Journal List > J Korean Acad Prosthodont > v.46(5) > 1034543

Kim, Shin, and Lee: Shade comparative analysis of natural tooth measured by visual and spectrophotometric methods

Abstract

Statement of problem

A clinically successful color match is one of the important factor to get an esthetic dental restoration. Dental shade guides are commonly used to evaluate tooth color in restorative procedure. But numerous reports have indicated that common shade guides do not provide sufficient spectral coverage of the natural tooth colors. To address issues associated with the shade guide, distinct avenues have been pursued objective spectrophotometric / colorimetric assessment.

Purpose

This study compared the accuracy of tooth color selection of spectrophotometer with that of human visual determination. Three main factors were investigated, namely, the effect of light, the individual variation and the experience of the observer.

Material and methods

At the first experiment, on ten patients, one operator independently selected the best matching shade to the unrestored maxillary central incisor, using a Vita Classical Shade Guide in the morning, at noon and in the afternoon. The same teeth were measured by means of a reflectance spectrophotometer. At the second experiment, on ten patients, ten operators (5 experts, 5 novices) selected and measured by the same method above at noon. At the third experiment, the results of the second experiment were divided into two groups, expert and novice, and analyzed.

Results

1. There was significant difference between visual and spectrophotometric assessment (mean ΔE values) in experiment 1, 2, 3 (P < .05). 2. There was no significant difference between experts and novices group, when comparing with each visual and spectrophotometric assessment (mean ΔE values).

Conclusion

Spectrophotometer could be used to analyze the shade of natural tooth objectively. Thereby, this method offers the potential tominimize considerably the need for corrections or even remakesafter intraoral try-in of restoration. Furthermore, to achieve its advantage, both the shade-matching environment and communication between dentist and technician should be optimized with use of visual and instrumental shade-matching systems. (J Kor Acad Prosthodont 2008;46:443-55).

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Fig. 1.
The VITAPAN® classical shade guide (Vita Zahnfabrik, Badsa¨ckingen, Germany).
jkap-46-443f1.tif
Fig. 2.
ShadePilotTM dental spectrophotometer (DeguDent GmbH, Rodenbacher, Germany).
jkap-46-443f2.tif
Fig. 3.
Calibration process.
jkap-46-443f3.tif
Fig. 4.
Measuring process.
jkap-46-443f4.tif
Fig. 5.
Image of single tone shade on ShadePilotTM.
jkap-46-443f5.tif
Fig. 6.
Text image of value, chroma, hue on ShadePilotTM.
jkap-46-443f6.tif
Table I.
Results of shade analysis evaluated with Vita classic shade guide and spectrophotometer of experiment 1
Visual Spectrophotometer
Morning Noon Afternoon Morning Noon Afternoon
A B3 A3 A3 A3 A3 A3
B D3 A3 A3 A3 A3 A3
C B2 A2 A2 A2 A2 A2
D A3 B2 B2 A2 A2 A2
E B2 B2 B3 A2 A2 A2
F A3 A3 D3 A3 A3 A3
G C2 B2 B2 A3 A3 A3
H B2 B2 C2 A2 C1 C1
I C2 A3 B2 A2 A2 A2
J D3 A3 A3 A2 A2 A2
Table II.
Mean shade and ΔE values assessed either by human evaluator or by spectrophotometric readings of experiment 1
  A B C D E F G H I J Mean
ØH A3 A3 A2 B2 B2 A3 B2 B2 A2 A3  
ØΔEH 3.59 5.02 0.87 4.15 7.48 5.02 5.62 5.62 3.27 5.02 4.57 ± 1.76
ØSP A3 A3 A2 A2 A2 A3 A3 C1 A2 A2  
ØΔESP 2.27 2.43 1.14 2.41 1.88 1.79 1.62 2.56 1.46 2.23 1.98 ± 0.47
ØΔEH-ØΔESP 1.32 2.59 -0.27 1.74 5.6 3.23 4 2.06 1.81 2.79  

ØH: Average of the human visual shade determination based on the Vita Classic Shade Guide

ØΔEH: Average of the numeric ΔE values related to the visually determined Vita Shade

ØSP: Average of the spectrophotometric shade determination based on the Vita Classic Shade Guide

ØΔESP: Average of the numeric ΔE values related to the spectrometrically determined Vita Shade

ØΔEH-ØΔESP: The difference in ΔE value between visual and spectrophotometric assessment

Table III.
Results of Wilcoxon Signed Ranks Test of experiment 1
  Visual (Mean ΔE) Spectrophotometer (Mean ΔE) P value
Experiment 1 4.57 1.98 0.007
Table IV.
Results of shade analysis evaluated with Vita classic shade guide and spectrophotometer of experiment 2
  A B C D E F G H I J
  V SP V SP V SP V SP V SP V SP V SP V SP V SP V SP
E1 A3 A3 A3 D3 A2 A2 A2 A2 A2 A2 A3 A3 A2 A3 B2 C1 A2 A2 A2 A2
E2 A3 A3 A3 D3 A1 A2 A2 A2 A2 A2 A3 A3 A2 A3 A2 C1 A2 A2 A2 A2
E3 A2 A3 A2 D3 A1 A2 A1 A2 A1 A2 A2 A3 A1 A3 A1 C1 A2 A2 A2 A2
E4 B3 A3 A3 A3 A2 A2 B2 A2 A2 A2 A3 A3 A2 A3 A2 C1 A3 A2 A3 A2
E5 A3 A3 A3 D3 A2 A2 A2 A2 A2 A3 A3 A3 A2 A2 A2 C1 A2 A2 A2 A2
N1 A3 A3 A2 A3 A2 A2 B2 A2 B2 A1 A3 A3 A2 A3 B2 C1 B2 A2 A3 D3
N2 A3 A3 A2 D3 A1 A2 B2 A2 C1 A1 A3 A3 B2 A3 B2 C1 B2 A2 A2 A3
N3 D2 A3 A1 D3 C1 A2 B2 A2 C1 A1 A4 A3 A1 A2 A1 C1 C1 A2 B2 A2
N4 B3 A3 B2 A3 A2 A2 A2 A2 A2 A2 B2 A3 A2 A3 A1 A2 A2 A2 B2 D3
N5 A3 A3 A3 A3 B2 A2 B2 A2 A3 A2 B3 A3 A2 A2 A2 C1 D2 A2 A3 D3

E: Expert V: Visual shade determination N: Novice SP: Spectrophotometric shade determination

Table V.
Mean shade and ΔE values assessed either by human evaluator or by spectrophotometric readings of experiment 2
  A B C D E F G H I J Mean
ØH A3 A3 A2 B2 A2 A3 A2 A2 A2 A2  
ØΔEH 4.6 4.76 3.99 1.68 3.65 4.77 3.6 2.89 3.03 2.56 3.55 ± 1.04
ØSP A3 D3 A2 A2 A2 A3 A3 C1 A2 A2  
ØΔESP 1.97 2.58 1.67 1.58 2.4 2.11 2.27 2.17 1.78 1.93 2.05 ± 0.32
ØΔEH-ØΔESP 2.09 2.18 2.32 0.1 1.25 2.66 1.33 0.72 1.25 0.63  

ØH: Average of the human visual shade determination based on the Vita Classic Shade Guide

ØΔEH: Average of the numeric ΔE values related to the visually determined Vita Shade

ØSP: Average of the spectrophotometric shade determination based on the Vita Classic Shade

ØΔESP: Average of the numeric ΔE values related to the spectrometrically determined Vita Shade

ØΔEH-ØΔESP: The difference in ΔE value between visual and spectrophotometric assessment

Table VI.
Results of Wilcoxon Signed Ranks Test of experiment 2
  Visual (Mean ΔE) Spectrophotometer (Mean ΔE) P value
Experiment 2 3.55 2.05 0.005
Table VII.
Results of shade analysis of expert group evaluated with Vita classic shade guide and spectrophotometer of experiment 3
  A B C D E F G H I J
  V SP V SP V SP V SP V SP V SP V SP V SP V SP V SP
E1 A3 A3 A3 D3 A2 A2 A2 A2 A2 A2 A3 A3 A2 A3 B2 C1 A2 A2 A2 A2
E2 A3 A3 A3 D3 A1 A2 A2 A2 A2 A2 A3 A3 A2 A3 A2 C1 A2 A2 A2 A2
E3 A2 A3 A2 D3 A1 A2 A1 A2 A1 A2 A2 A3 A1 A3 A1 C1 A2 A2 A2 A2
E4 B3 A3 A3 A3 A2 A2 B2 A2 A2 A2 A3 A3 A2 A3 A2 C1 A3 A2 A3 A2
E5 A3 A3 A3 D3 A2 A2 A2 A2 A2 A3 A3 A3 A2 A2 A2 C1 A2 A2 A2 A2
Table VIII.
Mean shade and ΔE values assessed either by expert group or by spectrophotometric readings
  A B C D E F G H I J Mean
ØH A3 A3 A2 A2 A2 A3 A2 A2 A2 A2  
ØΔEH 3.64 3.69 4.91 2.89 4.91 3.69 4.91 2.89 3.69 3.69 3.89 ± 0.77
ØSP A3 D3 A2 A2 A2 A3 A3 C1 A2 A2  
ØΔESP 1.7 2.83 1.58 1.27 2.46 2.15 2.36 2.15 2.22 1.98 2.07 ± 0.46
ØΔEH-ØΔESP 1.94 0.86 3.33 1.62 2.45 1.54 2.55 0.74 1.47 1.71  

ØH: Average of the human visual shade determination based on the Vita Classic Shade Guide

ØΔEH: Average of the numeric ΔE values related to the visually determined Vita Shade

ØSP: Average of the spectrophotometric shade determination based on the Vita Classic Shade Guide

ØΔESP: Average of the numeric ΔE values related to the spectrometrically determined Vita Shade

ØΔEH-ØΔESP: The difference in ΔE value between visual and spectrophotometric assessment

Table IX.
Results of Wilcoxon Signed Ranks Test for expert group of experiment 3
  Visual (Mean ΔE) Spectrophotometer (Mean ΔE) P value
Experiment 3 (Expert) 3.89 2.07 0.005
Table X.
Results of shade analysis of novice group evaluated with Vita classic shade guide and spectrophotometer of experiment 3
  A B C D E F G H I J
  V SP V SP V SP V SP V SP V SP V SP V SP V SP V SP
N1 A3 A3 A2 A3 A2 A2 B2 A2 B2 A1 A3 A3 A2 A3 B2 C1 B2 A2 A3 D3
N2 A3 A3 A2 D3 A1 A2 B2 A2 C1 A1 A3 A3 B2 A3 B2 C1 B2 A2 A2 A3
N3 D2 A3 A1 D3 C1 A2 B2 A2 C1 A1 A4 A3 A1 A2 A1 C1 C1 A2 B2 A2
N4 B3 A3 B2 A3 A2 A2 A2 A2 A2 A2 B2 A3 A2 A3 A1 A2 A2 A2 B2 D3
N5 A3 A3 A3 A3 B2 A2 B2 A2 A3 A2 B3 A3 A2 A2 A2 C1 D2 A2 A3 D3
Table XI.
Mean shade and ΔE values assessed either by novice group or by spectrophotometric readings
A B C D E F G H I J Mean
ØH A3 A2 A2 B2 C1 A3 A2 B2 B2 B2  
ØΔEH 5.57 6.37 3.38 0.87 3.33 5.13 2.89 4.61 4.85 2.28 3.96 ± 1.69
ØSP A3 A3 A2 A2 A1 A3 A3 C1 A2 D3  
ØΔESP 2.25 2.34 1.76 1.88 2.34 2.06 2.18 2.19 1.33 1.88 2.02 ± 0.31
ØΔEH-ØΔESP 3.32 4.03 1.62 -1.01 0.99 3.07 0.71 2.42 3.52 0.4  

ØH: Average of the human visual shade determination based on the Vita Classic Shade Guide

ØΔEH: Average of the numeric ΔE values related to the visually determined Vita Shade

ØSP: Average of the spectrophotometric shade determination based on the Vita Classic Shade Guide

ØΔESP: Average of the numeric ΔE values related to the spectrometrically determined Vita Shade

ØΔEH-ØΔESP: The difference in ΔE value between visual and spectrophotometric assessment

Table XII.
Results of Wilcoxon Signed Ranks Test for novice group of experiment 3
  Visual (Mean ΔE) Spectrophotometer (Mean ΔE) P value
Experiment 3 (Novice) 3.96 2.02 0.017
Table XIII.
Results of Mann-Whitney U test of experiment 3
Expert Novice P value
Visual (Mean ΔE) 3.89 3.96 0.939
Spectrophotometer (Mean ΔE) 2.07 2.02 0.821
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