Abstract
This study aimed to investigate and compare the reliability and accuracy of tooth shade selection in the model using 30 milled crowns via five methods: (1) digital single-lens reflex (DSLR) camera with twin flash (TF) and polarized filter (DSLR + TF), (2) DSLR camera with a ring flash (RF) and polarized filter (DSLR + RF), (3) smartphone camera with light corrector and polarized filter (SMART), (4) intraoral scanner (IOS), and (5) spectrophotometer (SPEC). These methods were compared with the control group or manufacturer’s shade. The CIE Lab values (L, a, and b values) were obtained from five of the methods to indicate the color of the tooth. Adobe Photoshop was used to generate CIE Lab values from the digital photographs. The reliability was calculated from the intraclass correlation based on two repetitions. The accuracy was calculated from; (a) ΔE calculated by the formula comparing each method to the control group, (b) study and control groups were analyzed by using the Kruskal–Wallis test, and (c) the relationship between study and control groups were calculated using Spearman’s correlation. The reliability of the intraclass correlation of L, a, and b values obtained from the five methods showed satisfactory correlations ranging from 0.732–0.996, 0.887–0.994, and 0.884–0.999, respectively. The ΔE from all groups had statistically significant differences when compared to the border of clinical acceptance (ΔE = 6.8). The ΔE from DSLR + TF, DSLR + RF, SMART, and SPEC were higher than clinical acceptance (ΔE > 6.8), whereas the ΔE from IOS was 5.96 and all of the L, a, and b values were not statistically significantly different from the manufacturer’s shade (p < 0.01). The ΔE of the DSLR + RF group showed the least accuracy (ΔE = 19.98), whereas the ∆E of DSLR + TF, SMART, and SPEC showed similar accuracy ∆E (ΔE = 10.90, 10.57, and 11.57, respectively). The DSLR camera combined with a ring flash system and polarized filter provided the least accuracy. The intraoral scanner provided the highest accuracy. However, tooth shade selection deserves the combination of various techniques and a professional learning curve to establish the most accurate outcome.
Highlights
Aesthetics is one of the highest esthetic concerns and most challenging factors for dental practitioners [1,2,3]
To estimate the sample size based on previous data by using the independent samples t-test under 80% power, 22 samples could be used for the accuracy testing
The accuracy was calculated from; (a) ∆E calculated by the formula comparing each method to the control group, (b) study and control groups were analyzed by using the Kruskal–Wallis test, and (c) the relationship between study and control groups were calculated using Spearman’s correlation at a 95% significance level
Summary
Aesthetics is one of the highest esthetic concerns and most challenging factors for dental practitioners [1,2,3]. To address the esthetic concern of the patient, a proper treatment plan, treatment technique, and communication is important. Technologies for color matching have been developed to increase the efficiency of esthetic restoration the accuracy, reproducibility, and communication. Current clinical techniques for tooth color determination in dentistry could be visual techniques and instrumental techniques. Visual tooth color determination is the standard and the most generally used technique due to its simplicity and cost-effectiveness [4,5]. The color determination accomplished by the visual method is usually applied by various standards, represents subjective outcomes, and mainly depends on the effectiveness of the human eyes. Despite the effectiveness of the human eye which can perceive a small color difference, the complexity of perception is not always infallible. Numerous factors need to be taken into account such as individual factors including observer’s age, sex, experience, color perception, eye fatigue, and environmental factors including the light source, location, and degree of light intensity [4,5,6,7]
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