Achieving natural, aesthetically pleasing results for anterior restorations is a key goal for every dental professional – and their patients. One crucial aspect of this process is effectively determining and matching the right colour and shade of the restorative material to the patient’s existing dentition.
Because aesthetic dentistry imposes several demands on the artistic abilities of the dentist and the technician, knowledge of the underlying scientific principles of colour is essential. A dentist’s ability to perceive and evaluate colours accurately is crucial for achieving optimal aesthetics and patient satisfaction. Indeed, tooth colour is one of the most important factors determining patient satisfaction with their dental appearance. Self-satisfaction with tooth colour decreases with increasing severity of discolouration.
Owing to the extensive range of natural tooth colours, achieving an intimate shade match between the restoration and natural teeth can be challenging.
Colour matching
The human brain can identify nearly one million shades, and precise devices that can recognise approximately 10m different shades have been developed. Human dentition shades differ significantly, and electronic devices can identify approximately 100,000 dental shades, while the human eye can identify only one per cent of these.
Three variables are used to characterise the perception of light reflected from the tooth surface: hue, value and chroma. Hue describes the dominant shade of the tooth, value is the lightness or darkness of the tooth shade measured independently of the hue, and chroma is the quality that distinguishes the degree of vividness of the hue.
Effective shade-taking techniques require proper lighting conditions, shade tabs and digital shade-matching devices/shade guides. Dental professionals should be aware of the disadvantages of shade guides. These include the fact that the colours often differ for each manufacturing company and that they do not cover the volume of colours that exist in natural dentition.
Spectrophotometers sometimes referred to as the gold standard for shade assessment (technology is always moving the goalposts), and digital photography can also improve the accuracy and consistency of shade selection.
Guiding light
The importance of the lighting conditions cannot be overstated. Dental colours exhibit metamerism, meaning they change under different light sources. Dentists should evaluate shade matches under various lighting conditions to ensure colour accuracy.
There are several factors that can influence shade matching. Primarily, the tooth’s structure and optical properties are key. When selecting restorative materials, dental professionals must consider the dentine, the enamel thickness, translucency and opalescence.
Age-related changes in tooth colour and gender-specific preferences may impact shade selection. One study found that, in general, older people (aged 55 and above) were more likely than younger people to be satisfied with their dental appearance, suggesting that the appearance of their teeth is not as important to older individuals than to younger. However, dental appearance is becoming equally important in all categories due to the strong impact of social media which portray men and women of all ages as needing to look younger and more beautiful.
Composite considerations
Direct composite restorations have become a pivotal part of dental practice. They involve a delicate procedure that requires skilful use of appropriate materials to aesthetically mimic natural tooth structure. Utilising multiple layers of composite or ceramic materials can create depth.
Translucent restorative materials can allow underlying tooth structure to show through, and they can also reflect surrounding tooth structure. Both of these phenomena can result in colour changes in restorations. Therefore, determining the level of translucency or opacity required for a particular case can create lifelike restorations.
Brilliant EverGlow from Coltene is a submicron hybrid composite. The average particle size of the glass filler has been reduced to below one micron to achieve maximum ease of polishability and gloss retention. The award-winning composite ensures natural-looking restorations that blend seamlessly with the surrounding teeth. The wide range of shades available allows dental clinicians to achieve accurate colour matching, resulting in highly satisfied patients, and it is suitable for both anterior and posterior restorations. It delivers excellent handling characteristics, making it easy for dental professionals to sculpt and shape the material precisely. Its superior high gloss increases its wear resistance, durability and smooth feel.
Achieving natural-looking anterior restorations requires a meticulous approach to colour analysis and shade selection. A dental professional’s proficiency in these areas directly impacts the success of their treatments and patient satisfaction. Selecting the correct shade is the foundation for superior aesthetics, which dentists can be proud of and their patients will love.
References available on request.