Shade Matching

Operative In-Service October 13, 2007 Thomas D. Larson DDS, MSD Associate Professor

Division of Operative Dentistry Department of Restorative Sciences

Shade Selection
Hue A= red-brown B= red-yellow C= grayish D= red-grey
A1 A2 A3 A3.5 A4 C1 C2 C3 C4 B1 B2 B3 B4 D2 D3 D 4

Chroma Value

Lightest---------------------------------------------Darkest B1 A1 B2 D2 A2 C1 C2 D3 A3 D4 B3 A3.5 B4 C3 A4 C4

Translucency

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Notice the opacity of the mamelons (arrow), the translucency apical to the mamelons and the pebbly surface texture and high gloss of the enamel.

Translucency

Notice the extreme translucency of the incisal edges and the opalescence. Note also the gloss to the external surface. Complex color like this requires a digital photograph to allow the ceramist a chance to accurately simulate tooth color.

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Quanta of light shown through a prism,separate into wavelengths from 400 nanometers (violet) to 700 nanometers (red).

Primary colors as seen by the human eye. Complimentary colors achieved by mixing the primary colors together.

Mixing colors is done additively using the CIELab system.

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The CIELab three dimensional matrix of color has value as its axis (from white to black with all the colors in between), with chroma arranged horizontally with the most saturated closest to the central axis and the least saturated farthest from the central axis.

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This is the Munsell system of organizing color and represents what most of us remember from dental school. This system is based on appearance (psychological). Since 1931 the CIELab construct of color an orderly additive color mixture basis (i.e., a psychophysical basis) has been used extensively in describing and measuring color and is now widely used in dentistry.

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CIE 1931 (x, y) chromaticity diagram

When a color is expressed in CIELAB, L* defines lightness, a* denotes the red/green value and b* the yellow/blue value. This Figure shows the colorplotting diagrams for L*a*b*. The a* axis runs from left to right. A color measurement movement in the +a direction depicts a shift toward red. Along the b* axis, +b movement represents a shift toward yellow. The center L* axis shows L = 0 (black or total absorption) at the bottom. At the center of this plane is neutral or gray.

Colorimeters

Physiology and Psychology of Color

Three types of cone receptors at the back of the eye read red, blue and green colors (and gradations). The signals are joined at the ganglia prior to being sent to the brain.
Rods read the lightness or darkness of an object and enable us to determine value of color and translucency.

Physiology and Psychology of Color

Color blindness Night vision loss Aging Lighting conditions light temperature, CRI index viewing time contrast reflectance: gloss, spectral quality

Shade Guides

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Lighting conditions affect perception of color. Note the differences seen by using different f-stops. With different lighting of the same object taken at the same time, different color becomes apparent.

Color rendering best done with *Light source of 5500oK *CRI= 93 18% reflective grey card = achromatic
*behind teeth when choosing hue and chroma

Black background in judging value

Tooth Morphology

Tooth Morphology
Enamel gets its color and translucency from the prismatic arrangement of the hydroxyapatite crystals. The translucency and opacity is the most critical feature of enamel color. Consider its value when matching shades.
Photo from Maria Pintado

Vital pulp imparts color to the tooth dependent on its distance to the exterior surface and the amount of intervening secondary dentin. Dentin gets its color from the collagen fibrils and the calcified portions of inter-tubular dentin as well as the the liquid in the dentinal tubules. Organic substances can be deposited in dentin.

Tooth Morphology

Photo from Dr. Michael Madden

The distinct difference in chroma and value as well as surface texture is apparent in these two patients of different ages. The gloss of the enamel appears similar.

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Use a neutral grey background behind the teeth when matching hue and chroma.

Use black background behind the teeth when QuickTime and a determining the translucency TIFF (Uncompressed) decompressor are needed to see this picture. of the enamel.
James Fondriest, Int J Perio & Rest Dent 2003; 23(5)

When drawing a color map, indicate the enamel/ dentin break in color indicated by the line and black arrow. Indicate the surface texture (smooth) and the gloss (high gloss). Describe the translucency (very grey translucent). Describe the white hypo calcification at the gingival margin (white arrow).

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Describe the texture and gloss of the enamel so the ceramist can replicate the spectral reflectance as well as the opacity and translucency and value of the enamel. The left figure has a more characterized surface than the right figure. Both figures have high gloss. The right figure has more translucency and thinner enamel than the left figure.

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Aberrant colors, hypo calcifications as seen on the left figure; craze lines and their color as seen on the right figure, should be described in detail or photographed so the ceramist can replicate these features in the restoration. Describe the color of the craze line, in this case grey to white.

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1. 2. 3. 4. 5. 6. 7.

Choose hue and chroma with grey behind the tooth Describe variations in chroma from shade tab Choose value with black background Draw color map indicating enamel dentin break Identify position and color of aberrant colors Describe surface texture and gloss Describe enamel thickness and translucency

Porcelain Effects
Porcelain powders come in a variety of hues, chromas, and translucency. Special effect tints and colored porcelains are also available to customize a prosthesis to match most (95%) of the colors found in natural teeth.

Vita Porcelain Powders

A shades D
16-O 7-IO 16-D 4-I S 2-T 16-OD 16-M 3-IM 5-MM 2-I 3_TI 1-MI 2-IS 16 DS 109 Effect powders

Assortment Materials / Shade groups A B C D Special ma terials IPS Classic V Opaquer (O) A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 D2 D3 D4 Intensive Opaquer (IO) IO-A IO-B IO -C IO -A/IO-B IO -white, IO-violet Dentin (D) A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4D2 D3 D4 Incisal (S) S1 S2 S2 S4 S4 S1 S2 S3 S4 S2 S2 S3 S4 S1 S2 S3 Transparent (T) cl ear, neutral IPS Opaque Dentin V Opaque Dentin (Op.D.) A 1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4D2 D3 D4 Opaque Dentin (Op.D.) yellow, orange, brown IPS Margin V Margin Material (M) A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1 C2 C3 C4 D2 D3 D4 Intensive (M) yellow, orange, brown IPS Impulse Occlusal Dentin (Oc.D.) orange yellow brown orange, yellow Mame lon Material (MM) MM1, MM2, MM3, MM4, MM orange Incisal (S) yellow-grey, grey Transparent (T) yellow-grey, grey, blue Molar Incisal (MS) MS Incisal Edge material (IS) light yellow, yellow IPS Shade V Dentin Stains A1 A2 A3 A3.5 A4 B1 B2 B3 B4 C1C2 C3 C4 D2 D3 D4

Vita Porcelain Stacking

Porcelain veneers on 5-6-7-8-10-11-12 match a porcelain fused to metal crown on tooth 9. Restorations show little translucency because the restorations were placed to mask grey tetracycline stained teeth.

Vita
A3 dentin, C2 enamel

Enamel is slightly translucent and thick. The surface is highly characterized and glossy. The incisal translucency is violet.

Composite Extended Shades

3M Filtec Supreme Plus Kerr Herculite XRV Dentsply EsthetX Ultradent Vit-l-essence Ivoclar Vivadent 4 Seasons Heraeus Kulzer Venus

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Prior to the availability of extended shade composite systems, this restoration on the lateral incisor was fabricated using two shades of 3M Filtec Z-250 with placement of a craze line on the facial to simulate a similar craze line to that found on the central incisor.

Photos from Marcos Vargas DDS, MS Prac Proc Aesthet Dent 2006;18(8):501-07

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Photography can be used in a comparative fashion, using shade tabs with the teeth to show translucency, surface reflectance, color distribution over the crown, color aberrations, and surface characterizations.

Thank you
Thomas D. Larson DDS, MSD Associate Professor Division of Operative Dentistry Department of Restorative Sciences
612-624-5998 (occasionally answered) larso004@umn.edu (always answered)