Visual Evaluation Research Articles

Effectiveness of ultrasound-guided hip injections on pain and functioning in patients with hip osteoarthritis: A systematic review

Background Osteoarthritis is the most common form of arthritis, causing pain, functional disability, and a reduction in terms of quality of life. Minimally invasive treatments like intra-articular hip injections are a therapeutic option and ultrasound guidance might improve the results of these injections. Objective To summarize the evidence about the effectiveness of ultrasound-guided hip injections in terms of pain and functioning in patients affected by hip osteoarthritis. Methods A systematic search of the literature was performed on three electronic databases: PubMed, Cochrane and PEDro, using a specific search strategy. We evaluated for inclusion all articles according to the following participants, intervention, comparison, and outcomes (PICO) model: P) Population: human patients affected by hip osteoarthritis; I) Intervention: intra-articular hip injections performed with a ultrasound-guidance; C) Comparator: sham therapy or every other conservative or oral, non-invasive, minimally invasive or surgical technique; O) Outcome measures: pain assessed by Visual Analogue Scale (VAS) or Numerical Rating Scale (NRS); functional outcomes. Results At the end of the search, 43 articles were included in the review. Several drugs have been considered in the included studies: hyaluronic acid, platelet-rich plasma, corticosteroids, micro-fragmented adipose tissue, bone marrow concentrates, amniotic suspension allograft. Conclusion Ultrasound-guided injections of hyaluronic acid might be effective on pain relief and functioning in patients affected by hip osteoarthritis. Also, other rehabilitative infiltrative techniques (i.e., corticosteroids and platelet-rich plasma) showed a positive effect in the short-term period.

CLP-Net: an advanced artificial intelligence technique for localizing standard planes of cleft lip and palate by three-dimensional ultrasound in the first trimester

BackgroundEarly diagnosis of cleft lip and palate (CLP) requires a multiplane examination, demanding high technical proficiency from radiologists. Therefore, this study aims to develop and validate the first artificial intelligence (AI)-based model (CLP-Net) for fully automated multi-plane localization in three-dimensional(3D) ultrasound during the first trimester.MethodsThis retrospective study included 418 (394 normal, 24 CLP) 3D ultrasound from 288 pregnant woman between July 2022 to October 2024 from Shenzhen Guangming District People’s Hospital during the 11–13+ 6 weeks of pregnancy. 320 normal volumes were used for training and validation, while 74 normal and 24 CLP volumes were used for testing. Two experienced radiologists reviewed three standard lip and palate planes (mid sagittal, retronasal triangle, and maxillary axial planes) as ground truth (GT) and the CLP-Net was developed to locate these planes.ResultsIn normal test set, mean angle(± SD)° and distance(± SD)mm differences were 6.24 ± 4.83, 9.81 ± 5.48, 15.36 ± 18.14 and 0.86 ± 0.72, 1.36 ± 1.15, 1.96 ± 2.35 for MSP ± SD, RTP ± SD and MAP ± SD, NCC and SSIM were 0.931 ± 0.079, 0.819 ± 0.122, 0.781 ± 0.157 and 0.896 ± 0.058, 0.785 ± 0.076, 0.726 ± 0.088 respectively. In the CLP cases, there were 8.61 ± 5.52, 10.67 ± 5.08, 16.91 ± 17.42 and 1.03 ± 1.20, 1.17 ± 1.08, 1.34 ± 0.95 for mean angle and distance in MSP, RTP, and MAP, respectively. NCC and SSIM were 0.876 ± 0.104, 0.803 ± 0.084, 0.793 ± 0.089 and 0.841 ± 0.105, 0.812 ± 0.085, 0.764 ± 0.100, respectively. CLP-Net predictions had a highly visual acceptance rate among radiologists (MSP: 95%, RTP: 70%, MAP: 70%), with improved localization speed 15s(31.3%) for senior radiologists and 63s(38.9%) for junior radiologists.ConclusionsCLP-Net accurately locates three planes for CLP screening, aiding radiologists and enhancing the efficiency of ultrasound examinations.

Atrazine sensitivity varies among soybean cultivars

AbstractAtrazine carryover from application to a monocot crop may adversely affect soybean (Glycine max (L.) Merr.) grown in rotation. Here, we tested the hypothesis that genotype selection could reduce atrazine carryover damage to soybean. Five commercially relevant soybean varieties were evaluated for differences in sensitivity to a range of atrazine rates using visual ratings, photosynthetic, and biomass parameters. Visual injury ratings and photosynthetic gas exchange, chlorophyll fluorescence, relative chlorophyll content (SPAD), and aboveground biomass were measured during vegetative stages. Under 9.0 g a.i. ha−1 atrazine, SH 5515 LL exhibited visual injury and aboveground fresh biomass reduction but was unaffected in net photosynthesis rate (A) and effective quantum yield of photosystem II (ϕPSII) compared to controls. By 21 days after emergence (DAE), P53A67X recovered in A and ϕPSII, and AG56X8 recovered in SPAD. S52RS86 remained unaffected visually and photosynthetically at this atrazine rate. All genotypes treated with 179.2 g a.i. ha−1 atrazine showed higher injury ratings and lower SPAD, A, and ϕPSII after 7 DAE and lower aboveground biomass 21 DAE except S52RS86, which was similar in SPAD throughout. Atrazine at 358.4 and 716.8 g a.i. ha−1 caused plant death in all genotypes 14 DAE. Visual ratings were strongly correlated with photosynthetic measurements and aboveground biomass at each sampling. Soybean atrazine sensitivity is a function of atrazine concentration in the soil and genotype‐specific tolerance or recovery ability, indicating that growers can select soybean genotypes that reduce risk when atrazine carryover is suspected.

MECHANISTIC OVERLAY DESIGN PROCEDURES FOR RIGID PAVEMENTS

The review of currently available overlay design methods indicates that these may be grouped in three categories: those based on a visual condition rating, those using NDT deflections and empirically derived relationships between allow­ able deflection and overlay needs, and semi­ rational procedures using stress analysis. The more promising of these procedures were subjected to detailed analysis and compared using data from a variety of projects. The result of this analysis show that none of the existing models is very satisfactory and that a new overlay design procedure is needed, This paper presents the formulation of a method that attempts to overcome the difficulties and limitations of current methods. The proposed method utilizes both NDT and visual condition evaluation as well as limited destructive and laboratory testing to evaluate existing pavement condition. A coupled FEM-multilayer elastic subgrade program is used in stress analysis, and the amount of overlay is determined based on limiting formation of load-induced fatigue cracking. This program will be used in a re-examination of the MSHO Road Test data as well as other available performance data to identify and correlate available field data with a performance distress function. Reflection cracking analysis incorporating load-induced shear as well as temperature induced stresses (both horizontal and curling stresses) will be used to minimize the probability of reflective crack formation.

Evaluation of Hair Growth Promoting Activity of Standardized Soybean Extract on Testosterone-Induced Alopecia.

Millions of men and women suffer from alopecia, especially androgenic alopecia (AGA), which is considered the most common form of hair loss. The available treatments for hair loss include multiple approaches, with the most popular being synthetic drugs including minoxidil and finasteride, in addition to natural products. However, synthetic drugs have shown many undesirable side effects, on the contrary, the specifications of the commonly used natural drugs have not been reported in most of the previous studies, despite the high market preference for them. One of these natural drugs is soybean (Glycine max), an economically important bean that has been reported in several studies to effectively prevent hair loss in humans and is widely used in many products treating alopecia. However, no reports were traced on the specification and standardization of the used soybean extract, which may lead to unreproducible results. Thus, in this study, we investigated the effects of different concentrations; 1%, 3%, and 5% (v/v) of a specified soybean extract (SSE) in coconut oil, using a testosterone-induced model of alopecia in adult male Wistar rats in comparison with a 2% finasteride solution. Visual and microscopical evaluations of follicular diameter, length, and density were performed. The data showed that 5% of SSE exhibited the highest activity with results comparable to standard 2% finasteride for hair diameter, length, and density, which could be attributed to the extract's isoflavone content. Genistin and diadzin isoflavones were isolated from the ethyl acetate fraction of the SSE. The total extract was standardized using high-performance liquid chromatography using genistin as a marker and showed a content of 6.2 µg/mL. Accordingly, the formulated 3% and 5% SSEs (containing 0.186 and 0.31 µg/mL of genistin, respectively) could be considered as a promising natural treatment for AGA.

A Comparative Study of the Compressed SENSE Accelerated Fat-suppressed 3D-turbo Spin Echo Sequence Method and Conventional Fat-suppressed 3D-TSE Method for Lingual Neurovascular Bundle Visualization

This study aimed to compare the compressed SENSE (C-SENSE) accelerated fat-suppressed 3D-turbo spin echo (TSE) method and the conventional SENSE accelerated fat-suppressed 3D-TSE method to examine the usefulness of C-SENSE technology in reducing imaging time. Fat-suppressed 3D-TSE using either C-SENSE or SENSE technology was utilized to capture consecutive preoperative images of 34 patients with tongue cancer. SNR, CNR, and visual evaluation were then used to compare both types of technology. No significant differences were observed in the SNR and CNR values between SENSE (SNR=21.8±7.5, CNR=27.2±8.9) and C-SENSE (SNR=20.1±5.2, CNR=25.6±8.4) (p=0.168 and p=0.125, respectively). C-SENSE reduced the imaging time of the oral cavity by approximately 30% while maintaining the same image quality when using the fat-suppressed 3D-TSE method.

Mind Drifts, Data Shifts: Utilizing Mind Wandering to Track the Evolution of User Experience with Data Visualizations.

User experience in data visualization is typically assessed through post-viewing self-reports, but these overlook the dynamic cognitive processes during interaction. This study explores the use of mind wandering- a phenomenon where attention spontaneously shifts from a primary task to internal, task-related thoughts or unrelated distractions- as a dynamic measure during visualization exploration. Participants reported mind wandering while viewing visualizations from a pre-labeled visualization database and then provided quantitative ratings of trust, engagement, and design quality, along with qualitative descriptions and short-term/long-term recall assessments. Results show that mind wandering negatively affects short-term visualization recall and various post-viewing measures, particularly for visualizations with little text annotation. Further, the type of mind wandering impacts engagement and emotional response. Mind wandering also functions as an intermediate process linking visualization design elements to post-viewing measures, influencing how viewers engage with and interpret visual information over time. Overall, this research underscores the importance of incorporating mind wandering as a dynamic measure in visualization design and evaluation, offering novel avenues for enhancing user engagement and comprehension.

Transformative approaches for clinical trials in ophthalmology: Virtual reality as a metric for functional vision in inherited retinal diseases

Determining the efficacy of therapeutic interventions in ophthalmology requires not only the assessment of retinal structure and visual function but also a comprehensive evaluation of functional vision. Functional vision pertains to the patient's capacity to execute essential, vision‐dependent tasks, thereby maintaining autonomy. Traditional measures like visual acuity, contrast sensitivity, and visual field evaluations can fall short in encapsulating the full spectrum of visual deficits experienced by patients. To address this gap, translational researchers are increasingly focusing on developing performance outcomes (PerfOs) that provide a holistic measure of the therapy's impact on daily life activities.PerfOs are designed to strike a balance between measurement precision, relevance to the patient's daily life, and ecological validity, all while being adaptable for use in multicenter studies. A promising approach to achieving these objectives is the use of virtual reality (VR) for performance assessment. VR offers unparalleled control over experimental conditions, such as lighting, and enables rapid, objective behavioral measurements. Additionally, its reproducibility across various assessment centers and the safety it provides to participants make VR an ideal tool for this context.In this presentation, we introduce two innovative PerfOs developed for inherited retinal diseases, employing VR to enhance clinical endpoint accuracy in ophthalmology. The first is a mobility test, validated extensively in both real‐world and virtual settings. It demonstrates high reproducibility and reliability, effectively differentiates between retinitis pigmentosa patients and healthy controls, and accurately categorizes disease stages. The second is a VR‐based visual search task, specifically designed for the same patient population. These studies collectively affirm the potential of VR in establishing novel, meaningful clinical endpoints, significantly advancing the field of ophthalmology and enhancing patient‐centric care.

Evidence for the dependence of visual and kinesthetic motor imagery on isolated visual and motor practice.

Motor imagery (MI) is a cognitive process believed to rely on the representation developed through experience. The equivalence between MI and execution has been questioned and the relationship between experience types and MI is unclear. We tested how observational and physical practice of hand gesture sequences impacted visual and kinesthetic MI and transfer to the unpracticed effector. Three groups (n = 22/gp.); no-vision physical practice, observational practice and no-practice control, practiced and visually and kinesthetically imagined performing the sequences. MI was assessed using mental chronometry, a movement time (MT) congruency measure and subjective ratings. Physical practice improved kinesthetic MI ratings and observational practice improved visual MI ratings. Contrary to predictions, physical practice did not enhance timing congruency. Imagined MTs were longer in transfer after physical practice, suggesting MI was not based on the same representation. These data question ideas of equivalence, with poor temporal matching after no-vision physical practice.

Audible tremor: Analysis of the validity of audible information in assessing tremor severity.

Assessing the severity of kinetic tremor is important in clinical and research settings. Archimedes spirals are often used to assess tremor severity. Rating tremor from spirals has been based solely on visual information. However, one can often "hear" tremor. We evaluated the type of information that could be gained from hearing tremors and assessed its validity using visualized tremor as a gold standard. 52 essential tremor cases (94 spirals), 11 Parkinson's disease patients and 11 controls (20 spirals each) were enrolled. During videotaping, cases drew Archimedes spirals in a standardized manner. Three experienced movement disorders neurologists first listened to videotaped spiral drawing (no visual) and assigned a tremor severity rating using Washington Heights Inwood Genetic Study of Essential Tremor (WHIGET) ratings (0, 0.5, 1, 1.5, 2, 3). Later, the neurologist rated the physical (i.e., visual) spiral and assigned a WHIGET tremor rating. The Spearman's correlation coefficient (visual vs. auditory rating) was 0.721 (p<0.001) and the weighted kappa statistic was 0.674, a level of agreement that is considered good. Auditory information provides in-time synchronous corroboration of what the rater is seeing. That is, it informs the visual data and provides construct validity. The results of this study have ramifications for observational and experimental therapeutic studies, which commonly rely on videotaped tremor examinations. Additional corroborative information is available if the sound is left on. Regardless of the decision to present sound to the rater or not, clear instructions and a standardized practice within the study are imperative.

Comparing membrane peeling techniques in lamellar macular hole surgery: A systematic review and meta‐analysis

Aims: To compare outcomes of standard and alternative membrane peeling techniques in LMH surgery.Methods: A systematic review and meta‐analysis was performed per the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Pairwise meta‐analysis of mean change in best corrected visual acuity (BCVA as logMAR) and LMH closure rate between flap embedding (FE) and standard peeling (ST) were conducted. A proportional meta‐analysis evaluated FTMH prevalence for each technique.Results: 36 studies of 1200 eyes were included. Three techniques were identified: ST (29 studies), FE (7 studies) and fovea‐sparing peeling (4 studies). FE was superior to ST in BCVA change (MD ‐0.21; CI ‐0.33 to ‐0.10), LMH closure (RR 1.53; CI 1.23–1.90) and postoperative FTMH (RR 0.08; CI 0.01 to 0.58). LMH closure rate was higher (0.97; CI 0.88 to 0.99 vs. 0.81; CI 0.70 to 0.88) in alternative vs. ST, with postoperative FTMH occurring only in ST peelings (0.026; CI 0.013‐0.054).Conclusions: Alternative peeling techniques have superior outcomes. Further randomized controlled studies are needed to confirm their efficacy and innocuity.

Effectiveness of the ARTHE-e app for exercise adherence in people with knee osteoarthritis: protocol for a randomised controlled trial

IntroductionOsteoarthritis, the most prevalent joint disease, poses a significant challenge due to its progressive nature and impact on the whole joint and periarticular structures. Although exercise is crucial for symptom...

A Consistent Decision Support System for Interpreting of Magnetocardiographic Data as a Tool to Improve the Acceptance of Magnetocardiography in Clinical Practice

Magnetocardiography undoubtedly has exceptionally high sensitivity to electrophysiological changes in the myocardium. This is an absolutely non-invasivemethod with no contraindications. However, several barriers exist to the widespread adoption of this technique into clinical routine. One of the most important is the lack of a clear and consistent medical algorithm for interpreting magnetocardiographic data, leading to a clinically significant decision. The article outlines the main clinical questions clinicians pose using the magnetocardiography method. Methods for assessing the degree of abnormality of the results of a magnetocardiographic study and differential diagnosis based on the analysis of CDV maps are described in detail. Both methods for visual evaluation of sets of these maps and automatic decision rules based on linear discriminant analysis and pattern recognition are characterized. Also, techniques are described for localizing the pathological changes in the myocardium. As an example of using the developed system for interpreting magnetocardiographic data, the results of two multicenter studies in which this system of interpretation of MCG studies was used are presented. СONCLUSION: The magnetocardiographic examination is reliable for diagnosing chronic coronary heart disease, including in difficult-to-diagnose cases. A consistent system for interpreting of magnetocardiographic data allows medical practitioners to easily master the MCG technology and obtain the correct examination result.

Developing soil quality indices to investigate degradation impacts of different land use types in Northern Ethiopia.

Assessing soil quality is imperative to diagnose soil functioning and recognize inappropriate soil managements. However, the absence of defined indicators and their scoring methods and lack of universally accepted soil quality indexing frameworks complicate soil quality assessment, given soil systems complexity and diversity caused by variation in soil formation factors. This study was aimed to assess soil quality of three land use managements (CL, cropland; GR, grassland; SL, shrubland) in Northern Ethiopia, using two data sets (Total data set (TDS) and minimum data set (MDS)), linear and non-linear indicator transformation techniques and three indexing scenarios (Additive (SQIa), nemoro (SQIn) and weighted additive (SQIw)). To screen MDS and TDS members, one-way analysis of variance and principal component analysis were applied. Twenty-two soil indicators responsible to changes in land use were screened as members of TDS. Four indicators (silt, mean weight diameter, visual evaluation of soil structure, and exchangeable calcium) were selected to establish MDS. The study results demonstrated a clear impact by land use managements to SQ in the study area. In all cases, CL soils scored significantly lower SQI values than those of GL and SL. Moderate (III) and low (IV) quality grade soils have the largest spatial share in the area. Soil organic carbon and structural stability were found to be the most important indicators explaining soil quality and its spatial variability. Overall, it was demonstrated by the study that soil quality deterioration is a serious issue particularly for soils in CL and GL, suggesting the essentiality to consider revisions and improvements in soil management. A positive and significant correlation was demonstrated among SQIs, revealing that all SQIs were sensitive to measure land use management impacts to soil quality. However, SQI was estimated and differentiated better when using non-linear indicator transformation and MDS indicator selection approach in the SQIw (SQI_NLw_MDS) than other SQIs, and thus was suggested for future soil quality studies in areas of similar soil and climate environments.

Visualization of Right Adrenal Vein in Non-Contrast-Enhanced MDCT and Its Guiding Role for Right Adrenal Venous Sampling.

This study aimed to evaluate the visualization of right adrenal vein (RAV) in non-contrast-enhanced multi-detector computed tomography (MDCT) and its guiding role for right adrenal venous sampling (AVS) in patients with primary aldosteronism (PA). A total of 237 patients diagnosed with PA who underwent successful AVS procedures from January 2020 to March 2021 were retrospectively analyzed. The non-contrast-enhanced MDCT image features of RAV included the degree of visualization and the position of RAV orifice. Subsequently, the concordance degree between RAV in non-contrast-enhanced MDCT and AVS images was calculated to evaluate its guiding effect for right AVS. The visualization rate of RAV in non-contrast-enhanced MDCT was 81.9% (n=194), with 73.7% (n=143) clearly displayed and 26.3% (n=51) generally displayed. In 6.2% (n=12) of patients who can display RAV, RAV formed a common trunk with the accessory hepatic vein and then merged into the inferior vena cava. Non-contrast-enhanced MDCT revealed that RAV orifice was located between the 10th thoracic vertebra (T10) and the 1st lumbar vertebra (L1), with 85.1% (n=165) located from the lower 1/3 of T11 to the lower 1/3 of T12. The concordance of imaging anatomy of RAV between non-contrast-enhanced MDCT and AVS image was found to be at a high rate of 94.3% (n=183). Non-contrast-enhanced MDCT provides excellent visualization of RAV and clearly depicts its anatomical characteristics. Furthermore, RAV images obtained from non-contrast-enhanced MDCT are highly consistent with those from AVS, indicating that interpretation of non-contrast-enhanced MDCT before AVS can reduce the failure rate of RAV cannulation.

Improving sonographic visualisation of the appendix in a regional referral hospital

Ultrasound is a first-line and often preferred imaging modality in the diagnosis of acute appendicitis. When the appendix is not visualised during a dedicated appendix ultrasound study, patients may require...

MGLI-Former: a multi-scale and global-local information interactive attention transformer for urban shantytown extraction

ABSTRACT Shantytowns, characterized by poor living conditions and simple houses, necessitate efficient extraction and analysis for urban planning. This paper proposes a multi-scale and global-local information interactive attention transformer (MGLI-Former) for shantytown extraction from high-resolution remote sensing images. First, the multi-level feature fusion block (MLFFB) integrates neighborhood encoding features to prevent the loss of small-target shantytowns. Second, joint global and local information transformer blocks (JGLB) effectively combine global and local features. Finally, boundary and feature joint optimization loss (BF-Loss) refines the output by edges and high-level semantics. Experiments in Beijing and Shanghai demonstrate the MGLI-Former achieved optimal visual and quantitative extraction evaluations. The F1-score, IoU, Precision, and Recall are 86.92%, 76.87%, 86.84%, 87.01% and 72.33%, 56.66%, 69.29%, 75.65%, respectively. Furthermore, the use of UIS-Shenzhen datasets and fine-tuning experiments with mixed datasets further validate the robustness and generalization capabilities of MGLI-Former. Moreover, spatial and landscape patterns of shantytowns in Beijing and Shanghai reveal: (1) Beijing’s shantytowns radiate uniformly from the old city center, whereas Shanghai exhibits a multi-core diffusion pattern. (2) Shanghai's shantytown distribution is clustered, while Beijing's shantytown distribution is more uniform. MGLI-Former demonstrates the potential for extracting shantytowns and has significant urban planning and management implications.

Analisis Tingkat Kerusakan Jalan Menggunakan Metode PCI dan Strategi Penanganannya Pada Ruas Jalan Meulaboh-Tutut

The analysis of road damage levels on the Meulaboh-Tutut road segment is crucial in determining effective maintenance priorities. This study aims to evaluate the damage levels on the Meulaboh-Tutut Road at KM 19 in Kaway XVI District, West Aceh Regency, using the Pavement Condition Index (PCI) method. The PCI method is a visual evaluation technique that provides an objective assessment of pavement conditions based on the type of damage, the area affected, and the severity of the damage. The PCI scale ranges from 0 to 100, where a PCI of 100 indicates total failure, while a score of 0 denotes a pavement in perfect condition. Field surveys revealed that the dominant types of damage in this road segment are alligator cracking, potholes, and subsidence. The average PCI score for this road section is recorded at 43.25, placing it in the "fair" category and indicating the need for intensive maintenance to restore road functionality. Detailed analysis shows variations in conditions across different road segments, with the lowest PCI score of 0 in certain segments indicating a perfect road, while the highest PCI score of 98.5, recorded between STA 0+350 and STA 0+400, indicates severe or complete failure. Based on the observed damage conditions, recommended repair strategies include the P5 and P6 repair methods for potholes, the P2 and P5 methods for alligator cracking, and the P5 and P6 methods for subsidence. These repair methods follow guidelines from the Ministry of Public Works, Directorate General of Highways, No. 001-01/M/BM/2011.

Color Response of Turfgrass Cultivars to Gibberellic Acid under Mediterranean Climate Conditions

Plant growth regulators (PGRs) are broadly used in turfgrass management. Gibberellic acid is also applied in many plants due to its positive effects on plant growth and development. However, some studies have indicated that these applications may have a negative effect on color. The study aimed to find out the effect of different doses of gibberellic acid applications on visual quality in different turfgrass species. Gibberellic acid was applied as control, 0.05 and 0.1 kg ha-1. Among the turfgrass species, twenty different cultivars of 4 different species were used as material in the experiment. Visual quality was assessed using a visual rating system. Color quality was examined using a spectrophotometer. In general, the use of gibberellic acid had negative effects on visual quality. Although there are studies showing that it increases resistance to stress conditions, visual quality is very important for turfgrasses. It was observed that grass species have different responses to gibberellic acid.

Shade Modulation Ability of Direct vs. Direct–Indirect Prepless Composite Veneers

ABSTRACTObjectiveAssess the shade modulation ability of direct–indirect prepless composite veneer using distinct composite resins and cement shades by instrumental and visual assessments.Materials and MethodsA total of 270 samples of direct and direct–indirect composite veneers were fabricated using three composite resins (3M Filtek Supreme Ultra A1B, Tokuyama Omnichroma, Transcend Universal) over a 3D designed mold in 10 × 10 mm cuboid shape with three depth cuts on the surface (0.3, 0.5, and 0.7 mm) to stimulate the veneer preparation and bonded using Ivoclar Variolink Esthetic LC neutral and light cement shades over a standard C4 shade substrate. Measurements were gathered through instrumental assessment by spectrophotometry and through visual assessment by four dental professionals. Color differences (ΔE00) were calculated according to the CIEDE2000 formula. Statistical analysis was conducted using three‐way ANOVA followed by the Tukey test.ResultsThe ΔE values were influenced by the technique (p &lt; 0.001), thickness (p &lt; 0.001), and type of composite resin (p &lt; 0.001). Cement shades were not statistically significant in the final shade of the direct–indirect technique (p = 0.168). There was no mismatch in the visual assessment between the direct–indirect samples compared to the direct samples.ConclusionThere is a difference in the final shade between the direct and direct–indirect techniques in the instrumental but not in the visual evaluation. The two cement shades used did not influence the final shade of the composite veneers.