A comparative evaluation of the variations on the shades of pressable ceramic system with the layering technique after different number of firing cycles: An in vitro study.

AIM: The main aim of the present study was to compare and evaluate the effect of repetitive firings on different shades of a pressable all ceramic system layered with veneering porcelain. SETTING AND DESIGN: In-vitro comparative study. MATERIALS AND METHODS: An in vitro comparative study was conducted, and a total of 60 disc shaped specimens (15 mm in diameter and 0.8 mm in thickness) were made of heat pressed ceramic of shades A2, A3, and B2 (20 discs of each shade) grouped as Group I, II, and III, respectively, using the lost wax technique. The discs were subsequently layered with veneering porcelain followed by glazing and overglazing and underwent a firing cycle at each step until six times combined. CIE L*a*b* measurements were noted on each sample after the third, fourth, fifth, and sixth firing using VITA Easyshade Advance 4.0 spectrophotometer. STATISTICAL ANALYSIS USED: Statistical Analysis was done by SPSS 17.0 software. One way analysis of variance, multiple comparisons using the Tukey test, and descriptive statistical analysis were done for all the groups in the study. P <0.05 was statistically significant. RESULTS: The mean color differences for the repeated firings were imperceptible (ΔE <1.67) to the human eye for all ceramic samples tested except between the fourth and fifth firing of Group II (shade A3). CONCLUSION: The analysis revealed that although repeated firings lead to changes in L*, a*, and b* values, the mean color difference was below the clinically acceptable color change (ΔE <3.7).

Three-dimensional representation of the Vita Toothguide 3D-Master: An in vivo clinical study.

STATEMENT OF PROBLEM: The Vita Toothguide 3D-Master (Vita Zahnfabrik) is considered the dental shade guide in which the three dimensions of color - lightness, hue, and chroma - are most well-ordered in the CIELAB color space. No research has yet explored how well the Vita Toothguide 3D-Master is ordered in the 3D color space by recording color coordinates in vivo. PURPOSE: To evaluate the spatial color distribution of the Vita Toothguide 3D-Master's lightness, chroma, and hue groups and its 26 physical shade tabs. MATERIALS AND METHODS: The dental color (L*, C*, h°, a*, and b* color coordinates) of a healthy maxillary central incisor was recorded for 1361 participants (aged between 18 and 89 years) using a Vita Easyshade Compact spectrophotometer (Vita Zahnfabrik). The R 2.7.2. statistics program was used to create the visual representations. RESULTS: The five lightness levels are those that are best distributed in the color space, in relation to the L* coordinates, followed by the chroma group and, finally, the hue group. The 5M1, 5M2, and 5M3 physical shade tabs are situated at a greater distance apart from the other tabs in the color space. CONCLUSIONS: The Vita Toothguide 3D-Master's 26 physical shade tabs are satisfactorily distributed in three-dimensional space, although strict mathematical criteria are not followed. The natural dental shades that fall lower on the lightness scale are the most poorly represented by the physical shade tabs. CLINICAL IMPLICATIONS: Darker teeth are poorly represented by the Vita Toothguide 3D-Master's physical shade tabs. The spatial distribution of dental shade guides needs to be improved to ensure they provide homogeneous coverage of the entire chromatic spectrum corresponding to natural teeth. This would help reduce the errors inherent to the subjective visual color selection process.

The Role of Intraoral Scanners in the Shade Matching Process: A Systematic Review.

PURPOSE: The variation in findings with regards to the accuracy and precision of intraoral scanners for shade selection are no doubt confusing for clinicians who may find it difficult to make evidence-based decisions. The aim of this systematic review is to provide a comprehensive and in-depth assessment of available studies to determine the viability of using intraoral scanners for the purpose of shade matching. The PICO-guided research question is as follows: when shade matching, are intraoral scanners as valid as visual or other digital shade measuring devices in determining tooth colors. METHODS: Electronic databases including PubMed/MEDLINE, SCOPUS, EBSCO, Cochrane, and ProQuest were systematically searched for articles published between January 1, 2011 and December 30, 2021 using the main search terms: "intraoral scanners," "scanners," "TRIOS," "CEREC," "Planmeca," "Medit," "digital dentistry" in concurrence with one of the following keywords: "EasyShade" OR "shade selection" OR "shade matching" OR "shade" OR "tooth color" OR "tooth shade" OR "digital shade matching." Bibliographies of included articles and the following journals were searched for relevant articles: Journal of Prosthetic Dentistry, Journal of Prosthodontics, Journal of Esthetic and Restorative Dentistry, Journal of Advanced Prosthodontics, and Journal of Dentistry. A total of 15 articles were included in the review. RESULTS: Intraoral scanners are highly repeatable for shade matching, and outperformed visual shade matching. Accuracy varied significantly between studies, with the majority recommending the use of visual shade matching to confirm/verify the intraoral scanner results. Setting intraoral scanners to the Vita 3D Master shade guide improved both accuracy and precision. Shade matching with intraoral scanners may be influenced by external factors such as ambient light sources and incorrect use or manipulation. CONCLUSION: Intraoral scanners set to the Vita 3D Master shade guide may be used for shade matching, but shade should be verified with visual shade matching. Further studies are required to address limitations of current studies.

Tooth color in dental students from Buenos Aires University, Dental School, Argentina.

The aim of this study was to evaluate tooth color in dental students at the University of Buenos Aires, Argentina. The participants were 184 students (157 women and 27 men) aged 21 to 33 years, mean age 24.45 (SD 2.79) years, who were in the fourth year of their dental degree. They agreed to participate through an informed consent. Exclusion criteria were: having undergone a bleaching treatment within the previous six months, presence of total or partial peripheral restoration, pigmentations, fracture, carious and non-carious lesions or absence of the right upper central incisor (1.1). A dental prophylaxis procedure was performed on the buccal surface of each 1.1 tooth with a prophylaxis brush (TDV) mounted on a low-speed rotary instrument Kavo 2068 CHC (Germany) micromotor and a Kavo LUX K201(Germany) contra-angle. Shade was measured in the middle third of each 1.1 tooth, by the same observer, using a VITA Easyshade V spectrophotometer (Zahnfabrikn Bad Säckingen, Germany), which was calibrated before each determination according to manufacturer's instructions, in the same dental unit (Sino S2316), with natural illumination, in the same time slot, without using the dental unit lamp. The results were recorded in an ad-hoc form and rates and confidence interval were obtained. Shade prevalence percentages (95% CI) were: A1: 46.2 (38.83 - 53.68); followed by A2 and B2, both with 17.39 (12.21 - 23.66); A3: 6.52 (3.41-11.11); B1: 4.35 (1.9-8.39); D2: 2.72 (0.89 - 6.23); B3: 2.17 (0.60-5.47) and C2: 1.09 (0.13-3.87); D3, C3, A3.5 and A4: 0.54 (0.01-2.99). Shades D1 and C1 were not determined in any subject. Within the conditions of this study, A1 was the most prevalent shade in central incisors, followed by A2 and B2.

El objetivo de este estudio fue evaluar la prevalencia de color dental en estudiantes de odontología de la Universidad de Buenos Aires (UBA). Los participantes fueron 184 estudiantes de cuarto año de la carrera de Odontología (157 mujeres y 27 hombres) de entre veintiuno y treinta tres años, con un promedio de edad de 24,45 (DE 2,79) años que aceptaron participar mediante consentimiento informado. Criterios de exclusión: quienes hayan recibido blanqueamiento en los últimos seis meses, tenían una restauración periférica total o parcial, pigmentaciones, fractura, lesiones cariosas y/o no cariosas en el incisivo central superior derecho (1.1) o éste estaba ausente. Se realizó profilaxis dental en la superficie bucal de cada 1.1 con un cepillo ad-hoc (TDV) montado en un micromotor de baja velocidad Kavo 2068 CHC (Alemania) y un contra-ángulo Kavo LUX K201 (Alemania). La medición del color se llevó a cabo en el tercio medio de cada 1.1, por el mismo observador, en la misma clínica dental, con iluminación natural en la misma franja horaria y sin utilizar la lámpara del equipo dental. Se utilizó un espectrofotómetro VITA Easyshade V (Zahnfabrikn Bad Säckingen, Alemania) que se calibró antes de cada determinación de acuerdo con las instrucciones del fabricante. Los resultados se registraron en una planilla ad-hoc y se obtuvieron tasas e intervalos de confianza. Prevalencia de colores % (IC 95%): A1: 46,2 (38,83 - 53,68), seguido de A2 y B2 ambos con 17,39 (12,21 - 23,66), A3: 6,52 (3,41-11,11), B1: 4,35 ( 1,9- 8,39), D2: 2,72 (0,89 - 6,23), B3: 2,17 (0,60-5,47) y C2: 1,09 (0,13- 3,87); D3, C3, A3.5 y A4: 0.54 (0.01-2.99) D1 y C1 no se determinaron en ningún sujeto. Dentro de las condiciones de este estudio A1 fue el color más prevalente en los incisivos centrales de estudiantes de odontología, seguido de A2 y B2.

3D Master Toothguide Is Adequate to Subjective Shade Selection?

Background and Objectives: To study the validity and the degree of representability of the toothguide 3D Master, with 26 physically shade tabs, on the natural tooth colour on a sample of the Spanish population. Materials and Methods: Natural tooth colour was measured in a sample of 1361 Spanish participants of both genders distributed within an age range of 18 and 89 years of age. The colour coordinates were calculated and the frequency of the 26 physically shade tabs of the toothguide as well as the "intermediate shades" (without physical representation in toothguide) through the Easyshade Compact (Vita-Zahnfabrik) spectrophotometer using the 3D Master System nomenclature. The colour differences between the "intermediate shades" were calculated using the Euclidean formula (ΔEab*). The program used for the present descriptive statistical analysis of the results was SAS 9.1.3. Results: A total of 49 "intermediate shades" were registered in 816 participants (60%). The colour coordinates of the 49 'intermediate shades' cover colour coordinates ranging from 0M1.5 (L* 100.0, C* 7.70, h* 112.2) to 5M2.5 (L* 56.8, C* 35.8, h* 78.5). Not all possible 3D Master System's "intermediate shades" were registered in the population studied. 82.4% of the colour differences among the "intermediate shades" were clinically unacceptable (ΔEab* ≥ 5.5 units). Conclusions: Only 40% of the population studied presented a natural tooth colour belonging to the 3D Master Toothguide's physical shade tabs.

Are Digital Methods Sufficiently Successful in Colour Determination for Monolithic All-Ceramic Crowns?

OBJECTIVE: The aim of this study was to compare the visual assessment of tooth shade with the measurement using intraoral scanner (IOS) and spectrophotometer devices. METHODOLOGY: The colour for a single unit implant supported crown was measured visually, using IOS, and spectrophotometer. The results of the digital methods were compared with the visual measurement. RESULTS: A complete colour match with the visual measurement was in 42.9% of cases for IOS, and in 33.3% of cases for spectrophotometry. The match in the colour value, hue, and chroma were in 61.9%, 95.2%, and 66.7% of cases, respectively, for the IOS; and in 61.9%, 61.9%, and 66.7% of cases, respectively, for the spectrophotometry. The differences between the IOS and spectrophotometry were not statistically significant. CONCLUSIONS: The most reliable method for tooth colour selection is the visual measurement by an experienced dentist. IOS and spectrophotometer can be used as an alternative method, however in both cases they should be verified using visual measurement.

Comportamiento cromático de resinas acrílicas y bisacrílicas para restauraciones provisionales / Chromatic behavior of acrylic and bisacrylic resins used for provisional restorations

Introducción: Las prótesis provisionales son restauraciones usadas en prótesis fijas durante un tiempo, hasta la cementación de la prótesis definitiva. Uno de los problemas que presentan este tipo de restauraciones es el cambio de color, que afecta a la estética y, en consecuencia, produce sensación de desagrado en los pacientes. Objetivo: Evaluar, para restauraciones provisionales, con y sin el pulido final de la superficie, la estabilidad del color de dos resinas al ser sumergidas en café. Métodos: Estudio experimental in vitro, realizado en el Laboratorio de Prótesis de la Facultad de Odontología de la Universidad Nacional del Nordeste, Corrientes-Argentina, 2019. Se comparó una resina acrílica (Duralay®) con una bisacrílica (ProtempIV 3M®) para restauraciones provisionales. Se elaboraron 40 discos de resinas a partir de moldes metálicos de 25 mm de diámetro y 2 mm de espesor. Se utilizaron 20 discos para cada tipo de resina, de ellos, 10 pulidos y 10 sin pulir. Las muestras fueron almacenadas en agua destilada en estufa a 37 °C durante 24 h para hidratarlos. Luego se procedió a la toma del color. Con posterioridad, cada grupo se sumergió en café, manteniéndolos en estufa a 37 °C durante 24 h más. Seguidamente, se realizó la segunda toma del color. Se utilizó el colorímetro Kónica Minolta®, determinando la diferencia total de color ΔE. Para el análisis estadístico se utilizó ANOVA una vía y test de Tukey para identificar la diferencia entre grupos. Resultados: Se observó en el grupo de resina acrílica pulida una diferencia ΔE = 0,82 ± DS = 0,22 y de ΔE = 3,86 ± DS = 0,30 sin pulido. En el grupo de resina bisacrílica pulido se obtuvo ΔE = 4,84 ± DS = 0,25 y, para el no pulido, ΔE = 5,85 ± DS = 0,29. Conclusiones: Se comprobaron diferencias significativas en la estabilidad del color de ambas resinas. La resina bisacrílica fue la menos estable, independientemente del pulido(AU)

Introduction: Provisional prosthesis are restorations used in fixed prostheses for a while, until the definitive prosthesis is cemented. One of the problems posed by this type of restoration is the change in color, which affects esthetics and therefore creates a feeling of displeasure in patients. Objective: Evaluate, in the case of provisional restorations with and without final surface polish, the color stability of two resins when soaked in coffee. Methods: An in vitro experimental study was conducted in the Prosthesis Laboratory at the Dental School of the National University of the Northeast in Corrientes, Argentina, in the year 2019. A comparison was made of an acrylic resin (Duralay®) versus a bisacrylic resin (ProtempIV 3M®) for provisional restorations. Forty resin disks were made from metal molds 2 mm thick and 25 mm in diameter. Twenty disks were used for each type of resin, of which 10 were polished and 10 were not. The samples were stored in distilled water in a stove at 37ºC for 24 h to hydrate them. Color measurements were then taken. Next, each group was soaked in coffee and kept in the stove at 37ºC for another 24 h. A second color measurement was then taken. A Konica Minolta® colorimeter was used to determine total color difference ΔE. Statistical analysis was based on one-way ANOVA and Tukey's test was used to identify the difference between the groups. Results: In the polished acrylic resin group a difference was found of ΔE = 0.82 ± SD = 0.22, whereas in the non-polish group the difference was ΔE = 3.86 ± SD = 0.30. In the polished bisacrylic resin group the difference was ΔE = 4.84 ± SD = 0.25, whereas in the non-polish group the difference was ΔE = 5.85 ± SD = 0.29. Conclusions: Significant differences were found in the color stability of both resins. The bisacrylic resin was the least stable, regardless of polish(AU)

Influência do polimento e tipo de solução extrínseca na pigmentação de restaurações de resina composta / Influence of the dental polishing and type of extrinsic solution in the pigmentation of composite resin restorations

Objetivo: avaliar a pigmentação de restaurações de resina composta (RC) submetidas a diferentes métodos de polimento. Materiais e método: foram realizadas restaurações de RC classe V em 80 dentes bovinos, corpos de prova, divididos em dois grupos experimentais: G1, polimento com Ultra-Gloss, e G2, polimento com um sistema que utiliza uma ponta siliconada impregnada com abrasivo, Enhance. Após, todos os grupos experimentais foram submetidos a soluções pigmentantes de café, chimarrão e refrigerante, 2 vezes ao dia, por 5 minutos, num período de 15 dias. Os corpos de prova foram analisados pela coloração da RC através de um colorímetro utilizando o sistema CIE-Lab. Aplicou-se a análise de variância seguida do método de comparação múltipla de Tukey, quando observada diferença significativa entre os corpos de prova. Resultados: os resultados mostraram que houve diferença estatística nos valores de médios (valor-p < 0,05), sugerindo o café com variação mais elevada; também para as variações entre a condição experimental (valor-p < 0,05), com exceção de delta a (valor-p = 0,817). Conclusão: o tipo de método para polimento de restaurações em RC não apresenta associação significativa com a pigmentação do material, sendo que esta está relacionada com o tipo da solução corante e com o tempo de exposição do compósito às pigmentações. (AU)

Objective: to evaluate the pigmentation of composite resin restorations submitted to different polishing methods. Materials and method: Class V composite resin restorations were performed on 80 bovine teeth, specimens, and divided into two experimental groups: G1-polishing with Ultra-Gloss and G2-polishing with a system using a silicon tip impregnated with abrasive, Enhance. Afterwards, all the experimental groups were submitted to pigmenting solutions of coffee, chimarrão and refrigerante, 2 times a day, for 5 minutes, in a period of 15 days. The specimens were analyzed by coloring the composite resin using a colorimeter using the CIE-Lab system. The analysis of variance was applied followed by Tukey's multiple comparison method when a significant difference was observed between the test specimens. Results: The results showed that there was statistical difference in the mean values (p-value <0.05), suggesting coffee with the highest variation; (p-value <0.05), with the exception of delta a (p-value = 0.817). Conclusion: The type of method for polishing restorations in composite resin does not present a significant association with the pigmentation of the material, which is related to the type of the dye solution and the time of exposure of the composite to pigmentation. (AU)

Effects of treatment with aqueous and acid-based coloring liquid on the color of zirconia.

STATEMENT OF PROBLEM: To preserve the mechanical property of color-treated zirconia for optimal restoration longevity, aqueous colorants have been developed as an alternative to acid-based coloring agents. However, little is known regarding the effects of aqueous colorants on the color of zirconia. PURPOSE: The purpose of this in vitro study was to compare the effect of aqueous coloring liquids with acid-based coloring liquids on the color of zirconia. MATERIAL AND METHODS: Eighty monolithic zirconia specimens (10×10×2 mm) were fabricated and divided into 4 groups according to their color treatment: unshaded zirconia (control), precolored zirconia, aqueous coloring liquid on zirconia, and acid-based coloring liquid on zirconia. The shaded zirconia specimens were further divided into 3 subgroups based on the number of coloring applications used (1, 3, or 6). The International Commission on Illumination (CIELab) color coordinates were measured by spectrophotometry. RESULTS: Significant differences in the CIE a∗ and b∗ values were observed between the specimen groups treated with the aqueous coloring liquid and the acid-based coloring liquid (P<.001). Increasing the number of colorings resulted in an increase in the CIE a∗ and b∗ values and a decrease in the CIE L∗ values in all the groups (P<.001). CONCLUSIONS: Treatment with aqueous coloring liquid on zirconia produced a greater redness or yellowness compared with treatment with acid-based coloring liquid. The coloring of zirconia lowered its brightness and imparted a red/yellow hue.

Analysis of Shade Matching in Natural Dentitions Using Intraoral Digital Spectrophotometer in LED and Filtered LED Light Sources.

PURPOSE: To evaluate the shade matching capabilities in natural dentitions using Vita Toothguide 3D-Master and an intraoral digital spectrophotometer (Vita Easyshade Advance 4.0) in various light sources. MATERIALS AND METHODS: Participants between 20 and 40 years old with natural, unrestored right maxillary central incisors, no history of bleaching, orthodontic treatment, or malocclusion and no rotations were included. According to their shades, subjects were randomly selected and grouped into A1, A2, and A3. A total of 100 participants (50 male and 50 female) in each group were chosen for this study. Shade selection was made between 10 am and 2 pm for all light sources. The same examiner selected the shade of natural teeth with Vita Toothguide 3D-Master under natural light within 2 minutes. Once the Vita Toothguide 3D-Masterwas matched with the maxillary right central incisor, the L*, a*, and b* values, chroma, and hue were recorded with Vita Easyshade Advance 4.0 by placing it on the shade tab under the same light source. The values were statistically analyzed using one-way ANOVA and Tukey's HSD post hoc test with SPSS v22.0 software. RESULTS: The mean ∆E*ab values for shades A1, A2, and A3 for groups 1, 2, and 3 were statistically significantly different from each other (p < 0.001). CONCLUSION: The intraoral digital spectrophotometer showed statistically significant differences in shade matching compared to Vita Toothguide 3D-Master. Incandescent light showed more accurate shade matching than the filtered LED, LED, and daylight.

A Painting Technique Using Ceramic Pigments for the Artificial Iris of an Ocular Prosthesis Guided by Applying Newton's Color Wheel.

This article describes a simple method for painting an artificial iris for the manufacturing of an ocular prosthesis with dark and light tones, both with excellent esthetic results. The challenge of choosing colors around the pupil and medium zone during painting is aided by the application of Newton's color wheel theory. This technique provides a safer choice of color during the painting procedure by using a mixture of ceramic pigments.

Inorganic filler content of resin-based luting agents and the color of ceramic veneers.

The influence of inorganic filler content of resin-based luting agents (RBLAs) on color change (ΔE00), CIEL*a*b* (individual color coordinates), and translucency parameters (TP) of simulated ceramic laminate veneer (CLV) was investigated. RBLAs with low, intermediate, and high inorganic filler content (55%, 65%, and 75% mass fractions, respectively) were prepared. Feldspar ceramic (Vitablocs Mark II) specimens (1.2 mm × 0.8 mm, A1C shade) were bonded to simulated composite resin substrates (1.6 mm × 1.2 mm, A2D shade) using three experimental and a commercial (RelyX Veneer) RBLA (translucent shade). The ΔE00 was calculated by CIEDE2000 color difference metric under three conditions (before, immediately after, and 24 h after luting). The TP was calculated using CIEL*a*b* color coordinates measured over white and black backgrounds. Surface morphology of the RBLAs was analyzed. One-way and two-way analyses of variance with a post-hoc Tukey's test were used respectively to calculate TP, CIEL*a*b* coordinates, and ΔE00 (α= 0.05). Overall, the tested RBLAs presented clinically visible ∆E00 values under the three conditions evaluated. For all RBLAs, higher ∆E00 values were observed between measurements obtained before and immediately after luting. Different inorganic filler content did not significantly increase the opacity of the ceramic-luting agents-resin composite set. The variation in inorganic filler content did not influence significantly the TP of simulated CLV; although all of the experimental RBLAs tested yielded ∆E00 above the perceptibility threshold. The L*, a*, and b* individual color coordinates were cementation-dependent.

Effect of metal opaquer on the final color of 3 ceramic crown types on 3 abutment configurations.

STATEMENT OF PROBLEM: The effect of a recently introduced metal opaquer when used to mask the color of a titanium abutment under ceramic crown systems is unknown. PURPOSE: The purpose of this study was to compare the color coordinates of 3 ceramic crown types-characterized monolithic lithium disilicate (LDC) (IPS e.max; Ivoclar Vivadent AG), layered lithium disilicate (LDL) (IPS e.max; Ivoclar Vivadent AG), and layered zirconia (ZL) (H.C. Starck)-on 3 abutment configurations, nonopaqued titanium (Ti), resin opaqued titanium (Op), and zirconia (Zir). In addition, the color differences (CIEDE2000) were evaluated among the 3 crown types on 3 different abutment substrates. MATERIAL AND METHODS: Ten Ti disks (10×1 mm) were fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) to represent the Ti abutments. Five Ti specimens were opaqued (Op) (whiteMetal Opaquer wMO; Blue Sky Bio), and 5 were not opaqued (Ti). Ten zirconia disks were fabricated with CAD-CAM and sintered (10×1.2 mm). Five disks were used as backings to represent Zir abutments, and 5 disks were layered with 1 mm of porcelain (B1, IPS e.Max Ceram; Ivoclar Vivadent AG) to represent layered zirconia crowns (ZL). Ten lithium disilicate plates (14×14×1.2 mm) were sectioned from CAD blocks (B1 IPS e.Max CAD; Ivoclar Vivadent AG). Five plates were layered with the same porcelain (B1, 1 mm), and 5 plates were surface characterized and glazed. An LDL crown on a Zir abutment configuration was used as the control. The 3 simulated crown types (n=5) were optically connected to each of the 3 abutment types, and the color of the 9 groups was measured using a spectroradiometer. Measured data were reported in CIELab coordinates. CIELab data were used to calculate color differences between the control and the 8 experimental groups. Color data were summarized for each group, and analyzed by repeated-measures ANOVA. For pairwise comparisons, a Bonferroni correction of t tests was used, and for interpretive analysis of resulting color difference data, a 1-way ANOVA and subsequent Tukey testing for pairwise comparisons were used. RESULTS: The statistical significance of the analysis of color coordinates was found to be P≤.002. Although 3-way interaction was not found to be significant (P=.335), all three 2-way interactions of the main effects were found to be significant (P≤.002). All crown types on the Zir abutment revealed color differences from the control group. The color differences of the crown types on the Op and Zir abutment configurations compared with the control (LDL/Zir) were not (P>.05) statistically different. CONCLUSIONS: Colors of tested crown systems on Ti backing were each unacceptably different from the control group. Colors of these systems on zirconia backing were not perceivably different. Use of opaquer on titanium backing resulted in a small color difference from the control group (P>.05) for each crown system, demonstrating that it may be used to prevent the unfavorable metal show-through that can influence the final color of all ceramic crown systems tested.

Dental Shade Guide Variability for Hues B, C, and D Using Cross-Polarized Photography.

This study evaluated the color variability of hues B, C, and D between the VITA Classical shade guide (Vita Zahnfabrik) and four other VITA-coded ceramic shade guides using a digital camera (Canon EOS 60D) and computer software (Adobe Photoshop CC). A cross-polarizing filter was used to standardize external light sources influencing color match. A total of 275 pictures were taken, 5 per shade tab, for 11 shades (B1, B2, B3, B4, C1, C2, C3, C4, D2, D3, and D4), from the following shade guides: VITA Classical (control); IPS e.max Ceram (Ivoclar Vivadent); IPS d.SIGN (Ivoclar Vivadent); Initial ZI (GC); and Creation CC (Creation Willi Geller). Pictures were evaluated using Adobe Photoshop CC for standardization of hue, chroma, and value between shade tabs. The VITA-coded shade guides evaluated here showed an overall unmatched shade in all their tabs when compared to the control, suggesting that shade selection should be made with the corresponding manufacturer guide of the ceramic intended for the final restoration.

Evaluation of small-group education on the shade determination ability of preclinical dental students-A controlled clinical trial.

OBJECTIVES: To evaluate the effect of small-group education including practical training on dental students' shade determination performance compared with a control group. METHODS: Sixty-three non-colour-blind preclinical students were asked to participate and belonged to an intervention (n = 31) and a control (n = 32) group, respectively. All students received a lecture on dental shade determination. The members of the intervention group were educated and practically trained in small groups in addition. Ten volunteers, each with unrestored upper right middle and lateral incisors, were recruited. The students of both the intervention and control groups were then asked to determine the colour of the volunteers' test teeth using the 3D-Master shade guide (Vita Zahnfabrik, Bad Säckingen, Germany) under artificial daylight illumination. For analytical purposes, the CIE L*a*b* coordinates were obtained using a spectrophotometer. Colour differences, ΔE, between all shade tabs selected by the students and the natural teeth were calculated. ΔE observed in the intervention and control groups were compared using t tests. In addition, a multi-level regression model was adjusted for age and gender. RESULTS: Mean (SD) ΔE between the shade tabs selected by the students and the natural teeth in the intervention and control groups were 3.8 (2.1) and 4.3 (2.3), respectively (P < .001). The effect of group membership was reproduced in multivariate analysis whereas age and gender did not reach statistical significance. CONCLUSIONS: With more intensive education and practical training the ability to perform clinical shade determinations improved for students without previous clinical experience. The results obtained support the idea of implementing thematic small-group education in the dental curriculum.

Color Match Between Composite Resin and Tooth Remnant in Class IV Restorations: A Case Series.

Rehydration of the tooth remnant and complete polymerization of the composite resin are aspects that should be considered in shade selection of composite resin. This article presents a case series of Class IV restorations performed to evaluate the color match between the composite resin and the tooth remnant. Thirteen Class IV restorations were performed in maxillary central incisors and evaluated according to the period following the restorative procedure: 10 minutes (baseline), 48 hours before and after finishing and polishing, and seven, 14, and 28 days. The color match of the restorations was evaluated by the ΔE values of the tooth remnant (TR) and the composite resin (CR) in each evaluation period using a spectrophotometer. The translucency, luminosity, and saturation were analyzed qualitatively in digital photographs of the restorations. The CR ΔE was statistically similar to the TR ΔE at 14 and 28 days ( p>0.05). The saturation and luminosity of most of the restorations remained unchanged, but there was a greater change in the translucency. The color match of the composite resin in Class IV restorations was observed after 14 days of clinical assessment in this case series.

A Study on Possibility of Clinical Application for Color Measurements of Shade Guides Using an Intraoral Digital Scanner.

PURPOSE: To assess if color measurement with intraoral scanner correlates with digital colorimeter and to evaluate the possibility of application of a digital scanner for shade selection. MATERIALS AND METHODS: The L*a*b* values of the five shade tabs (A1, A2, A3, A3.5, and A4) were obtained with an intraoral scanner (TRIOS Pod) and a colorimeter (ShadeEye). Both devices were calibrated according to the manufacturer's instructions before measurements. Color measurement values were compared with paired t-test, and a Pearson's correlation analysis was performed to evaluate the relationship of two methods. RESULTS: The L*a*b* values of the colorimeter were significantly different from those of the digital scanner (p < 0.001). The L* and b* values of both methods were strongly correlated with each other (both p < 0.05). The device repeatability in both methods were reported to be excellent (p < 0.05). Within the limitations of this study, color measurements with digital intraoral scanners and computer-assisted image analysis were in accordance with those of the colorimeter with respect to L* and b* values; however, all the coordinates of shade tabs were significantly different between two methods. CONCLUSIONS: The digital intraoral scanner may not be used as the primary method of color selection in clinical practices, considering significant differences in color parameters with colorimeter. The scanner's capability in shade selection should be further evaluated.

Evaluation of a Novel Computer Color Matching System Based on the Improved Back-Propagation Neural Network Model.

PURPOSE: To explore the feasibility of a novel computer color-matching (CCM) system based on the improved back-propagation neural network (BPNN) model by comparing it with the traditional visual method. MATERIAL AND METHODS: Forty-three metal-ceramic specimens were fabricated by proportionally mixing porcelain powders. Thirty-nine specimens were randomly selected to train the BPNN model, while the remaining four specimens were used to test and calibrate the model. A CCM system based on the improved BPNN model was constructed using MATLAB software. A comparison of the novel CCM system and the traditional visual method was conducted by evaluating the color reproduction results of 10 maxillary central incisors. Metal-ceramic specimens were fabricated using two color reproduction approaches. Color distributions (L*, a*, and b*) of the target teeth and of the corresponding metal-ceramic specimens were measured using a spectroradiometer. Color differences (ΔE) and color distributions (ΔL*, Δa*, and Δb*) between the teeth and their corresponding specimens were calculated. RESULTS: The average ΔE value of the CCM system was 1.89 ± 0.75, which was lower than that of the visual approach (3.54 ± 1.11, p < 0.01). With respect to color distributions, substantial differences were found between the two color-matching systems, except for ΔL* (p > 0.05). CONCLUSION: The novel CCM system produced greater accuracy in color reproduction within the given color space than the traditional visual approach.

Clinical Study of the 3D-Master Color System among the Spanish Population.

PURPOSE: To study whether the shades of the 3D-Master System were grouped and represented in the chromatic space according to the three-color coordinates of value, chroma, and hue. MATERIALS AND METHODS: Maxillary central incisor color was measured on tooth surfaces through the Easyshade Compact spectrophotometer using 1361 participants aged between 16 and 89. The natural (not bleached teeth) color of the middle thirds was registered in the 3D-Master System nomenclature and in the CIELCh system. Principal component analysis and cluster analysis were applied. RESULTS: 75 colors of the 3D-Master System were found. The statistical analysis revealed the existence of 5 cluster groups. The centroid, the average of the 75 samples, in relation to lightness (L*) was 74.64, 22.87 for chroma (C*), and 88.85 for hue (h*). All of the clusters, except cluster 3, showed significant statistical differences with the centroid for the three-color coordinates (p <0.001). CONCLUSIONS: The results of this study indicated that 75 shades in the 3D-Master System were grouped into 5 clusters following coordinates L*, C*, and h* resulting from the dental spectrophotometer Vita Easyshade compact. The shades that composed each cluster did not belong to the same lightness color dimension groups. There was no special uniform chromatic distribution among the colors of the 3D-Master System.

Technique to Match Gingival Shade when Using Pink Ceramics for Anterior Fixed Implant Prostheses.

Use of pink gingival ceramics can reduce the necessity for extensive surgical procedures attempting to restore missing soft and hard tissues in the maxillary esthetic zone. Selecting the appropriate shade for pink porcelain poses a challenge, especially when the patient presents with a high smile line. This paper describes a simple and effective technique to facilitate shade selection for gingival ceramics to match the patient's existing gingival shade.