假牙擬真的三要素之二:顏色特徵

Manipulation 4

有關顏色部分,要讓瓷牙看起來像自然牙的三大要素是:

  1. 顏色特徵(shade characterization)
  2. 顏色數據(shade data)
  3. 表面結構(surface texture)

之前 tof 已經在 這篇 介紹過有關因為閃光燈造成的表面結構的重要性。這一篇,要跟各位談談另一項重要的因素:顏色特徵(shade characterization)。這項元素的重要性,以 tof 的觀點來看,不亞於其他兩項,如果要把它列為假牙擬真三要素中,最重要的一項也不為過。許多美學大師在談到用視覺判斷假牙顏色相似度的時侯,常常會 cite 這篇 Johnston & Kao, 1989 年 publish 在 JDR 的 article,說ΔE=3.7 時是視覺判斷假牙顏色像或是不像的閥值,這實在是犯了嚴重的錯誤,因為 Johnston 的 study 忽略了假牙要擬真,除了顏色數據外,還有其他的兩個重要要素。今天要談的,就是其中之一:顏色特徵。

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24 十二月 2012

Do you consider the gingival zenith when doing anterior single implant restorations?

IMG 4946

若要檢視本篇的中文版,請按 這裡

One day, Tof went to a lecture by a local dental implant master.  I was thinking, since I couldn’t steal any of Dr. Johnny Chang’s dental implant techniques, maybe I could steal some from other masters; and at least I would be able to bluff more about dental implantology to my fans of the blog. The speaker’s techniques were impeccable, both the positioning and the angle of the implant placement were masterfully controlled. His techniques are as good as Dr. Johnny Chang’s. But when he showed us the prostheses, it was hilarious; whether it’s the temporal crowns or the final ones, they were all poorly made. Personally, I don’t have a high standard about this, but I wasn’t expecting him to brag about himself so much when the shapes and colors of the crown were all off.

This master likes to emphasize on the notion of super GP, only focuses on the traits that can make big money; dental implants, orthodontics, and ceramic crowns are all his specialties. But for me, I can only focus on being in a single specialty, because I know concentrating on one realm is hard enough, that’s why I cannot cross over to other specialty.

I enjoy being professional at what I do. That’s why I couldn’t stand it when I meet someone with a self-title of super GP master. If the work he has done like that could be deemed as a masterpiece, then my work would be a world class one, too.

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06 十二月 2012

你有考慮前牙植牙的 gingival zenith 嗎?

IMG 4946

To view English version of this post, please click here

有一次,tof 心血來潮,去聽了一位本土植牙大師的演講,心裏想既然偷學不到 Dr. Johnny 張的植牙技術,說不定可以出去偷學一點其他大師的技巧,以後部落格編輯催稿的時候,也可以多吹牛一點有關植牙的部份。那位某大師植牙的技術真不是蓋的,不論是位置、角度都是一等一的,實在不輸 Dr. Johnny 張。沒想到在秀出 crown 的時候,實在讓 tof 噴飯,無論是 temporal crown 或是 final crown,都做的很抱歉的抱歉。 tof 本身的標準就已經不高了,只是沒想到這樣子型態、顏色都不對也能上去大講特講。

這位大師很喜歡強調 super GP,那個好賺就去做,所以植牙、矯正、全瓷冠,每項都是他的專長。tof 會乖乖的當假牙科醫師,就是心想「術業有專攻」,因為本身資質弩頓,一項專科就學不完了,實在無法跨足他科。

所以 tof 很喜歡專業分科,碰到這種號稱 super GP 的「大師」,實在很給他受不了。這樣也能號稱前牙植牙美學?那 tof 早就是「宇宙世界級的植牙美學大師」了。哪還需要在這裡爬格子賺稿費?

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15 十一月 2012

GBR for anterior single implant –To Start from Scratch

本篇的中文版,請按這裡

For the replacement of an anterior tooth with a dental implant, it should be one of the most challenging procedures in implant dentistry. In order to accomplish it well, there are three essentials:

The first essential is: find a good periodontist as a partner;

The second essential is: find a good periodontist who is willing to be your partner;

The third essential is: a good periodontist is already your partner…

It sounds like what a real estate broker will say, but what I said above is for real. If you have already read this article, you will know what tof means here. Hence, in the next series of articles, tof is going to use several cases to praise my collaborative partner: Periodontal & Implant Specialist, Dr. Johnny Chang…..

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09 十一月 2012

從無到有的 GBR 前牙植牙

Post op 3 months

To read English version of this post, please click here.

前牙單顆植牙,應該是美容牙醫中,最具挑戰性的一項技術了。而要做好前牙單顆植牙的條件有三要件:

第一要件就是:找一位好的牙周植牙醫師當夥伴

第二要件是:一個好的牙周植牙醫師願意當你的夥伴

第三要件是:一個好的牙周植牙醫師已經成為你的夥伴……

聽起來像是跟房地產的說詞很像,可是這卻是千真萬確的事實,如果你讀過這篇就會知道 tof 說的是什麼意思,所以以下一系列文章 tof 要用幾個案例來表揚我的合作夥伴:牙周植牙醫師 Johnny 張……

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08 十一月 2012

One of the three essentials in making crowns look real: Surface Texture

Surface texture 095

如果要看本篇的中文版,請按這裡

As a Prosthodontist, I naturally have higher expectations on my own finished works. As shown in the photo above, tooth #21 is a temporary crown, and if you’re the fans of tof, you can immediately identify this and speak out loud: “Wow, it’s such an amazing work, and it’s no doubt like the real ones!”. Meanwhile, some would think: “Not again, this is possibly another flashy article! After one hundred times of practices for trying, it just comes out right once, and here is it for the show!”

Eh, two ways of sayings are both right and wrong. The right part about the above photo is, #21 is indeed a neat temporary crown, but for the wrong part, ha-ha, this is not made by tof. In fact, there is too much bitterness as well as things out of my control, and please just hear me out for what I’m going to reveal in the followings.

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02 十月 2012

假牙擬真的三要素之一:表面結構

Surface texture 095

To view English version of this post, please click here

身為假牙科的醫師,自然會對自己的成品有較高的要求。就像上圖,牙齒#21是一顆臨時假牙,tof 的粉絲一看就說:「哇,真是神乎奇技,做的太擬真了!」,有些人會想:「又來了,這又是炫耀文吧!100顆做一顆像這樣的就拿來現!」。嗯,兩種說法都對也都錯。對的部份是以上圖來看,#21的確是一顆完美無暇的臨時假牙,錯的部份呢,哈哈,這不是 tof 做的,其實這中間有太多的辛酸與無奈,請看下去就知道了。

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01 十月 2012

Evernote: An Indispensable Cloud Tool for the Prosthodontists

頁首照片

如果要看本篇的中文版,請按這裡

For the ways to transfer pictures to the dental technician from the prosthodontists, other than the one introduced in the last post about the “dropbox”, today in this section, tof is going to introduce an even more powerful cloud interface, which almost covered all the requirements from the prosthodontists on information transfers. It is already renowned to the general public with its popular name-“Evernote”.

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16 八月 2012

Evernote: 假牙科醫師不可或缺的雲端工具

頁首照片

To view English version of this post, please click here

假牙科醫師傳遞照片給技師的方法,除了上一篇所介紹的 dropbox 之外,這一篇 tof 要介紹一個功能更強大的雲端介面,這個雲端介面幾乎涵蓋了所有假牙科醫師對資訊傳遞的需求。這個介面就是大家耳熟能詳、響噹噹的 Evernote。 假牙科醫師在執業過程中,需要傳遞資訊給不同人士的機會有以下幾點: 1.傳遞比色照片及比色機所產生的資料檔給技師。 2.傳遞電子技工單給技師。 3.與協同治療的其他次專科醫師共同追蹤客戶治療計畫進度。

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15 八月 2012

傳遞比色照片給技師的方法 (1)- dropbox

 

Dropbox icon 幾乎只要做假牙的醫師,都會需要傳遞數位比色照片給技師,過去常用的方法是利用 email,但是由於相機的畫素越來越大,動輒 1,2 mega 一張照片算是小 case,這種情形下 email 常常自動怠工,根本就寄不到。於是乎以下的對話就常常發生…….

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08 七月 2012

前牙瓷牙冠顏色驗證-廠商篇

Screen Shot 2012 06 17 at 9 13 50 PM  tof 醫師最近因為國事繁忙,嚴重拖稿,導致過去承諾要寫的比色驗證廠商篇一直難產。

其實這一篇主要就是跟大家討論,如果你現在要選擇購買一台比色機,要考慮哪些功能,簡單的說,就是要選哪一台比色機的意思啦。

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17 六月 2012

Anterior Ceramic Crown Shade Verification -About the Manufacturers

Screen Shot 2012 06 17 at 9 13 50 PM

Tof promised to write something about shade matching/ shade verification regarding manufacturer part, but I was so busy on my works. As a result, I was short to make delivery of my promise by this article.

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06 六月 2012

僥倖的前牙單顆植牙

(本篇文章的简体版在 这里

前幾天去聽了 Paulo Malo 的演講,這位大師講到有關假牙醫師的一段話,讓我覺得不是滋味,卻又不得不承認。 大意如下:當假牙醫師在台上 demo 一個漂亮的不得了的 crown,Paulo 會對那個 crown 的 ceramist 印象深刻,而不是假牙醫師,他會想認識那個 ceramist,因為那個 crown 會漂亮,大部分是 ceramist 的功勞,而不是假牙醫師。但有多少醫師在大秀 case 的時候會標註這個 crown 的 ceramist 是誰?很少是吧!滔滔不絕說的好像這個 case 會漂亮是自己的功勞,這樣是太自我了吧!!

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26 五月 2012

臨床小秘訣- crown tryin 時如何簡單找出過緊的臨接面而加以修整

 

IMG 1553  1

當在試戴假牙時,如果臨接面很緊,通常需要調整臨接面,crown 或 implant crown才下的去,在前牙時,我們可以使用咬合紙標出太緊的部份,然後很精準的調整,但在後牙,有時候卻不是這麼一回事。後牙常常不容易放入咬合紙,有時候甚至是反手,那就更困難了。大家都知道,screw retained crown,臨接面更是難 try。有沒有一個比較簡單的方法,讓我們可以標出後牙臨接面太緊的部份而像前牙一樣做精準的調整呢?

 

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22 四月 2012

前牙瓷牙冠顏色驗證:技師篇

我是一個事業有成的齒科技師,也在台北擁有一家規模不小的技工所,所內的瓷技師就有4、5個,當然也包括我在內。在我看似完美的職業生涯中,其實也有一點小小的缺憾,那就是前牙單顆瓷牙的齒色,常讓我捉摸不定,所以有些遠程的 case 我不敢放心的接。 原因是,各位知道,偶爾會有醫師因為齒色不正確的原因而 repeat 我的case,如果幾次還不能達到要求,到最後無奈只好請客戶到我的技工所來比色(為此,我還耗資數十萬裝修了一間比色室,好讓客戶來不會看到亂亂的感覺)。有時候我也得親自出馬去診所幫客戶比色(不好意思,以我的身價,小診所我可是不會親自出馬的)。
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17 三月 2012

Shade verification of anterior Porcelain Crowns- dental office part.

Shadepilot spectrophotometer

要看本篇的中文版,請按 這裡 (但內容有一些不同哦!)

Tof mentioned about the shade verification procedure and how it works in previous articles. Now let’s see how it is practiced clinically.

First of all, let’s see who needs a system like this.

Since this system is designed to avoid the troubles that a patient has to come back and forth for a shade mis-matched crown. (Remakes due to shade also sometimes caused the loss of faith of the patients on the dentist, tof has heard a true story in the clinic I used to worked for. A patient lost her patience on the never-ending process of changing shades. She took the crown out of her mouth, threw it on the floor and yelled: “I am done with this nonsense!” And then she turned around and stormed out of the clinic.)

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17 三月 2012

前牙瓷牙冠顏色的驗證:醫師篇

Shadepilot spectrophotometer

To view English version of this article, please click here !

tof 在 比色機的妙用 這篇提到瓷牙顏色的驗證及比色驗證模,現在讓我們來看看實務上,在診所端是如何應用的。

首先,我們來想想看誰需要這套系統?既然這個系統是用來降低因為錯誤的瓷牙顏色造成客戶必須忍受重複拆、黏臨時假牙(有時候還要用 crown remover 敲哩!)及再約診舟車勞頓,甚至對醫師喪失信心(tof 在以前服務過的診所聽過一個真實的案例,客戶實在改顏色改到不耐煩了,把 crown 從口內拆下來,往地上用力一扔,說:「我不做了可以吧!!」,掉頭就走的這種尷尬的案例)。

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17 三月 2012

比色機的妙用:瓷牙顏色的驗證

前牙瓷牙顏色的複製,是前牙美學中,醫師較難掌握的一部分,尤其是單顆前牙,更是常常讓醫師被客戶退貨重來(想想那些多金的明星,藝人及上市公司的董事長),這些 repeat,讓人舟車勞頓,最後不得已,通常是請技師出馬親自來看顏色,或是讓客戶去技工所比色。除此之外,似乎只有降低自己的標準,讓 case 就這樣過去吧…. 難道沒有辦法讓顏色一次到位?讓客戶對你敬佩有加?四處幫你介紹她的明星朋友? 為此, tof 嘔心瀝血,翻遍史籍,歷經數十載寒暑日,開發了一個比色工作流程,把這個問題解決。

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17 三月 2012

牙齒的寬長比

牙齒的比例是一個很重要的課題,越來越多的客戶了解這個重要性,讓我們來看看這一個案例吧!!

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17 三月 2012

比色資料的收集

tof 出一題選擇題,讓各位資深的牙醫師回答:請問就前牙美學瓷牙來說,以下三種職務,誰該比色?

1.dentist

2.dental technician

3.燒瓷的人…….

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16 三月 2012