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ABSTRACT
Light dynamics is a relevant phenomenon with respect to esthetic restorations, as incorrect
analysis of the optical behavior of natural dentition may lead to potential clinical failures. The
nature of incident light plays a major role in determining the amount of light transmission or
reflection, and how an object is perceived depends on the nature of the light source. Natural
teeth demonstrate translucency, opalescence, and fluorescence, all of which must be replicated
by restorative materials in order to achieve clinical success. Translucency is the intermediary
between complete opacity and complete transparency, making its analysis highly subjective. In
nature, the translucency of dental enamel varies from tooth to tooth, and from individual to
individual. Therefore, four important factors must be considered when appraising translucency.
Presence or absence of color, thickness of the enamel, degree of translucency, and surface
texture are essential components when determining translucency. State-of-the-art resin compos-
ites provide varying shades and opacities that deliver a more faithful reproduction of the chro-
maticity and translucency/opacity of enamel and dentin. This enables the attainment of
individualized and customized composite restorations. The objective of this article is to provide
a review of the phenomena of translucency and opacity in the natural dentition and composite
resins, under the scope of optics, and to describe how to implement these concepts in the
clinical setting.
CLINICAL SIGNIFICANCE
Choosing composite resins, based on optical properties alone, in order to mimic the properties
of natural tooth structures, does not necessarily provide a satisfactory esthetic outcome. In
many instances, failure ensues from incorrect analysis of the optical behaviors of the natural
dentition as well as the improper use of restorative materials. Therefore, it is necessary to
implement a technique that enables a restorative material to be utilized to its full potential to
correctly replicate the natural teeth.
(J Esthet Restor Dent 23:73–88, 2011)
INTRODUCTION reflected, absorbed, refracted, they form with the surface.4 When
and diffused.1 light collides with the correct
is refracted. Specifically, the light follows its way through the glass orange, and yellow, and reflects
penetrates the translucent body and refracts again once it reaches red. When an object completely
while changing the direction of the air.2,5 After this process, if the absorbs all wavelengths of light, it
its motion.6 light ray is not diverted from its is considered to be black.3,4 These
path, light transmission is said to definitions lead to the conclusion
The refractive index, or the rela- be regular, as in transparent glass.4 that an object will show color
tionship between the speed of the If the light is diffused in all direc- more proportionally to its opacity,
light in a vacuum and in a concrete tions, diffuse transmission occurs, rather than its ability to absorb
body, is a distinctive property of a typical property of translucent and reflect light. According to this
matter typically used for identify- glass. If one direction prevails over principle, a translucent body pre-
ing materials.2,5 When the refrac- the others, there will be mixed sents color in an inversely propor-
tive index of light in the vacuum transmission, as in organic glass tionate manner to the level of
coincides with the index in the and crystals with rugged surfaces.5 its translucency.
medium, without path modifica- Therefore, it is understood that the
tion, the medium is called transpar- optical behavior of each medium is Similarly, the capability of a body
ent. If, however, the refractive determined by not one, but rather to allow light passage through its
indexes are different, the medium many different factors, including interior is called the concept of
will present distinct translucent or the degree of dispersion, refraction, light transmission. A transmitting
opaque characteristics.5,6 transmission, and absorption of medium can be classified into three
light rays.5 categories that include opaque,
Light, aside from being refracted transparent, and translucent. These
or reflected, can also be absorbed Optical Phenomena of characteristics are dependent upon
by matter. This absorption is Color Perception how a specific material or body
caused by the decrease of energy of Under natural conditions, the light reacts to incident light.2,4,5 Bodies
luminous radiations when colliding that illuminates an object is white and materials either have the
with an opaque body or across light, which is the result of the ability to transmit light or not
transparent surfaces.5 Absorption mixture of all colors in the spec- transmit light. If a specific kind of
techniques consist of capturing the trum.3 An object presents itself as matter allows the passage of light,
different wavelengths that compose “colorful” when its surface is it is called transparent or translu-
white light. In general, bodies do capable of absorbing specific wave- cent. When matter is unable to
not absorb all of the frequencies of lengths of incident light. When one allow passage of light, it is
the light spectrum with equal or more wavelengths are reflected, considered opaque.
intensity. Therefore, a selective an object is recognized as being a
absorption is produced.3 specific color. Matter is considered to be opaque
when it only absorbs and/or
Transmission, another property of For example, an object is white reflects light but does not have the
light, is considered double refrac- when it is capable of reflecting all ability to transmit it.2 Opacity is
tion.6 When looking at a crystal, it wavelengths of which light is com- typically observed in materials that
is possible to see light undergoing posed. An object is considered red do not transmit light. Oftentimes,
an initial refraction as it passes when it absorbs all wavelengths, it is used to describe materials that
from the air to the glass. It then including violet, blue, green, absorb or reflect all light by not
Figure 2. Properties of achromatic and chromatic Figure 3. Different saturations of the dentin; age enhances
translucent glass (A), (B), on different colored saturation.
backgrounds.
important, because color percep- greater at the incisal one-third, is applied to composite resins,
tion of the dentin composite resin decreasing gradually toward the especially to those used to restore
is influenced by the enamel com- cervical one-third.8,11 Therefore, missing natural enamel, the thick-
posite resin selected (Figure 5). translucency in the cervical ness chosen is critical. This is
region is greater when compared important because a small thick-
When dealing with these types of with the incisal region, allowing ness increase may significantly
translucent substances, the varia- for a clearer perception of the change the color value of the res-
tion in the refractive index is also dentin (Figure 7). The same toration, thereby altering the per-
an important consideration, as it principle applies to tooth ception of the color beneath
is directly related to the thickness age, whereby younger teeth it (Figure 9).
of the material.1,5 When light is present more enamel than in
diffused in the interior, the mate- older teeth.11 The degree of translucency of a
rial becomes translucent. The material is an inherent property.2
translucency of the substance may Young teeth present a high color Light does not always pass through
also vary because of the thickness value, with typically no translu- matter with the same incidence and
of the material. For example, if cency whatsoever. This is because direction.1 Many times, a major
there are three bodies of the same of the high quantity of enamel fraction is deflected by the action
material with three different present, as the enamel of older of particles or anomalies within the
thicknesses (i.e., 0.5, 1, 2 mm), teeth becomes thinner and more object.5 As previously mentioned,
the one with the greatest thickness translucent over time, sometimes translucency is directly related to
will be the least translucent presenting as nearly transparent the diffusion of light, and both
(Figure 6).10 (Figure 8A and B). Older teeth concepts depend on the refraction
also present a much lower color index of the material.1 The larger
In natural teeth, the thickness of value than that which is seen in this index, the larger the degree of
the enamel varies greatly and is younger teeth. When this principle light dispersion and,
Figure 4. A side-by-side comparison was made to colorless Figure 5. Interaction of chromatic and achromatic enamel
young enamel and older enamel, which is achromatically resins, which modify the perception of the dentin resin.
translucent.
consequently, the lower the degree The glass also becomes opaque and depth are important character-
of translucency.2,5 on the surface at this time because istics when attempting to replicate
of the reflection limits on translu- what was created naturally.
Surface texture is also an impor- cency and light transmission. This
tant characteristic of an object that surface does not only modify color When dealing with depth, or
can significantly change the per- perception but also the perception “depth effect,” a challenge often
ceived translucency of an object. of the translucency and opacity. faced is the distance between the
The more a surface reflects light, extreme positions of a screen, over
the less selective absorption is Depth and Translucency which an optical system can chart
observed. If surface conditions An important as well as critical images. This is the result of the
enhance light reflection, transmis- challenge in the clinical setting is different levels of translucency that
sion is proportionally reduced.12 restoring the natural shape of a a structure may present.12 It is nec-
When light reflection is increased, tooth. This involves rendering essary to note that translucency
the color of the object tends to be proper anatomy, depth, and trans- and depth are intertwined and are
more luminous and of a higher lucency in the typical adverse con- responsible for the simultaneous
value. In objects with a certain ditions encountered in dental perception of various special situa-
degree of light transmission, reflec- restorations. Clinicians must tions, such as “close and far” and
tion of the surface reduces the achieve perfect rendering and con- “front or back.”
amount of light that crosses the touring in an area that presents a
object. For example (Figure 10), lack of space, little material thick- In applying this concept to natural
translucency of a sandblasted glass ness, and the need to employ dentition, depth is said to be all
is greatly reduced as a result of opaque materials under thin outer structures that are part of the
reflection on its irregular surface. layers. If done incorrectly, the tooth. This is attributed to the dif-
The glass therefore becomes more result may be inexpressive, lifeless ferent levels of translucency and
luminous, as it is more reflective. restorations because translucency depth that the enamel and dentin
Figure 6. Enhancing the thickness of composite resins Figure 7. Enamel presents itself with different
determines an increase in translucency: 0.5 mm (A), 1 mm translucencies.
(B), and 2 mm (C).
Figure 9. Value enamel resin can alter the Figure 10. An image showing translucent glass at various levels
perception of the underlying dentin resin. of sandblasting.
increases as the wavelength However, when unreflected, lumi- luminous enamel, attenuating the
increases. This effect causes the nous radiation passes through color of the dentin. Conversely,
enamel to become more translucent matter and reaches prisms of more mineralized and less porous
under larger wavelengths. The cor- diverse orientation, additional enamel becomes more translucent
relation between wavelength size refraction then occurs. This refrac- and has a reduced color value. All
and transmission of light is of tion determines the varying degrees achromatic translucent matter over-
paramount importance during of translucency and opacity laying an object produces more
shade selection because the nature present. These situations occur grayish tones because the less light
of the light source also influences when light passes through a multi- that is reflected, the less the object
the outcome of translucency crystalline structure, such as dental illuminates. Therefore, translucent
and esthetics.18 enamel. Relative translucency of enamel imparts a grayish color to
the enamel also depends on the the tooth, whereas opaque enamel
Enamel also modifies the chro- light reflection and/or transmission presents itself as whiter, more
matic aspects of the teeth because properties of the enamel. Enamel reflective, and luminous because of
of phenomena such as reflection, translucency may also be attributed its high value.
transmission, refraction, thickness, to variations in calcification levels,
and surface texture. It is also because the more porous and less Older patients, however, display
important to note that enamel has mineralized the enamel, the larger enamel that may be slightly thinner
the ability to attenuate underlying the dispersion index.8,20 and translucent as a result of per-
colors, which can affect the chro- manent wear. This type of wear
matic aspects of the teeth.19 There- This variation occurs in young promotes an enhancement of den-
fore, properties of light reflection, teeth, as they reflect more light and tinal chroma toward the cervical
or transmission of enamel, are are brighter because of their higher one-third. Both incisal and proxi-
dependent on its texture, orienta- color value. Young teeth also tend mal enamels are also highly trans-
tion of enamel rods, and its ability to exhibit a milkier and less translu- lucent. Between the incisal area of
to refract light, in addition to his- cent appearance. Younger patients the enamel and the incisal portion
tological characteristics. typically display thicker and more of the dentin, there is an
1. Artificial body enamel resins: In the same study, colorimetric In the incisal third area, the
keyed to the Vita shade guide, and CR values for the enamel restorative challenge is even more
provide a chromatic basis to the vary according to dental age, so complex, as the range of translu-
restoration, responsible for gen- owning a wide range of enamel cency and opalescence is greater.30
erating color hue composite resins to replace dental This area, seen mainly in young
2. Artificial translucent effect tissue is a must. In the case of teeth, tends to be highly translu-
enamel: provides translucency young enamel, the choice of resins cent and spreads from the
especially to deep areas through- should rely on a low-translucency, mamelon outline to the incisal
out incisal and proximal edges milky white color. In the case of opaque halo. Using an opalescent
3. Artificial milky-white semi- adult enamel, the resins should material is often insufficient to
translucent enamel: used for have a neutral color and medium properly replicate this phenom-
creating halos, which are translucency. For older enamel, enon in restorations. Rather, a
high-value areas with white resins should have high translu- detailed analysis of the opalescent
effects cency and a yellow hue.28,29 pattern is necessary. Therefore,
4. Artificial value-modifying each case should be undertaken
enamel: used as final layers in After choosing the correct resins, utilizing a special approach,
specific areas of the labial it is important to consider the because opalescence presents high
aspect, in order to enhance, to thickness of the material to be variability.31 It is also advisable to
decrease, or to corroborate the layered during the application of use a translucent composite
preexisting natural enamel the composites because the per- termed “incisal” (high translu-
color value.26 ception of higher chroma and cency at the incisal region)
opacity is related to an increase in between the dentin and enamel
Recent reports, based on the afore- thickness.12 The handling of these layers in order to fill the areas
mentioned classifications, have layers is crucial for obtaining the between the lobes and the
shown that an ideal material for desired chromaticity, translucency, incisal halo.32
replacing dentin should present and opacity.23 When using a two-
features such as uniform hue and resin system (e.g., bichromatic This layer’s thickness is closely
opacity as well as a wide range of technique: “artificial enamel” related to the amount of translu-
saturations.28 These principles are layer + “artificial dentin” layer), cency required for the type of
based on a colorimetric study of the material with less translucency effect required. The high-
contrast rates (CR) of human (more opacity) and higher chroma translucency resin layer will
enamel and dentin, making it may be used for the dentin, increase the perception of depth
unnecessary to choose colors for whereas enamel can be replaced and will allow the restoration to
the dentin, apart from the Vita A by a more translucent resin. Com- demonstrate a more natural look.
(A1 to A4) and B (B1 to B3) pared with dentin and enamel High-translucency resins should
scales. Contrast rate fluctuation, resins, polychromatic techniques not be placed on the surface of the
within the same group, does not require effect resins that impart a final layer of the restoration,
support using different levels of more natural appearance to the however, because they tend to
translucency and opacity for dentin restoration. Similarly, tints allow reduce restoration value and may
resins (translucent, regular, and greater characterization of potentially modify the chroma to
opaque dentins).28,29 the restoration. some extent.
Figure 14. Intrinsic opacity and thickness of achromatic It should be expected that the use
enamel shades play a fundamental role in the modulation
of the perceived chroma and value.
of artificial enamels of the same
refractive index as natural enamel
becomes slightly grayer.36 The many variations in natural denti- would account for an ideal repro-
same phenomenon occurs on tion make the restorative process duction of the optical characteris-
wet surfaces. much more efficient and predict- tics found in nature. Unfortunately,
able. For example, achromatic having the correct refractive index
Additionally, dentists should con- enamels of different opacities and is only one of the many compo-
sider the color of the underlying increasing thickness, layered over a nents necessary for rendering a life-
dentin when using chromatic resin composite dentin substrate of like restoration. Choosing artificial
enamel composite resins in order to equal opacity and chroma, will dentin and enamel composites of
avoid unwanted chromatic varia- allow the perception of varying the proper opacities, as well as
tions. The stratification of translu- chromas and values (Figure 14). As determining the correct thickness
cent chromatic enamel resin the thickness increases (e.g., from of each layer, is of paramount
composites on the dentin occurs 0.3 to 1.5 mm), more light is importance and should be just as
following a subjective mixture of reflected and scattered throughout significant as the use of refractive
colors. The resulting phenomena of the achromatic resin substrate, indices (Figure 15).
the interaction of light and matter thereby blocking the perception of
are of great importance for esthetic the underlying dentin in F I N A L C O N S I D E R AT I O N S
restorations, as they allow a faithful various degrees. Of all dental structures, enamel
reproduction of the properties of seems to be the optical entity that
natural dentition. However, inad- T and P shades of a commercially is most difficult to imitate. There is
equate analysis of the optical available composite resin (Vit-l- a common trend among practitio-
behavior of natural dentition may escence, Ultradent, South Jordan, ners to layer artificial enamel and
lead to failure of the UT, USA) will appear to have dentin composites according to the
restorative procedures. almost the same translucency at actual thickness of the missing
0.3 mm of thickness while display- natural enamel and dentin. This
The logical use of the different ing nearly the same chroma and proves futile, however, because no
composite resins available and the value. As thickness increases, P known composite behaves exactly
Figure 15. A, View of a defective class IV restoration. B, The artificial value enamel was applied to establish a lingual shelf.
C, The artificial dentin should reproduce the dentin mamelons. To achieve a natural opalescent effect at the incisal third, a
high-translucency resin was used. D, A final enamel layer is applied on the proximal and buccal surfaces to complete the
restoration. E, Finishing and polishing can be achieved with various instruments. F, Completed restoration after tooth
rehydration.
as natural enamel or dentin. A res- teeth. However, with a thorough Powers JM, editors. Restorative dental
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