Examination of Natural Tooth Color Distribution Using Visual and Instrumental Shade Selection Methods

A. Dilek Nalbant 1 , Yeşim Göknur Babaç 2 , İrem Türkcan 3 , Kaan Yerliyurt 4 , Cihan Akçaboy 3  and Levent Nalbant 3
  • 1 Gazi University, Faculty of Dentistry, Department of Prosthodontics, Biskek Cad. 1. Sokak No.4, Emek, Ankara, Turkey, Tel: +90 312 203 41 83, Fax: +90 312 203 41 78
  • 2 Private Practice, Ankara, Turkey
  • 3 Gazi University, Faculty of Dentistry Department of Prosthodontics, Ankara, Turkey
  • 4 Gaziosmanpaşa University, Faculty of Dentistry Department of Prosthodontics, Tokat, Turkey


Aim: Although visual color determination is the most frequently applied method in dentistry, instrumental color analysis offers advantages like objectivity, measurability and rapidity. The aim of this study was to evaluate the natural teeth color in teeth without any restoration visually, and by using a computerized shade measuring and analyzing system in the population.

Materials and Methods: 202 patients were inspected. Before instrumental shade matching visual matching was done by the inspector with Vitapan 3D Master Shade Guide in the day light. Images were taken with computerized shade measuring and analyzing system from patients’ natural right or left maxillary incisors and canines without any restoration. Then these images were evaluated by the original software of its own.

Results: Value differences between visual and instrumental shade matching were statistically significant. Darker value levels were obtained with instrumental measurement. The distribution of hue was more reddish in instrumental examination than visual examination. Significant difference was found at cervical and middle third of the tooth in both visual and instrumental determination of chroma. Chroma of the tooth was higher at these two regions in visual assessment.

Conclusions: Teeth colors were distributed more uniform in visual shade matching compared to instrumental matching. However, some teeth shades were more common in instrumental matching. Value scores were found higher with instrumental shade matching. Individual selection of shades for each tooth and different regions of a tooth instead of a single color is considered to be a factor to increase the success of the restoration.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Dozić A, Kleverlaan CJ, El-Zohairy A, Feilzer AJ, Khashayar G. Performance of five commercially available tooth color-measuring devices. J Prosthodont, 2007; 16:93-100.

  • 2. Ishikawa-Nagai S, Ishibashi K, Tsuruta O, Weber HP.Reproducibility of tooth color gradation using a computer color-matching technique applied to ceramic restorations. J Prosthet Dent, 2005; 93:129-137.

  • 3. Craig RG, Powers JM. Restorative Dental Materials. 11th ed. Philadelphia; Mosby; 2002.

  • 4. Analoui M, Papkosta E, Cochran M, Matis B. Designing visually optimal shade guides. J Prosthet Dent, 2004; 92:371-376.

  • 5. Marcucci B. A shade selection technique. J Prosthet Dent, 2003; 89:518-521.

  • 6. Paravina RD, Powers JM, Fay RM. Color comparison of two shade guides. Int J Prosthodont, 2002; 15:73-78.

  • 7. Ahn JS, Lee YK. Color distribution of a shade guide in the value, chroma, and hue scale. J Prosthet Dent, 2008; 100:18-28.

  • 8. Hammad IA. Intrarater repeatability of shade selections with two shade guides. J Prosthet Dent, 2003; 89:50-53.

  • 9. Corciolani G, Vichi A, Goracci C, Ferrari M. Colour correspondence of aceramic system in two different shade guides. J Dent, 2009; 37:98-101.

  • 10. Yuan JC, Brewer JD, Monaco EA Jr, Davis EL. Defining a natural tooth colorspace based on a 3-dimensional shade system. J Prosthet Dent, 2007; 98:110-119.

  • 11. Paravina RD. Performance assessment of dental shade guides. J Dent, 2009;37Suppl 1:e15-20.

  • 12. Kim-Pusateri S, Brewer JD, Davis EL, Wee AG. Reliability and accuracy of four dental shade-matching devices. J Prosthet Dent, 2009; 101:193-199.

  • 13. Brewer JD, Wee A, Seghi R. Advances in color matching. Dent Clin North Am, 2004; 48:v, 341-58.

  • 14. Kim-Pusateri S, Brewer JD, Dunford RG, Wee AG. In vitro model to evaluate reliability and accuracy of a dental shadematching instrument. J Prosthet Dent, 2007; 98:353-358.

  • 15. Bayindir F, Gozalo-Diaz D, Kim-Pusateri S, Wee AG. Incisal translucency of vital natural unrestored teeth: a clinical study. J Esthet Restor Dent, 2012; 24:335-343.

  • 16. Okubo SR, Kanawati A, Richards MW, Childress S. Evaluation of visual and instrument shade matching. J Prosthet Dent, 1998; 80:642-648.

  • 17. Paul S, Peter A, Pietrobon N, Hämmerle CH. Visual and spectrophotometric shade analysis of human teeth. J Dent Res, 2002; 81:578-582.

  • 18. Hugo B, Witzel T, Klaiber B. Comparison of in vivo visual and computer-aided tooth shade determination. Clin Oral Investig, 2005; 9:244-250.

  • 19. Klemetti E, Matela AM, Haag P, Kononen M. Shade selection performed by novice dental professionals and colorimeter. J Oral Rehabil, 2006; 33:31-35.

  • 20. Derdilopoulou FV, Zantner C, Neumann K, Kielbassa AM. Evaluation of visual and spectrophotometric shade analyses: a clinical comparison of 3758 teeth. Int J Prosthodont, 2007; 20:414-416.

  • 21. Della Bona A, Barrett AA, Rosa V, Pinzetta C. Visual and instrumental agreement in dental shade selection: three distinct observer populations and shade matching protocols. Dent Mater, 2009; 25:276-281.

  • 22. Browning WD, Chan DC, Blalock JS, Brackett MG. A comparison of human raters and an intra-oral spectrophotometer. Oper Dent, 2009; 34:337-343.

  • 23. Judeh A, Al-Wahadni A. A comparison between conventional visual and spectrophotometric methods for shade selection. Quintessence Int, 2009; 40:e69-79.

  • 24. Gómez-Polo C, Gómez-Polo M, Celemin-Viñuela A, Martínez Vázquez De Parga JA. Differences between the human eye and the spectrophotometer in the shade matching of tooth colour. J Dent, 2014; 42:742-745.

  • 25. Bahannan SA. Shade matching quality among dental students using visual and instrumental methods. J Dent, 2014; 42:48-52.

  • 26. Kröger E, Matz S, Dekiff M, Tran BL, Figgener L, Dirksen D. In vitro comparison of instrumental and visual tooth shade determination under different illuminants. J Prosthet Dent, 2015; 114:848-855.

  • 27. Alshiddi IF, Richards LC. A comparison of conventional visual and spectrophotometric shade taking by trained and untrained dental students. Aust Dent J, 2015; 60:176-181.

  • 28. Imbery TA, Geissberger M, Hakim F, Al-Anezi S, Uram- Tuculescu S, Gottlieb R, Estrich CG. Evaluation of four dental clinical spectrophotometers relative to human shade observation. J Am Dent Assoc, 2013; 144:1183-1186.

  • 29. Tung FF, Goldstein GR, Jang S, Hittelman E. The repeatability of an intraoral dental colorimeter. J Prosthet Dent, 2002; 88:585-590.

  • 30. Joiner A. Tooth colour: a review of the literature. J Dent, 2004; 32 Suppl1:3-12.

  • 31. Douglas RD. Precision of in vivo colorimetric assessments of teeth. J Prosthet Dent, 1997; 77:464-470.

  • 32. Li Q, Yu H, Wang YN. In vivo spectroradiometric evaluation of colour matching errors among five shade guides. J Oral Rehabil, 2009; 36:65-70.

  • 33. Cho BH, Lim YK, Lee YK. Comparison of the color of natural teeth measured by a colorimeter and Shade Vision System. Dent Mater, 2007; 23:1307-1312.

  • 34. Hasegawa A, Ikeda I, Kawaguchi S. Color and translucency of in vivo natural central incisors. J Prosthet Dent, 2000; 83:418-423.

  • 35. Russell MD, Gulfraz M, Moss BW. In vivo measurement of colour changes in natural teeth. J Oral Rehabil, 2000; 27:786-792.

  • 36. Jahangiri L, Reinhardt SB, Mehra RV, Matheson PB. Relationship between tooth shade value and skin color: an observational study. J Prosthet Dent, 2002; 87:149-152.

  • 37. Dozic A, Kleverlaan CJ, Aartman IH, Feilzer AJ. Relation in color of three regions of vital human incisors. Dent Mater, 2004; 20:832-838.

  • 38. Goodkind RJ, Schwabacher WB. Use of a fiber-optic colorimeter for in vivo color measurements of 2830 anterior teeth. J Prosthet Dent, 1987; 58:535-542.

  • 39. Phelan S. Use of photographs for communicating with the laboratory in indirect posterior restorations. J Can Dent Assoc, 2002; 68:239-242.

  • 40. O’Brien WJ, Hemmendinger H, Boenke KM, Linger JB, Groh CL. Color distribution of three regions of extracted human teeth. Dent Mater, 1997; 13:179-185.


Journal + Issues