Influence of printing orientation on mechanical properties of aged 3D-printed restorative resins.

OBJECTIVE: To evaluate the influence of printing orientation on flexural strength (σf) and elastic modulus (E) of different 3D printing dental restorative resins. METHODS: Bar-shaped specimens (n = 20) were fabricated from two SLA-printed resins (FT- Formlabs Temporary, and FP- Formlabs Permanent) and two DLP-printed resins (DFT- Detax Freeprint Temp, and GCT- GC Temporary) using two building orientations (0º and 90º). The 3D-printed structures were aged (14 d) before submitted to three-point bending in 37ºC distilled water at a crosshead speed of 1.0 ± 0.3 mm/min until fracture to calculate the σf and the E values. The fractured surfaces were evaluated using stereomicroscopy and scanning electron microscopy (SEM) following fractography principles. Data were statistically analyzed using two-way ANOVA and Tukey post-hoc (α = 0.001). RESULTS: FP and FT showed significantly higher E values than DFT and GCT, irrespectively of printing orientation (p < 0.001). There was no statistical difference between the building orientations (0º and 90º) for the mean σf and E values for the resin materials evaluated. Fractographic characteristics were similar for the surface fracture from all the materials evaluated, showing typical brittle fracture behavior. SIGNIFICANCE: Printing orientation did not influence of flexural strength and elastic modulus values for the 3D-printed resin structures evaluated. Surface topography was mostly governed by the 3D printer type.

Chroma-dependence of CIEDE2000 acceptability thresholds for dentistry.

OBJECTIVES: Determine visual 50:50% color difference acceptability thresholds (AT) for regions of the dental color space with varying chromaticity. METHODS: A 40-observer panel belonging to two different groups (dentists and laypersons) evaluated 144 dental resin composites pairs (divided in three different sets of 48 pairs according to chroma value: Low Chroma (LC), Medium Chroma (MC) and High Chroma (HC) placed 40 cm away and inside of a viewing cabinet (D65 Standard light source; diffuse/0° geometry). A Takagi-Sugeno-Kang (TSK) fuzzy approximation was used for fitting the data points and calculate the 50:50% acceptability thresholds in CIEDE2000. A paired t-test was used to evaluate the statistical significance between thresholds differences and Bonferroni correction was applied. RESULTS: The CIEDE2000 50:50% AT were ∆E00 = 2.84, ∆E00 = 2.31 and ∆E00 = 1.80 for LC, MC and HC sets of sample pairs, respectively. The 50:50% AT values were statistically significant between the different sets of sample pairs, as well as the 50:50% AT values obtained for different observer groups. CONCLUSIONS: 50:50% CIEDE2000 acceptability thresholds for dentistry are significantly different depending on the chromaticity of the samples. Observers show higher acceptability for more achromatic samples (low chroma value) than for more chromatic samples. CLINICAL SIGNIFICANCE: The difference in the AT for distinct regions of the dental color space can assist professionals as a quality control tool to assess clinical performance and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization processes.

Optical properties of dental zirconia, bovine dentin, and enamel-dentin structures.

OBJECTIVE: To evaluate the optical properties and the relative translucency parameter of Ceramill ZI White (3Y-TZP) and Ceramill Zolid FX White (5Y-PSZ) zirconia ceramic systems and compare them with those of the bovine dentin and enamel/dentin structures. MATERIALS AND METHODS: 3Y-TZP and 5Y-PSZ zirconia ceramic systems were evaluated. A 0.5-mm-thick 3Y-TZP (3Y-NC.5), 0.5-mm-thick (5Y-NC.5), and 1.4-mm-thick (5Y-C.14) were used. A 0.5-mm-thick dentin specimens and 1.4-mm-thick enamel/dentin specimens (n = 5) were obtained from anterior bovine maxillary teeth. Scattering, absorption, transmittance, and albedo coefficient were calculated using Kubelka-Munk's model. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (p < 0.001), and goodness-of-fit coefficient (GFC). Relative translucency parameter differences were evaluated using translucency thresholds. RESULTS: Reflectance, scattering, absorption, and transmittance properties were wavelength dependent. Good matches (GFC ≥ 0.999) in spectral reflectance were observed between 0.5-mm-thick dentin and 1.4-mm-thick enamel/dentin, and 3Y-NC.5 and 5Y-NC.5. Scattering was the main optical extinction process during light interaction with zirconia and dental structures, as indicated by albedo coefficient. Translucency differences were acceptable only for 3Y-NC.5 and the dentin structure, and 5Y-C.14 and the enamel/dentin structure. CONCLUSIONS: Optical properties of 3Y-TZP and 5Y-PSZ dental zirconia differed from each other and from bovine dental structures. Nevertheless, 3Y-TZP showed similar relative translucency parameter to bovine dentin. CLINICAL SIGNIFICANCE: To achieve the best esthetic results in restorative dentistry, it is crucial for clinicians to know about the optical properties of 3Y-TZP and 5Y-PSZ and to be able to compare these properties with those of dental structures.

Effect of layering strategy and prolonged water aging on masking ability of composite resins.

STATEMENT OF PROBLEM: Layered composite resins may adequately mask discolored substrates. However, whether color changes that occur over time affect masking ability is unclear. PURPOSE: The purpose of this in vitro study was to investigate the effect of layering and water aging on the masking ability of 2 composite resins. MATERIAL AND METHODS: Disk specimens (1.5 mm-thick and shade A1) from Charisma Diamond (CD) and Filtek Z350XT (Z350) were made according to the composite resin shade combination used in the layering strategies: bilayer for CD (enamel/dentin) and for Z350 (enamel/body and enamel/dentin) and trilayer for Z350 (enamel/body/dentin) (n=5). Color measurements were obtained with a spectrophotometer over an A3.5 ceramic substrate, and the whiteness index for dentistry (WID) was calculated. The specimens were aged in water at 37 °C and evaluated at different times: 24 hours, 1 week, 1 month, 2 months, 6 months, 12 months, 18 months, and 24 months. CIEDE2000 color differences (ΔE00) and WID differences (ΔWID) were calculated and interpreted by 50:50% color and whiteness perceptibility and acceptability thresholds. Changes among strategies and aging times were analyzed using the Kruskal-Wallis test (α=.05). Contrasts were made using the Mann-Whitney U test with Bonferroni correction (α=.001). RESULTS: ΔE00 decreased from 24 hours to 2 months of aging. From 2 months onwards, ΔE00 increased for all layering strategies and times, without significant changes in lightness for CD (P>.004). Overall, for the CD restorative system, an increase in ΔWID was observed after 1 month of aging (P<.001), while for the Z350 restorative system, ΔWID decreased after aging (P<.001), except for the Z350 bilayer strategy (enamel + dentin) at 1 week and 2 months (P>.004). For all layering strategies and aging times, color differences were higher than the 50:50% perceptibility threshold for ΔE00 and, after 6 months, higher than the 50:50% acceptability threshold for ΔE00 and the 50:50% whiteness acceptability threshold. CONCLUSIONS: The ability of the tested composite resins to mask a discolored substrate was affected by the layering approach applied and by prolonged water aging.

Optical behavior of 3D-printed dental restorative resins: Influence of thickness and printing angle.

OBJECTIVES: To evaluate the influence of thickness and printing angle on the optical properties of 3D-printed dental restorative resins. METHODS: Four 3D printing resin systems were evaluated: DFT-Detax Freeprint Temp; FP- Formlabs Permanent Crown; FP- Formlabs Temporary CB; and GCT- GC Temporary-. Samples from each material were printed at 0° and 90°, and polished up to 0.5, 1.0, 1.5 and 2.0 mm thickness. Scattering (S), absorption (K) and albedo (a) coefficients, transmittance (T%), light reflectivity (RI) and infinite optical thickness (X∞) were calculated using Kubelka-Munk's model. Data were statistically analyzed using Kruskal-Wallis¸ Mann-Whitney tests, and VAF coefficient. RESULTS: The spectral distribution on S, K, T%, RI,X∞ were wavelength dependent. Although the spectral behaviors were similar for all the specimens evaluated, the values of S, K, T% andX∞ presented significant differences between specimen thicknesses for all the materials used and for both printing orientations. Values for S and K increased, and T% and X∞ decreased. Significant differences between 0° and 90° were found for RI values at 0.5 and 1.0 mm thick samples, for S and K at 2.0 mm, for X∞ at 0.5 and 1.0 mm for DFT, and at 0.5 mm for FT. CONCLUSIONS: Optical properties of 3D-printed restorative resins vary between thicknesses, and could be affected by the building orientation. Therefore, these factors should be considered in order to improve the biomimetic potential of 3D-printed dental restorative resins. CLINICAL SIGNIFICANCE: Understanding the optical behavior of the 3D-printed restorative resins is essential to optimize their clinical performance.

Color stability and degree of conversion of gingiva-colored resin-based composites.

OBJECTIVES: To evaluate gingiva-colored resin-based composites' (GCRBC) color stability and degree of conversion (DC%). METHODS: Eight discs (8 × 1 mm) of 20 shades of GCRBC were prepared. Color coordinates were measured against a gray background with a calibrated spectroradiometer, CIE D65 illuminant and the CIE 45°/0° geometry at baseline and after 30 days of storage in distilled water, coffee, and red wine. Color differences ( ∆ E 00 ) between final and baseline conditions were calculated. An ATR-FTIR spectrometer with a diamond tip was used to calculate DC%. The results were analyzed statistically using ANOVA and Tukey post-hoc test. The level of significance was p < 0.05. RESULTS: DC% and color stability correlated with each other and with the GCRBC brand. DC% ranged between 43% and 96%, highest values correspond to flowable composites. All composites have experienced color changes after immersion in water, wine and coffee. However, the magnitude of the color change has varied widely depending on the immersion medium and the GCRBC. Color changes generated by the wine were, globally, greater than those induced by coffee (p < 0.001) and above the acceptability thresholds. CONCLUSIONS: The DC% of GCRBCs is sufficient to achieve adequate biocompatibility and physicomechanical properties, but the high susceptibility to staining could compromise aesthetic long-term results. CLINICAL SIGNIFICANCE: The degree of conversion and the color stability of gingiva-colored resin-based composites correlated with each other. All composites have experienced color changes after immersion in water, wine and coffee. Color changes generated by wine were, globally, greater than those induced by coffee and above the acceptability thresholds that could compromise aesthetic long-term results.

The influence of printing angle on color and translucency of 3D printed resins for dental restorations.

OBJECTIVES: To evaluate the influence of printing orientation on color and translucency of 3D printing restorative resins. METHODS: Four 3D printing resin systems in the available shades (DFT-Detax Freeprint Temp- A1, A2,A3; FP-Formlabs Permanent Crown- A2,A3,B1,C2; FT- Formlabs Temporary CB- A2,A3,B1,C2; GCT-GC Temporary- Light, Medium) were evaluated. Three samples (10×10×1.2 mm) from each material were printed at two different printing orientations (0° and 90°) and polished to 1.00 ± 0,01 mm of thickness. Spectral reflectance was measured against black background using a calibrated spectroradiometer, CIE D65 standard illuminant and the 45°/0°geometry. Color and translucency differences were evaluated using CIEDE2000 metric (ΔE00) and 50:50% perceptibility (PT00 and TPT00) and acceptability (AT00 and TAT00) thresholds. RESULTS: In general, color changes due to printing orientation at (0° and 90°) were mainly produced by ΔL* or ΔC* . ΔE00 were above PT00 for all DFT shades, FP-B1, FP-C2, FT-A2 and FT-B1. Only for DFT-1, ΔE00 was above AT00. ΔRTP00 values were above TPT00 for DFT-A1, DFT-A3, FP-B1 and FT-B1, but lower than TAT00. The direction of the changes in translucency (ΔRTP00) depends on the material and shade. SIGNIFICANCE: The selection of building orientation (0° and 90°) for the 3D printed resins influence the visual color and translucency and therefore their esthetic appearance. These aspects should be considered when printing dental restorations using the evaluated materials.

Investigation of the Optical Properties of Indium Tin Oxide Thin Films by Double Integration Sphere Combined with the Numerical IAD Method.

Transparent conductive electrodes have become essential components of numerous optoelectronic devices. However, their optical properties are typically characterized by the direct transmittance achieved by making use of spectrophotometers, avoiding an in-depth knowledge of the processes involved in radiation attenuation. A different procedure based on the Double Integration Sphere combined with the numerical Inverse Adding-Doubling (IAD) method is employed in this work to provide a comprehensive description of the physical processes limiting the light transmittance in commercial indium tin oxide (ITO) deposited on flexible PET samples, highlighting the noticeable contribution of light scattering on the total extinction of radiation. Moreover, harnessing their flexibility, the samples were subjected to different mechanical stresses to assess their impact on the material's optical and electrical properties.

Development of Thickness-Dependent Predictive Methods for the Estimation of the CIEL*a*b* Color Coordinates of Monolithic and Layered Dental Resin Composites.

Usually, dentin and enamel shades are layered in dental restorations with the purpose of mimicking the natural appearance of teeth. The main objective of this study was to develop and assess accuracy of a color-prediction method for both monolithic and layered dental resin-based composites with varying shades and under different illuminants. A total of 15 different shades of VITAPAN Excell, VITAPAN Dentine and VITA Physiodens as well as VITA Enamel of five different thicknesses (0.5-2.5 mm range) were used to manufacture monolithic and layered samples. A non-contact spectroradiometer with CIE 45∘/0∘ geometry was used to measure the color of all samples over a standard ceramic black background. Second-degree polynomial regression was used as predictive method for CIE-L*a*b* color coordinates. Performance of predictive models was tested using the CIEDE2000 total color difference formula (ΔE00), while accuracy was evaluated by comparative assessment of ΔE00 with corresponding 50:50% acceptability (AT00) and perceptibly (PT00) thresholds for dentistry. A mean color difference between measured (real) and predicted color of ΔE00=1.71, with 62.86% of the color differences below AT00 and 28.57% below PT00, was registered for monolithic samples. For bi-layered samples, the mean color difference was roughly ΔE00=0.50, with generally 100% and more than 85% of the estimations below AT00 and PT00, respectively. The predictive method allowed highly accurate color estimations for both monolithic and layered dental resin-based composites with varying thicknesses and under different illuminations. These results could be useful to maximize the clinical success of dental restorations.

Effect of thickness on color and translucency of a multi-color polymer-infiltrated ceramic-network material.

OBJECTIVES: To evaluate the effect of thickness on color and translucency of a multi-color polymer-infiltrated ceramic-network (PICN) material. METHODS: Specimens of 0.5, 1.0, 1.5 mm thicknesses were obtained by sectioning VITA ENAMIC® multiColor (E-MC) High Translucent CAD-CAM blocks (1M1-HT, 1M2-HT, 2M2-HT, 3M2-HT, and 4M2-HT). Spectral reflectance and color coordinates were measured on white and black backgrounds using a spectroradiometer, CIE D65 illuminant and CIE 45°/0° geometry. CIEDE2000 color and translucency differences (ΔE00 and ΔTP00 ) between thicknesses and adjacent layers were evaluated using their respective 50:50% perceptibility and acceptability thresholds (PT00 and AT00 ). RESULTS: In general, ΔE00 between thicknesses for all shades and layers were above AT00 in general. Chroma decreased from cervical to incisal layers with statistically significant differences (p < 0.05), and ΔE00 between sequential layers were above PT00 , for all shades and thicknesses. TP00 decreased from 0.5 to 1.5 mm and increased from cervical to incisal layers for all shades with statically significant translucency differences (p < 0.05). In general, for all thicknesses, TPT00 < ΔTP00 < TAT00 for sequential layers. CONCLUSIONS: The gradient in color and translucency of E-MC PICN material was influenced by the thickness of the CAD-CAM block. In addition, color and TP transition values between the layers depends on the thickness and shade. CLINICAL SIGNIFICANCE: The effect of thickness must be taken into account by dental technicians and dentists when CAD-CAM multicolor PICN materials are used.

Validation of a Hyperspectral Imaging System for Color Measurement of In-Vivo Dental Structures.

A full comprehension of colorimetric relationships within and between teeth is key for aesthetic success of a dental restoration. In this sense, hyperspectral imaging can provide point-wise reliable measurements of the tooth surface, which can serve for this purpose. The aim of this study was to use a hyperspectral imaging system for the colorimetric characterization of 4 in-vivo maxillary anterior teeth and to cross-check the results with similar studies carried out with other measuring systems in order to validate the proposed capturing protocol. Hyperspectral reflectance images (Specim IQ), of the upper central (UCI) and lateral incisors (ULI), were captured on 30 participants. CIE-L*a*b* values were calculated for the incisal (I), middle (M) and cervical (C) third of each target tooth. ΔEab* and ΔE00 total color differences were computed between different tooth areas and adjacent teeth, and evaluated according to the perceptibility (PT) and acceptability (AT) thresholds for dentistry. Non-perceptible color differences were found between UCIs and ULIs. Mean color differences between UCI and ULI exceeded AT (ΔEab* = 7.39-7.42; ΔE00 = 5.71-5.74) in all cases. Large chromatic variations between I, M and C areas of the same tooth were registered (ΔEab* = 5.01-6.07 and ΔE00 = 4.07-5.03; ΔEab* = 5.80-8.16 and ΔE00 = 4.37-5.15; and ΔEab* = 5.42-5.92 and ΔE00 = 3.87-4.16 between C and M, C and I and M and I, respectively). The use of a hyperspectral camera has proven to be a reliable and effective method for color evaluation of in-vivo natural teeth.

Relevant optical properties for gingiva-colored resin-based composites.

OBJECTIVES: To evaluate the optical properties of gingiva-colored resin-based composites (GCRBCs). METHODS: Five discs (8 mm diameter x 1mm height) of 17 shades of GCRBCs were prepared. Diffuse reflectance was measured against white and black backgrounds using a calibrated spectroradiometer, CIE D65 illuminant and the CIE 45°/0° geometry. Relative translucency parameter was calculated using ΔE00 (RTP00). Translucency differences were evaluated using published data of 50:50% translucency perceptibility (TPT00) and acceptability (TAT00) thresholds. Scattering (S) and absorption (K) coefficients and transmittance (T%) were calculated using Kubelka-Munk's equations. Data were statistically analyzed using Kruskal-Wallis, Mann-Whitney tests, and VAF coefficient. RESULTS: The RTP00 values of the 17 evaluated shades ranged from 8.69 to 21.34. There were perceptible translucency differences (TPT00=0.62) between different shades of the same brand and between composites designated with the same shade of different brands. Spectral distributions of S, K and T were wavelength-dependent. Although the spectral behavior of the S and K coefficients and T% were similar for all the gingival composites evaluated, the values of these parameters presented statistically significant differences between shades, which would justify the differences found in the relative translucency parameter. CONCLUSIONS: The optical properties S, K and T% of GCRBCs were significantly different, resulting in perceptible translucency differences between the same shade of different commercial brands and between different shades of the same brand. CLINICAL SIGNIFICANCE: Translucency differences of gingiva-colored composites may significantly influence their masking ability affecting the clinician's choice of restorative material.

Masking ability of resin composites: Effect of the layering strategy and substrate color.

OBJECTIVE: To evaluate the effect of layering strategy and substrate color on the masking ability of resin composites. MATERIALS AND METHODS: A1-shaded specimens from Charisma Diamond and Filtek Z350XT were produced using different layering strategies. Color measurements were made by a reflectance spectrophotometer over A2, C2, A3.5, C3, C4 substrates. Color differences were calculated and interpreted by the 50%:50% perceptibility and acceptability visual thresholds. Data was analyzed by Kruskal-Wallis and Dunn post hoc test. Chi-square test was used to determine the association between masking ability, and independent variables. RESULTS: Color differences were significantly lower on A2 and C2 in comparison with C4 for the majority of the layering strategies. Acceptable matches were observed on most of the combinations over A2. Moderately unacceptable mismatches were observed in most of the combinations over C2 and A3.5. Clearly unacceptable mismatches were observed on the C3 and C4. The ΔE00 color shifts were predominantly influenced by ΔL00 for all layering strategies and substrate colors. CONCLUSION: Masking ability was affected by the layering strategy and substrate color. Acceptable masking was associated with A2 and C2, and with layering strategy composed of 0.5 mm enamel opacity and 1.0 mm dentin opacity thicknesses, using the Filtek Z350XT. CLINICAL SIGNIFICANCE: Resin composites-shade A1-applied by different layering strategies with a final thickness of 1.5 mm were able to mask mild and moderately discolored substrates. Severely discolored substrates were not masked effectively.

CIEDE2000 lightness, chroma and hue human gingiva thresholds.

OBJECTIVE: To determine the visual 50:50% perceptibility and acceptability CIEDE2000 lightness, chroma and hue human gingiva thresholds. METHODS: A psychophysical experiment based on visual assessments of simulated images of human gingiva on a calibrated display was performed. A 20-obsever panel (dentists and laypersons; n=10) evaluated three subsets of simulated human gingiva: lightness subset (|ΔL'/ΔE00|≥ 0.98); chroma subset (|ΔC'/ΔE00|≥ 0.98) and hue subset (|ΔH'/ΔE00|≥ 0.96) using ΔE00< 5 units. A Takagi-Sugeno-Kang (TSK) Fuzzy Approximation model was used as fitting procedure, and 50:50% perceptibility threshold (PT) and acceptability threshold (AT) were calculated. Data was statistically analyzed using t-test (p ≤ 0.05). RESULTS: The 50:50% PT were ΔL' = 0.74 (95% confidence interval (CI) 0.39-1.09); ΔC' = 1.10 (95% CI 0.57-1.46); ΔH' = 2.40 (95% CI 1.66->3.85). The 50:50% AT were ΔL' = 2.57 (95% CI 2.00-3.06); ΔC' = 2.70 (95% CI 2.19-3.38). AT ΔH' may be considered no computable. PT values were statistically significant among the three metric differences (p ≤ 0.05). No difference was found between observers for PT values. CONCLUSIONS: Statistically differences in perceptual limit were found among hue, lightness and chroma for human gingiva. Thus, the observers seem to show lower sensitivity for changes in hue (ΔH') than in chroma (ΔC') and in lightness (ΔL') in the gingiva color space. CLINICAL SIGNIFICANCE: PT and AT for lightness, chroma and hue specific for human gingiva should be used when evaluating natural gingiva, pink gingival shade guides or pink materials, since the thresholds of perception and acceptability for teeth are not suitable.

Optical Behavior of Human Skin Substitutes: Absorbance in the 200-400 nm UV Range.

The most recent generation of bioengineered human skin allows for the efficient treatment of patients with severe skin defects. Despite UV sunlight can seriously affect human skin, the optical behavior in the UV range of skin models is still unexplored. In the present study, absorbance and transmittance of the UGRSKIN bioartificial skin substitute generated with human skin cells combined with fibrin-agarose biomaterials were evaluated for: UV-C (200−280 nm), -B (280−315 nm), and -A (315−400 nm) spectral range after 7, 14, 21 and 28 days of ex vivo development. The epidermis of the bioartificial skin substitute was able to mature and differentiate in a time-dependent manner, expressing relevant molecules able to absorb most of the incoming UV radiation. Absorbance spectral behavior of the skin substitutes showed similar patterns to control native skin (VAF > 99.4%), with values 0.85−0.90 times lower than control values at 7 and 14- days and 1.05−1.10 times the control values at 21- and 28-days. UV absorbance increased, and UV transmission decreased with culture time, and comparable results to the control were found at 21 and 28 days. These findings support the use of samples corresponding to 21 or 28 days of development for clinical purposes due to their higher histological similarities with native skin, but also because of their absorbance of UV radiation.

Does Backgrounds Color Influence the Appearance of Gingiva-Colored Resin-Based Composites?

Dental materials are mainly tested in vitro, so laboratory conditions must reproduce the oral environment to ensure the validity of their results. This study aimed to evaluate the influence of backgrounds on the color of gingiva-colored resin-based composites (GCRBC). Three discs of each of 20 shades of GCRBCs and each thickness (1 and 2 mm) were prepared. Diffuse reflectance was measured on-air and over three natural teeth (0M3/B1, 3M3/B3, and 5M3/B4 shades of Vita 3D Master/Vita Classical guides, respectively) using a calibrated spectroradiometer, CIE D65 illuminant and the CIE 45°/0° geometry. CIEDE2000 color difference formula and its 50:50% perceptibility and acceptability thresholds have been used to calculate and interpret the results. It can be stated that the background influences the color of all GCRBCs tested, although the effect is more pronounced for 1 mm thick samples. L*, a* and b* coordinates values of GCRBCs on air were significantly different from those obtained on natural teeth backgrounds, and the total color differences were greater than the acceptability thresholds. Since GCRBCs are placed on a dental substrate in clinical conditions, it is not advisable to perform color measurements of GCRBCs on-air because of the high color differences found. This recommendation is especially relevant for thin specimens.

Visual and instrumental coverage error of two dental shade guides: an in vivo study.

OBJECTIVES: This study aims to evaluate in vivo the color agreement between natural teeth and dental shade guides by means of visual and instrumental coverage error ([Formula: see text]) index. MATERIALS AND METHODS: The color of the middle third of 735 incisors was visually determined by two evaluators using the Vita Classical (VC) and Vita 3D Master (V3DM) shade guides. The color match between the natural tooth and the shade tab was rated as poor (P), good (G), or optimum (O) by each observer. CIE color coordinates of the target teeth and shade tabs of VC and V3DM were instrumentally measured using a clinical spectrophotometer. Visual ([Formula: see text]) and instrumental ([Formula: see text]) coverage error indexes were computed using CIELAB and CIEDE2000 metrics for both shade guides. For [Formula: see text] calculation, only the concordant inter-observer determination on tooth shade rated as O-O or O-G was used. The results were evaluated using perceptibility (PT, [Formula: see text]= 1.2, [Formula: see text]= 0.8) and acceptability (AT, [Formula: see text]= 2.7, [Formula: see text]= 1.8) color thresholds for dentistry. RESULTS: VC and V3DM exhibited [Formula: see text] (2.5, 3.2, and 3.2, 2.7 CIELAB units; 1.9, 2.3, and 2.8, 2.4 CIEDE2000 units, respectively, for O-O and O-G match) and [Formula: see text] (4.7, 4.8, and 4.1, 4.6 CIELAB units; 3.3, 3.4, and 3.4, 3.6 CIEDE2000 units, respectively, for O-O and O-G match) values greater than 50:50% AT for both color difference formulas. [Formula: see text] contributes more than 50% (53.2-82.4% range) to the [Formula: see text] value. This contribution depends on the shade guide used and the quality of the visual rating. CONCLUSIONS: The evaluated shade guides exhibited visual coverage errors above acceptability thresholds, largely due to the contribution of the instrumental coverage error to the visual coverage error. CLINICAL RELEVANCE: It necessary to further improve commercially available dental shade guides to facilitate achievement of satisfactory esthetics results in clinical practice.

Color and optical properties of 3D printing restorative polymer-based materials: A scoping review.

OBJECTIVE: Color and optical properties are particularly crucial to mimic natural tooth. This scoping review aimed to present an overview of the literature published on color and optical properties of 3D printing restorative polymer-based materials. The literature search was performed in MED-LINE/Pubmed, Scopus and Web of Science. MATERIALS AND METHODS: The literature search was conducted in the three databases based on the question: "Are the optical properties and color adequately reported on polymer-based 3D printing dental restorative materials studies?" with no restriction on year of publication. Data were reported and synthesized following PRISMA-ScR statement. RESULTS: Nine studies fit the inclusion criteria. Five studies focused on evaluating only color stability; three articles assessed the color stability along with mechanical and morphological properties and only one study compared color parameters of 3D printed to conventional polymers. Two studies evaluated translucency parameter and no study was found evaluating scattering, absorption, and transmittance. CONCLUSIONS: Color and optical properties of 3D printed polymers that can be used in restorative dentistry are not adequately evaluated and characterized. Future studies on the influence of experimental printing conditions should include these physical properties to assist on improving esthetics. CLINICAL SIGNIFICANCE: This review shows the scarce literature existing on color and optical properties of 3D printing restorative polymer-based materials. These properties and their study are of outmost importance to create materials that mimic natural tooth to allow clinicians to obtain esthetically pleasant restorations.

Reflectance and color prediction of dental material monolithic samples with varying thickness.

OBJECTIVE: To assess accuracy of reflectance reconstruction and color estimation of different dental materials with varying thicknesses using Principal Component Analysis (PCA). METHOD: A1, A2, A3, A3.5, B2, C2 and D2 shades and 5 thicknesses (within 0.5-2.5 mm range) of Vita Suprinity (VS-PC) and Vitapan Dentine (VD), were used. Reflectance measurements were performed over black background using a non-contact spectroradiometer with CIE 45∘∕0∘ geometry. A PCA based algorithm was proposed to reconstruct spectral data and color of samples, using both extrapolation and interpolation approaches. Root Mean Square Error (RMSE), Goodness of Fit (GFC), correlation coefficient (R2) as well as ΔE00 with corresponding 50:50% acceptability and perceptibly thresholds (AT and PT) were used as performance assessment. RESULTS: The interpolation approach provided an average RMSE = 0.01 and GFC > 0.999 when comparing predicted and measured spectral reflectances for both materials, while for the extrapolation approach RMSE = 0.02 and GFC > 0.999. Interpolation approach also resulted in lower overall mean color difference ΔE00 = 0.8 (ΔE00 = 0.9 for VS-PC and ΔE00 = 0.7 for VD), while using extrapolation approach resulted in higher overall mean color difference ΔE00 = 1.6, although below the AT (ΔE00 = 1.8 for VS-PC and ΔE00 = 1.5 for VD). Correlation values between predicted and measured spectral reflectances of R2 = 0.987 and R2 = 0.993 were globally obtained for VS-PC and VD, respectively. SIGNIFICANCE: The proposed PCA-based algorithm is able to efficiently predict reflectance spectrum and color of monolithic samples of different dental materials with varying thickness. It can be used to optimize dental materials manufacturing processes and to improve chromatic accuracy of clinical dental restorations.

Effectiveness and color stability of bleaching techniques on blood-stained teeth: An in vitro study.

OBJECTIVE: Evaluate the effectiveness and color stability of bleaching techniques on blood-stained teeth. MATERIAL AND METHODS: The teeth were stained by blood and allocated to groups: walking bleach, inside/outside, and in-office bleaching. L*, a*, b*, C*, h° color coordinates were measured using a clinical spectrophotometer at baseline, weekly (T1-T2-T3), and at 1-week (T4), 6-months (T5), and 1-year (T6) follow-up evaluations. ΔEab* , ΔE00 , and ΔWID were calculated between sequential evaluation timepoints and between baseline and each evaluation timepoint. Color coordinates and WID differences in each timepoint and technique were analyzed by Wilcoxon Signed Rank, Kruskal-Wallis and Mann-Whitney U test, respectively. ΔEab* , ΔE00 , and ΔWID were interpreted by color visual thresholds. RESULTS: The techniques presented a significant increase in L* and WID and, a significant decrease in a* and b* until the completion of treatments. Statistical differences between the techniques for a*, b* and WID were observed from T1 until T3. All techniques demonstrated excellent effectiveness for ΔEab* , ΔE00 , and ΔWID between baseline and each evaluation and follow-up timepoints. However, at T6, it was possible to identify a rebound effect for all techniques. CONCLUSIONS: All bleaching techniques presented excellent effectiveness. The stability of the whitening produced was maintained for 6 months. CLINICAL SIGNIFICANCE: Effective whitening of blood-stained teeth was achieved using walking bleach (sodium perborate), inside/outside (hydrogen peroxide - 7.5%) and in-office techniques (hydrogen peroxide - 35%). The bleaching techniques were effective after the completion of the treatments. A slight rebound was observed at 1 year follow-up.