A stepwise approach to shade selection in composite restorations. Reference: Art & Science of Restorative Dentistry

1. Shade Selection in Composite Restorations
Prepared by: Wafadar Hussain
Reference: Sturdivant’s Art and Science of Operative Dentistry

2.  Understanding natural shades of teeth
 Why different shades exist naturally
 Understanding shade guides
 Difference between enamel and dentin guides
 Importance of shade selection
 Learning basic principles of good shade selection
 Stepwise Approach to Shade Selection
 Tips and Tricks for good shade selection
 New technologies in shade selection
Learning Objectives

3.  Normally teeth are predominantly white, with
varying degrees of yellow, gray or orange tints.
 The Color also varies with the translucency,
thickness, and distribution of enamel and dentin
and the age of the patient.
 Other factors may also affect the natural coloring
of the teeth such as fluorosis, tetracycline
staining and endodontic treatment.
Natural Shades of Teeth

4. A cross Section of an anterior tooth shows why
color zones exits.
The incisal third (w) has a lighter shade and is
more translucent than the cervical third (y).
Whereas the middle third represented by letter
x blends both shades.
Why different shades exist
Mostly Enamel
Mostly Dentin

5. A universally adopted shade guide is known as
VITA classical shade guide.
Most manufacturers provide shade guides for
their specific materials, which cannot be used
for materials provided by other manufacturers.
Also different manufacturers vary in the
number of shades available.
Because of popularity of bleaching, many
manufacturers also provide very light shades.
Understanding Shade Guides

6. Most composite materials are available in both
enamel and dentin shades.
Enamel shades are more translucent and are
for restoration of incisal edges.
Whereas dentin shades are mostly used for
restoration of cervical areas.
Dentin vs Enamel Shade Guides

7. The success of restorative dentistry is
determined on the basis of both functional and
esthetic results.
Careful shade selection is necessary to provide
patients with an aesthetic restoration that
harmoniously blends to the remaining
dentition.
Good shade selection makes the restoration
appear natural and attractive.
Importance of Good Shade Selection

8. The Patient should be in upright positon,
mouth should be at dentist’s eye level.
Teeth to be matched must be clean.
Remove bright colors from field of view.
Daylight or standard lamps should be used to
determine the shade.
Basic Principles of Shade Selection

9.  Use multiple light sources for confirmation.
 Select the shade before prolonged drying,
because dehydration decreased translucency.
 Quickly confirm the shade to avoid eye fatigue.
 If more time is needed, rest the eyes by looking
away at a blue or violet object for a few seconds.
Basic Principles of Shade Selection

10. 1. Hold the entire shade guide near the
patient’s teeth to determine the general
color.
2. Select a specific shade tab according to the
general color of the teeth.
3. Hold the selected specific shade tab beside
the area of the tooth to be restored.
Stepwise Approach to Shade Selection

11. 4. Verify the final shade selection with the
patient by using a hand mirror.
5. Record the shade in the patients chart.
6. To be more certain of a proper shade
selection, a small amount of selected shade
material can be placed on the tooth near the
area to be restored and cured.
Stepwise Approach to Shade Selection

12. To try and mimic the different shades the tooth
has in it naturally, we can use several different
layers of composite.
For good shade selection hand the patient a
mirror and assess the shade together with the
help of the patient.
Have patients remove lipstick.
Use a neutral bib to cover the patient’s
clothing.
Tips & Tricks for Good Shade Selection

13. Remove staining on adjacent teeth first before
matching shades.
Keep the shade guide at arm’s length.
Check the shade guide against surrounding
teeth as well.
Study the shade guide for short time rather
than extended studies to avoid eye fatigue.
Tips & Tricks for Good Shade Selection

14. Some new digital devices have been
developed to analyze the shade of a
patient’s tooth for most accurate selection.
Some of these devices are mentioned below.
1. Spectrophotometry, e.g. Vita easy shade
2. Colorimeter, e.g. shade vision
3. Digital camera and RGB devices, e.g.
shade scan.
New Technologies in Shade Selection

15. Stepwise Approach to Shade Selection

16. Thank You for your attention