By: Lee Ann Brady DMD
This topic originally appeared on Pankey.org: Dr. Brady allowed permission for igniteDDS to share with our readers.
Determine Value Before Chroma and Hue
Shade matching is one of the biggest challenges for dentists when it comes to composite restoration. It requires a great knowledge of color science and playing with enamel and dentin shades to achieve a seamless restoration.
Cosmetic dentistry has gained wide importance among both dentists and patients who want esthetic results that symmetrically blend with adjacent teeth.
We see different colors and shades, based on the reflection of the light on different substrates, such as tooth, enamel, and dentin.
Shade matching should be done in a systematic order, that includes value, chroma, and hue, ensuring accuracy, natural-looking teeth, and predictable results which are absolutely important in cosmetic dentistry.
Composites 101: Defining ‘Shades’ and Their Components
Before you can begin to choose which aspects of a natural ‘shade’ to preference, it’s integral to delve into the nature of these complex components.
Reflectiveness and translucence combined determine the appearance of a tooth.
Reflective properties are especially important for shade matching because this is the true definition of ‘value.’ Value tends to be defined as the coloring on a range of white to grey, but it’s actually a measure of tooth reflectiveness.
Other esthetic qualities of dentin and enamel include ‘chroma’ and ‘hue’. A classic numeric scale of 1 (lowest) to 4 (highest) is used to judge chroma, which simply refers to the intensity of a color. Hue, on the other hand, is generally deconstructed into the letters A, B, C, and D. These indicate the names of color.
‘Shade’ is simply the end result when all three parameters of value, intensity, and hue are viewed together. The key lesson here is that these parameters must be matched separately. To achieve the best case outcome, you must rank them according to importance.
Layering Composites For Best Shade Match
The layering technique for composite placement is great not just because it lowers the shrinkage stress, but also helps to achieve an esthetically pleasant result. Since enamel and dentin have different molecular compositions and they reflect light differently, showing different shades, we should try to mimic that light reflection with dentin and enamel shade composites also.
Layering is paramount because dentin shades and light properties differ in composites versus real dentin. This is also true for enamel shades. Added to these differences is the fact that dentin and enamel do not have the same amounts of reflectiveness and translucence. Basically, you have dentin and enamel discrepancies between composites and real teeth in addition to the discrepancies that exist between dentin and enamel.
Precision will impact the final appearance of the tooth, so it’s important that you layer composites to get around these discrepancies. The composite materials selected should match for value before chroma and chroma before hue. Because the final value is a blend of the individual values of every composite layer, you must consider that each layer is not going to be representative of your intended value. They build on one another to create life-like reflectiveness and translucency.
A Method You Can Use for Determining Value in Composites
My favorite method for constructing an esthetically superior value is to start the appointment with layering. I plan what composite shades I want to combine ahead of time and work efficiently so that inevitable teeth dehydration doesn’t affect my results.
I layer the materials on the labial of the adjacent tooth in their final thicknesses and photograph the outcome. This allows me to see if my chosen combinations match my esthetic goals and troubleshoot if the composite doesn’t disappear against the tooth.
When I’m not happy with the look, I easily pop the composite of the tooth and re-do the process. I only begin to contemplate chroma and hue once I’ve matched the value.
In Conclusion
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