SHADE SELECTION IN ESTHETIC DENTISTRY.pdf

Shade select in aesthetic dentistry. Munsell colour system, ceilab colour system, vita shade guides.

1. GOOD MORNING

2. SHADE SELECTION IN
ESTHETIC DENTISTRY
Dr. SouravKirtania
MDS PGT
Department of Conservative Dentistry and Endodontics

3. Contents
–Introduction
–Colour
–Classification of colour
–Light
–Visible spectrum of light
–Color mixing -additive and subtractive
–Munsellcolor system
–Value
–Hue chroma
–CEILAB color system
–Eye and color perception
–Shade selection principles
–Optical characteristic of natural tooth
–Translucency
–Fluorescence
–Opalescence
–Influence of surface apperance
–Metamerism
–Simultaneous contrast
–Actual contrast
–Spatial contrast
–Measurement of colour
–Visual technique -shade guides
–Protocols for using shade guides
–Vita classical shade guide
–Instructions to use vita classical shade
guide
–Vita 3d master shade guide

4. Contents
–Instructions to use vita 3d shade guide
–Chromascopshade guide
–Dentin and extended shade guides
–Value vs hue based shade guides
–Merits and demerits of shade guide
–Instrumental technique for shade
selection
–Spectrophotometers and
spectroradiometers
–Colorimeters
–Digital cameras and imaging system
–Hybrid devices
–Restrictions of digital shade guide
–Custom made shade guide
–Self made shade guide -using
micrometer
–Self made shade guide -using
prefabricated mold
–Composite buttons
–Recommended protocols for clinical
shade selection
–Work site lightning
–Environment
–Condition of teeth
–Position of patient and timing
–Factors affecting shade selection
–Age
–Gender
–Eye color

5. Contents
–Fatigue
–Binoculardifference
–Environmentalinfluences
–Conclusion
–References

6. Introduction
–“Coloris unimportant to the physiological success of dental restoration, yet it
could be the controlling factor in overall acceptance by the patient”
-Billmayerand Saltzman

7. Colour
Philips 12
th
Edition,
–Color-Sensation induced from light of varying wavelengths reaching the eye.
–Color scientists have defined the three basic dimensions, or colorimetric
properties, of color characterization as hue, saturation/chroma, and lightness
(Tristimulusdata)

8. Classification
Colour
Primary Secondary
Colour
Natural Artificial

9. Light
Visible
electromagnetic
energy
Visible spectrum
360-750 nm
Prism breaks it into
component
wavelengths (color)
Light isn’tjust what we can see, light can be broken up into
different types and we call the whole family the
electromagnetic spectrum
So even when it’s dark, light is still around us
Light can be made by making an electron oscillate, this creates
an oscillating magnetic field and an electric field which we call
an electromagnetic wave or light.
We often represent light as a wave. It has a wavelength, a
frequency and speed.

10. Visible spectrum of light

11. Colour mixing –additive
and substractive
–Additive system:
–Primary colors: Red, Green and Blue
White
Red
Blue Green
Black
Cyan
Magenta Yellow
–Subtractive system:
–Secondary colors: cyan, magenta and yellow
There are twotypes of colour mixing system. Human eyes can see
three basic colors–red, green and blue. Together in equal
proportions they make white color. This colormixing principle is used
in screens of tv, monitor and phones. But if we focus on the colors
produced by mixing two of the basic colors, which is known as the
secondary colorsand mixing those resulting three colors, it gives
black.

12. Munsellcolour system
–Munsellcolourtheoryisbased
onathree-dimensionalmodel
–Eachcoloriscomprisedofthree
attributesofhue(coloritself),
value(lightness/darkness)and
chroma(colorsaturationor
brilliance)

13. Value
–Value is the darkness or lightness of a colour
–Scale ranges from 0-10
–More important than chromaor hue

14. Chroma
–Variation in intensity of same colour
–Ranges from 0-18

15. Hue
–The dominant colorof an object is called hue
that is represented on a circular scale.

16. CEILAB colour system
–CIE: Commission Internationaled’Eclairage,
✓Devised a mathematical model for the purpose of numerically
describing all color visible to the human eye: CIE XYZ Color Space.
✓CIE LAB (L*a*b*) -successive more refined colorimetric systems for
the measurement and specification of color.
✓Published in 1976 by the International Commission on Illumination
✓Coordinates of CIELAB -L*a*b* but Coloursystem is informally
referred to -L-a-b.
✓CIELAB -system to triangulate and precisely define and specify any
color reference point within the theoretical sphere containing all
visible color

17. CEILAB colour system
–In 3D model,
•Chromatic a* axis extends from green (-a*) to
red (+a*)
•Chromatic b* axis extends from blue (-b*) to
yellow (+b*)
•Lightness dimension = L* = ranges from 0 (pure
black) to 100 (diffuse white).
•Point at which the a* and b* axes cross, at the L*
value of 50, is pure, balanced, neutral gray
Visible gamut within
CIELAB colorspace D65
whitepointmesh

18. Eye and colour perception (Rods
and Cones)
Rods
•Located more at
periphery
•Few at center
•Activated more in
low light
•Perceive value but
not chroma/hue
•Called scotopic
vision
Cones
•Concentrated near
center
•Principal mediators
of color
•Function in only
higher light levels
•Called photopic
vision

19. Optical characteristic of natural
tooth
Translucency Fluorescence OpalescenceMetamerism Surface gloss
Influence of
surface
appearance

20. Translucency
–Considered as the fourth dimension of colour.
–Translucency of enamel varies with angle of incidence,
surface texture, lustre and illumination
Enamel
Translucent
70.1% avg.
light
passage
Dentin
Less
translecent
52.6% avg.
light
passage
JOURNAL COMPILATION © 2011, WILEY PERIODICALS, INC. VOLUME
23 , NUMBER 2 , 2011

21. Fluorescence
–It is a type of luminescence
–Because there is a higher concentration of organic material in
the dentin of a human tooth, this condition predominately
occurs there.
The distal edge of tooth 11 is
restored with composite
The fluorescence intensity of the composite exceeds
the respective parameters of the tooth

22. Opalescence
–Opalescence is the optical property of a material in which it seems to be of one
color upon the reflection of light, while on transmission of light, it appears to be
another color.

23. Influence of surface appearance
Characterization
Stippling
Striations
Ridges
Developmental
lobes
Wear away

24. Metamerism
–When two colors appear to match under specific lighting conditions yet have
differing shadow-like reflectances, known as metamers, the phenomenon is
known as metamerism, and the entire process is considered to be metamerism.

25. Simultaneous contrast
–Light and dark contrasts can be correlated
to the surrounding environment like skin
tone, hair color, and brightness of adjacent
soft tissues
–Brighter shade should be selected for light
tone patients and darker shades for
pigmented toned patients
Same shade is perceived differently due to inflamed gingiva

26. Actual contrast
–Influenced by size and chroma
–Brighter tooth looks larger while darker tooth of same
dimension looks smaller

27. Spatial contrast
–It is discerned when the tooth is observed in different
positional planes
–Recessed tooth looks darker while overlapping tooth
appears brighter

28. Shade selection principles
Full spectrum of light is needed to elicit all the color a tooth is capable of reflecting
“summers noon with clear sky daylight”
Standardized light source required that resembles natural daylight
C.R.I >90 ideal & Colortemperature 5500K
Light source should have a near UV component
Intensity of light should be comfortable to eyes
Neutral grey suggested for was, staffs, clothing and patient drape

29. Measurement of colour
a. Visual Technique;
b. Instrumental Technique.

30. Visual technique –shade guides
Shade
guides
Composite
Acrylic
based
Ceramic
Vita classical
Vita tooth guide or 3D
master
Chromascope
Based on
Munsell
color
system

31. Protocols for using visual shade
guides
–Make sure to perform the test underneutral light, ideally in daylight.
–Try and use aneutral environment, avoiding make-up, lipstick, and brightly
colouredclothing.
–Choose quickly: in case of doubt, always prefer the first option because after 5
to 7 seconds, the eye gets tired.
–Perform this testbefore preparationbecause the color of the tooth after
dehydrogenation becomes too white.
–Consideradjacent teethand their color.
–Disinfectthe colourchart before and after each use

32. Vita classical shade guide
–Colorspace is
defined into four
groups
A
Red &
brown
B
Red &
yellow
C
Grey
D
Red &
grey
–Chroma is
designated with
numerical values
–Comprise
leading
HUE (name
of colour)

33. Instructions to use the vita
classical shade guide
–Determine the tooth shade before
preparation, since after preparation the
tooth appears lighter due to dehydration
–Determine the tooth shade preferably in
natural daylight or using standardized
daylight lamps (5500K –6500K) and not
under typical indoor lighting conditions.
–The surrounding area should be as color
neutral as possible. Remove influencing
lipstick or cosmetics and cover up strong
colored clothes with a gray cape
–Hold the shade sample tooth as close to
the patient’s tooth as possible
https://www.vita-zahnfabrik.com/pdb_GG1G10G100_en.html

34. Vita 3D master shade guide
–26 tabs
–5 groups
vertical in relation to chromaand
horizontal axes according to hue
First
groupTwo tabs
Rest Seven tabs
Every
shade
tab
•3 markers (1-5)
•Level of value

35. Vita 3D master shade guide
There is an extensive range of value
The red spectra are wide-ranging
The shade tabs are more correspondingly divided into the color space
The development in distribution of groups has improved and become
more concise

36. Instructions to use the Vita 3D shade guide
https://www.globaldentalso
lutions.com/wp-
content/uploads/2018/05/V
ITA_961_961E_Toothguide_
BA_EN_V03_screen_en.pdf

37. Instructions to use the Vita 3D shade guide
https://www.globaldentalso
lutions.com/wp-
content/uploads/2018/05/V
ITA_961_961E_Toothguide_
BA_EN_V03_screen_en.pdf

38. Instructions to use the Vita 3D shade guide
https://www.globaldentalso
lutions.com/wp-
content/uploads/2018/05/V
ITA_961_961E_Toothguide_
BA_EN_V03_screen_en.pdf

39. Chromascopshade guide
White
100
Yellow
200
Orange
300
Grey
400
Brown
500
Rajan, N. ., Krishna S, R. ., Rajan, A. ., Singh, G. ., & Jindal, L.
. (2020). Shade Selection –Basic for Esthetic Dentistry:
Literature Review.International Journal of Contemporary
Research and Review,11(09).

40. Dentin and Extended Shade
Guides
–Dentin system can be used for the fabrication of
translucent all-ceramic crowns and veneers
–Specially coloreddie materials corresponding to the
dentin shade are used, which allows the technician to
appraise the esthetics of the restoration
2022 Alnusayri et al. Cureus 14(3): e23331.

41. Value-based versus Hue-based
Shade Guides
–Value-based shade guides are a more accurate
means of shade selection, since our eyes are more
sensitive to changes in lightness/darkness and
chromathan subtle changes in hue
–Examining a B1 versus A1 shade tab, it would be
difficult to assess which tab contains more yellow or
orange; however, it is relatively easy to determine
which tab is brighter (value)
Science and art of porcelain laminate veneers, GalipGurel

42. The importance of Stump Shade
–Through communication about color tone, dental labs can
create the best translucency effect, especially when there
is a porcelain jacket or pressed material involved.
–This is why it is so important to communicate the stump or
preparation shade for every all-porcelain restoration as
well as every Zircon structure
–The lab technician can use this information to make a
model die that is the same shade as the preparation and
make sure there is no show-through or shade change to
the ceramic from the underlying tooth structure.
https://bayshoredentalstudio.com/importance-of-stump-shade/

43. Merits of shade guide
The most common method of shade selection is using a visual shade guide
It is economical and durable, i.e., does not require frequent replacement of the
shade guide.
It provides an efficient comparison with natural tooth color.
Most frequently used by dentists, dental assistants and dental laboratory
technicians to communicate the proper tooth color, brightness and translucency
Easily available

44. Demerits of shade guide
In shade guides, the colors may differ for each company.
Porcelain that is used for restoration of teeth may be different with a shade guide.
Guides are not able to direct the manufacturing of porcelain restoration.
The shades of a tooth in a shade guide are not rationally arranged and do not
cover the capacity of color space that is normally unoccupied in natural teeth.
A normal shade tab is prepared from synthetic resin having greater density than a
crown.
A shade guide tab reflects and transforms light-forming translucency and provides
a look of vitality

45. Instrumental Techniques in Tooth
Shade Selection –Spectrophotometers
and Spectroradiometers
VITA Easyshade® V Spectrophotometer
Aspectrophotometeris an instrument that supports spectrophotometry to measure the amount of
light intensity absorbed after passing through a sample solution.

46. Colorimeters
–Colorimeter presents a complete measurement of light absorbed
–Colorimeters record tri-stimulus values and filter light in red, green
and blue regions of the visible spectrum
–Colorimeters are not capable of recording spectral reflectance and
their accuracy can be diminished because of over usage
Rajan, N. ., Krishna S, R. ., Rajan, A. ., Singh, G. ., & Jindal, L. . (2020). Shade
Selection –Basic for Esthetic Dentistry: Literature Review.International
Journal of Contemporary Research and Review,11(09).

47. Digital Cameras and
Imaging Systems
–Digital cameras show the most basic method for electronic
shade measurement
–The quality of the camera and image-processing method
affects its precision and accuracy
Rajan, N. ., Krishna S, R. ., Rajan, A. ., Singh, G. ., & Jindal, L. . (2020). Shade
Selection –Basic for Esthetic Dentistry: Literature Review.International
Journal of Contemporary Research and Review,11(09).

48. Hybrid Devices
–SpectroShade delivers an amalgamation of digital
imaging as well as spectrophotometric exploration.
–It applies the Clear Match Software System (Hood River,
OR, USA: Smart Technology) and it is a product of
independent hardware, which is developed for use on
PCs that have the Windows platform and virtually any
digital camera
SpectroShade(MHT Optic research)
ClearMatchsystem
(Smart technology)
Rajan, N. ., Krishna S, R. ., Rajan, A. ., Singh, G. ., & Jindal, L. . (2020). Shade
Selection –Basic for Esthetic Dentistry: Literature Review.International
Journal of Contemporary Research and Review,11(09).

49. Restrictions of Digital Shade
Guide
The color measurement accurateness is affected due to the loss of power supply.
For all systems, translucent recording is insufficient.
Settlement of the probe or mouthpiece appears to be vital for the
reappearance of the measurement.
No digital shade guide is satisfactorily progressive to function in a mode of
formulation.
The research laboratory must be well equipped with the latest and most updated
systems for the effective use of this process

50. Custom made shade guide
–Self made shade guide, using micrometer
–Self made shade guide, using prefabricated molds
–Composite buttons

51. Self made shade guide (using
micrometer)
–“Self-made” shade guides reflect the need for more reliable commercial ones.
Paolone, Gaetano & Orsini, Giovanna & Manauta, Jordi & devoto, Walter & Putignano, Angelo. (2014).
Composite shade guides and colormatching. The international journal of estheticdentistry. 9. 164-82.

52. Self made shade guide
(prefabricated mold)
Paolone, Gaetano & Orsini, Giovanna & Manauta, Jordi & devoto, Walter & Putignano, Angelo. (2014).
Composite shade guides and colormatching. The international journal of estheticdentistry. 9. 164-82.

53. Composite buttons
–In this technique composite buttons of
different shades are placed on the tooth
surface and cured
–High resolution picture is taken and
visualised in a software (Photoshop,
Lightroom)
–Visualisation in high contrast and black and
white.
Composite shade guides and colormatching. The international
journal of estheticdentistry. 2014. vol9. 164-82.

54. Recommended Protocols for Clinical
Shade Selection -Working Site Lighting
–Midday sunlight is ideally considered for the best shade selection.
–The exposure of midday sunlight comprises nearly the same blend of whole-
light wavelengths as compared to the sunlight exposure of morning and evening
timings, which are more affluent with reddish and yellow wavelengths
Daylight 6500K
Fluorescent
tube light
5500K
CRI of
95%
Tungsten/
Incandescent
light
2800-
3200K
CRI of
100%
Rite Lite2

55. Recommended Protocols for Clinical
Shade Selection -Environment
–The ideal backdrop for color matching is a very light shade of
gray.
–Surroundings with bright colors should be evaded as they
affect suitable color matching through influencing the colors
in the reflected light.
–Unwanted colors in the patient’s jewelry and clothing can be
covered with a drape, and the patient’s lipstick should be
removed to prevent any changes in color perception.
–High-gloss surfaces create disturbing shines and should be
avoided
BorseS, ChawareSH. Tooth shade analysis and selection in prosthodontics: A systematic review and meta-analysis. J Indian
ProsthodontSoc. 2020 Apr-Jun;20(2):131-140 Epub2020 Apr 7. PMID: 32655217; PMCID: PMC7335029.

56. Recommended Protocols for Clinical
Shade Selection -Condition of Teeth
–The tooth to be matched and its neighboring teeth must be free of surface
stains and plaque along with other deposits
–The tooth of interest must be moist with saliva because a lack of moisture will
result in a whiter look
–Color matching of a tooth ought to be done before applying the rubber dam
–Selection of shade should not be executed quickly after bleaching
–During the selection of shade,
–teeth must be distributed into three areas each time, such as gingival area (it
provides perfect measurement of dentinal chroma), middle and incisal area
(where enamel is more dense and differs from translucent to transparent)

57. Distance of the Operator from the Tooth,
Position of the Patient and Timing
–distance from the oral cavity of about 61cm (2 feet) to 183 cm
(6 feet) is preferably considered for the matching of shade.
–The position of a patient on the dental chair should be in such
a way that the teeth of a patient are at the level of the
operator’s eyes.
–Shade selection must be finalized by the operator in the
morning preferably, when eye tiredness is minimal
BorseS, ChawareSH. Tooth shade analysis and selection in prosthodontics: A systematic review and meta-analysis. J Indian
ProsthodontSoc. 2020 Apr-Jun;20(2):131-140 Epub2020 Apr 7. PMID: 32655217; PMCID: PMC7335029.

58. Factors Affecting
Shade Selection -
Age
–Shade-matching skills become unfavorable due
to aging because the cornea and lens of the eye
yellow with age, conveying a yellow-brown bias
–This change starts at the age of 30; it becomes
more obvious at 50 years of age and has medical
importance after the age of 60.
–After the age of 60, many people face problems
in distinguishing blue and purple colors.
Appl. Sci. 2022, 12, 6841

59. Factors Affecting Shade
Selection -Gender
–It is generally assumed that women recognize color more precisely than men.
PechoOscar, GhineaR, Perez MM, Della Bona A. Influence of Gender on Visual Shade Matching in Dentistry. J EsthetRestorDent. 2017
Apr;29(2):E15-E23. PMID: 28185440.
Objective: This observational study evaluated the influence of gender on accuracy of VSM
Results: Irrespective of the color difference metric, the most prevalent shade performed by females showed greater
success (50% for CIELAB and100% for IEDE2000(2:1:1)) than males (25% for CIELAB and 50% for CIEDE2000(2:1:1)).
Conclusions: Themostprevalent shade option resultant from VSM performed by females using VC shade guide perfectly
agreed (100% success rate) with measurements from Spectroradiometerand CIEDE2000(2:1:1) color difference metric.

60. Factors Affecting Shade
Selection –Eye color
–Brown-eyed people have more melanin and are
able to absorb ample light and wavelengths,
possibly influencing view but not color acuity.
–Those with less melanocyte cannot absorb as
much light.
Appl. Sci. 2022, 12, 6841

61. Factors Affecting Shade Selection –
colorvision problem/colorblindness
–Misperceptions exist in different types of color vision:
–Achromatism: Entire shortage of hue sensitivity;
–Dichromatism: Sensitivity to only two major hues,
generally both red and green are not perceived;
–Trichromatism: Sensitivity to all three hues with
abnormality or deficiency in one of the three primary
pigments or colors in the retinal cones
Appl. Sci. 2022, 12, 6841

62. Factors Affecting Shade
Selection –Fatigue
–Fatigued eyes cannot sense color as perfectly as vigilant
eyes.
–Compromised visual sensitivity occurs due to local,
general or mental fatigues.
–Failure in shade selection (managing several patients
necessitating shade evaluation during a single day of work)
can be a main reason for fatigue.
Appl. Sci. 2022, 12, 6841

63. Factors Affecting Shade
Selection –Binocular difference
–Binocular difference is the difference
between the perception of the right and
left eye.
–Positioning of shade tabs below or above,
rather than next to, the tooth of interest
will support the removal fault caused
through binocular difference
Appl. Sci. 2022, 12, 6841

64. Factors Affecting Shade Selection –
environmental influences
–Develop a neutral gray background in order
–Lessen the effect of surrounding colors so as to determine perfect shade match
facial
appearance
make-up
dental
instruments’
reflection
walls
Appl. Sci. 2022, 12, 6841
Rubber dam

65. Conclusion
To provide an esthetic
restoration to the
patient, the dentist
must have a full
understanding of the
science of color and
color perception.
Matching the correct
shade satisfies both
the dentist and
patient and gives a
pleasing appearance
to the patient.
In order to achieve
good esthetics, both
conventional and
digital shade systems
should be employed
during the shade
selection process.

66. References
–Jouhar, R.; Ahmed, M.A.; Khurshid, Z. An Overview of Shade Selection in Clinical
Dentistry.Appl. Sci.2022,12, 6841
–Paolone, Gaetano & Orsini, Giovanna & Manauta, Jordi & devoto, Walter &
Putignano, Angelo. (2014). Composite shade guides and colormatching. The
international journal of estheticdentistry. 9. 164-82.
–Rajan, N. ., Krishna S, R. ., Rajan, A. ., Singh, G. ., & Jindal, L. . (2020). Shade Selection
–Basic for Esthetic Dentistry: Literature Review.International Journal of
Contemporary Research and Review,11(09).
–Paolone, Gaetano & Orsini, Giovanna & Manauta, Jordi & devoto, Walter &
Putignano, Angelo. (2014). Composite shade guides and colormatching. The
international journal of estheticdentistry. 9. 164-82.

67. –SproullRC. Color matching in dentistry. I. The three-dimensional nature of color. J
ProsthetDent. 1973 Apr;29(4):416-24. doi: 10.1016/s0022-3913(73)80019-8. PMID:
4511779.
–WiederS. Custom shade guide system for composite resins. J EsthetDent. 1990 Jan-
Feb;2(1):10-2. doi: 10.1111/j.1708-8240.1990.tb00596.x. PMID: 2098058.
–AlnusayriMO, SghaireenMG, Mathew M, AlzareaB, BandelaV. Shade Selection in
EstheticDentistry: A Review. Cureus. 2022 Mar 20;14(3):e23331. doi:
10.7759/cureus.23331. PMID: 35464532; PMCID: PMC9015060.
–Ly, Bao& Dyer, Ethan & Feig, Jessica & Chien, Anna & Bino, Sandra. (2020). Research
Techniques Made Simple: Cutaneous Colorimetry: A Reliable Technique for
Objective Skin ColorMeasurement. The Journal of investigative dermatology. 140. 3-
12.e1. 10.1016/j.jid.2019.11.003.

68. –Esthetic Restorations Based on Translucency and Opacity of Composite Resins. ,
23(2), 73–87.doi:10.1111/j.1708-8240.2010.00392.x
–Shade selection; BasavannaR S, GohilChitra, ShivannaVasundhara; Year : 2013
| Volume:3 | Issue Number:1 | Page: 26-31
–https://bayshoredentalstudio.com/importance-of-stump-shade/
–Shade selection; RS Basavanna,ChitraGohil,VasundharaShivanna
Department of Conservative Dentistry and Endodontics, College of Dental
Sciences, Davangere, Karnataka, India; Year: 2013|Volume: 3|Issue:
1|Page: 26-31