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Brian Stevenson
One of the main driving forces in dentistry described by its three attributes:
today is the demand for aesthetic Hue: The quality by which we
dentistry. Aesthetics have grown in distinguish one colour family from
importance in restorative dentistry another, such as red from yellow, or green
and the need for the correct shade from blue or purple.
of restoration, as well as other factors Value: The quality by which we
such as contour, amount of glaze and distinguish a light and dark colour.
surface texture are essential if the final Chroma: The quality of colour by which
restoration is going to meet the patient’s we distinguish a strong colour from a
and the clinician’s expectations. This weak one.
review focuses on the literature available Dentine provides the main
on clinical shade matching, while other source of colour in a tooth but it is
authors provide an excellent overview of modified by enamel. In addition, as one
the other factors cited, including reference ages and secondary dentine is laid down,
to the technical processes.1 its Value decreases and therefore the
Knowledge of colour is tooth is darker.2
required to communicate accurately the The shade guide most
shade of restorations. The colour perceived commonly used for indirect restorations is
is dependent on three factors, the light based on the Vita Classical shades. Shade
source, the object being viewed and guides for direct restorations are usually Figure 1. Vita System 3D-Master, Vita Classical, and
the observer. If any of these elements provided by the manufacturer and are Coltene-Whaledent Miris 2 Shade Guides.
is changed, the colour perceived and based on the Vita shades, or they consist
described will be different. Colour is of dentine, enamel and effect colours.
The Vita Classical shade guide The Vita System 3D-Master
is organized into groups of similar hues is a different type of shade guide which
(A to D), with these groups being divided arranges tabs systematically. The tabs are
Brian Stevenson, BDS MFDS RCS Ed, Clinical further via numerical values (1 to 4). divided into five lightness groups (six if
Lecturer in Restorative Dentistry, Dundee Generally, the Chroma (intensity of colour) the bleached shades are included). Each
Dental Hospital, University of Dundee, Park increases and Value (lightness) decreases group includes a central tab with tabs
Place, Dundee, DD1 4HN, UK. as the numbers rise. arranged around it for the determination
270 DentalUpdate June 2009
Hue selection
Several authors33 34 have
investigated the relationship between
the shades of different tooth types. These
authors showed that canines exhibit the
highest Chroma values and can be used as
a useful guide to the Hue of the dentition.
the dentist, patient and technician almost The general consensus from observational study. J Prosthet Dent
immediately and numerous systems are these pieces of research is that the 2002; 87: 149−152.
available. Figure 7 shows IdentaColor II instruments are consistent. They are able 3. Seghi RR. Effects of instrument-
and Ikam that use a spectrophotometer to produce results that illustrate that the measuring geometry on colorimetric
and digital camera, respectively, to record machines give results that agree over time assessments of dental porcelains.
the colour of a tooth. and this is an improvement compared to J Dent Res 1990; 69: 1180−1183.
Each system, depending human observers. The shortcomings and 4. Barghi N, Pedrero JA, Bosch RR. Effects
on the instrument-type used and the variability of these instruments occurs in of batch variation on shade of dental
manufacturer, has recommended routines their dental accuracy, as slight calibration porcelain. J Prosthet Dent 1985; 54:
for the shade selection which are outwith errors will result in consistent but incorrect 625−627.
the scope of this article to mention. shades. Their use in the oral environment 5. Rinke S, Huls A, Kettler MJ.
However, most involve the use of a probe, used to be problematic owing to cross- Colorimetric analysis as a means of
which is approximated to the tooth to be infection problems, but this has now quality control for dental ceramic
used for shade matching. Measurements largely been overcome. Unfortunately, materials. Eur J Prosthodont Restor
are taken and immediately displayed by several authors46,50,54 could not find a Dent 1996; 4: 105−110.
the system. correlation between the magnitude of 6. Seghi RR, Johnston WM, O’Brien WJ.
There are problems with some the instrumentally measured colour Spectrophotometric analysis of
of these devices, including edge-losses, difference and the clinical ratings given to color differences between porcelain
instrumental drift, approximation and cost. restorations by human observers. systems. J Prosthet Dent 1986; 56:
However, they are more repeatable than Instrumental methods 35−40.
humans, with more recent studies showing appear to be a promising area for 7. Groh CL, O’Brien WJ, Boenke KM.
day-to-day repeatability of 83% to 100%. further research and are well suited in Differences in color between fired
However, colour measurements of the long-term observational studies, for porcelain and shade guides. Int J
same sample over time have previously example, assessment of bleaching. They Prosthodont 1992; 5: 510−514.
been shown to produce colour difference undoubtedly can aid people who have 8. Swift EJ, Jr, Hammel SA, Lund PS.
values that would be visible.44 problems with colour matching and can Colorimetric evaluation of vita shade
Recently, there have been be used to provide a base shade from resin composites. Int J Prosthodont
research papers that have attempted to which the laboratory prescription can be 1994; 7: 56−61.
compare the colour-matching abilities formed. 9. Sproull RC. Color matching in
of dental observers to the shades gained Further research is needed dentistry. I. The three-dimensional
using an instrumental method.43,46,50-54 to assess these devices with regard to nature of color. J Prosthet Dent 1973;
Some studies have shown that corrections needed in their software to 29: 416−424.
instruments may improve the clinical match human observers and this may 10. Sorensen JA, Torres TJ. Improved
shade-matching process, while others have require increased co-operation between color matching of metal-ceramic
shown little difference. One investigation53 dental materials companies. In addition, restorations. Part I: A systematic
showed that only 8% to 34% of the further research is needed to provide an method for shade determination.
shade tabs selected by human observers evidence base for all parts of the shade- J Prosthet Dent 1987; 58: 133−139.
matched those selected by these devices. matching process. 11. Schwabacher WB, Goodkind RJ. Three-
Studies43,51,52 have compared crowns dimensional color coordinates of
made after instrumental shade taking natural teeth compared with three
and compared them to human observers. Conclusion shade guides. J Prosthet Dent 1990; 64:
Okubo et al 43 tested the ability of In conclusion, using a 425−431.
humans and instruments to match shade repeatable process should improve 12. O’Brien WJ, Boenke KM, Groh CL.
tabs to a standard shade guide. They the shade-matching procedure. Coverage errors of two shade guides.
demonstrated little difference in shade Photographs or diagrams can show the Int J Prosthodont 1991; 4: 5−50.
matching, 48% and 50% correct shade individual characteristics of each tooth 13. Yap AU. Color attributes and accuracy
matches for humans and instruments, to a technician who can then provide an of Vita-based manufacturers’ shade
respectively. Paul et al51 demonstrated aesthetic restoration. guides. Oper Dent 1998; 23: 266−271.
larger differences in the match of crowns 14. Yap AU, Bhole S, Tan KB. Shade match
made when conventional shade selection of tooth-colored restorative materials
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June 2009 DentalUpdate 275
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276 DentalUpdate June 2009