RESEARCH ARTICLE

Shade-Matching Performance Using a New

Light-Correcting Device
CRISTINA GASPARIK, DMD, PhD student*, ALEXANDRU GRAŢIAN GRECU, DMD, PhD student*,
BOGDAN CULIC, DMD, PhD†, MÎNDRA EUGENIA BADEA, DMD, PhD‡, DIANA DUDEA, DMD, PhD§

ABSTRACT
Purpose: To evaluate the shade-matching performance of dental students when using a new light-correcting device
with polarization filter.
Materials and Methods: A total of 21 observers assessed the shade of the upper frontal teeth in one patient under
three lighting conditions: daylight (A), daylight and a light-correcting device (Smile Lite, Switzerland) (B), daylight and a
light-correcting device with a polarization filter attached (C) by using two shade guides: VITA Classical and 3D Master.
Matching scores were calculated as a sum of the color differences between the reference shades and the selected
shades (ΔEab*). Data were analyzed using analysis of variance (ANOVA) test (α = 0.05).
Results: A significant difference was found between the shade-matching scores under the three lighting conditions
(p < 0.001). However, pairwise comparisons showed that between A (ΔEab*A = 1,873.6) and C (ΔEab*C = 2,019.1), there
was no significant difference (p > 0.05). The best matching scores were calculated for B (ΔEab*B = 1,652.5). Significant
differences were found in respect to the observer’s gender (p < 0.05) and color competency (p < 0.05), as well as with
the shade guide used (p < 0.05).
Conclusions: Dental students’ shade-matching ability was better when the light-correcting device was used, but the
addition of the filter to it did not prove beneficial. The shade guides used, the observer’s gender, and color competency
influenced the shade matching.

CLINICAL SIGNIFICANCE
The light-correcting device influenced the shade-matching performance; however, the attached polarization filter did
not improve the results of the shade matching.
(J Esthet Restor Dent 27:285–292, 2015)

INTRODUCTION unless a perfect balance between color, translucency,

Color plays a major role in the appearance of dental
structures. However, it is not the only attribute
responsible for the vivid look of a natural tooth. The
outcome of a restoration meant to replace the missing
tooth structures will never be esthetically pleasing,
opacity, opalescence, fluorescence, iridescence, and
surface gloss is achieved. Nevertheless, shade selection
is the first step in recreating the natural appearance of
altered or missing dental structures. During this
procedure, information on the other optical
characteristics of dental structure should be analyzed

*Assistant professor, Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
†
Lecturer, Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
‡
Professor, Department of Conservative Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
§
Professor, Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

© 2015 Wiley Periodicals, Inc. DOI 10.1111/jerd.12150 Journal of Esthetic and Restorative Dentistry Vol 27 • No 5 • 285–292 • 2015 285
 SHADE-MATCHING USING A NEW LIGHT-CORRECTING DEVICE
and included into the color map that is transferred to
the dental technician. Two methods are currently
available for shade selection: visual and instrumental
methods.1–3
Visual shade selection is the most frequently used
method in dentistry.4,5 Color matching is a comparison
between the sample (tooth) and multiple standards
(shade guide tabs).6 Shade guide tabs are organized in
shade guides, which, according to their fabrication
concept, are divided into hue-based shade guides and
value-based shade guides.1 Because the human eye is
more sensitive to changes in lightness/darkness and
chroma than to changes in hue, value-based shade
guides are considered more accurate means of shade
selection.1 Visual color matching is subjective and
influenced by a variety of factors. However, this method
is not inferior and should not be underrated. It is
recommended that whenever possible, both visual and
instrumental methods should be used as they
complement each other and can lead toward a
predictable esthetic outcome.1,7,8 Moreover,
instrumental methods allow the recording of CIE L*a*b*
color parameters required for the calculation of the
color difference formula (ΔEab*). The CIE L*a*b* is a
rectangular coordinate system, where CIE L* coordinate
(lightness or value) is represented on a vertical axis,
with values ranging from 0 (black) to 100 (white). The
CIE a* and the CIE b* coordinates represented on
two horizontal axes, express the amount of
redness–greenness or yellowness–blueness of a color.9
The lighting conditions in the dental office vary greatly
according to the moment of the day, year, and type of
light sources in the office, and consequently a mixture
between daylight and fluorescent or incandescent light
results.10 Color-corrected lighting tubes and handheld
light-correcting devices have been recommended to be
used in order to minimize the effect of environmental
lighting. The first types of handheld light-correcting
devices used fluorescent tubes and had several
inconveniences such as large dimensions and lack of
user friendliness. In the next years, the need for
improvement led to the introduction of a new
generation of light-correcting devices, more
user-friendly and versatile. Several studies report their
286 Vol 27 • No 5 • 285–292 • 2015 Journal of Esthetic and Restorative Dentistry
Gasparik et al.
efficiency in color-matching results.11,12 More recently,
polarization filters have been attached to such
light-correcting devices; their primarily role is to reduce
reflected light and to allow for a more accurate
assessment of the dental translucency. Yet, to the best
of our knowledge, no studies were reported so far upon
the performance of polarization filters in
color-matching process.
The aim of the present study was to evaluate the
shade-matching performance of observers with
different levels of experience in dental selection (dental
undergraduate or postgraduate students) when using a
new light-correcting device with polarization filter. The
null hypotheses were: (1) there was no difference in
the shade selection performance of dental students
under the tested lighting conditions, and (2) the
characteristics of the observers such as gender and
color competency, as well as the shade guide used, did
not influence the shade-matching results.
MATERIALS AND METHODS
Observers
A total of 26 observers participated in this study (9
men, 17 women). The age range was 18–26 years, with
different levels of dental education (20 undergraduate
students, 6 postgraduate students). The study was
approved by the Ethics Committee of University of
Medicine and Pharmacy Cluj-Napoca, Romania (No.
64/20.02.2014). Before enrollment, each subject
received proper information on the study protocol and
signed the written consent. All subjects proved normal
color vision by successfully completing the Ishihara
Color Blindness Test (24 Plate version,
computer-based).13 A calibration test was used
according to the ISO standard 28642/201114 to
determine the color discrimination competency of the
observers.
The subjects had limited experience in dental shade
selection; hence, before starting the study, they were
trained on shade matching: information on the color
parameters (value, hue, and saturation), as well as on
DOI 10.1111/jerd.12150 © 2015 Wiley Periodicals, Inc.
 SHADE-MATCHING USING A NEW LIGHT-CORRECTING DEVICE Gasparik et al.

the configuration and the protocol of use for each of During the study, the original markings of the shade
the shade guides used in the study were presented. tabs were covered so that neither the observers, nor the
patient knew the selected shades.

The Patient
Shade Selection Tests
One patient with normal dentition, good oral hygiene,
After completing the color-matching training, the
and without restorations or crowding in the frontal area
observers were asked to select the color of the upper
was selected for the shade-matching tests. Before
right central and lateral incisors and the upper right
recording the shade of the target teeth (upper right
canine of one patient (for the cervical, middle, and
central and lateral incisors, upper right canine), the
incisal thirds) using the two shade guides. One
patient received a professional cleaning and was
experienced dentist supervised the tests and recorded
instructed not to consume drinks with high-staining
the selected shades in an Excel Database (Microsoft
potential (red wine, coffee, tea) during the study.
Office Excel 2007; Microsoft, San Francisco, CA, USA).

The dental shades used as reference were recorded by

Shade selection tests were performed on three separate
one experienced dentist with the VITA Easyshade
days, at the same time of the day (10 a.m.–2 p.m.), and
Advance spectrophotometer (VITA, Bad Säckingen,
in the same dental office. The illumination in the dental
Germany), in the tooth area mode for each of the target
office (500–600 lux) was a mixture between daylight
teeth. Measurements were performed five times for
and light generated by the overhead lamps (fluorescent
each tooth, and the shades that repeated more than
light tubes). A light meter was used for illumination
three times were recorded. VITA Classical and 3D
measurements at the beginning of the shade selection
Master shades were registered. The reference shades,
tests. The observers performed the tests under the
determined instrumentally using the VITA Easyshade
following conditions: the usual lighting conditions of
Advance dental spectrophotometer, were verified
the dental office (A); then using the light-correcting
visually by the same experienced dentist who performed
device (Smile Lite, Model No. 6,500, Smile Line, Smile
the measurements. The patient was not informed on
Line, St-Imier, Switzerland, Switzerland) (B) (1,000 lux
any of the selected shades. The reference shades were:
constant illumination on site by holding the lamp at a
upper right canine—cervical: A3.5(3M3); middle:
distance of 20 cm); and eventually using the
A3.5(3M3); incisal: A3.5(3M3); upper right lateral
light-correcting device with the live polarization filter
incisor—cervical: A2(2L2.5); middle: A2(2R2.5); incisal:
(Style LENSE, polarizing filter, Model No. 6,510, Smile
A2(2R2.5); upper right central incisor—cervical:
Line) (C) (1,000 lux constant illumination on site by
A2(1M2); middle: A1(1M2); incisal: A1(1M2).
holding the lamp at a distance of 10 cm). No time limit
was set for the selection tests. The observers used only
Shade Guides one randomly assigned light setting per day. The
patient was allowed to close the mouth to rehydrate
The shade guides used for the shade selection tests teeth between two observers.
were the VITA Classical shade guide (VC) and the
VITA 3D Master shade guide (VITA). Commission Shade-Matching Scores and Statistical Analysis
Internationale de L’Éclairage (CIELAB) color
parameters of each tab were recorded with the VITA Color difference (ΔEab*) between the reference tabs (the
Easyshade Advance spectrophotometer. A polyethylene matching tabs) and the selected tabs was calculated
guide with a perforation equal in diameter with the according to the following equation:
spectrophotometer’s tip, corresponding to the central
area of the tab was used to reproduce the same
positioning of the tip throughout the measurements. ΔEab * = ( ΔL*)2 + ( Δa*)2 + ( Δb*)2

© 2015 Wiley Periodicals, Inc. DOI 10.1111/jerd.12150 Journal of Esthetic and Restorative Dentistry Vol 27 • No 5 • 285–292 • 2015 287
 SHADE-MATCHING USING A NEW LIGHT-CORRECTING DEVICE Gasparik et al.

where ΔL*, Δa*, and Δb* are the differences in TABLE 1. Shade matching scores by lighting condition and
lightness, redness–greenness, and yellowness–blueness shade guide
respectively. Shade-matching scores (Σ ΔEab*) for each A B C Overall
illumination condition were computed as a sum of the VC 719.3 659.5 954.2 2,333.0
color differences between the reference and the selected
3D 1,154.2 993.0 1,064.9 3,212.1
tabs,15 a lower score meaning a better matching.
Overall 1,873.5 1,652.5 2,019.1 —
The Shapiro–Wilk test was used to assess the (A) Daylight; (B) daylight and the light-correcting device; (C) daylight
normality of the data and univariate analysis of and the light-correcting device with a polarization filter attached.
variance (ANOVA) tests and pairwise comparisons VC = VITA Classical shade guide; 3D = VITA 3D Master shade guide.

adjusted by the Bonferroni method were used to

compare the shade-matching scores by the type of TABLE 2. Shade matching scores by tooth and dental area
illuminant, shade guide, tooth and dental area at a
Σ ΔEab* Upper Upper right Upper right Overall
significance level of α = 0.05 (SPSS v.20.0.0, Chicago, IL, right lateral central
USA). Pearson correlation coefficients were calculated canine incisor incisor
between ΔEab* and absolute ΔL*, Δa*, and Δb* values Cervical 679.6 626.5 442.4 1,748.5
(α = 0.01).
Middle 693.8 598.1 485.4 1,777.3

Incisal 574.2 619.2 825.6 2,019.0

Overall 1,947.6 1,843.8 1,753.4 —

RESULTS

A total of 12 subjects had superior color discrimination
competency, 9 subjects had average and 5 subjects had
poor. Only subjects with average or superior color
discrimination were further included in the study (21
subjects, 5 men and 16 women).
A statistically significant difference was found between
the shade-matching scores (ΣjEab*) under the three
lighting conditions (p < 0.001). However, pairwise
comparisons showed that there was no significant
difference in the observers’ shade-matching ability
under the usual lighting conditions of the dental office
and the use of handheld device, when the polarization
filter was attached to it (p > 0.05). When the matching
scores were compared by the shade guide used, the VC
lead to the best matching scores, as compared with the
3D (p < 0.001) (Table 1). Moreover, the differences
between the scores for the cervical, middle, and incisal
third of the frontal teeth were significant, a poor
matching being observed for the incisal third as
compared with the other two areas (p < 0.01). No
statistically significant difference was found
between the matching scores for the three target teeth
(Table 2).
Gender significantly influenced the results of shade
selection tests (p = 0.008), women showing a better
shade-matching ability than men (Table 3). A
significant interaction effect between gender and
lighting condition was found (p < 0.05), pairwise
comparisons showing a significant difference between
the shade-matching scores of men and women only
under the usual lighting conditions of the dental office
(p = 0.014).
The results of shade matching (p = 0.018) were
influenced by the color discrimination competency,
observers with superior color discrimination
competency showing a better ability in selecting the
correct shades as compared with observers with
average competency (Table 3). A significant
interaction effect between competency and lighting
conditions was found (p < 0.05), pairwise comparisons
showing a significant difference between the
two groups only when the polarization filter was used
(p = 0.003).
When absolute ΔL*, Δa*, and Δb* values were
compared by the lighting condition, significant

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 SHADE-MATCHING USING A NEW LIGHT-CORRECTING DEVICE Gasparik et al.

TABLE 3. Means and standard deviations of ΔEab* values by lighting condition, gender and color discrimination competency
A B C

M F M F M F

Average competency

Overall 6.28 (3.58) 4.85 (3.37) 4.51 (2.00) 4.42 (3.31) 7.85 (1.74) 5.13 (3.67)

3D 5.72 (4.57) 6.48 (2.86) 5.40 (1.07) 5.56 (3.00) 8.38 (1.84) 5.42 (2.91)

VC 6.84 (2.34) 3.21 (3.04) 3.63 (2.36) 3.28 (3.23) 7.31 (1.56) 4.85 (4.31)

Superior competency

Overall 5.55 (3.68) 4.59 (3.38) 4.65 (2.99) 4.15 (3.00) 4.43 (3.67) 5.68 (3.48)

3D 7.03 (3.64) 5.31 (3.25) 5.60 (2.93) 4.75 (2.84) 4.44 (3.89) 6.09 (3.42)

VC 4.07 (3.13) 3.87 (3.38) 3.70 (2.78) 3.56 (3.05) 4.43 (3.49) 5.26 (3.52)

(A) Daylight; (B) daylight and the light-correcting device; (C) daylight and the light-correcting device with a polarization filter attached.
3D = VITA 3D Master shade guide; F = female; M = male; VC = VITA Classical shade guide.

TABLE 4. Means and standard deviations of ΔL*, Δa*, and TABLE 5. Pearson’s correlation coefficients between ΔEab*
Δb* absolute values by lighting condition values and the absolute differences in color parameters
A B C r A B C Overall

ΔL* 3.08 (2.76) 2.87 (2.43)a 3.51 (2.86)a ΔL* 0.674 0.714 0.704 0.699

Δa* 0.92 (0.81) 0.89 (0.69) 1.00 (0.85) Δa* 0.373 0.276 0.395 0.359

Δb* 2.81 (3.17)a 2.25 (2.83)ab 2.84 (3.32)b Δb* 0.779 0.760 0.768 0.771

(A) Daylight; (B) daylight and the light-correcting device; (C) daylight (A) Daylight; (B) daylight and the light-correcting device; (C) daylight
and the light-correcting device with a polarization filter attached. and the light-correcting device with a polarization filter attached.
Same superscript letters show significant difference at the 0.05 level.

Our results showed that dental students’

differences were found except for Δa* (p = 0.09)
(Table 4). Furthermore, moderate and high correlations
were calculated between ΔEab* and ΔL* absolute values,
and ΔEab* and Δb* absolute values respectively
(Table 5).
shade-matching ability was better when the
light-correcting lamp was used, and therefore, the first
null hypothesis was rejected. However, the use of the
polarization filter did not improve the results of shade
matching, in comparison with the common lighting
condition.

DISCUSSION Color cannot be accurately perceived if a proper

Visual shade selection is strongly related to the color
perception of the observer. Several factors influence
color perception of an object: color-defective vision,
fatigue, aging, experience, medication are factors related
to the observer, whereas background, surround, surface
texture, illumination are non-related to the
observer.1,2,11,12,16,17
illumination of the viewing object is not achieved. Light
intensity regulates the pupillary diameter, and thus, it
controls the amount of light that will stimulate the
retinal receptors.9
The standard illuminant for dentistry, D55, is defined as
Washington, DC, June, noon to 1 p.m., with a slight
overcast, a color temperature of 5,500 K, and a

© 2015 Wiley Periodicals, Inc. DOI 10.1111/jerd.12150 Journal of Esthetic and Restorative Dentistry Vol 27 • No 5 • 285–292 • 2015 289
 SHADE-MATCHING USING A NEW LIGHT-CORRECTING DEVICE
color-rendering index of 90.18 The illuminance at the
tooth level should range from 1,000 lux to 1,500 lux.19
Since these ideal conditions are difficult to achieve in
the dental offices, color-corrected lighting tubes are
recommended to be used for overhead lamps.19
Handheld color-corrected shade-matching lamps are
also available, and several studies reported better
shade-matching performances when they were
used.11,12
The shade selection device used in the present study
(Smile Lite, Smile Line) is a handheld light-correcting
lamp with a LED-based technology and a correlated
color temperature of 5,500K. The light source is similar
to the internal light source of the dental
spectrophotometer used in the present study. Among
the features of this lamp are the see-through
rectangular shape window and the easily attachable live
polarization filter.20 The polarization filter eliminates
glare and enhances the visualization of details and
translucency areas in the dental structures. A polarizing
filter is a colorless filter that reduces oblique reflections
from glossy surfaces and therefore can darken and
saturate the perceived color by eliminating redundant
reflections. However, it is not clear to what extent the
polarizing filter influences the results of visual shade
selection. In a study that aimed to evaluate the use of a
cross-polarization filter in digital photography, it was
concluded that the filter did not improve the
assessment of the changes in enamel gray levels that
occur with demineralization.21
Color vision among observers with normal color vision
varies significantly, the largest source of variability
being caused by the yellowing of the lens from exposure
to ultraviolet radiation. The effects of this yellowing are
gradual throughout our lifetimes.9 Approximately 8% of
men and 0.5% to 2% of women have color-defective
vision, where either one or more receptor type is
missing.9,11,12,15 Of dental personnel, 8% to 14% have
been found to be color deficient.11,22,23 However, several
studies concluded that gender is not an influencing
factor in shade selection.11,12,15,16
Although the performance of color deficient laypersons
was far below the results of color normal dentists and
290 Vol 27 • No 5 • 285–292 • 2015 Journal of Esthetic and Restorative Dentistry
Gasparik et al.
laboratory technicians, as reported in the study of
Poljak-Guberina and colleagues,24 33% of color-deficient
persons exhibited average discrimination according to
Farnsworth–Munsell 100 Hue Test.
In our study, gender influenced shade matching results
only when color selection was performed under
daylight conditions. When the shade selection device
was used, both men and women performed the
same.
Experience in the dental profession is controversially
presented with respect to color matching. Several
studies reported that students with no or with little
experience in shade matching achieved the same results
as experienced dental professionals.11,12,15,16 However, in
a study conducted by Della Bona and colleagues,25
assessing the agreement between visual and
instrumental selection, it was found that the clinically
experienced dentists had a higher agreement compared
with the non-experienced subjects, regardless of shade
guides and lighting conditions. Furthermore, Borbely
and colleagues26 concluded that training of dental
students using computer software significantly
improved shade matching. Similar findings were also
reported by Olms and colleagues.27 The study
conducted by Corcodel and colleagues28 concluded that
the use of a group-learning approach in a clinical
setting could improve the shade-matching performance
ability in dental students.
The observers in our study were dental students with
limited experience in shade selection. We classified the
observers by using a color competence test
recommended by the ISO standard 28642/2011,14 and
we have included only participants with average or
superior color discrimination competency; a statistically
significant difference has been demonstrated between
the two groups, with the superior competency group
showing better results.
Better shade matching was obtained when the
observers in our study used the VC. These results could
be explained by the limited experience in shade
matching of the observers and the simpler organization
of the VC. However, several studies reported a better
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 SHADE-MATCHING USING A NEW LIGHT-CORRECTING DEVICE
performance of the VITA 3D Master shade guide as
compared with the VC. In a study assessing the
coverage errors of three shade guides, Bayindir and
colleagues29 concluded that VITA 3D Master shade
guide had lower coverage errors than the VC and the
Chromascope shade guides. Öngül and colleagues30 also
reported that ceramic crowns fabricated according to
the 3D Master shade guide system showed a closer
color match to the natural teeth than those of the VITA
Classical system.
The second null hypothesis was rejected—both
characteristics related (gender and color competency)
and non-related (type of shade guide) to the observer
influenced the matching scores.
A good correlation was found between absolute ΔL*
and ΔEab* values, and absolute Δb* and ΔEab* values,
respectively, meaning that the errors in shade matching
were mainly generated by the lack of precision in the
evaluation of L* and b* parameters.
One of the limitations of the present study
was that the target teeth for shade selection presented
whitish spots in the incisal thirds, explaining thus the
lower results regarding the matching scores for this
area. Another limitation was that no time limit
for the shade selection process was set; therefore, eye
fatigue may have occurred during the tests. Still,
during shade selection, the observers were instructed
to rest their eyes on a neutral color background,
if needed.
CONCLUSIONS
Within the limitations of this study, the following
conclusions may be drawn:
1 The dental students’ shade-matching ability was
better when the new light-correcting device was
used. However, the polarization filter did not
improve the overall results of the shade matching.
2 The shade guides used, as well as the observer’s
gender and color competency influenced the shade
matching.
© 2015 Wiley Periodicals, Inc. DOI 10.1111/jerd.12150
Gasparik et al.
DISCLOSURE AND ACKNOWLEDGEMENTS
The authors do not have any financial interest in the
companies whose materials are included in this article.
This study was supported by Romanian Ministry of
Education and Scientific Research, Research Project
PN-II-PT-PCCA-2011-3-2-1275 and by 2014 SCAD
VITA Award for Excellence in Research Related to
Color and Appearance in Esthetic Dentistry.
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Reprint requests: Cristina Gasparik, DMD, PhD student, Department of
Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of
Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca,
Romania; email: gasparik.cristina@umfcluj.ro
This research was presented at the 6th Annual Conference of the
Society for Color and Appearance in Dentistry (SCAD) held in Chicago
on October 2–4, 2014.
DOI 10.1111/jerd.12150 © 2015 Wiley Periodicals, Inc.