG. 14. The value images 4
may be coded as follows: VL 236 for low, VML 238 for medium-low,
VMH 240 for medium-high, and VH 242 for high. As shown in FIG. 14,
the images become progressively brighter from VL 236 to VH 242.
[0064] The category of variations 60, which combines features in
less commonly occurring formats, is depicted in the four images 4
shown in FIG. 15. The variations images 4 may be coded as follows:
T 244 for tetracycline, CB 246 for combination banding, F 248 for
fluorosis, and MC 250 for maverick coloration. As shown in FIG. 15,
the image T 244 shows a tooth with a blue/green color in the lower
half and the upper one-fourth of the tooth, but with a darker
region between. The image CB 246 shows a tooth with color bands
reaching laterally across the tooth. The image F 248 shows areas of
the tooth that are especially bright. The image MC 250 shows
various colors dispersed throughout the tooth.
[0065] The LADDER may also be used to supplement standardized
methods known in the dental industry for choosing a base color or
shade 30 (see FIG. 3A) in a tooth restoration. For instance,
Vita.RTM. porcelain, which is commonly known in the dental
industry, is available in four different categories of base shades
30 labeled as A, B, C, and D. In addition, Vita.RTM. porcelain is
available in five different hues within the A category, four
different hues within the B category, four different hues within
the C category, and three different hues within the D category. The
images in the LADDER may be presented in combination with the
various shades 30 of Vita.RTM. porcelain, or any other standardized
color scheme, as a supplement to the standard LADDER schema to
indicate how a finished restoration on a particular type of
porcelain or ceramic might appear.
[0066] For example, FIG. 16A depicts four images of a tooth coded
as defined translucency (DIT-L 74 in FIG. 6A) from the LADDER
displayed in Vita.RTM. porcelain shades A-2 252, B-2 254, C-2 256,
and D-2 258. Four images of a tooth coded as brown translucency
(BIT-L 80 in FIG. 6B) from the LADDER are similarly displayed in
Vita.RTM. porcelain shades A-2 260, B2 262, C-2 264, and D-2 266,
as depicted in FIG. 16B. FIG. 16C depicts four images of a tooth
coded as characterized translucency (CIT-L 86 in FIG. 6C) from the
LADDER displayed in Vita.RTM. porcelain shades A-2 268, B-2 270,
C-2 272, and D-2 274. Four images of a tooth coded as diffuse
surface hypocalcification (DSH(T) 138 in FIG. 9A) from the LADDER
are similarly displayed in Vita.RTM. porcelain shades A-2 276, B-2
278, C-2 280, and D-2 282, as depicted in FIG. 16D. The Vita.RTM.
porcelain shades are mentioned here to demonstrate by example how
the LADDER may be used to supplement any standardized restoration
material coloring scheme, and it is not limited to use with the
Vita.RTM. porcelain shades shown. Images of the types described in
FIGS. 16A-16D may be displayed on a sheet rather than booklet form
or in smaller sizes in order to accommodate additional feature
variations or include each of the hues in each shade category.
[0067] With this understanding of the LADDER scheme, the
prescription form 300 of FIG. 3A may now be described in further
detail. In addition to the dentist and patient identification
information described above, several fields are provided on the
prescription form 300 to communicate the information necessary to
recreate an accurate tooth appearance in a restoration. It should
be understood that although the schematic tooth template 314 shown
in FIG. 3A (as well as in FIGS. 3B-3E) is in the form of a right
maxillary incisor, the prescription form 300 could depict any tooth
form, e.g., canines and molars. Further, the schematic tooth
templates 314 are merely meant to be used as shorthand for
identifying the locations of certain tooth characteristics on the
tooth to be restored. Casts of the natural dentition or other
common methodologies are used to indicate the actual shape of the
tooth to be restored.
[0068] Several factors may be considered in determining the base
shade of the tooth restoration. Initially, the principal shade 30
of the tooth restoration must be chosen to match the natural
dentition. This may be done by indicating one or more shades 30 on
the tooth template 314. For example, in prescription 300 of FIG.
3A, the upper or cervical portion of the tooth shape 314 is
indicated as Vita.RTM. shade A-2 33, whereas the body portion is
indicated as A-1 34. These shades may be determined by comparing
the natural dentition to a Vita.RTM. shade guide, for example, as
depicted in FIGS. 16A-16D, or by comparison to any other industry
shade guide. Since the color of the underlying dentin preparations
may greatly effect the color of ceramic restorations, the
prescription form 300 includes fields for recording, for example,
the cervical Stumpf shade 31 and the body Stumpf shade (Stumpf
Shade Guide, Ivoclar, Amherst, N.Y.). The shade 30 is also affected
by the chroma 56 and the value 58. On the exemplary prescription
form 300, values of CMH 232 for chroma 56 and VL 236 for value 58
from FIGS. 13 and 14 on the LADDER 2 are entered in the appropriate
fields.
[0069] The prescription form 300 provides additional tooth
templates 314 for the recordation of specific characteristics of
the other categories 42 of tooth appearance classified in the
LADDER 2. It should be recognized that one or more characteristics
of tooth appearance in each category 42 may be present in a subject
tooth and each of these characteristics is then combined to create
an appropriate restoration. The second tooth template 314 is
designated to receive information regarding the translucency
category 44. In the exemplary prescription form 300 of FIG. 3A, the
PT-L 92 code of FIG. 6D for proximal translucency-low is indicated.
The third tooth template 314 on the exemplary prescription form 300
is provided to record an indication of characterization 62. In FIG.
3A, the characterization recorded is DSBH 148, or diffuse
sub-surface hypocalcification, as depicted in FIG. 9B on the LADDER
2. The tooth template of the prescription form also allows the
dentist to indicate the area 36 of the tooth upon which the
characteristic of tooth appearance should appear on the
restoration. The final tooth template 314 on the prescription form
300 is for the recordation of surface anatomy 54, which in this
exemplary case is indicated as SA-3, as shown in FIG. 12A on the
LADDER 2. An additional field of depth 37 is provided to allow the
dentist to indicate the depth of the features of the surface
anatomy 54 in the surface of the tooth.
[0070] Once a ceramist receives a prescription form, he must then
determine how to recreate the indicated characteristics into the
desired tooth appearance in a restoration. This typically requires
great knowledge and skill on the part of the ceramist in choosing,
for example, the appropriate ceramic or porcelain, the colors and
surface treatments, and whether cutbacks or multiple bake cycles
are required to achieve the desired effects. Unfortunately, in the
hands of a less skilled ceramist, even the best instructions may
not result in a quality restoration. This disparity in quality of
restorations may be alleviated, however, by providing recipes
corresponding to each of the tooth characteristics depicted in the
ladder.
[0071] The LADDER may incorporate multiple formulations for each
applicable image outlining the necessary tints, opaquers, and
mixtures respective to dominant porcelain/ceramic manufacturers.
The colors, modifiers, and other applications are essentially the
same to achieve the image, but termed differently by each
manufacturer. For example, Jeneric-Pentron (Wallingford, Conn.)
manufactures Finesse.RTM. porcelain and Vita manufactures Vita.RTM.
porcelain. For example, one might take samples of an incisal
modifier from both manufacturers and find them to be identical in
coloration, while Jeneric-Pentron labels this modifier "blue
incisal" and Vita labels this modifier as "indigo incisal."
[0072] Most all dental laboratories tend to use one or two lines of
porcelain or ceramic. The set-up expense of having multiple lines
is quite costly. Outlining multiple "recipes" using the jargon of
varied manufacturers thus accommodates universal applicability of
the reference. The recipes themselves readily allow for an average
technician to output a much higher quality of esthetic restoration
and encourages such by eliminating the time and costs of
experimentation to achieve the desired effects.
[0073] Several exemplary recipes are shown in FIGS. 3B-3E. FIG. 3B
depicts a restoration recipe 350 for the LSSH(T) 136 image, or
localized sub-surface hypocalcification characteristic, of FIG. 9A
on the LADDER 2 as prepared on Finess.RTM. Low-Fusing Ceramic. The
base shade 352 of the majority of the restoration is Vita.RTM. A-1.
Portions of the upper tooth 354 are shaded in Vita.RTM. A-2, as
indicated. Also the upper portion of the tooth restoration 356 is
coated with a natural light incisal enamel overlay, as indicated.
The middle to lower body of the tooth 358 is coated with a layer of
A-1 Dentin mixed with Clear in a 50/50 ratio. A non-mamelon cutback
366 is indicated between the middle and lower third of the tooth. A
discoloration or stain 360 is indicated and is created using Faint
White. In the center of the bottom third of the tooth, an area 362
of different coloration is indicated and is created using Ivory
Opal. Finally, the tip of the tooth 364 is tinted using A-1 and
Clear Halo in a 75/25 mixture, respectively. The colors and
treatments used in creating this tooth restoration are all standard
colors and treatments used as part of the Finesse.RTM. restoration
system.
[0074] FIG. 3C depicts a second restoration recipe 350 for creating
a restoration shown in the CIT-M 88 image, characterized incisal
translucency-medium characteristic of FIG. 6C. This recipe is again
based upon a tooth restoration material of Finesse.RTM. Low-Fusing
Ceramic. In this exemplary recipe, the base shade 368 of the
restoration is again Vita.RTM. A-1. Portions of the upper half of
the restoration 370 are again Vita.RTM. A-2 shade, as indicated.
Additional areas of the upper half of the restoration 372 are
overlaid with Natural White Incisal Enamel, as indicated. Three
mamelon cutbacks 378 are indicated in the lower third of the
restoration and are tinted to match the Vita.RTM. B-1 shade. Below
the mamelon cutbacks 378 is an area to be covered with Natural
Light Enamel Incisal. Finally, the tip of the tooth restoration 380
is colored using A-1 Dentin Halo.
[0075] FIG. 3D depicts a third exemplary restoration recipe 350,
this time using a base material of Ducera.RTM. porcelain. The
colors and treatments in this recipe, therefore, are specific to a
Ducera.RTM. restoration system. The tooth appearance to be created
by the restoration is MBS 160, or middle brown stain, as depicted
in FIG. 10A. The base shade 382 of this restoration is Vita.RTM.
A-3. The top of the tooth adjacent to gingival tissue 386 is then
shaded to match Vita.RTM. A-3. The bottom two thirds 382 of the
tooth are also covered by a layer of Natural White mixed with Blue
Opal in a 50/50 ratio. An area of the middle third of the tooth 388
is tinted using White Opal Incisal. Additionally, the central area
between the middle third and bottom third of the tooth 385
indicates that a mamelon colored Amber should be built up in this
area. Vertical crack lines 384 tinted in White are also indicated
at several locations on the tooth. Finally, several areas at the
bottom tip of the tooth 387 are colored White Opal, as
indicated.
[0076] FIG. 3E depicts a fourth exemplary restoration recipe 350,
this time using a base material of Vita.RTM. porcelain. The colors
and treatments in this recipe, therefore, are specific to a
Vita.RTM. restoration system. The tooth appearance to be created by
the restoration is PDBT 130, or progressed blue translucency, as
depicted in FIG. 8C. The base shade 396 of this restoration is
Vita.RTM. D-3. The top of the tooth adjacent to gingival tissue 390
and extending down the sides is then tinted with a mixture of
Vita.RTM. D-3 Dentin and Coral in a 90/10 ratio, respectively, to
build a mamelon area. The bottom quarter of the restoration and
extending up the sides to partially overlap the area of D-3 Dentin
and Coral 392 is tinted with a mixture of two parts Natural Medium
Incisal and three parts Blue Opal. Finally, a portion of the bottom
tip of the tooth 394 is colored with White Opal.
[0077] Although the description of the invention has thus far
focused on the use of a booklet containing images depicting various
features of tooth appearance in order to document and communicate
these features to the laboratory technician or ceramist, a dentist
or dental auxiliary may use various other means for displaying
images. For example, images may be stored on a computer server for
ready access by a user. Composite images may also be displayed by
using semi-transparent overlays or computer morphing software. The
dentist could then select the appropriate image presented on the
visual display and a software program could automatically record
the selection for preparation of a prescription. Computers linked
via a communication network, for example, a local area network or
the Internet, could further enable a user to transmit a
prescription directly to the laboratory. When displaying images
using a monitor or overlays, care must be exercised to insure that
the quality and consistency of the images are not diminished.
[0078] The quality and type of images viewed by users of the LADDER
are an important aspect of the invention, because they help to
assure more accurate communication of specific features of tooth
appearance between the dentist or dental auxiliary and the
laboratory technician or ceramist. In one embodiment of the
invention, the images may be created according to the method
depicted in FIG. 17. In step 1700, various categories of specific
features of appearance for a particular type of tooth are selected.
Representative photographs taken of specific teeth are reviewed and
certain ones of the photographs are selected in step 1710. The
selected photographs are then, in step 1720, converted to a digital
format. Although step 1720 calls for the photographs to be
converted to a digital format, other means may also be utilized,
such as photo manipulation, separation, and filtering. Specific
features are then digitally or photographically separated from the
original image in step 1730. Steps 1700 through 1730 are then, in
step 1740, repeated for each selected category. The specific
features are then applied to a respective template in step 1750.
Any necessary further manipulation of each image that may be
required to heighten or enhance the respective feature is carried
out in step 1760. The template representing the tooth is then, in
step 1770, set into a second template representing attached
gingival tissue. Both templates are then, in step 1780, set on a
matte black background for contrast. Steps 1750 through 1780 are
then repeated for each image (step 1790). Because the various
features depicted on the images have been enhanced, less
subjectivity and expertise is involved with selecting an image that
accurately reflects the specific feature of a patient's tooth.
Although the images have been manipulated, they are true
representations of natural phenomenon.
[0079] Although various embodiments of this invention have been
described above with a certain degree of particularity, or with
reference to one or more individual embodiments, those skilled in
the art could make numerous alterations to the disclosed
embodiments without departing from the spirit or scope of this
invention. It is intended that all matter contained in the above
description and shown in the accompanying drawings shall be
interpreted as illustrative only of particular embodiments and not
limiting. Changes in detail or structure may be made without
departing from the basic elements of the invention as defined in
the following claims.
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