Tooth Shade Determination

Dr. Judit Borbély

•The American Academy of Cosmetic Dentistry
completed a study regarding tooth brightness and
appearance. An overwhelming majority (90 percent)
of those surveyed viewed people with whiter teeth as
healthier and more attractive,”
•In fact, further studies by the American Academy of
Cosmetic Dentistry show that 96 percent of adults
believe an attractive smile makes a person more
appealing to the opposite sex, and 74 percent of
adults feel an unattractive smile can hurt a person’s
chances for career success.
Color and Shade Selection

Esthetics-patients satisfaction!
De gustibus et coloribus non
est disputandum

• Raffaello Santi: Scuola di Atene

NO LIGHT NO SIGHT!
Color Vision
• Everything that we see is
reflected light
• Visible light is portion of the
electromagnetic
spectrum
• Light enters the eye, and
reaches the retina: rods,
cones
• Electrical impulses
transmitted to the brain
• Visual perception:
interaction of light, eyes,
brain
• Patterns of illumination on
the retina,other senses, past
experiences
 Color perception:
subjective!
Observer metamerism: Every individual perceives color slightly differently

Normal Metamerism:
Similar colors appear
Color different under
vision: different conditions
•1 million •Geometric:
different Different
colors angle/different color
•Simple:
Different lightning
source/different color
Color vision deficiency :
inability to perceive differences between
some or all colors
•1 in 200 females
•1 in 12 males
•Ishiara test
 Shade Determination
I. Comparison method with Shade guides

II. Measurement
Instruments for color measurement
 Classical shade guide:
practical experience

A-orange
B-yellow orange
C-grey orange
D-brown orange
 Shade selection keys
• Use correct environment and lightning
• Select shade at the beginning of appointment
• Patient sitting upright
• Patient’s teeth/dentist’s eyes at same level
• Look for variance between gingival ,middle and
incisal thirds of teeth

•gingival -higher chroma

•middle -higher value

•incisal -higher translucency

 Control of the environment
• Must surround teeth with colour
that aids color perception
• Use neutral colors in operatory
• Window light-daylight
• No lipstick
• Always use a bib
Cover brightly-colored clothing
Natural teeth-orange/compliment
of orange is blue
Use gray patient bibs
• Visual color match !
Dilemma of the method:
number of color samples available in the
shade guide:
more samples - human eye tires
small number of samples-
random factors
color perception is subjective and varies
between individuals :
lightning conditions, experience, age,
physiological variables such as color
blindness lead to inconsistencies

• Vita-Vita teszt
• Evaluation of visual and instrument shade
matching
Scott R. Okubo, School of Dentistry, West Virginia University
Morgantown, J Prosthet Dent 1998;80:642-648
•Proceedings of the National Academy of Science U S A.

•Isia Leviant Enigma

•CIE Lab tooth color space
• Grassmann/ Munsell:
• Value degree of lightness or darkness of a
color relative to a series of grays

• Chroma the difference between the color

and a gray having the same brightness

• Hue physical wavelength of light, represented as

an angle ranging from 0° to 360°.

V
A
L
U
E

•Chroma
 3D-MASTER Toothguide
• Introduced in 1988 1M1 •Classical Shade Guides
• Systematic and *
equidistant Limitations:
R-red •Not uniformly positioned
coverage of the 1.5M1
natural tooth shade throughout tooth color
spectrum space
* •No standard difference
• Exactly defined 2M1
between adjacent shades
mixed colors:52 L-yellow
•In-between shades
interpolated colors (eg.”A2.5” ) are inaccurate
• Reflects distribution
of tooth shades in 3M1
nature

4M1

5M3

VITA
 3D Master Tooth Guide
Systematic precision of shade matcing :
•5 Value Groups (1-5) left to right
• Chroma
represented
by a number
(1- 3)within
each value
group: pale
to intensive

•Hue represented by L,M, R left to right

 Value:
brightness of the color (high value-brighter
lower value-darker)

The proper Value is the most important dimension in the

shade determining process!
Black GV. A work on operative dentistry. Chicago:
Medico-Dental Pub Co; 1908. p. 347.
 Chroma
intensity, saturation, purity of the color
(low chroma=weak,
high chroma=highly saturated, pure colors)
Chroma
 HUE
the color itself dependent upon wavelength
The attribute of a color by which we distinguish red from
green, blue from yellow, etc.
HUE
• Value
First step:
Value level from the five
value groups (levels 1 - 5)
that is closest to the
value of the tooth to be
compared

• Chroma
Second step:
Chroma (levels 1 2,3) is
determined, color sample
of the selected M group
that is closest to the tooth
to be compared.

• Hue
Third step:
hue (L, M, R) is
determined,whether the
natural tooth displays a
"more yellowish" (L) or
"more reddish" {R) shade
than M-group
• Linearguide

1. Value
2. Chroma/Hue
 Digital color determination
• Technological Shade Systems
• Measurement data analyzed by
computers
• Color quantified using numerical values
• Objective,consistent,reproducible color
measurement

• Printing house-press
• Textile industry
• Interior decorators
• Paintwork on cars
Digital Tooth Shade Determination
• RGB Devices
• Colorimeter
• Spectrophotometer

•Colorimeter:
•ShadeEye SHOFU Inc., Japan
•Digital Shade Guide DSG 4 PLUS, Rieth

•Spectrophotometer:
•Easyshade Compact, Vita
•Shadepilot, Degudent
•RGB device:
•ShadeScan, Cynoprod, Canada
•ShadeVison System, x-rite
Dental spectrophotometers
 Vita Easyshade
dental spectrophotometer
Measure reflected wave
length
 Placement of probe tip
Correct placement: (probe tip
perpendicular and flush on tooth
surface)

Incorrect placement: (probe tip not

flush on surface of tooth)

Incorrect incisal placement:

(probe tip must be have a minimum
distance of 2 mm to the incisal edge)

Incorrect cervical placement:

(probe tip too close to gingival tissue.
Maintain minimum distance of 2 mm to
, tissue margin.)
 Lab communication

Tooth color: BASIC SHADE and :

• Tooth surface
• Bluish, whitish, greyish incisal edge
• Inclusion of perykimata
• Glossy, matt surface
• Mamelons
• Longitudional and transverese lines
• Hairline cracks and stains
• Transparency zones trans/appearance
• Translucency trans/lucence
• Individual characteristics
• Anatomic differences
 Digital Photography
•Overall appearance ( face, lips,
full smile)
•Translucency, opacity
•Tooth surface characteristics
•Color map
•Shape and form
•Adjacent information
Best solution: several methods combined!

Lab technician
requires adequat tooth
color information to
make a matching,
lifelike restoration!
Thank You for Your Attention!