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d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1307–1312

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Comparison of the color of natural teeth measured


by a colorimeter and Shade Vision System

Byeong-Hoon Cho a , Yong-Kyu Lim b , Yong-Keun Lee c,∗


a Department of Conservative Dentistry and Dental Research Institute, College of Dentistry,
Seoul National University, Seoul, Republic of Korea
b Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Republic of Korea
c Department of Dental Biomaterials Science and Dental Research Institute, College of Dentistry,

Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul, Republic of Korea

a r t i c l e i n f o a b s t r a c t

Article history: Objectives. The objectives were to measure the difference in the color and color parame-
Received 13 February 2006 ters of natural teeth measured by a tristimulus colorimeter (CM, used as a reference) and
Accepted 15 November 2006 Shade Vision System (SV), and to determine the influence of color parameters on the color
difference between the values measured by two instruments.
Method. Color of 12 maxillary and mandibular anterior teeth was measured by CM and SV
Keywords: for 47 volunteers (number of teeth = 564). Color parameters such as CIE L* , a* and b* values,
Tooth color chroma and hue angle measured by two instruments were compared. Chroma was calcu-
1/2
Colorimeter lated as C∗ab = (a∗2 + b∗2 ) , and hue angle was calculated as h◦ = arctan(b* /a* ). The influence
Shade Vision System of color parameters measured by CM on the color difference (E∗ab ) between the values
Color difference measured by two instruments was analyzed with multiple regression analysis (˛ = 0.01).
Results. Mean E∗ab value between the values measured by two instruments was 21.7 (±3.7),
and the mean difference in lightness (CIE L* ) and chroma was 16.2 (±3.9) and 13.2 (±3.0),
respectively. Difference in hue angle was high as 132.7 (±53.3)◦ . Except for the hue angle, all
the color parameters showed significant correlations and the coefficient of determination
(r2 ) was in the range of 0.089–0.478. Based on multiple regression analysis, the standard-
ized partial correlation coefficient (ˇ) of the included predictors for the color difference was
−0.710 for CIE L* and −0.300 for C∗ab (p < 0.01).
Conclusion. All the color parameters showed significant but weak correlations except for hue
angle. When lightness and chroma of teeth were high, color difference between the values
measured by two instruments was small. Clinical accuracy of two instruments should be
investigated further.
© 2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

1. Introduction with a large set of color tabs. Value is determined first, and
chroma is determined next with tabs that are close to the
Color can be described according to the Munsell color space measured value but are of increasing saturation of color. Hue
in terms of hue, value and chroma. When the color is mea- is determined last by matching with color tabs of the value
sured by a visual technique, the color considered is compared and chroma already determined [1]. In 1976, the Commission


Corresponding author. Tel.: +82 2 740 8693; fax: +82 2 740 8694.
E-mail address: ykleedm@snu.ac.kr (Y.-K. Lee).
0109-5641/$ – see front matter © 2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.dental.2006.11.008
1308 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1307–1312

Internationale de l’Eclairage (CIE) refined a color space. CIE L* ferences in measured tooth color depending on measuring
value is a measure of the lightness of an object, CIE a* value instruments; however, there were few studies on the differ-
is a measure of redness or greenness, and CIE b* value is a ence in color and color parameters of teeth measured by a
measure of yellowness or blueness [2]. tristimulus colorimeter and Shade Vision System in the CIE
The color and appearance of teeth is a complex phe- L* , a* and b* scale. The working hypothesis in this study was
nomenon, with many factors such as lighting conditions, that all the color parameters such as CIE L* , a* and b* values,
translucency, opacity, light scattering, gloss and the human chroma and hue angle measured by two instruments showed
perception [3]. The measurement of teeth color remains a significant correlations regardless of the shade of teeth. The
challenge [4]. Therefore, a thorough understanding of appear- objectives of this study were to measure the difference in
ance attributes of natural teeth is required along with new the color and color parameters of natural teeth measured
shade guides and shade-taking instruments to maximize by a tristimulus colorimeter and Shade Vision System, and
shade-matching results [5]. to determine the influence of color parameters on the color
Tooth color is measured by varied methods including difference between the values measured by two instruments.
visual assessment with a shade guide, spectrophotometer,
colorimeter and computer analysis of digital images [3]. Due
to inter-human differences in the perception of color, visual 2. Materials and methods
shade assessment of teeth is lacking standardization that may
be improved by the use of a spectrophotometer. Spectropho- 2.1. Tooth color measurement
tometric shade analysis of natural teeth was more accurate
and more reproducible compared with human shade assess- Total of 47 volunteers, older than 19-year-old, were included
ment (83.3% compared to 26.6%) [6]. Assessment of tooth color in this study. Approval was obtained from the institutional
change was performed with a small-area colorimeter, and the review board and informed consent was obtained from each
standard deviation for CIE L* value was 0.22 [7]. A study on patient. Through clinical examinations, their general and
the accuracy of a colorimeter was concluded that this instru- oral health conditions were checked. They did not have
ment could be used as a tool for the quantitative assessment caries, abraded lesions or restorations in the 12 maxillary and
of the gradual change in the shade of teeth [8]. However, mandibular anterior teeth. Their periodontal conditions were
it was reported that the accuracy of a new colorimeter in fair to good. Eight males and 39 females were included, and
matching porcelain shade guide teeth was only slightly better their mean age was 29.5 (±5.2) and 29.0 (±6.8), respectively.
than visual matching (50% in colorimeter and 48% in visual Color of 12 maxillary and mandibular anterior teeth was
matching) [9]. The disadvantages of using a colorimeter for measured by a tristimulus colorimeter (CM: Chroma Meter
measuring tooth color include: the instrument is designed to CR 321, Minolta, Osaka, Japan) and Shade Vision System (SV:
measure flat surfaces, and small aperture colorimeter is prone X-rite, Grandville, MO, USA). When CM was used, individual
to significant edge-loss effects [10–12]. positioner was not fabricated because the total number of
In addition to tristimulus colorimeters, a new clinical col- teeth was too many (564 teeth), and also it was intended to
orimeter system, Shade Vision System (X-rite, Grandville, MO, obtain the tooth color affected by the surrounding tissue. To
USA), was introduced. Shade Vision System is a commer- exclude the influence of direct sunlight, all the measurements
cially available shade-taking system that provides an accurate were performed at a unit chair receiving no direct sunlight
colored ‘contour map’ image of the tooth. It is essentially a between 5 and 6 p.m., and one dentist measured the color
colorimeter that utilizes image-grabbing technology, and com- based on the same measurement protocol. The aperture diam-
prises a handheld measuring instrument that is used to scan eter of the colorimeter was 3 mm, and the illuminating and
the tooth surface together with a docking station linked to a viewing configuration was 45◦ illumination/0◦ viewing angle.
computer and associated software [13]. Correlations on the After calibration using a white standard tile, aperture head of
measured color of natural teeth before and after bleaching the colorimeter was contacted to the center of a tooth. Mea-
using a standard clinical shade guide, Shade Vision System surements were repeated three times. When SV was used,
and a colorimeter were determined [13–15]; however, they all the measurements were scheduled between 5 and 6 p.m.
used shade guide unit (SGU) instead of CIE L* , a* and b* values to exclude the influence of direct sunlight, and one dentist
in Shade Vision System. They regarded E∗ab values measured measured the color based on the same measurement pro-
by a colorimeter of 1.76–4.17 as 0 SGU change (no change) with tocol. Aperture head was contacted to the center of a tooth.
Shade Vision System. Measurements were repeated three times.
The result of investigations on the relationship between the
color perceived by human observers and the color measured 2.2. Comparison of tooth color measured by two
by a colorimeter was inconclusive [16]. There was significant instruments
correlation between instrumental colors and human obser-
vations [10,17], whereas there was no significant correlation In both instruments, the CIELAB system allows color speci-
between them [9,18]. Colorimeter measurements were com- fication within a three-dimensional color space. Differences
pared with spectrophotometer readings [17,18]. Though the in CIE L* , a* and b* values measured by two instruments
accuracy of a colorimeter on the tooth color measurement were calculated, and the color difference between the color
is inconclusive, this instrument has been used for a long coordinates measured by two instruments was calculated
2 2 2 1/2
time; therefore, can be regarded as a reference to a new color as: E∗ab = [(L∗s − L∗c ) + (a∗s − a∗c ) + (b∗s − b∗c ) ] , in which sub-
measuring instrument. There have been studies on the dif- script s and c indicates SV and CM, respectively. Since the color
d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1307–1312 1309

Table 1 – Mean and distribution range of CIE L* , a* , b* , C∗ab


and h◦ values measured by CM and SV
Range Mean (S.D.)

CM SV CM SV

CIE L* 39.0–65.8 64.5–83.2 57.8 (3.5) 74.0 (3.4)


CIE a* −5.1–4.0 1.6–9.8 −1.0 (0.9) 5.0 (1.5)
CIE b* −1.0–15.1 10.4–29.0 6.7 (3.1) 19.4 (4.0)
C∗ab 0.4–15.3 10.8–29.9 6.9 (2.9) 20.1 (4.2)
h◦ −89.9–90.0 57.8–84.6 −56.5 (53.1) 75.5 (3.1)

Standard deviations are in parentheses.

is compared in the order of value, chroma and hue in visual


color matching procedure [1], differences in chroma and hue
angle were also calculated. Chroma was calculated as C∗ab =
(a∗2 + b∗2 )
1/2
, and hue angle was calculated as h◦ = arctan(b* /a* ) Fig. 1 – Correlation in CIE L* values measured by CM and SV.
[2].

2.3. Statistical analysis

Correlations in the color parameters (CIE L* , a* and b* values,


chroma and hue angle) measured by CM and SV based on all
the teeth measured were determined with a linear regression
analysis (˛ = 0.01).
Pearson correlation coefficients between the color differ-
ence and the color parameters measured by CM were also
determined with a linear regression analysis. To determine
the influence of color parameters on the discrepancy in color
depending on the instruments, the influence of CIE L* , a* ,
b* , C∗ab and h◦ values measured by CM on the color differ-
ence (E∗ab ) measured by the two instruments was analyzed
with a multiple regression analysis (˛ = 0.01). To eliminate the
impact of inter-related independent variables, the variable Fig. 2 – Correlation in CIE a* values measured by CM and SV.
which showed the lower standardized partial correlation coef-
ficient (ˇ) was not included in the regression equation when
the tolerance between two influencing variables was lower cient of determination (r2 ) was not high and was in the range
than 0.30 [19]. of 0.089–0.478. In the case of CIE a* values, values measured by
Correlations between each pairs of CIE L* , C∗ab and h◦ values CM were positive or negative, whereas those measured by SV
measured by CM or SV were also determined to determine the ranged from 0 to 10 units. In the case of h◦ values, values mea-
correlation between three color parameters of natural teeth. sured by CM were divided into two groups such as around 85◦
and −85◦ , and there was no significant correlation (p = 0.531).

3. Results

Mean and distribution range of CIE L* , a* , b* , C∗ab and h◦ values


measured by CM and SV are listed in Table 1. CIE L* , a* , b* and
C∗ab values measured by SV was higher than those measured by
CM. h◦ values measured by CM showed wide range of distribu-
tion, whereas those by SV showed small range of distribution.
Mean E∗ab value between the color coordinates measured by
two instruments was 21.7 (±3.7). Mean L* value (=value mea-
sured by SV − that by CM) was 16.2 (±3.9), mean a* value was
6.0 (±1.5), mean b* value was 12.7 (±3.0), mean C∗ab value
was 13.2 (±3.0) and mean h◦ value was 132.7 (±53.3).
Correlation in CIE L* values measured by CM and SV is pre-
sented in Fig. 1, that of CIE a* values is in Fig. 2, that of CIE b*
values is in Fig. 3, that of C∗ab values is in Fig. 4, and that of h◦
values is in Fig. 5. Except for the hue angle (h◦ ), all the color
parameters had significant correlations; however, the coeffi- Fig. 3 – Correlation in CIE b* values measured by CM and SV.
1310 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1307–1312

Table 2 – Correlation between each pairs of CIE L* , C∗ab and h◦ values measured by CM or SV based on all the teeth
measured
Y X Measured by CM Measured by SV

Regression equation r2 Regression equation r2

L* C∗ab p = 0.082 L* = − 0.42C∗ab + 82.35 0.263


L* h◦ L* = − 0.013h◦ + 57.05 0.038 L* = 0.430h◦ + 41.52 0.157
C∗ab h◦ C∗ab = −0.009h◦ + 6.41 0.029 p = 0.595

All the coefficients of determination (r2 ) were significant at the level of 0.01.

(ˇ) for CIE L* and C∗ab was −0.710 and −0.300, respectively
(p < 0.01).
Correlation between each pairs of CIE L* , C∗ab and h◦ val-
ues measured by CM or SV based on all the teeth measured
are presented in Table 2. When measured by CM, there were
significant correlations between CIE L* and h◦ , and C∗ab and
h◦ . When measured by SV, there were significant correlations
between CIE L* and C∗ab , and CIE L* and h◦ . The coefficient of
determination increased when measured by SV.

4. Discussion

The working hypothesis of the present study was rejected


because there was no significant correlation in the hue angles
∗ values measured by CM and SV. measured by two instruments (p = 0.531), although there were
Fig. 4 – Correlation in Cab
significant correlations in CIE L* , a* and b* values and chroma
measured by two instruments (p < 0.01). Although there were
significant correlations in color parameters except for hue
Pearson correlation coefficients (r) between the color differ- angle, the coefficients of determination were lower than 0.50,
ence and the color parameters measured by CM are as follows: which indicate not high correlations. In the case of CIE a* , this
E∗ab versus CIE L* = − 0.684; E∗ab versus CIE a* = 0.194; E∗ab value was 0.089, which induced a significant difference in hue
versus CIE b* = − 0.237; E∗ab versus C∗ab = −0.230; E∗ab versus angle.
h◦ = 0.209. All five color parameters influenced the color differ- Based on the multiple regression analysis for the influ-
ence significantly (p < 0.01). ence of color parameters on the color difference by the two
Multiple correlation coefficient was 0.746 and the included instruments, the included predictors were CIE L* and C∗ab val-
predictors were CIE L* and C∗ab values based on the multiple ues measured by CM, and the standardized partial correlation
regression analysis, in which E∗ab between the two mea- coefficient (ˇ) for CIE L* and C∗ab was −0.710 and −0.300, respec-
sured values were set as a dependent variable and CIE L* , a* , tively. This result implies that when lightness and chroma of
b* , C∗ab and h◦ values measured by CM were set as indepen- tooth were high value when measured by CM, color differ-
dent variables. The standardized partial correlation coefficient ence measured by two instruments was small, and also the
influence of lightness (t value = − 25.17) on the color difference
was higher than that of chroma (t value = − 10.62). Therefore,
when the lightness of natural teeth was low, the discrepancy
between the color coordinates measured by two instruments
was also high.
Minolta Chroma Meter CR-321 (CM indicated in the present
study) is a compact tristimulus color analyzer that electron-
ically measures the reflective colors of surfaces. An internal
pulsed xenon arc lamp in a mixing chamber provides diffuse,
even illumination on the sample surface. Six high sensi-
tivity silicon photocells filtered to match the CIE standard
observer response, are used by the meter’s double-beam feed-
back system to measure both incident and reflected light.
The colorimeter detects any slight deviation in the spectral
power distribution of the pulsed xenon arc lamp, and compen-
sates for this automatically [13]. One of the instruments used
for assessing tooth was CM. The available information indi-
Fig. 5 – Correlation in h◦ values measured by CM and SV. cates that, although this instrument provides quantitative and
d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1307–1312 1311

objective measurements of tooth color, it can be tedious to use As a result, shade determination by visual means was incon-
with a custom alignment instrument [4]. The data measured sistent. Accuracy of a new colorimeter in matching porcelain
by this instrument are inconsistent with the commonly used shade guide teeth was only slightly better (50% in colorime-
visual instruments such as Vitapan Classical shade guide, ter and 48% in visual matching). Though the manufacturer of
although in many cases the general trends are similar. It is the colorimeter was different from that used in the present
also questionable whether the small area measured repre- study, the aperture size was similar (3 mm diameter in the
sents the color of the whole tooth adequately. Consequently, present study). Therefore, the accuracy of the colorimeter used
at present the data obtained with this instrument alone do not in the present study was concerned. The shape of shade guide
appear to be adequate for determining tooth color change in is similar to that of natural tooth; therefore, no flat surface for
whitening research, although the quantitative measurements color measurement. This should have influenced the measur-
may be useful as supplemental or supportive data [4]. In the ing accuracy.
present study, individual positioner could not be fabricated Color distribution in three regions in a sample of 95
because the total number of teeth was too many (564 teeth). extracted human teeth was determined using a recording
Since there have been no report on the accuracy of SV, CM was spectrophotometer. The mean L* , a* and b* values were 72.6, 1.5
regarded as the reference. Compared with the dada measured and 18.4 for gingival, 72.4, 1.2 and 16.2 for middle, and 71.4, 0.9
by SV, there was significant difference, especially in hue angle. and 12.8 for incisal [20]. In the present study, mean L* , a* and
But at present, there are no guidelines for the accuracy of CM b* value was 57.8, −1.0 and 6.7, respectively, with CM. When
and SV, in other words which instrument measures the color measured by SV, the mean L* , a* and b* value was 74.0, 5.0 and
accurately. Further study is recommended. 19.4, respectively. In the present study, the color of only cen-
There appear to be marked differences in the CIE L* , a* tral point (3 mm diameter) of tooth was measured by CM and
and b* values of tooth obtained by CM compared with other the color coordinates were smaller than those measured in the
systems, such as other colorimeters, spectrophotometers and previous study of O’Brien et al. [20]. But the values measured
digital imaging system that are also capable of generating the by SV were similar to those of the previous study of O’Brien et
same parameters. In general, the CIE L* , a* and b* values of al. [20].
tooth obtained with this instrument tend to be lower than There have been many studies on the percepti-
those obtained with other systems (CIE L* , a* and b* values ble/acceptable limit of color difference. A color difference
were 40–60, −1.5–0.5 and 2–12 with CM, and 65–75, −1.5–10 value of greater than 2 E∗ab unit was perceived by the 100%
and 12–23 with other instruments) [4]. Theoretically, the mea- observers, and E∗ab units between 1 and 2 were not perceived
surements should be the same for the same color as they are infrequently [21]. Thresholds for perceptibility (mean; 0.4 E∗ab
all based on the three-dimensional coordinates of the CIELAB units) were significantly lower than thresholds for accept-
color space. One of the possible factors that may contribute to ability (mean; 1.7 E∗ab units) [22]. As to the acceptability, 50%
this difference is the small (3 mm in diameter) measurement acceptability was approximately 1 E∗ab unit [23]. E∗ab values
aperture of this instrument. A study using a spectrophotome- of 3.3 were unacceptable in 50% of the observers [24].
ter and a spectroradiometer found that the CIE L* , a* and b* Discoloration model was assessed by a shade guide, Shade
values obtained from extracted human teeth decreased with Vision System and a colorimeter. In the group of no change
smaller-size measuring windows [12]. The trend for CIE a* and (shade guide unit change = 0) with a shade guide and Shade
b* value measurements was similar, indicating that tooth color Vision System, color changes were observed when measured
measurements using a small window tend to shift toward by a colorimeter (E∗ab = 3.90–4.17, L* = 3.22–3.58, a* = − 0.25
green and blue color coordinates in the CIELAB color space, to −0.07, b* = − 0.40 to 0.56) [13]. In this case, E∗ab value was
which was explained by the wavelength-dependent edge loss in the unacceptable range even when the highest threshold
[12]. In the present study, color coordinates measured by CM value claimed by Ruyter et al. [24] (E∗ab = 3.3) was adopted;
was smaller than those with SV, and the differences were however, the change in color measured by SV was reported
16.2 for L* , 6.0 for a* and 12.7 for b* . This result could be as no change. Bleaching effect was assessed with the same
explained by the wavelength-dependent edge loss. In addi- three instruments used in the previous study of Sulieman et
tion, CIE a* values measured by CM distributed from −5.1 to al. [13]. In the group of no change with a shade guide and Shade
4.0, whereas those with SV distributed from 1.6 to 9.8. The Vision System, color changes were observed when measured
difference in the range of distribution was not so big (9.1 and by a colorimeter (E∗ab = 2.6 − 3.2) [14]. If the E∗ab value of 3.3
8.2); however, negative value with CM influenced hue angle is adopted as the threshold acceptable value [24], these values
significantly. Additionally, correlation between each pairs of were in the range of acceptable value. But except the report
CIE L* , C∗ab and h◦ values measured by CM or SV showed clear of Ruyter et al. [24], others proposed smaller E∗ab value for
difference, which implied that tooth color was influenced by acceptability (E∗ab = 1 − 1.7). If these criteria are adopted, the
the measuring instrument. Although it has not been con- color difference which a shade guide and Shade Vision System
firmed which instrument reflects the real color of teeth, the resulted in no change was unacceptable. The effect of hydro-
discrepancy in tooth color by the instrument should be studied gen peroxide on the shade change of teeth was determined
further. with the same three instruments used in the previous study
Ability of a new computerized colorimeter equipped with [13]. In the group of no change with a shade guide and Shade
a positioning guide and a simple visual test to match ceramic Vision System, small changes were observed by a colorime-
shade guide teeth was evaluated. The colorimeter comes with ter (E∗ab = 1.76, L* = 0.49, a* = 0.21, and b* = 1.03) [15]. If the
a 3 mm × 4 mm aperture that attaches to the bottom of the E∗ab value of 1–1.7 was regarded as the threshold acceptable
unit, which can be placed directly on an anterior tooth [9]. value [22,23], the color difference which a shade guide and
1312 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1307–1312

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