Razvan Ghinea

Color difference thresholds in dentistry

PURPOSE The aim of this prospective multicenter study was to determine 50:50% perceptibility threshold (PT) and 50:50% acceptability threshold (AT) of dental ceramic under simulated clinical settings. MATERIALS AND METHODS The spectral radiance of 63 monochromatic ceramic specimens was determined using a non-contact spectroradiometer. A total of 60 specimen pairs, divided into 3 sets of 20 specimen pairs (medium to light shades, medium to dark shades, and dark shades), were selected for psychophysical experiment. The coordinating center and seven research sites obtained the Institutional Review Board (IRB) approvals prior the beginning of the experiment. Each research site had 25 observers, divided into five groups of five observers: dentists-D, dental students-S, dental auxiliaries-A, dental technicians-T, and lay persons-L. There were 35 observers per group (five observers per group at each site ×7 sites), for a total of 175 observers. Visual color comparisons were performed using a viewing booth. Takagi-Sugeno-Kang (TSK) fuzzy approximation was used for fitting the data points. The 50:50% PT and 50:50% AT were determined in CIELAB and CIEDE2000. The t-test was used to evaluate the statistical significance in thresholds differences. RESULTS The CIELAB 50:50% PT was ΔEab  = 1.2, whereas 50:50% AT was ΔEab  = 2.7. Corresponding CIEDE2000 (ΔE00 ) values were 0.8 and 1.8, respectively. 50:50% PT by the observer group revealed differences among groups D, A, T, and L as compared with 50:50% PT for all observers. The 50:50% AT for all observers was statistically different than 50:50% AT in groups T and L. CONCLUSION A 50:50% perceptibility and ATs were significantly different. The same is true for differences between two color difference formulas ΔE00 /ΔEab . Observer groups and sites showed high level of statistical difference in all thresholds. CLINICAL SIGNIFICANCE Visual color difference thresholds can serve as a quality control tool to guide the selection of esthetic dental materials, evaluate clinical performance, and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization. The importance of quality control in dentistry is reinforced by increased esthetic demands of patients and dental professionals.

Color and translucency of zirconia ceramics, human dentine and bovine dentine

OBJECTIVES Evaluate color and translucency of both non-colored and colored zirconia ceramics and compare them with corresponding properties of human dentine. METHODS 0.5mm thick samples of human (MSHD) and bovine (MSBD) dentine were obtained from 5 extracted human anterior maxillary teeth and 5 bovine incisors, respectively. The zirconia systems evaluated (0.5mm samples) were: (1) IPS e.max(®) ZirCAD sintered samples: (a) regular (ZC1); (b) colored - coloring liquid CL2 (ZC2); (2) LAVA™ Zirconia sintered samples: (a) regular (LV1); (b) colored - coloring liquid FS3 (LV2). Translucency parameter (TP) and ΔE(ab)(*) and ΔE(00) color differences (with respect to the MSHD) were calculated. Spectral reflectance curves were compared using the VAF coefficient. RESULTS Reflectance spectral behaviour of MSBD and MSHD were similar (VAF=99.3%). All zirconia samples showed higher spectral reflectance values than the MSHD. Lightness values obtained for all zirconia ceramics (especially LV) were higher than MSHD and MSBD. The range of color differences, with respect to MSHD, was 6.9-20.5 for ΔE(ab)(*) and 4.9-15.6 for ΔE(00). Colored samples showed lower color differences with respect to MSHD. The highest TP values were found for IPS e.max(®) ZirCAD system and the lowest for LAVA™ Zirconia system. In terms of translucency, MSHD, MSBD and zirconia ceramics showed no statistically significant differences. CONCLUSIONS In terms of translucency, the studied zirconia systems could satisfactorily replace the human dentine within a dental restoration but, in order to produce a clinically acceptable match, it is necessary to carefully adjust the color of these systems.

Color and translucency in silorane-based resin composite compared to universal and nanofilled composites

OBJECTIVES The purpose of this study was to determine the optical properties, color and translucency, of the new silorane-based resin composite and to compare it to universal dimethacrylate-based composites. METHODS Six dimethacrylate-based resin composites and one silorane-based resin composite (all A2 shade) were studied. Color of non-polymerized and polymerized composites was measured against white and black backgrounds using a spectroradiometer. Changes in color (ΔE*(ab)), translucency (ΔTP) and color coordinates (ΔL*, Δa* and Δb*) were calculated for each resin composite. Results were evaluated using a one-way ANOVA, a Tukeys test and a t-test. RESULTS The polymerization-dependent ΔE*(ab) ranged from 4.7 to 9.1, with the smallest difference for the silorane-based resin composite. The color changes of silorane-based composite were due to the changes of coordinates Δa* and Δb*. However, for the dimethacrylate-based composites, the color changes mainly originated by ΔL*and Δb*. The silorane composite exhibited the smallest TP values. Tukeys test confirmed significant statistical differences (p<0.05) between mean TP values of Filtek Silorane and each brand of dimethacrylate-based composites before and after polymerization. CONCLUSIONS The new silorane-based restorative system showed different optical properties compared to clinically successful dimethacrylate composites. The silorane composite exhibited better polymerization-dependent chromatic stability, and a lower translucency compared to other tested products.

Optical behavior of dental zirconia and dentin analyzed by Kubelka–Munk theory

OBJECTIVES To use the Kubelka-Munk theory to evaluate the scattering (S), absorption (K) and transmittance (T) of non-colored and colored dental zirconia systems and human (HD) and bovine (BD) dentins. METHODS Two zirconia systems were used: ZC- ZirCAD (Ivoclar Vivadent) and LV-LAVA (3M ESPE). Specimens from each ceramic system were divided into 3 groups (n=5): ZC1 and LV1 (non-colored); ZC2 and LV2 colored to shade A1, and ZC3 and LV3 colored to shade A3. Five human and bovine anterior teeth were flattened and polished through 1200 grit SiC paper to expose the superficial buccal dentin. All samples were prepared to a final thickness of 0.5 mm. Diffuse reflectance was measured against white and black backgrounds, using a spectroradiometer in a viewing booth with D65 illuminant and d/0° geometry. S and K coefficients and T were calculated using Kubelka-Munks equations. Data was statistically analyzed using Kruskal-Wallis, Mann-Whitney tests, and VAF coefficient. RESULTS Spectral distributions of S, K and T were wavelength dependent. The spectral behavior of S and T was similar to HD (VAF≥96.80), even though they were statistically different (p≤0.05). The spectral behavior of K was also similar to HD, except for LV1 (VAF=38.62), yet all ceramics were statistically different from HD (p≤0.05). HD and BD showed similar values of S and T (p>0.05). SIGNIFICANCE The dental professional should consider the optical behavior differences between the zirconia systems evaluated and the human dentin to achieve optimal esthetics in restorative dentistry.

Visual and instrumental shade matching using CIELAB and CIEDE2000 color difference formulas

OBJECTIVES To compare visual and instrumental shade matching performances using two shade guides and three color difference formulas. METHODS One hundred dental students (DS) volunteers (35 males and 65 females) with normal color vision participated in the study. The spectral reflectance of 4 extracted human upper central incisors (UCI) and shade tabs from Vita Classical (VC) and Vita Toothguide 3D-Master (3D) shade guides were measured using a spectroradiometer (SP) under D65 illuminant (diffuse/0° geometry) inside a viewing booth with a gray background. Color coordinates (CIE L*, a*, b*, C* and h°) were calculated according to CIE D65 illuminant and CIE 2° Standard Observer. Color coordinates of UCI were also evaluated using a dental spectrophotometer (EA - Easyshade Advance). DS used VC and 3D to visually select the best shade match for each UCI, under same experimental conditions used for the SP evaluation. Three color difference metrics (CIELAB, CIEDE2000(1:1:1) and CIEDE2000(2:1:1)) were used to calculate the best instrumental shade matching based on minimum color difference. RESULTS The agreement between visual and instrumental shade matching was greater using SP (25-75%) than EA (0-25%). The percentage of best match for the visual assessment was more consistent using VC (23-55%) than 3D (19-34%). Considering the best performance (using SP and VC), the CIEDE2000(2:1:1) color difference formula showed the best estimate to the visual perception from DS. SIGNIFICANCE Within the limitations of this study, combining the use of SP, CIEDE2000(2:1:1) and Vita Classical shade guide most closely represented the visual perception of DS. Instrumental shade determination should be accompanied by experienced human visual assessment.

Colour parameters and shade correspondence of CAD–CAM ceramic systems

OBJECTIVES To evaluate colour differences between (1) CAD-CAM ceramic systems considering shades A1, A2 and A3 and the corresponding nominal shade of VC (Vita Classical shade guide) and (2) shades A1-A2, A2-A3 and A1, A2 and A3 within the same ceramic system. METHODS Samples of shades A1, A2 and A3 were fabricated (n=5) from CAD-CAM ceramic blocks (IPS e.max(®) CAD LT and HT, IPS Empress(®) CAD LT and HT, Paradigm™ C, and VITABLOCS(®) Mark II) and polished to 1.0±0.01mm in thickness. Spectral reflectance and colour coordinates were measured using a spectroradiometer inside a viewing booth using the CIE D65 illuminant and the d/0° geometry. Spectral reflectance curves were compared using VAF coefficient and were statistically analyzed using Kruskal-Wallis and the Mann-Whitney U test (α=0.05). Colour coordinates were statistically analyzed using one-way ANOVA, Tukeys test with Bonferroni correction (α=0.001). All colour differences (ΔEab(*) and ΔE00) were analyzed through comparisons with the PT - perceptibility and AT - acceptability thresholds for dental ceramics. RESULTS ΔE between ceramic systems and its corresponding shade ranged from 6.32 to 13.42 (ΔEab(*)) and 4.48 to 9.30 (ΔE00). ΔE between shades A1-A2, A2-A3 and A1, A2 and A3 ranged, respectively, 1.93-4.82, 1.22-5.59 and 3.63-8.84 (ΔEab(*)); 1.54-3.87, 1.03-3.90 and 2.95-6.51 (ΔE00). CONCLUSIONS Considering the corresponding nominal shade from VC, none of the ceramic systems showed colour differences below the AT. In addition, some ceramic systems showed colour differences below AT (shades A1-A2 and A2-A3) and below PT (shades A2-A3). CLINICAL SIGNIFICANCE Careful adjustments should be made to the final shade of CAD-CAM ceramic restorations to reach a clinically acceptable shade match.

Influence of surface roughness on the color of dental-resin composites.

This study deals with the influence of surface roughness on the color of resin composites. Ten resin composites (microfilled, hybrid, and microhybrid) were each polished with 500-grit, 1 200-grit, 2 000-grit, and 4 000-grit SiC papers. The roughness parameter (Ra) was measured using a Plμ confocal microscope, and field-emission scanning electron microscope (Fe-SEM) images were used to investigate filler morphology. Color was measured using a spectroradiometer and a D65 standard illuminant (geometry diffuse/0° specular component excluded (SCE) mode). Surface roughness decreased with grit number and was not influenced by filler size or size distribution. A significant influence of Ra on lightness (L*) was found. Lightness increased with decreases in roughness, except for specimens that underwent polishing procedure 4 (PP4; 500-grit, 1 200-grit, 2 000-grit, and 4 000-grit SiC papers consecutively). Generally, it was found that surface roughness influenced the color of resin composites. The composites that underwent PP1 (500-grit SiC paper) exhibited significant differences in chroma (C*), hue (h°), and lightness (L*) compared to composites that underwent PP3 (500-grit, 1 200-grit, and 2 000-grit SiC papers consecutively) and PP4. Color difference (ΔE*) between the polishing procedures was within acceptability thresholds in dentistry.

Predictive algorithms for determination of reflectance data from quantity of pigments within experimental dental resin composites

BackgroundBeing able to estimate (predict) the final spectrum of reflectance of a biomaterial, especially when the final color and appearance are fundamental for their clinical success (as is the case of dental resin composites), could be a very useful tool for the industrial development of these type of materials. The main objective of this study was the development of predictive models which enable the determination of the reflectance spectrum of experimental dental resin composites based on type and quantity of pigments used in their chemical formulation.Methods49 types of experimental dental resin composites were formulated as a mixture of organic matrix, inorganic filler, photo activator and other components in minor quantities (accelerator, inhibitor, fluorescent agent and 4 types of pigments). Spectral reflectance of all samples were measured, before and after artificial chromatic aging, using a spectroradiometer. A Multiple Nonlinear Regression Model (MNLR) was used to predict the values of the Reflectance Factors values in the visible range (380 nm-780 nm), before and after aging, from % Pigment (%P1, %P2, %P3 and %P4) within the formulation.ResultsThe average value of the prediction error of the model was 3.46% (SD: 1.82) across all wavelengths for samples before aging and 3.54% (SD: 1.17) for samples after aging. The differences found between the predicted and measured values of the chromatic coordinates are smaller than the acceptability threshold and, in some cases, are even below the perceptibility threshold.ConclusionsWithin the framework of this pilot study, the nonlinear predictive models developed allow the prediction, with a high degree of accuracy, of the reflectance spectrum of the experimental dental resin composites.

Dentin translucency and color evaluation in human incisors, canines, and molars

STATEMENT OF PROBLEM For restorations with excellent esthetics, an understanding of the optical properties of human dentin is needed. Little information is available on the translucency and color parameters of dentin and its relationship to tooth type and position. PURPOSE The purpose of this in vitro study was to investigate the translucency and CIELab color coordinates of human dentin in both anterior (incisors and canines) and posterior teeth (molars) by using spectrophotometric and spectroradiometric assessment methods. MATERIAL AND METHODS Uniformly thick specimens (2 mm) of midcoronal human dentin were taken from 33 central and lateral incisors, 7 canines, and 33 molars (all maxillary teeth). The CIELab color coordinates were measured with a clinical spectrophotometer (Easyshade Compact) and a noncontact spectroradiometer (SpectraScan PR-704). The translucency parameter (TP) was calculated. Bland-Altman plots and Wilcoxon signed rank tests for paired samples were used to assess the agreement of the 2 measurement techniques. The differences between anterior and posterior dentin specimens regarding color coordinates and the translucency parameter were analyzed using Mann-Whitney-Wilcoxon rank sum tests. RESULTS Statistically significant differences between spectrophotometric and spectroradiometric measurements of the TP and CIELab color coordinates were found in both groups of dentin specimens (P<.05). TP values of molar dentin specimens were significantly higher than those of the anterior ones, regardless of the assessment method (P<.001). Dentin specimens of the anterior teeth exhibited higher L∗ values but lower a∗ and b∗ values on both black and white backgrounds compared with molar dentin specimens. CONCLUSIONS The dentin of anterior teeth was found to be lighter but less translucent and less chromatic than in molars, regardless of the assessment method used.

Shade Correspondence, Color, and Translucency Differences between Human Dentine and a CAD/CAM Hybrid Ceramic System

OBJECTIVE To determine the shade correspondence between human dentine and two versions of a CAD/CAM hybrid ceramic system and to investigate color and translucency differences between these materials. MATERIALS AND METHODS Twenty-four samples of different shades and opacities were fabricated from Vita Enamic CAD/CAM ceramic blocks. Human dentine samples were obtained from 73 extracted maxillary teeth. Color coordinates of all samples were measured using VitaEasyshade spectrophotometer. The translucency parameter (TP) and ΔEab* and ΔE00 color differences, with respect to human dentine of anterior and posterior teeth, were calculated. RESULTS Vita Enamic Translucent was the best match for anterior teeth (>90% of cases) while Vita Enamic T 3M2 was the best option for the dentine samples of posterior teeth in 78.8% ( ΔEab*) and 54.5% ( ΔE00) of the cases. The smallest differences in translucency ( ΔTP) with the dentine samples of anterior teeth were obtained for Vita Enamic T 3M2 (92.5%) and with those of posterior teeth for Vita Enamic HT 1M2 (45.4%). CONCLUSIONS VITA Enamic Translucent is the best option as color match for both anterior and posterior teeth dentine. In terms of translucency, VITA Enamic Translucent closely matched anterior teeth dentine while for posterior teeth, VITA Enamic HT was the best option. CLINICAL SIGNIFICANCE The results of the present study could help clinicians in their decision of choosing a specific shade and translucency for their anterior or posterior esthetic restorations with hybrid ceramics. (J Esthet Restor Dent 28:S46-S55, 2016).