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Digital tools to improve shade selection

The adoption of digital technology is minimizing the human errors in shade selection. (Photo: Pexels/Karolina Grabowska)

Fri. 4 November 2022

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Dentistry is adopting computer technology & newer digital tools in multiple areas, including shade matching to minimize or eliminate human errors.

Patients today are more aware of their esthetic appearances and are very particular when restoring their anterior teeth. Similarly, for a dentist, the aesthetics of the oral cavity is the main factor of concentration along with treating the pathology. The satisfaction rate of the patient is high when the site at which the dentist has worked is brought back to its standard form to retain the originality of the oral cavity. A restoration’s esthetic makeup includes the shape and color matching with the adjacent teeth.

Shade matching is one of the most critical factors for an esthetic restoration. The capability to correctly match the shade of the teeth to the shade guide is a vital step in the treatment process. This critical step today is mainly done with the help of human eyes.

Visual shade selection by various shade guides in the market is influenced by many external factors like surrounding illumination, environment, dentist’s judgment, and patient factors. Moreover, currently available shade guides manufactured by various companies differ from each other in hue, value, and chroma.

Dentists are now moving towards computer technology to improve their routine procedures to minimize or eliminate human errors. Electronic shade-matching devices include spectrophotometers, colorimeters, digital color analyzers, or combinations.

A spectrophotometer is the most accurate for absolute color measurement of all devices. The new spectrophotometer for shade selection is the VITA Easyshade system [1], a handheld device using electronic, optical measurements. This device is superior in reading and analyzing color giving the correct match that is more accurate than the visual shade selection.

Studies have compared the VITA Easyshade system with visual shade selection systems where shade matching was performed under similar conditions and during the same time of day. It was considered a “match” if the visual evaluator’s choice matched the machines’ reading. The results showed that the machine was accurate 97.5% of the time. However, at a 95% confidence interval, one can be sure that 95% of the time, the machine will not perform below 92.7% matching the visual method. The Vita Easyshade spectrophotometer is thus popular for its repeatability, reliability, accuracy, and ease of use.

Recently, a smartphone application was developed with the JAVA programming language [2] using a total of 1300 shade tab images captured using a smartphone camera. Color features were extracted and classified using the nearest neighbor classification algorithm to form a software training dataset. The software matching accuracy gives 70% matching compared to the visual method, which gives 65 % matching accuracy. This smartphone application proved that digital photography could emerge as a viable alternative to spectrophotometers for shade selection in a clinical setup. Some smartphone applications are DMP Dental Chromatcher, Shadent [3], SMART, DTSR, Tshade [4], and Denthue.

An improper shade selection is considered the second most common reason for a remake of restorations, the primary reason being issues with tooth preparation and impressions [5]. Correctly evaluating tooth shade is as much an art as a science. So we can make small changes in the process by implementing electronic ways or smartphone applications to match shade along with the visual tools of shade selection, which will make a big difference in the treatment outcome and increase the procedure’s success rate along with patient satisfaction.

References:

1) Nafea, I., Alharbi, A., Abduh, A., Alharbi, A., & Mousa, R. (2019). Color shade matching by mobile applications in dental practice: An experimental comparative in-vitro double-blind study. The Saudi Dental Journal. doi:10.1016/j.sdentj.2019.02.006
2) Fayed, A., Mohamed, H., Othman, H. (2022). A Comparison between visual shade matching and digital shade analysis system using K-NN algorithm. Al-Azhar Journal of Dental Science, 25(2), 133-141. doi: 10.21608/ajdsm.2021.85035.1211
3) Raza FB, Kumar VA, Jacob A, Ali A. Assessment of a smartphone-based software application as a potential digital tool in tooth shade selection: a prospective clinical study. Quintessence Int. 2021 Jun 9;52(7):608-617. doi: 10.3290/j.qi.b1044157. PMID: 33688711.
4) Moussa, R. (2021). Dental Shade Matching: Recent Technologies and Future Smart Applications. In Journal of Dental Health and Oral Research (Vol. 02, Issue 01). Athenaeum Scientific Publishers. https://doi.org/10.46889/jdhor.2021.2103
5) Maclaren EA (2010). Shade analysis and communication-essential aspect of evaluating and communicating tooth color in practice. Inside Dentistry 2010;6:58-67.

Editorial note:

Dental Tribune South Asia had earlier published an interview with Dr. Sachin Chaware, the creator ‘Denthue’ shade selection app.

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