Dental Color-Matching Ability: Comparison between Visual Determination and Technology.

BACKGROUND: The choice of the correct color is of paramount importance in esthetic dentistry; however, there is still no consensus on the best technique to determine it. The aim of the present study is to compare the accuracy of a recently introduced colorimeter in shade matching with human vision. In addition, possible variables affecting color-matching by human eye have been analysed. METHODS: 18 disc-shaped composite samples with identical size and shape were produced from a composite flow system (Enamel plus HriHF, Micerium): Nine were considered control samples (UD 0-UD 6), and nine were test samples with identical flow composite shade to the control ones. Parallelly, 70 individuals (dental students and dental field professionals) were individually instructed to sit in a dark room illuminated with D55 light and to perform visual shade matching between control and test discs. An error matrix containing ΔE94 between control and test discs was generated, containing four match-clusters depending on perceptibility and acceptability thresholds. The frequency and severity of errors were examined. RESULTS: The colorimeter achieved a 100% perfect matching, while individuals only achieved a 78%. A higher occurrence of mismatches was noted for intermediate composite shades without a statistically significant difference. No statistically significant differences were reported for age, sex, and experience. A statistically significant difference was present among the Optishade match and the visual determination. CONCLUSIONS: The instrumental shade-matching evaluation proved to be significantly more reliable than the human visual system. Further research is needed to determine whether the same outcomes are achieved in a clinical setting directly on patients.

Color Comparison Between Intraoral Scanner and Spectrophotometer Shade Matching: A Systematic Review and Meta-Analysis.

OBJECTIVE: This systematic review and meta-analysis compared the accuracy of intraoral scanners and spectrophotometers in determining tooth shade. MATERIALS AND METHODS: An electronic search of five databases (PubMed, Scopus, Embase, Web of Science, CENTRAL) was conducted on October 19, 2023. A total of 163 studies were identified from the databases, of which 23 articles were eligible for inclusion. In vivo and in vitro quasi-experimental studies were included. After data extraction, a quantitative analysis was performed to determine the accuracy of the intraoral scanner in subgroups using four outcomes: trueness and precision with different measurement locations. A random-effects model was used to pool effect sizes. The pooled proportion with a 95% confidence interval (CI) was used for the effect size measure. RESULTS: Eleven articles were included in the meta-analysis. Trueness with the intraoral scanner was between 0.28 (CI: 0.09-0.60) and 0.38 (CI: 0.24-0.53). Repeatability was between 0.81 (CI: 0.64-0.91) and 0.85 (CI: 0.74-0.92). Trueness showed low, and precision had moderate certainty of evidence. CONCLUSION: The trueness of shade matching with intraoral scanners is low compared to spectrophotometers, although the precision is considered high and is similar to spectrophotometers. CLINICAL SIGNIFICANCE: Shade determination with intraoral scanners is not recommended.

Bridging instrumental and visual perception with improved color difference equations: A multi-center study.

OBJECTIVES: This multicenter study aimed to evaluate visual-instrumental agreement of six color measurement devices and optimize three color difference equations using a dataset of visual color differences (∆V) from expert observers. METHODS: A total of 154 expert observers from 16 sites across 5 countries participated, providing visual scaling on 26 sample pairs of artificial teeth using magnitude estimation. Three color difference equations (ΔE*ab, ∆E00, and CAM16-UCS) were tested. Optimization of all three equations was performed using device-specific weights, and the standardized residual sum of squares (STRESS) index was used to evaluate visual-instrumental agreement. RESULTS: The ΔE*ab formula exhibited STRESS values from 18 to 40, with visual-instrumental agreement between 60 % and 82 %. The ∆E00 formula showed STRESS values from 26 to 32, representing visual-instrumental agreement of 68 % to 74 %. CAM16-UCS demonstrated STRESS values from 32 - 39, with visual-instrumental agreement between 61-68 %. Following optimization, STRESS values decreased for all three formulas, with ΔE' demonstrating average visual-instrumental agreement of 79 % and ∆E00 of 78 %. CAM16-UCS showed average visual-instrumental agreement of 76 % post optimization. SIGNIFICANCE: Optimization of color difference equations notably improved visual-instrumental agreement, overshadowing device performance. The optimzed ΔE' formula demonstrated the best overall performance combining computational simplicty with outstanding visual-instrumental agreement.

Assessment of Tooth Shade Measurement Precision and Consistency with Digital Photography Calibration System.

Objectives: To ascertain the degree of precision and repeatability inherent in the "capture to edit" digital imaging system, namely the ColorChecker Passport Photo (X-Rite, MI, USA), and to juxtapose its performance against spectrophotometric assessments utilizing the Vita Easyshade® (Vita Zahnfabrik, H Rauter GmbH & Co. KG., Bad Sackingen, Germany) for the same set of teeth. Materials and methods: Eighty participants aged 19-25 were included in the study; all of them were Croatian students at the School of Dental Medicine, University of Zagreb. Color measurements of the maxillary right central incisors were performed in controlled, standardized laboratory conditions. The measurements were performed on calibrated digital photographs by an experienced clinician three times in a row, and L, a, and b of CIELAB color space values were recorded. The same procedure was performed using the Vita Easyshade 5.0 spectrophotometer (Vita Zahnfabrik, Bad Säckingen, Germany) in "Tooth single" mode. Results: The Cronbach's alpha was used as a repeatability measurement, thus revealing high consistency for both methods (α=0.94-1). Correlations were moderate (Pearson r=0.44-0.66 p<0.05). Testing confirmed that digital photography is inaccurate as spectrophotometry (p<0.05). An analysis of errors of means and their standard deviations revealed consistent discrepancies with minor deviations. Conclusion: The "capture to edit" method showed high consistency (Cronbach's α=0.94-0.96), and it exhibits comparability in terms of variability, reliability, and repeatability when compared to spectrophotometric measurement (VitaShade 5, VitaZahnfabrik). Disparities between the methods are evident and anticipated, yet they do not follow a consistently linear pattern. The combination of repeatability and consistency renders the "capture to edit" method a valuable tool for enhanced color mapping, thus facilitating comparisons between digital images.

Effect of air-abrasion pretreatment with three desensitizing agents on efficacy of in-office tooth bleaching.

OBJECTIVE: To evaluate the influence of air-abrasion of enamel with three different desensitizing powders on the whitening effect of a bleaching gel containing 40% H2O2, which was used for in-office tooth bleaching. MATERIALS AND METHODS: Forty human incisors, extracted and prepared, were acquired for this study and subsequently randomized into four groups (n = 10). The control group specimens underwent no pretreatment prior to the bleaching procedure, whereas the remaining three groups underwent air abrasion using distinct desensitizing powders; (a) Sylc, which contains bioglass 45S5; (b) BioMinF, which contains calcium phospho-fluoro-silicate glass; and (c) MI Pearls, which contains nano-hydroxyapatite, 1 h preceding the Opalescence Boost PF 40% bleaching procedure. Color measurements were conducted using a double-beam UV-Vis spectrophotometer at four distinct time points (prior to bleaching, 24 h, 15 days, and 30 days post-bleaching). RESULTS: Tooth color change outcomes revealed that there were no statistically significant results with respect to the interaction of the two criteria (treatments and time) (p = 0.990). Additionally, there were no statistically significant results with respect to the main effects of treatments (p = 0.385), while there were statistically significant effects with respect to the time criterion (p = 0.013). CONCLUSIONS: The use of the tested desensitizing powders prior the bleaching procedure did not affect the tooth color change induced by the tested bleaching agent. CLINICAL SIGNIFICANCE: Tooth color change and whiteness are not affected by air-abrasion desensitizing treatments when applied prior to in-office bleaching procedures.

Effect of weight satisfaction on adolescent facial and dental satisfaction.

PURPOSE: To investigate if facial and dental satisfaction is related to body fat percentage and body weight satisfaction. METHODS: A self-administered questionnaire was applied to adolescents from a Private School in Southern Brazil containing sociodemographic (sex and age) and self-perception variables. Adolescents were asked about their perceptions concerning dental problems. Body fat percentage was collected using bioelectrical impedance analysis. RESULTS: A total of 372 adolescents were examined. Most adolescents were satisfied with their dental (81.7%) and facial appearance (87.6%), while 39% of adolescents were satisfied with their body weight. Poisson regression model showed that adolescents who expressed satisfaction with their body weight (PR = 1.12, 95%CI 1.06-1.19) and were satisfied with their dental appearance (PR = 1.24, 95% CI 1.08-1.41) exhibited a positive association with facial satisfaction. Adolescents dissatisfied with dental color (PR = 0.88, 95%CI 0.80-0.97), those reporting dental pain (PR = 0.88, 95%CI 0.80-0.97), and individuals with obesity (PR = 0.91, 95%CI 0.83-0.99) demonstrated a decrease in facial satisfaction. Adolescents aged 16 to 19 years (PR = 1.08, 95% CI 1.01-1.15) and those satisfied with their facial appearance (PR = 1.20, 95%CI 1.01-1.43) exhibited a higher prevalence of dental satisfaction. Conversely, adolescents dissatisfied with dental color (PR = 0.74, 95% CI 0.66-0.82) and those with misaligned teeth (PR = 0.63, 95%CI 0.55-0.73) reported lower levels of dental satisfaction. Parametric g-formula analysis found that the association between body fat and facial satisfaction was mediated by body weight satisfaction (p = 0.001). CONCLUSIONS: While dental satisfaction was not influenced by corporeal characteristics, facial satisfaction was influenced by dental and body weight satisfaction. Obese adolescents had low facial satisfaction.

A Smartphone Application for Personalized Tooth Shade Determination.

Tooth shade determination methods for evaluating the effectiveness of whitening products at home are limited. In this study, an iPhone app for personalized tooth shade determination was developed. While capturing dental photographs in selfie mode before and after whitening, the app can maintain consistent illumination and tooth appearance conditions that affect tooth color measurement. An ambient light sensor was used to standardize the illumination conditions. To maintain consistent tooth appearance conditions determined by appropriately opening the mouth, facial landmark detection, an artificial intelligence technique that estimates key face parts and outlines, was used. The effectiveness of the app in ensuring uniform tooth appearance was investigated through color measurements of the upper incisors of seven participants via photographs captured in succession. The coefficients of variation for incisors L*, a*, and b* were less than 0.0256 (95% CI, 0.0173-0.0338), 0.2748 (0.1596-0.3899), and 0.1053 (0.0078-0.2028), respectively. To examine the feasibility of the app for tooth shade determination, gel whitening after pseudo-staining by coffee and grape juice was performed. Consequently, whitening results were evaluated by monitoring the ∆Eab color difference values (1.3 unit minimum). Although tooth shade determination remains a relative quantification method, the proposed method can support evidence-based selection of whitening products.

Lipstick influence on teeth color appearance.

Background and aim: A beautiful smile with white and shiny teeth is nowadays a must, according to aesthetics norms. The color of the lips, with or without lipstick, may influence the appearance of the teeth color. The objective of the study was to evaluate the influence of the lipstick on the tooth color appearance. Methods: Four female patient smiles were photographed from the frontal view with five different colored lipsticks. Each photo was evaluated by 100 observers and noted from 1-dark to 6-white. Data were statistically analyzed with dedicated software. Results: The majority of the observers noted with lower grades the nude lipstick color photos and with higher grades the red and purple ones. Conclusion: Within the limitation of the study, the surrounding (the lipstick) has an important influence on the appearance of the tooth color.

Synthesis, Characterization, and Investigation of Novel Ionic Liquid-Based Tooth Bleaching Gels: A Step towards Safer and Cost-Effective Cosmetic Dentistry.

The objective of this study was to synthesize a novel choline hydroxide ionic liquid-based tooth bleaching gel. Ionic liquid-based gels were synthesized and characterized using FTIR along with pH testing. Tooth sample preparation was carried out in line with ISO 28399:2020. The effects of synthesized gels on tooth samples were tested. Tooth samples were stained and grouped into three experimental groups: EAI (22% choline hydroxide gel), EAII (44% choline hydroxide gel), and EB (choline citrate gel) and two control groups: CA (commercial at-home 16% carbamide peroxide gel) and CB (deionized water). The tooth color analysis, which included shade matching with the Vitapan shade guide (n = 2), and digital colorimetric analysis (n = 2) were evaluated. The surface characteristics and hardness were analyzed with 3D optical profilometry, Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), and Microhardness testing (n = 3), respectively. The tooth color analysis (Vitapan shade guide) revealed that all the tooth samples treated with synthesized choline citrate gel (EB) showed an A1 shade as compared to the other four groups, giving a range of shades. An analysis of the ΔE values from digital colorimetry; EAI, EAII, CA, and CB showed ΔE values in a range that was clinically perceptible at a glance. However, EB showed the highest value of ΔE. The mean microhardness values for the five groups showed that the effects of three experimental gels i.e., 44% choline hydroxide, 22% choline hydroxide, and choline citrate, on the microhardness of the tooth samples were similar to that of the positive control, which comprised commercial at-home 16% carbamide peroxide gel. SEM with EDX of three tested subgroups was closely related in surface profile, elemental composition, and Ca/P ratio. The roughness average values from optical profilometry of four tested subgroups lie within approximately a similar range, showing a statistically insignificant difference (p > 0.05) between the tested subgroups. The synthesized novel experimental tooth bleaching gels displayed similar tooth bleaching actions without any deleterious effects on the surface characteristics and microhardness of the treated tooth samples when compared with the commercial at-home tooth bleaching gel.

Comparison of digital and visual tooth shade selection.

OBJECTIVE: In dental restorations, color determination is very important for achieving esthetic results. The aim of this study was to compare visual shade selection using digital methods and to assess the repeatability of the utilized intraoral scanners. MATERIALS AND METHODS: In 31 probands, tooth color was determined on teeth 11, 13, and 16. Shade selection was performed visually by a dentist and digitally using Trios 3 and Cerec Omnicam. Three measurements were performed to determine the repeatability of intraoral scanners. Fleiss' κ was used for statistical evaluation of the repeatability and Cohen's κ was used for comparison of methods. RESULTS: The visual method showed only slight agreement with Trios 3 (Cohen's κ: 0.198) and Cerec Omnicam (Cohen's κ: 0.115). Moderate agreement was found between Trios 3 and Cerec Omnicam (Cohen's κ: 0.452). In terms of repeatability, Trios 3 scored higher overall than Cerec Omnicam (Fleiss' κ: 0.612 vs. 0.474). CONCLUSION: Intraoral scanners can facilitate the workflow in clinical practice. They are a good supplement for color determination, but should additionally be confirmed by the visual method. Clinical significance: The use of digital instruments is increasingly being preferred over conventional treatments. Therefore, it is essential to continuously improve the accuracy of intraoral scanners for color selection in order to offer an alternative to visual methods.

Effect of calcium silicate-based endodontic sealers on tooth color: A 3-year in vitro experimental study.

Objective: To analyze the change in tooth color produced by two hydraulic and one resin-based sealers by means of spectrophotometry for 3 years. Methods: Forty maxillary anterior teeth were selected (n = 10 per group). Root canals were prepared by rotary instrumentation and irrigation was performed with NaOCl, which was also used in the final irrigation, followed by saline and activated with Endoactivator. Root canals were then filled using single cone technique. Negative control (NC): gutta-percha filling; Positive control: gutta-percha and AH Plus; experimental groups: gutta-percha and Bioroot RCS/TotalFill BC Sealer. Gutta-percha was cut 2 mm below the cementoenamel junction, the pulp chamber was sealed with flowable composite. The teeth were kept in PBS. Color was measured in the cervical and incisal halves before root canal treatment (RCT), one and six months after RCT, and after one, two and three years, with the Vita EasyShade spectrophotometer; positioned using an individualized splint. ΔEab and ΔE00 were calculated. Two-way ANOVA repeated measures test followed by Bonferroni post-test were performed to analyze the ΔL, Δa*, Δb*, ΔEab, and ΔE00, considering treatment groups and evaluation periods. Statistical significance was set at p < 0.05. Results: In the incisal half, in decreasing order of darkening, the groups at three years were ordered according to the ΔEab: AH Plus > NC > TotalFill > Bioroot. ΔE00 values were: 1.38 ± 0.61 NC, 2.37 ± 0.70 AH Plus, 1.86 ± 0.60 BioRoot and 1.53 ± 0.85 TotalFill. In the cervical half, the ΔEab values, showed the same descending order, except for Bioroot and TotalFill which alternated the order. The ΔE00 values were 1.86 ± 0.61 NC, 3.01 ± 0.70 AH Plus,1.89 ± 0.58 Bioroot and 1.65 ± 0.41 TotalFill, with no significant differences between groups and times in both locations. Conclusions: All groups presented some degree of discoloration. Lightness and b* component were the most influential. Calcium silicate-based cements (Bioroot RCS and TotalFill BC Sealer) produced acceptable levels of discoloration at the end of follow-up.

Antibacterial potential of riboflavin mediated blue diode laser photodynamic inactivation against Enterococcus faecalis: A laboratory investigation.

OBJECTIVES: This study aimed to evaluate the inactivation potency of riboflavin-mediated blue diode laser photodynamic inactivation (PDI) against Enterococcus faecalis at planktonic and biofilm stages and also investigated its effect on the tooth color change. MATERIALS AND METHODS: The antibacterial and antibiofilm activities of riboflavin mediated PDI against E. faecalis were investigated. The numbers of colony-forming units (CFUs)/mL were calculated. Teeth discoloration were evaluated using the CIE L*a*b* based color difference (ΔE). RESULTS: Antibacterial analysis indicated that the blue diode laser irradiation at 12, 18, 24, and 30 J/cm2 alone and different concentrations of riboflavin solution (6.25 to 100 µM) reduced the number of CFU/mL of E. faecalis, but the reduction was not statistically significant (P > 0.05). Depending on the riboflavin concentration and the light dose, there can be as much as a 1-log effect on CFU/mL. In addition, E. faecalis biofilm was more affected with 30 J/cm2 irradiation dosage and 100 µM riboflavin than other groups. Meanwhile, bacterial suspensions treated with 5.25% sodium hypochlorite (NaOCl) showed maximum biofilm inhibition and colony number reduction, compared with the control. The teeth exhibited clinically acceptable color change after riboflavin treatment at concentration ranging from 6.25 to 50 µM (ΔE < 3.7). CONCLUSIONS: The riboflavin mediated PDI process is somewhat less effective than NaOCl but perhaps less toxic to tissues. It might be feasible to repeat the riboflavin + light treatment to further promote efficacy.

Influence of Bleaching Agent Containing Bioactive Glass on Color and Microhardness of Bovine Enamel

To try to reduce the deleterious effects of tooth whitening, bioactive materials have been used. Forty enamel/dentin blocks were stained on dark tea and randomly assigned into four groups (n=10): control group (unbleached), HP35 % (35 % hydrogen peroxide), BG45S5 (Bioglass 45S5® incorporated into HP35 %), and BIO (Biosilicate® incorporated into HP35 %). Colorimetric analysis and microhardness evaluation was performed at baseline, 24 hours and 7 days after the final whitening session. Two-way ANOVA for repeated measures and Bonferroni test was used at a significance level of 5 %. All the coordinates (ΔL*, Δa*, Δb*, ΔE00 and WID) showed a difference between the control group and the experimental ones (p0.05), which suggest a color stability over a week. In contrast, after 7 days, the WID showed that control and PH35 % were different than the other groups (p 0.05). The microhardness did not change over time (p>0.05), except for 35 % HP. In conclusion Bioglass 45S5® and Biosilicate® prevented enamel damage without negatively affect the whitening efficacy.

Para intentar reducir los efectos nocivos del aclaramiento dental, se han usado materiales bioactivos. Cuarenta bloques de esmalte/dentina se tiñeron con té oscuro y se asignaron al azar en cuatro grupos (n=10): grupo de control (sin blanquear), HP35% (peróxido de hidrógeno al 35 %), BG45S5 (Bioglass 45S5® incorporado en HP35%) y BIO (Biosilicato® incorporado a HP35%). El análisis colorimétrico y la evaluación de la microdureza se realizaron al inicio del estudio, 24 horas y 7 días después de la última sesión de blanqueamiento. Se utilizó ANOVA de dos vías para medidas repetidas y la prueba de Bonferroni a un nivel de significancia del 5 %. Todas las coordenadas (ΔL*, Δa*, Δb*, ΔE00 y WID) mostraron diferencia entre el grupo control y el experimental (p0.05), lo que sugiere una estabilidad del color durante una semana. En cambio, a los 7 días, el WID mostró que el control y el PH35 % eran diferentes a los demás grupos (p 0.05). La microdureza no cambió con el tiempo (p>0.05), excepto para 35 % HP. En conclusión Bioglass 45S5® y Biosilicate® previnieron el daño del esmalte sin afectar negativamente la eficacia del blanqueamiento.

Modeling the Relationship Between Tooth Color and Skin Color in Equations to Predict Tooth Color.

Background Color selection for discolored teeth or for edentulous patients is a subjective process in dentistry. To the best of the authors' knowledge, there is no objective method for tooth color selection for edentulous patients. Several studies have investigated the relationship between tooth color and skin color and the ability to use skin color as a guide to select tooth color in dental rehabilitation cases. The objective of this study was to find and model the relationship between tooth color and skin color in equations to be able to predict tooth color by assessing skin color. Methodology This study was done on 150 participants with equal gender distribution. Digital photography with soft boxes and strobe lights were used to measure tooth and skin color. Digital photography was performed in a dark room with controlled and measured lighting sources and strength. A calibration board was used to create two calibration profiles in software. All photos were calibrated in Adobe Lightroom software. Then, color measurement was done using Adobe Photoshop software in the Commission International de I'Eclarirage (CIELab) system. Results There were positive significant relationships in color spaces L* and a* between tooth color and skin color, and an inverted significant relationship in color space b* between tooth and skin. Three equations with excellent reliability were formulated in this study to predict tooth color by assessing skin color. Conclusions The relationship between tooth color and skin color was modeled in three equations. For edentulous patients, this research might be useful in detecting the proper tooth color and transferring the CIELab color data to dental technicians for further processing. Computerized shade matching and prediction dental software may be designed using these equations.

EXPERIMENTAL STUDY OF CHANGES IN THE CHEMICAL COMPOSITION OF TOOTH ENAMEL WHEN USING HYDROGEN PEROXIDE AS THE MAIN CHEMICAL COMPONENT IN PROFESSIONAL BLEACHING.

OBJECTIVE: The aim: To study changes in the chemical composition of the tooth enamel surface when using hydrogen peroxide as a chemical component of the whitening system in combination with professional oral hygiene. PATIENTS AND METHODS: Materials and methods: To achieve this goal, during the study, we studied the enamel of the teeth of the frontal area, which was removed for orthodontic and orthopedic indications. The age of the patients whose teeth were examined ranged from 18 to 44 years. In the experiment, we studied the chemical structure of enamel by a method thatcovered the selection of the study area, with the designation of areas for microanalysis, and subsequent elemental analysis in selected areas of the enamel. RESULTS: Results and conclusions: Analyzing the results of this study, we can make assumptions about the impact of professional dental hygiene on the procedure of photo-whitening teeth based on 35% hydrogen peroxide gel and its subsequent impact on theother clinical indicators, which will depend on the characteristics of functional and structural resistance of the enamel.

The effect of two different prophylaxis paste applying processes on color stability in-office bleaching: 24-month clinical follow-up.

OBJECTIVE: The purpose of this study was to examine the effect of applying two different prophylaxis pastes with various protocols on the degree of bleaching and color stability in the office bleaching process with a bleaching agent containing 40% hydrogen peroxide. MATERIAL AND METHOD: The 300 teeth of 15 (9 female, 6 male) patients were included in our study, and 5 different study groups were randomly formed. The bleaching process with Ultradent Opalescence Boost (Ultradent, South Jordan, USA) was performed according to the manufacturer's instructions. Two different prophylaxis pastes, Ultrapro (Ultradent, Cologne, Germany) and Cleanic (Kerr, Rastatt, Germany), were applied with protocols determined according to the groups. The effect on color stability at 6-, 12-, and 24-month follow-up was determined using the CIE L* a* b* color system. The changes in the parameters were analyzed using the one-way ANOVA, chi-square, and Tukey test (p > 0.05). RESULTS: The evaluation rate of the treatments was 100% at the end of 24 months. Control group 6-month ΔE (0-6) and 12-month ΔE (0-12) values were higher than 24-month ΔE (0-12) values. UU + UU, KC + KC, and UU group 6-month ΔE (0-6) values were higher than 12-month ΔE (0-12) values. In addition, 6-month ΔE (0-6) and 12-month ΔE (0-12) values were higher than 24-month ΔE (0-24) values. KC group 6-month ΔE (0-6) and 12-month ΔE (0-12) values were higher than 24-month ΔE (0-24) values. Control, UU + UU, KC + KC, UU, and KC group ΔE (1-6) values at 6 months were lower than 12-month ΔE (1-12) and 24-month ΔE (1-12) values in all groups. In addition, 12-month ΔE (1-12) values were lower than 24-month ΔE (1-24) values. According to the study data, there was no statistically significant difference between the groups according to the prophylaxis paste and prophylaxis procedure (p > 0.05). However, it was observed that whiteness decreased in all groups over time. CONCLUSIONS: Discoloration was observed at 6 months, 12 months, and 24 months after bleaching. However, at the end of 24 months, the tooth color was significantly whiter than the initial color. CLINICAL RELEVANCE: Pre-bleaching prophylaxis application and pre-bleaching and post-bleaching prophylaxis application have no effect on color stability.

Evaluation of Color and Spectral Behavior of a Novel Flowable Resin Composite after Water Aging: An In Vitro Study.

BACKGROUND: This study aimed to evaluate the color matching, light transmittance, and reflectance characteristics of the novel flowable resin composite OCF-001 (OCF). METHODS: Fifty-four resin composite molds were made with simulated class I cavities of A2, A3, and A4 shades by filling the rubber mold interspace with Estelite Sigma Quick (ESQ), Gracefil Putty (GP) and Filtek Supremme Ultra (FSU). After applying the adhesive, three different flowable resin composites (n = 6), OCF, Gracefil LoFlo (GLF), and Supreme Ultra Flowable (SUF), were used to fill the cavities. A colorimeter was used to measure the color parameters (CIEDE2000). The color measurements were taken immediately and after 28 days. Data were analyzed using the nonparametric Kruskal-Wallis (α = 0.05) and Wilcoxon tests. The light transmittance and reflection characteristics were measured with a black background using a spectrophotometer under D65 illumination. RESULTS: The ΔE00, and ΔC of OCF was lower than other tested materials in A2 and A3 shades both immediately and after 28 days. OCF showed the highest transmittance characteristic, and a relatively stable reflectance curve in all the wavelengths. CONCLUSIONS: OCF showed better shade matching with the surrounding shades of A2 and A3, a relative uniform reflectance and higher light transmission properties.

Comparison of two optical devices used for artificial tooth color selection.

BACKGROUND: Correct color assessment and the selection of the color of the prosthetic restoration are important aspects of prosthetic treatment, which significantly affect the success of the treatment. OBJECTIVES: The aim of this study was to compare 2 commercial devices used for tooth color selection. MATERIAL AND METHODS: The color of maxillary right central incisors and right canines was assessed in a group 100 patients aged 22-40 years (25.11 ±3.24 years), using the Easyshade® spectrophotometer and the ShadeStar® colorimeter. Two visual shade guides were used as references for the tests - VITA VITAPAN® Classical and VITA 3D­Master. The 2 instruments and the 2 visual shade guides were assessed in terms of agreement in tooth color selection. RESULTS: There were statistically significant differences between the 2 instruments in terms of agreement in tooth color selection as well as between the 2 shade guides. The VITA VITAPAN Classical shade guide was shown to be more accurate in tooth color selection than VITA 3D­Master. There was agreement between the Easyshade spectrophotometer and ShadeStar colorimeter measurements for incisors in 49% of cases with the VITA VITAPAN Classical shade guide and in 22% of cases with VITA 3D­Master. In the comparative analysis of the Easyshade and ShadeStar devices with regard to the measurements performed on canines there was 52% agreement for the VITA VITAPAN Classical shade guide and 32% agreement for VITA 3D­Master. CONCLUSIONS: The VITA VITAPAN Classical system demonstrated superior agreement in shade selection as compared to the VITA 3D­Master system. A low degree of agreement between the optical devices used in the selection of the color of artificial teeth may indicate optical differences between devices from different manufacturers.

In vivo evaluation of whitening toothpaste efficiency and patient treatment satisfaction: a randomized controlled trial.

OBJECTIVES: To assess the whitening efficiency and patient satisfaction after usage of commercially available toothpastes with the different whitening ingredients. MATERIALS AND METHODS: This randomized controlled trial study comprised 161 participants who were randomly divided into eight groups based on used whitening or control/conventional toothpaste (Colgate Max Expert White [CMEW], n = 20; Signal Daily White [SDW], n = 20; Himalaya Sparkly White Herbalis [HSWH], n = 20; Signal White System [SWS], n = 20; Rembrandt Deeply White + Peroxide [RDWP], n = 20; Splat Extreme White [SEW], n = 20; Splat White Plus [SWP], n = 21; and Kalodont Multi Repair [control], n = 20). Tooth color and color change were evaluated using a spectrophotometer (CIELAB coordinates, ΔEab*, ΔE00, whiteness index change [ΔWID]). Measurements were performed at baseline, 30 days and 60 days after the beginning of treatment, and 30 days after completing treatment - follow-up. Side effects and satisfaction with the whitening outcome were reported throughout the questionnaire. RESULTS: The results for ΔL*, Δa*, and Δb* showed an increase in lightness and decrease in yellowness for all tested whitening toothpastes compared to the control group after 30 days of use (p ≤ 0.05). Also, significant tooth color difference (ΔEab*, ΔE00) and whiteness index change (ΔWID) were recorded for all tested whitening toothpastes 30 days and 60 days from the beginning of use (p ≤ 0.05). Toothpaste containing a combination of urea peroxide and enzyme ingredients (SEW) demonstrated the highest and the longest whitening effect. CONCLUSIONS: Whitening toothpastes can show perceptibly whitening effect after a short time of usage, but without a long-lasting impact. CLINICAL RELEVANCE: Toothpaste containing a combination of enzymes and peroxides showed the best whitening performance compared to those containing only enzymes, peroxides, or abrasives. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04460755.

Application of optical illusion in stomatological aesthetics / 口腔疾病防治

@#Optical illusion refers to the phenomenon in which the scene observed by the human eye is not completely consistent with the objectively presented scene. Optical illusions in stomatology, as well as their clinical application, are demonstrated in this paper in terms of shade, shape and aesthetic design. Shade is not only affected by the optical illusions with which it is associated, such as color metamerism, color constancy and the Chevreul illusion, but also influenced by the surroundings. It is suggested that the surrounding lighting during veneering should be the same as that during color matching in the clinic. As indicated by the Poggendorf illusion and the Leaning Tower illusion, the practice should be conducted and checked from multiple perspectives to compensate for the limitation of human eyes, such as intraoral scanning. Other digital technologies, including digital facial scanning and cephalometric measurement, could be used to reduce the subjective influence of observation. In terms of esthetic design, the interaction of the part and the whole, suggested by Ebbinghaus illusion, should be considered: an individual harmony smile should be designed considering the characteristics of the personality and the features of the face, lips, teeth and gingiva of the patient. Furthermore, personal information, such as gender and age, should be taken into consideration in beautification presentation. Further research should be focused on the influence of optical illusions in stomatology in more details. More communication among doctors, technicians and patients is needed. Clinicians should be aware of the impact of optical illusions to reduce subjective bias in clinical standardized operations and further take advantage of optical illusions to create beautification presentations of dental restorations and smiles.