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1

UNIVLkSI1 CI SILNA
Schoo| of Denta| Med|c|ne

hD kCGkAM:
"8IC1LCnNCLCGILS:
SLC1ICN CI DLN1AL 8ICMA1LkIALS"

hD 1nLSIS CI:
Gabr|e|e Corc|o|an|__________________________________!

1I1LL

A study of denta| co|or match|ng, co|or se|ect|on and co|or
reproduct|on.
2

Academ|c ear 2009]10

December, 11
th
2009

Comm|ttee:
romoter rof. Marco Ierrar|
Co-romoter rof. A|essandro V|ch|
rof. Andrea 8orracch|n|
rof. Lorenzo 8resch|
rof. Leopo|do Iorner Navarro
rof. Cec|||a Goracc|
rof. S|mone Grand|n|
rof. Mar|a de| Carmen L|ena uy
rof. 2oran Vu||cev|c

1I1LL:
A study of denta| co|or match|ng, co|or se|ect|on and co|or
reproduct|on.

CANDIDA1L
Gabr|e|e Corc|o|an|
!"#$%&'()%*+'
3

CCN1LN1S

CnA1Lk 1
1.1 Ceneral lnLroducLlon..............................3
1.2 Color and sclence................................................6
1.3 Shade guldes............................................................8
1.4 Shade Laklng devlces: elecLronlc aldes.....................................11
1.3 Shade reproducLlon..........................................................16
8eferences.................................18

CnA1Lk 2.
2.1 LvaluaLlon of measuremenL repeaLablllLy of cllnlcal and
laboraLory specLrophoLomeLers for color maLchlng
Lechnlque..............................21
8eferences...................................33

CnA1Lk 3.
3.1 SpecLrophoLomeLrlc evaluaLlon of Lhe color maLch Lo vl1A
classlcal shade gulde of four dlfferenL veneerlng porcelaln
sysLems for meLal ceramlc resLoraLlons..............37
8eferences...................................49

CnA1Lk 4.
4.1 Colour correspondence of a ceramlc sysLem ln Lwo dlfferenL
shade guldes..........................................33
8eferences.................................63
4

4.2 Color correspondence of Lwo dlfferenL ceramlc sysLems ln one
shade gulde..............................63
8eferences..............................79

CnA1Lk S.
3.1 lnfluence of layerlng Lhlckness on Lhe color parameLers of a
ceramlc sysLem....................................................................83
8eferences...................................96

CnA1Lk 6.
6.1 Summary, concluslons and fuLure dlrecLlons...........................99
6.2 8lassunLo, concluslonl e dlrezlonl fuLure..............110
6.3 8esumen, concluslones y dlrecclones fuLuras.........123
6.4 Zusammenfassung, schlussfolgerungen und zukunfLlge
rlchLungen..............................................................................136
6.3 8esume, concluslons and dlrecLlons fuLures...........148
6.6 8esumo, concluses e fuLuras lnvesLlgaes .........160

Comp|ete ||st of keferences...............................................................171
Curr|cu|um V|tae................................................................................179
Internat|ona| ub||cat|ons.................................................................181
Abstracts............................................................................................183
Aknow|edgements..................................183
5

CnA1Lk 1

1.1 Genera| Introduct|on
AccuraLe shade maLchlng ls one of Lhe mosL challenglng
aspecLs of denLal resLoraLlons and aesLheLlc denLlsLry. uue Lo Lhe greaL
varleLy of naLural LooLh color, achlevlng a close shade maLch of an
arLlflclal resLoraLlon wlLh Lhe naLural denLlLlon ls a complex process.
racLlLloners requlre an undersLandlng of color, llghL and relaLed
characLerlsLlcs of porcelaln and resln, as well as Lhe ablllLy Lo clearly
communlcaLe lnsLrucLlons wlLh laboraLory Lechnlclans. Successful
shade maLchlng lnLegraLes a number of crlLlcal facLors, lncludlng an
lndlvldual's percepLlon of color, Lhe llghL source ln whlch shade ls
belng deLermlned (Lhe pracLlLloner's offlce), Lhe color of Lhe
surroundlng walls and cablneLs, and Lhe colors of paLlenLs' cloLhlng
and makeup. racLlLloners musL also Lake sLeps Lo reduce Lhe problem
of meLamerlsm, a phenomenon ln whlch Lhe color of 2 ob[ecLs look
ldenLlcal ln one llghL source buL look dlfferenL under oLher llghL
condlLlons (for example ln sunllghL versus fluorescenL llghL).
ln order Lo obLaln a naLural looklng resLoraLlon, Lhere are Lwo
cruclal sLeps ln everyday denLal pracLlce: Lhe selecLlon of a color,
Lhrough a shade gulde, whlch wlll harmonlously lnLegraLe lLself wlLh
Lhe surroundlng blologlcal Llssues and consequenLly Lhe correcL
reproducLlon of Lhls color ln Lhe prosLhesls or resLoraLlon.
6

1.2 Co|or and sc|ence
Slnce newLon's experlmenLs durlng Lhe 18
Lh
cenLury, color and
sclence have Lrled Lo flnd a common fleld. 8uL color ls dlfflculL Lo
manage, as lL ls usually someLhlng LhaL has been relaLed more Lo arL
raLher Lhan Lo sclence. Color ls almosL lndeflnable, and even wlLh
dramaLlc lmprovemenLs ln sclenLlflc knowledge, a loL of work ls sLlll
requlred. uenLlsLry ls noL away from Lhls problem, and even lf several
aLLempLs have been made Lo raLlonallze color maLch beLween naLural
LeeLh and resLoraLlve maLerlals, shade selecLlon ls sLlll one of Lhe mosL
emplrlc procedures ln everyday pracLlce. Many auLhors have Lrled ln
Lhe pasL Lo address Lhls lssue, and Lhe paper from Clark (1933), based
malnly on Lhe Munsell color scale of 1903, was Lhe flrsL aLLempL Lo
organlze denLal colors.
ln Lhe same perlod, Lhe Commlsslon lnLernaLlonal de l'Lclalrage
(ClL, 1931) publlshed Lhe sLandards for color maLchlng, esLabllshlng
some sclenLlflc parameLers for color evaluaLlon. 8uL Lhe absence of
valld sclenLlflc lnsLrumenLs for color measuremenL dld noL allow
slgnlflcanL lmprovemenLs. Sproull (1973, 1974) publlshed a serles of
arLlcles ln whlch Lhe Lhree dlmenslonal naLure of color, and lLs
relaLlonshlp wlLh denLal shades was sLudled and a serles of LheoreLlcal
and pracLlcal lndlcaLlons were glven ln order Lo lmprove color
maLchlng ln denLlsLry. 1hese arLlcles, LhaL represenLed for a long Llme
Lhe sLaLe of Lhe arL" for color maLchlng, polnLed ouL how Lhe shade
guldes were poor and lnadequaLe ln relaLlonshlp wlLh Lhe complexlLy
of Lhe appearance of Lhe LeeLh. 8uL whlle color denLal appllcaLlons
7

seem Lo slow down for some Llme, Lhe sclence of color dld greaLly
lmprove. 1he deslre was Lo use sclence express color and dlfferences
ln color numerlcally. Slnce Lhe Munsell sysLem had an lrregular space
dlsLrlbuLlon, lL was noL posslble Lo correlaLe Lwo colors and Lo
calculaLe Lhe dlfferences beLween Lhem. ln 1976 and 1978 Lhe ClL
developed a new sysLem, called ClL Lab* (ClL, 1978), ln whlch for Lhe
flrsL Llme lL was posslble Lo express color ln numbers, and calculaLe Lhe
dlfferences beLween Lwo colors uslng a formula LhaL glves one number
as value for color dlfferences.

1hls so called AL" value became crlLlcal ln color sclence as well as ln
Lhe color lndusLry ranglng from LexLlles Lo denLlsLry (Clarke, 1983)

L = [(L
1
-L
2
)
2
+ (a
1
-a
2
)
2
+ (b
1
-b
2
)
2
]
1]2

unforLunaLely, denLal pracLlce dld noL beneflL lmmedlaLely from Lhls
new knowledge Lo lmprove color maLchlng, vlsual assessmenL was sLlll
consldered Lhe benchmark approach.
8

1.3 Shade gu|des
1ooLh shade maLchlng ls mosL frequenLly performed vlsually
uslng denLal shade guldes.
1he flrsL shade gulde was lnLroduced on Lhe markeL ln 1936 by
vlLa Zahnfabrlk for Lhe measuremenL of Lhe color of ceramlc sysLems.
AlLhough sLlll lmperfecL, lL lnLroduced some vlsual parameLers LhaL
wlLh some mlnor modlflcaLlons are sLlll rouLlnely used by denLal
pracLlLloners. 1he vlLapan Classlcal Shade Culde conslsLs of 16 Labs
arranged lnLo four groups based on hue and wlLhln Lhe groups
accordlng Lo lncreaslng chroma (also known as A-Lo-u arrangemenL)
(aravlna, 2009). 1he mosL lmporLanL lssues are relaLed Lo Lhe need
for and lack of a loglcal and adequaLe dlsLrlbuLlon ln parL of Lhe color
space encompassed by human LeeLh.
AnoLher qulLe popular shade gulde noL sysLemaLlcally arranged
ls Lhe lvoclar-vlvadenL Chromascop. As wlLh Lhe vlLapan Classlcal, Lhe
Chromascop ls arranged ln groups based on Lhe hue (1=WhlLe, 2=LlghL
?ellow, 3=uark ?ellow, 4= Crey and 3=8rown) and wlLhln Lhe groups
accordlng Lo lncreaslng chroma (from 10 Lo 40).
uenLal color sclence Lhen developed ln a manner LhaL
mlnlmlzed Lhe errors ln vlsual color selecLlon (Mlller, 1993 and 1994).
ln Lhe laLe 1990s Lhe Lab* sysLem was adopLed by denLlsLry and one of
Lhe flrsL cllnlcal resulLs was Lhe developmenL of Lhe vlLa 3u MasLer
Shade Culde.
9

1he vlLapan 3u-MasLer color sysLem conslsLs of 11 seLs of flred

porcelaln LooLh-shaped samples bullL up wlLh cervlcal, denLlnal

and
lnclsal powders and composed of feldspar nephellne and hlgh-
LemperaLure

ceramlc plgmenLs from Lhe vlLa famlly of ceramlc
porcelalns.

1he 11 seLs conslsL of 26 samples ranglng from llghLesL Lo
darkesL

value, from lowesL Lo hlghesL lnLenslLy and from yellow Lo red.

Samples are arranged ln groups of Lwo or Lhree LhaL form flve

seLs
(numbered 1 Lhrough 3). Lach seL represenLs a slngle value,

1 belng
Lhe llghLesL LooLh color and
3 Lhe darkesL. Chroma and

hue are represenLed wlLhln
each value seL.

1he dlsLance
beLween each of Lhe palrs
of ad[acenL colors ls

approxlmaLely 2 AL unlLs. Lach of Lhe flve
llghLness levels

dlffers from Lhe nexL by a AL of approxlmaLely 3. Lach
chroma

level dlffers from Lhe nexL by a AL of approxlmaLely 6. Pues

are separaLed lnLo mlddle, or M, yellow, or L, and red, or 8 (!AuA,
2002).
1he vl1A 3u-MasLer Shade Culde ls based on a color
classlflcaLlon prlnclple ln whlch 3 dlmenslons of color, value
(brlghLness), chroma (lnLenslLy of Lhe color), and hue (Lhe color lLself),
are consldered equally so LhaL Lhe deLermlnaLlon of shade can be
easlly carrled ouL uslng sysLemaLlc, conslsLenL crlLerla (aravlna, 2009).
1he vl1A 3u-MasLer Shade Culde addressed Lhe mosL lmporLanL
10

elemenLs of LooLh shade measuremenL: a sclenLlflc color dlsLrlbuLlon,
havlng a sysLemaLlc arrangemenL of shades wlLhln Lhe naLural LooLh
color space and an ob[ecLlve, numerlcal measure of color, accordlng Lo
Lhe colorlmeLrlc ClLLab* order prlnclple, raLher Lhan on Lhe mere
observaLlon of Lhe naLural Llssue aspecLs (Pammad, 2003), LhaL can be
wrlLLen as a clear prescrlpLlon for Lhe laboraLory Lechnlclans.

8ecenLly, Lhls gulde was modlfled wlLh Lhe lnLroducLlon of Lhe
slxLh group (number 0) for Lhe shade maLchlng of bleached LeeLh. A
furLher developmenL was Lhe lnLroducLlon of Lhe vlLa Llneargulde 3u
MasLer gulde whlch adopLed a llnear approach Lo shade Laklng.
11

1.4 Shade tak|ng dev|ces: e|ectron|c a|des
ln order Lo mlnlmlze color mlsmaLch due Lo vlsual esLlmaLlon,
Lwo maln caLegorles of elecLronlc lnsLrumenLs were developed for
denLal color analysls: colorlmeLers and specLrophoLomeLers (PunLer,
1987). 1he ColorlmeLer ls a relaLlvely slmple and low-cosL lnsLrumenL
and lL ls deslgned Lo measure color on Lhe basls of Lhree axes or
sLlmull by uslng a fllLer LhaL slmulaLes Lhe human eye. 1he
specLrophoLomeLer ls a more sophlsLlcaLed lnsLrumenL, bullL Lo
measure by reflecLlon or Lransmlsslon an observed ob[ecL, glvlng Lhe
enLlre specLral curve and ls llmlLed for color measuremenL Lo Lhe
vlslble frequency range (usually 330-800nm). SlgnlflcanL advanLages
wlLh specLrophoLomeLrlc measuremenLs lnclude Lhe ablllLy Lo analyze
Lhe prlnclpal componenLs of a serles of specLra and Lhe ablllLy Lo
converL specLrophoLomeLrlc measures Lo varlous color measures.
AlLhough Lhe flrsL specLrophoLomeLers were really accuraLe, Lhey were
qulLe complex lnsLrumenLs and dlfflculL Lo manage and correcLly
callbraLe. Moreover, specLrophoLomeLers were bulky, wlLh a large
openlng for measuremenLs and expenslve. lor Lhese reasons, Lhelr use
was llmlLed Lo Lhe research laboraLory. ColorlmeLers were porLable,
cheaper, wlLh a smaller readlng openlng, buL Lhelr lower accuracy and
llmlLaLlons resulLed ln Lhe commerclal fallure of Lhe Chromascan
sysLem ln Lhe pasL, Lhe only denLal colorlmeLer commerclally produced
aL LhaL Llme. 8ecenL advances ln elecLronlcs have resulLed ln more
sophlsLlcaLed CCus. 1hls has resulLed ln Lhe developmenL of elecLronlc
devlces LhaL are clalmed Lo be able Lo measure Lhe color of LeeLh. Such
12

devlces range from sofLware LhaL can be used ln con[uncLlon wlLh
lmages Laken wlLh a dlglLal camera, Lo pure" colorlmeLers and pure"
specLrophoLomeLers, Lo Lhe very laLesL developmenL ln whlch dlglLal
lmages are comblned wlLh a colorlmeLer or specLrophoLomeLer.

Shade 1ak|ng dev|ces (from 8rewer et a|., 2004, Infodent
2007, mod|f|ed)
Instrument 1ype
Shade Lye, Shofu ColorlmeLer
Lasyshade / Lasyshade
CompacL, vlLa
SpecLrophoLomeLer
Shade Scan, Cynovad
ulglLal color lmaglng /
ColorlmeLer
Shade vlslon, x-8lLe
ColorlmeLer
SpecLro Shade Mlcro, MP1
SpecLrophoLomeLer
Clear MaLch, SmarL
1echnology
SofLware (requlres a dlglLal
camera)
Color Scanner 2006, nuova
lranco Sulsse
SofLware (requlres a dlglLal
camera)
uvS11, uv SpecLrophoLomeLer

13

SpecLro Shade Mlcro (MP1), a comblnaLlon
of dlglLal color lmaglng and
specLrophoLomeLer, may be consldered one
of Lhe mosL sophlsLlcaLed lnsLrumenLs. 1he
advanLages of Lhese devlces lnclude Lhe
ablllLy Lo acqulre polarlzed lmages and use
Lhem for color analysls and calculaLlon,
comparlson wlLh several shade guldes,
coarse and flne color shade mapplng, Lhe
ablllLy Lo send daLa vla e-mall Lo Lhe lab, Lhe ablllLy Lo overlay Lhe
cllnlcal lmage wlLh Lhe Lechnlclan's work and several oLher feaLures.

14

1he vlLa Lasyshade ls one of Lhe laLesL
specLrophoLomeLers avallable for
cllnlcal use. 1he lnsLrumenL's sofLware
ls programmed Lo glve absoluLe
ClLLab* color values only for naLural
LeeLh. Conversely, when assesslng Lhe
color of a ceramlc, Lhe
specLrophoLomeLer provldes Lhe dlfferences (A values) from color
value preseLs ln Lhe lnsLrumenL's daLabase. 1he specLrophoLomeLer
daLa acqulslLlon ls dlfferenL when readlng naLural LooLh and ceramlc
also because Lhe lnsLrumenL applles
dlfferenL scannlng meLhods on Lhe
Lwo dlversely sLrucLured subsLraLes
(!!L 1echnology, 2003). Ceramlc
resLoraLlons are generally less Lhan
1.6mm ln Lhlckness and Lhe color
layers (denLln and opaque) are from
0.2-0.4 mm under Lhe enamel porcelaln layer. Conversely, lnslde Lhe
LeeLh, Lhe denLln layer ls generally 1.0-1.3 mm from Lhe ouLer surface
(Shllllngburg eL al., 1991). lurLhermore, Lhe enamel Lhlckness causes a
scaLLerlng of Lhe peneLraLlng llghL. Moreover, Lhe overall Lhlckness of a
naLural LooLh ls greaLer Lhan LhaL of a ceramlc LooLh.
ln 2009 vlLa Zahnfabrlk lnLroduced onLo Lhe markeL a new
shade Laklng devlce, Lhe Lasyshade CompacL, whlch represenLs an
evoluLlon of Lhe prevlous one. 1hanks Lo Lhe use of LLu Lechnology,
15

Lhe new devlce became smaller, wlreless
and easler Lo handle. 1he mosL
lmporLanL dlfference beLween Lhe Lwo
devlces ls LhaL Lhe CompacL has a slngle
specLrophoLomeLer raLher Lhan Lhe Lwo
ones belonglng Lo Lasyshade sLandard.
ln Lhe sLandard Lasyshade Lhe dlfference
ln color readlng beLween naLural LeeLh and ceramlc resLoraLlons ls due
Lo Lwo dlfferenL specLrophoLomeLers embedded ln Lhe lnsLrumenL. ln
Lhe Lasyshade CompacL's Llp Lhere are Lwo dlfferenL seLs of LLus LhaL
provlde dlfferenL llghL accordlng Lo whaL ls belng measured and Lhe
reflecLed llghL converges ln a slngle Charge Coupled uevlce (CCu).
1he quesLlon Lo ask ls how rellable Lhese lnsLrumenLs are and lf
Lhey are ready Lo be rouLlnely used ln Lhe denLal offlce. very few
sclenLlflc papers are avallable on Lhls sub[ecL (aul eL al., 2002, 1ung eL
al., 2002, 8alLzer eL al., 2003, klemeLLl eL al., 2006, klm-usaLerl eL al.,
2007).

Powever, lL ls necessary Lo underllne LhaL Lhls dlfferenL and
lnnovaLlve approach Lo shade selecLlon has enormous educaLlonal
poLenLlal. 8oLh undergraduaLe and posL-graduaLe sLudenLs can beneflL
from Lhese devlces. 1hese lnsLrumenLs allow an lmproved
undersLandlng of color percepLlon and lLs correlaLlon wlLh cllnlcal
aspecLs as well as measurlng dlfflculL parameLers such as
1ranslucency, Pue, Chroma, and value.

16

1.3 Shade reproduct|on
Cnce Lhe correcL shade has been selecLed, Lhe second sLep ls Lo
reproduce Lhls color ln Lhe resLoraLlon. Several sLudles demonsLraLed
LhaL Lhe layerlng raLlo beLween opaque and LranslucenL shades greaLly
lnfluences Lhe flnal resulLs of Lhe resLoraLlon. Lven a correcL shade
selecLlon ls noL enough lf lL ls noL correlaLed wlLh Lhlckness and
layerlng of Lhe resLoraLlon (Cmar eL al., 2008).

uouglas eL al. (2003) found LhaL Lhe ablllLy Lo reproduce Lhe
color of Lhe LargeL shade Lab dlffered among laboraLorles and mosL
crowns fabrlcaLed by Lhe laboraLorles ln Lhelr sLudy, when compared
Lo Lhe prescrlbed shade Lab, were above Lhe cllnlcal Lhreshold for an
accepLable shade maLch (AL=3.7). 1hls ls probably due Lo Lhe long llsL
of facLors LhaL are relevanL ln lnfluenclng Lhe flnal color of Lhe
porcelaln resLoraLlons, such as flrlng (CzLurk eL al., 2008), glazlng
(?llmaz eL al., 2008), Lhe mlxlng raLlo beLween powder and llquld
(Zhang eL al., 2004), dlfferenL subsLrucLures (kourLls eL al., 2004) and
layerlng (uozlc eL al., 2003, !arad eL al., 2007). uozlc eL al. (2003)
lnvesLlgaLed Lhe lnfluence of porcelaln layer Lhlckness on Lhe flnal
shade of meLal free ceramlc resLoraLlons, flndlng a slgnlflcanL
correlaLlon beLween Lhe Lhlckness raLlo of Lhe opaque/veneerlng
porcelaln sysLem wlLhln 1.00 mm and color coordlnaLes a* and b* and
LhaL Lhe correlaLlon of Lhe L* value wlLh Lhlckness of opaque and
LranslucenL porcelalns was shade dependenL. !arad eL al. (2007) ln an
ln vlLro sLudy found LhaL a change ln enamel porcelaln Lhlckness had a
greaLer effecL on hlgher chromaLlc shades Lhan Lhose wlLh lower
17

chroma, and Lhe reducLlon of Lhe enamel Lhlckness produced Lhree-
dlmenslonal color changes (llghLness, hue angle and meLrlc chroma).
Wee eL al. (2002) found LhaL rellable dellvery of a properly maLched
resLoraLlon Lo exlsLlng porcelaln resLoraLlons cannoL be ensured
regardless of Lhe shade assessmenL meLhod used (vlsual or compuLer-
generaLed).
18

keferences

8alLzer A, Paufmann-!lnolan v. Shadlng of ceramlc crowns uslng dlglLal
LooLh shade maLchlng devlces. lnL ! CompuL uenL 2003,8:129-132.
8rewer !u, Wee A, Seghl 8. Advances ln color maLchlng. uenL Clln norLh Am
2004,48:341-338.
ClL (Commlsslon lnLernaLlonale de l'Lclalrage). LlghL as a 1rue vlsual CuanLlLy:
rlnclples of MeasuremenL. ClL ub. no.41, vlenna, AusLrla: 8ureau CenLral de la
ClL, 1978.
ClL (Commlsslon lnLernaLlonale de l'Lclalrage). SLandard ColorlmeLrlc
Cbserver x2 (lambda), y2 (lambda), z2 (lambda). vlenna, AusLrla: 8ureau CenLral de
la ClL, 1931.
Clark L8. 1ooLh color selecLlon. ! Am uenL Assoc 1933, 20: 1063-73.
Clarke l!!. MeasuremenL of Lhe color of Lhe human LeeLh. uenLal Ceramlcs:
roceedlngs of Lhe flrsL lnLernaLlonal symposlum on ceramlcs. Chlcago: CulnLessence
ub Co lnc, 1983, 441.
uouglas 8u, 8rewer !u. varlablllLy of porcelaln color reproducLlon by
commerclal laboraLorles. ! rosLheL uenL 2003,90:339-46.
uozlc A, kleverlaan C!, Meegdes M, van der Zel !, lellzer A!. 1he lnfluence of
porcelaln layer Lhlckness on Lhe flnal shade of ceramlc resLoraLlons. ! rosLheL uenL
2003,90:363-70
Pammad lA. lnLraraLer repeaLablllLy of shade selecLlons wlLh Lwo shade guldes.
!ournal of rosLheLlc uenLlsLry 2003,89:30-3.
PunLer 8S. 1he measuremenL of appearance. new ?ork: !ohn Wlley and Sons,
lnc, 2
nd
Ld. 1987.
!AuA. uenLal Shade Culdes. ! Am uenL Assoc 2002,133:366-367.
!arad lu, Moss 8W, ?oungson CC, 8ussell Mu. 1he effecL of enamel porcelaln
Lhlckness on color and Lhe ablllLy of a shade gulde Lo prescrlbe chroma. uenL MaLer
2007,23:434-460.
!!L 1echnology, LLC. vlLa Lasyshade 1echnology 2003:3-7.
19

klm-usaLerl S, 8rewer !u, uunford 8C, Wee AC. ln vlLro model Lo evaluaLe
rellablllLy and accuracy of a denLal shade-maLchlng lnsLrumenL. ! rosLheL uenL
2007,98:333-338.
klemeLLl L, MaLela AM, Paag , kononen M. Shade selecLlon performed by
novlce denLal professlonals and colorlmeLer. ! Cral 8ehabll 2006,33:31-33.
kourLls SC, 1rlpodakls A, uoukoudakls AA. SpecLrophoLomeLrlc evaluaLlon of
Lhe opLlcal lnfluence of dlfferenL meLal alloys and porcelalns ln Lhe meLal-ceramlc
complex. ! rosLheL uenL 2004,92:477-83.
Mlller LL. Shade MaLchlng. ! LsLheL uenL 1993, 4: 143.
Mlller LL. Shade selecLlon. ! LsLheL uenL 1994, 2: 47.
Cmar P, ALLa C, Ll-Mowafy C. ulfference beLween selecLed and obLalned shade
for meLal-ceramlc crown sysLems. Cper uenL 2008,33: 302-307.
CzLurk C, uludag 8, usumez A, Sahln v, Cellk C. 1he effecL of ceramlc
Lhlckness and number of flrlngs on Lhe color of Lwo all-ceramlc sysLems. ! rosLheL
uenL 2008,100:99-106.
aravlna 8u. erformance assessmenL of denLal shade guldes. ! uenL 2009,
37
s
:e13-e20.
aul S, eLer A, lerobon n, Pammerle CPl. vlsual and SpecLrophoLomeLrlc
Shade Analysls of Puman 1eeLh. ! uenL 8es 2002, 81:378.
Shllllngburg P1, !acobl 8, 8rackeLL SL. lundamenLals of 1ooLh reparaLlon for
CasL MeLal and orcelaln 8esLoraLlons. 2nd ed. Chlcago: CulnLessence ub Co lnc.
1991.
Sproull 8C. Color maLchlng ln denLlsLry. arL l: 1he Lhree dlmenslonal naLure of
color. ! rosLheL uenL 1973,29:416.
Sproull 8C. Color maLchlng ln denLlsLry. arL ll: racLlcal appllcaLlons for Lhe
organlsaLlon of color. ! rosLheL uenL 1973,29:336.
Sproull 8C. Color maLchlng ln denLlsLry. arL lll: Color conLrol .! rosLheL uenL.
1974,31:146.
1ung ll, ColdsLeln C8, !ang S, PlLLelman L. 1he repeaLablllLy of an lnLraoral
denLal colorlmeLer. ! rosLheL uenL 2002,88:383.
20

Wee AC, Monaghan , !ohnsLon WM. varlaLlon ln color beLween lnLended
maLched shade and fabrlcaLed shade of denLal porcelaln. ! rosLheL uenL
2002,87:637-666.
?llmaz C, korkmaz 1, uemlrkprulu P, Lrgun C, Czkan ?. Color sLablllLy of
glazed and pollshed denLal porcelalns. ! rosLhodonL 2008,17:20-4.
Zhang ?, Crlggs !A, 8enham AW. lnfluence of powder/llquld mlxlng raLlo on
poroslLy and Lranslucency of denLal porcelalns. ! rosLheL uenL 2004,91:128-133.

21

CnA1Lk 2

2.1 Lva|uat|on of measurement repeatab|||ty of c||n|ca| and
|aboratory spectrophotometers for co|or match|ng techn|que.
Cabrlele. Corclolanl, Alessandro vlchl. ($)#,$%)"-$%*' .#$)"/),+' !-0)1'
23,"4%'566789:75;<6.

Introduct|on
CorrecL shade selecLlon and reproducLlon has been a
conLlnuous challenge for Lhe cllnlclan, as colour maLchlng of LeeLh ls
complex, and shade selecLlon errors can resulL (lshlkawa-nagal eL al.,
1994).
1he mosL common way Lo evaluaLe and reproduce naLural
LeeLh colour for ceramlc resLoraLlon ls vlsual comparlson uslng denLal
shade gulde Labs.
1he flrsL shade gulde, lnLroduced ln 1929 by vlLa, was
developed accordlng Lo Lhe epldemlologlcal dlsLrlbuLlon of naLural
LooLh colour. 1he lnLroducLlon of vlLa Lumln vacuum Shade Culde ln
1936 was Lhe flrsL aLLempL Lo creaLe a unlversal sLandard for LeeLh
colour maLchlng. Slnce Lhen, several denLal manufacLurers have
produced Lhelr own shade guldes, produclng a marked lmprovemenL
ln color reproducLlon for ceramlc resLoraLlon (Wee eL al., 2002), buL aL
Lhe same Llme generaLlng a cerLaln amounL of confuslon ln cllnlclans.
8eLween 1976 and 1978 Lhe Commlsslon lnLernaLlonale de
l'Lnclalrage" (ClL) developed a new sysLem, called ClLLab*, when for
22

Lhe flrsL Llme lL was posslble Lo classlfy and correlaLe colour
numerlcally, and Lo calculaLe Lhe dlfference beLween Lwo colours
uslng a formula LhaL glves one number (AL) as value for colour
dlfferences (Clarke eL al., 1983).
ln Lhe laLe 1990's Lhe ClLLab* sysLem was lncorporaLed lnLo
denLlsLry and consequenLly, one of Lhe flrsL cllnlcal advances was Lhe
developmenL of Lhe vlLa 3u MasLer Shade Culde. 1hls shade gulde was
noL based merely on Lhe observaLlon of naLural LooLh colour, buL on
sclenLlflc flndlngs and Lhe sysLemaLlc coverage of Lhe LooLh colour
space of naLural LeeLh, accordlng Lo a sysLemaLlc colorlmeLrlc ClLLab*
order prlnclple (Pammad eL al., 2003).
More recenLly, ln order Lo mlnlmlze poLenLlal error ln colour
maLchlng by personal esLlmaLlon, research has endeavoured Lo use
Lhe sclence and Lheory of colour Lo devlse a sLandard LhaL wlll allow
colours Lo be classlfled numerlcally, for easler and more preclse
Lransfer and communlcaLlon of colour ln resLoraLlve denLlsLry. 1hls has
been a slgnlflcanL sLep ln Lhe developmenL of specLrophoLomeLers
(8alLzer eL al., 2003, uouglas eL al., 1997, lshlkawa-nagal eL al., 2003,
Ckubo eL al., 1998, aul eL al., 2004, 1ung eL al., 2002).
1he specLrophoLomeLer ls a sophlsLlcaLed lnsLrumenL, deslgned
Lo measure an observed ob[ecL by reflecLlon or Lransmlsslon, glvlng
Lhe enLlre specLral curve as resulL, llmlLlng colour measuremenL Lo
vlslble frequencles range (usually 330-800 nm).
1he posslblllLy Lo measure a colour numerlcally wlLh a rellable
dlglLal lnsLrumenL and Lo have a close correspondence wlLh Lhls
23

number and Lhe resLoraLlve maLerlal marks a new developmenL ln
denLlsLry and specLrophoLomeLers could become parL of Lhe rouLlnely
used offlce devlces. 1o achleve Lhls requlres lnvesLlgaLlon lnLo any
doubL cllnlclans may have ln Lhe scannlng repeaLablllLy and Lhe
rellablllLy of Lhese lnsLrumenLs.
1he alm of Lhls sLudy was Lo esLabllsh wheLher Lhere ls
repeaLablllLy ln specLrophoLomeLrlc measuremenL and Lo make a
comparlson beLween a cllnlcal specLrophoLomeLer and a laboraLory
one.

Mater|a|s and Methods
1wo dlfferenL Lypes of specLrophoLomeLers were used for Lhls
sLudy: Lhe vl1A Lasyshade (vlLa Zahnfabrlk, 8ad Sacklngen, Cermany),
a sLandalone cllnlcal sysLem and Lhe Su1000 (Ccean CpLlcs, lL, uSA)
LhaL ls equlpped wlLh an lnLegraLlng sphere (lS-8Ll, Ccean CpLlcs, lL,
uSA) wlLh a 10mm aperLure. 1he specLrophoLomeLer Su1000 was
connecLed Lo a compuLer runnlng measuremenL sofLware (CCl8ase
32, Ccean CpLlcs, lL, uSA).
ln order Lo verlfy Lhe readlng repeaLablllLy of Lhe Lwo
specLrophoLomeLers LesLed, flve ceramlcs dlsks were produced ln
dlfferenL layerlng, wlLh a flxed LoLal Lhlckness of Lhe samples belng
malnLalned.
0,7 mm Lhlck sample dlscs of 13mm ln dlameLer of a self-curlng
acryllc resln maLerlal (uuraLay, LC1 032802, 8ellance uenLal
ManufacLurlng Co., WorLh, lL, uSA) were made ln a cyllndrlcal mould.
24

AfLer applylng Lhe maLerlal lnLo Lhe mould, a glass plaLe was pressed
on Lhe surface ln order Lo obLaln a flaL surface. CreaL aLLenLlon was
glven Lo avold bubble formaLlon.
When compleLely cured, Lhe resln sample was exLracLed from
Lhe mold and puL lnLo a refracLory casL fllled wlLh Lhe refracLory
lnvesLmenL (CC SLellavesL, CC Lurope, Leuven, 8elglum) and placed ln
a burnouL furnace (CvomaL 7, Manfredl-SALu, 1orlno, lLaly) uslng Lhe
wax ellmlnaLlon Lechnlque.
AL Lhe end of Lhe burnouL cycle, Lhe lnvesLmenL was puL lnLo an
lnducLlon casLlng machlne (LnLerprlse, !elrus, Plcksvllle, n?, uSA) and
fllled wlLh a base meLal alloy (8lomaLe-C, Sllpo, lLaly).
1he dlsc-shaped speclmens obLalned were roughened uslng a
sandblasLer (Skylab, 1ecnogaz, arma, lLaly) wlLh AlC
2
parLlcles of
100m dlameLer.

MeasuremenLs were based on a slngle ceramlc sysLem (vlLa
Cmega 900 MeLallkeramlk, vlLa Zahnfabrlk, 8ad Sacklngen, Cermany).
1he colour selecLed was A3. A flrsL wash opaque layer was used, as
recommended by Lhe manufacLurer's lnsLrucLlons. AfLer Lhe
appllcaLlon Lhe opaque layer was flred ln a ceramlc oven (rogramaL
x1, lvoclar vlvadenL, Schaan, LlechLensLeln) accordlng Lo Lhe
manufacLurer's lnsLrucLlons. A second opaque layer was applled and
flred.
lollowlng manufacLurer's lnsLrucLlons, Lhe denLlne layer was
Lhen sLraLlfled. A flrsL opaque denLlne layer (A3 Cpaque uenLlne 9033,
vlLa Zahnfabrlk, 8ad Sacklngen, Cermany) was applled ln a Lhlckness
25

conLrolled by Lhe regulaLed mold and flred followlng Lhe
manufacLurer's lnsLrucLlons afLer whlch a second denLlne layer was
sLraLlfled (A3 uenLlne 9033, vlLa Zahnfabrlk, 8ad Sacklngen, Cermany)
and consequenLly flred.
1hen, as lndlcaLed ln Lhe ceramlc lnsLrucLlons, Lhe enamel layer
was sLraLlfled (Ln2 Lnamel 9072, LC1 7846, vlLa Zahnfabrlk, 8ad
Sacklngen, Cermany) and flred ln Lhe ceramlc oven.
llnally, a glaze flrlng was performed accordlng Lo Lhe
manufacLurer's lnsLrucLlons for each sample.
Lach layer was measured by an elecLronlc dlglLal callper (1631
uC1, 8eLa, Mllan, lLaly) wlLh a 10m resoluLlon.
1he varlable Lhlcknesses of Lhe speclmens are shown ln Lable 1.

1able 1. 1hlckness of Lhe speclmens.
Sample Alloy Cpaque
Cpaque
uenLln uenLln Lnamel llnal
1 0,70 mm 0,13 mm 0,20 mm 0,43 mm 0,30 mm 1,30 mm
2 0,70 mm 0,13 mm 0,23 mm 0,60 mm 0,30 mm 1,30 mm
3 0,70 mm 0,13 mm 0,13 mm 0,30 mm 0,70 mm 1,30 mm
4 0,70 mm 0,13 mm 0,33 mm 0,70 mm 0,10 mm 1,30 mm
3 0,70 mm 0,13 mm 0,43 mm 0,30 mm 0,20 mm 1,30 mm

1he colour evaluaLlon of each sample was repeaLed 3 Llmes
wlLh each specLrophoLomeLer Lo verlfy Lhe scannlng repeaLablllLy.
1he vlLa Lasyshade uenLal SpecLrophoLomeLer conslsLs of a
base unlL and a hand plece: Lhe colour evaluaLlon was repeaLed 3
Llmes for each sample by flxlng Lhe handplece of Lhe devlce Lo a
26

graduaLed sLand and 3 Llmes for each sample by free hand slmulaLlng
cllnlcal use. 8esLoraLlon" mode was selecLed uslng A3 shade as
comparlson.
1he Ccean CpLlcs Lab SpecLrophoLomeLer Su 1000 conslsLs of
an lnLegraLlng sphere, a base unlL and lnLegraLlng sofLware. 1he
samples were placed on Lhe sphere aperLure and Lhe colour evaluaLlon
was repeaLed for 3 Llmes for each sample.
1he specLrophoLomeLer repeaLablllLy was sLaLlsLlcally
evaluaLed by analyzlng Lhe CoefflclenL of varlaLlon (Cv), whlch
represenLs Lhe raLlo of Lhe sLandard devlaLlon Lo Lhe mean, of Lhe
ClLLab* colour values. 1he sofLware used was SSS 12.0 (SSS,
Chlcago, lL, uSA).

kesu|ts
1he resulLs are shown ln Lhe Lables 2, 3 and 4.
ln Lable 2 and 3 Lhe colour values obLalned wlLh vlLa Lasyshade are
reporLed.
1he flrsL column lndlcaLes Lhe scannlng of each sample, where
Lhe sample ls represenLed numerlcally and Lhe leLLer represenLs Lhe
number of Lhe scan. 1he values of Lhe uelLa relaLed Lo LlghLness,
Chroma, Pue and AL, are reporLed ln Lhe oLher columns, a resulL of
Lhe comparaLlve measuremenLs made by Lhe Lasyshade. 1he column
AL LC lndlcaLes Lhe values of AL wlLhouL Laklng lnLo conslderaLlon Lhe
value of Lhe Pue. 1he lasL column noLes Lhe lnsLrumenL's evaluaLlon of
Lhe resLoraLlon.
27

1able 4 reporLs Lhe colour values obLalned wlLh Ccean CpLlcs
Su 1000.
1he flrsL column lndlcaLes Lhe scannlng of each sample, where
Lhe sample ls represenLed numerlcally and Lhe leLLer represenLs Lhe
number of Lhe scannlng. As Lhe Su 1000 glves absoluLe ClLLab*
values, Lhe absoluLe values of colour evaluaLlon are lndlcaLed ln Lhe
oLher columns.
1he values of Cv ranged beLween 0 and 0,913, as shown ln Lhe
1ables. 1hese very low values demonsLraLed an excellenL scannlng
repeaLablllLy for boLh Lhe specLrophoLomeLers LesLed.
28

1able 2. vlLa Lasyshade color evaluaLlon (flxed Lo Lhe sLand).
Scannlng AL AC AP AL AL
LC
value
1.a 3,1 -3,6 -2,7 3,3 3,0 lalr
1.b 3,1 -3,7 -2,7 3,3 3,1 lalr
1.c 3,2 -3,7 -2,7 3,6 3,2 lalr
1.d 3,3 -3,8 -2,7 3,6 3,2 lalr
1.e 3,3 -3,8 -2,7 3,6 3,2 lalr
Cv
#
0,019 0,023 0 0,013 0,017
2.a 4,3 -2,6 -3,4 3,2 4,1 Ad[usL
2.b 4,3 -2,6 -3,4 3,2 4,1 Ad[usL
2.c 4,3 -2,6 -3,4 3,2 4,2 Ad[usL
2.d 4,3 -2,6 -3,4 3,2 4,1 Ad[usL
2.e 4,3 -2,6 -3,4 3,2 4,1 Ad[usL
Cv
#
0 0 0 0 0,011
3.a 6,1 -4,9 -2,9 3,3 6,1 lalr
3.b 6,1 -3,0 -2,9 3,3 6,1 lalr
3.c 6,2 -3,0 -2,9 3,3 6,1 lalr
3.d 6,2 -3,0 -2,9 3,3 6,1 lalr
3.e 6,2 -3,0 -3,0 3,3 6,1 lalr
Cv
#
0,009 0,009 0,013 0 0
4.a 2,4 0,1 -3,6 2,0 2,0 Cood
4.b 2,4 0,1 -3,6 2,0 2,0 Cood
4.c 2,4 0,1 -3,6 2,0 2,0 Cood
4.d 2,4 0,1 -3,6 2,0 2,0 Cood
4.e 2,4 0,1 -3,6 2,0 2,0 Cood
Cv
#
0 0 0 0 0
3.a 2,8 -1,1 -3,3 2,2 2,3 Cood
3.b 2,7 -1,1 -3,3 2,2 2,3 Cood
3.c 2,7 -1,1 -3,3 2,2 2,3 Cood
3.d 2,7 -1,1 -3,3 2,2 2,3 Cood
3.e 2,7 -1,1 -3,3 2,2 2,3 Cood
Cv
#
0,016 0 0 0 0
#
CoefflclenL of varlaLlon
29

1able 3. vlLa Lasyshade color evaluaLlon (hold by hand).
Scannlng AL AC AP AL AL
LC
value
1.a 4,0 -2,6 -3,0 2,8 3,9 Ad[usL
1.b 3,9 -2,7 -3,1 2,7 3,9 Ad[usL
1.c 3,8 -2,3 -3,0 2,7 3,7 Ad[usL
1.d 3,9 -2,7 -3,1 2,7 3,8 Ad[usL
1.e 3,7 -2,3 -3,1 2,3 3,6 Ad[usL
Cv
#
0,0293 0,0383 0,0179 0,0409 0,0343
2.a 3,2 -1,1 -3,7 2,7 2,9 Ad[usL
2.b 2,9 -1,1 -3,8 2,4 2,6 Cood
2.c 3,1 -1,2 -3,7 2,6 2,9 Ad[usL
2.d 2,9 -1,1 -3,6 2,4 2,7 Cood
2.e 3,1 -1,3 -3,8 2,3 2,8 Ad[usL
Cv
#
0,0441 0,0771 0,0223 0,0317 0,0469
3.a 3,2 -4,1 -2,3 3,1 3,1 lalr
3.b 3,4 -4,2 -2,8 3,2 3,3 lalr
3.c 3,3 -4,4 -2,8 3,2 3,3 lalr
3.d 3,6 -4,6 -2,3 3,1 3,6 lalr
3.e 3,6 -4,6 -2,6 3,1 3,6 lalr
Cv
#
0,0306 0,0321 0,0374 0,0174 0,04
4.a 2,9 0,1 -3,3 2,1 2,1 Cood
4.b 2,9 0,1 -3,3 2,1 2,1 Cood
4.c 2,8 0,0 -3,4 2,0 2,0 Cood
4.d 2,9 0,0 -3,3 2,1 2,1 Cood
4.e 2,9 0,1 -3,3 2,1 2,1 Cood
Cv
#
0,0133 0,9129 0,0082 0,0213 0,0213
3.a 3,0 -1,4 -3,7 2,3 2,7 Cood
3.b 3,0 -1,4 -3,6 2,3 2,7 Cood
3.c 2,7 -1,1 -3,6 2,1 2,4 Cood
3.d 2,9 -1,4 -3,6 2,3 2,7 Cood
3.e 2,9 -1,3 -3,6 2,3 2,6 Cood
Cv
#
0,0422 0,0988 0,0124 0,0396 0,0498
Cv = CoefflclenL of varlaLlon
30

1able 4. Ccean CpLlcs Su 1000 color evaluaLlon.
Scannlng L* a* b* Chroma Pue x ? Z
1.a 73,46 2,38 20,78 20,92 1,46 47,33 49,02 34,43
1.b 73,79 2,83 18,79 19,01 1,42 48,02 49,34 36,39
1.c 73,77 2,98 18,30 18,74 1,41 48,03 49,31 36,39
1.d 73,48 2,47 20,40 20,33 1,43 47,41 49,04 34,74
1.e 73,72 2,72 19,16 19,36 1,43 47,87 49,43 36,00
Cv
#
0,002 0,094 0,032 0,049 0,013 0,007 0,003 0,028
2.a 73,33 3,03 22,02 22,23 1,43 47,72 49,13 33,61
2.b 73,33 3,01 22,22 22,42 1,44 47,71 49,13 33,46
2.c 73,39 3,19 21,16 21,40 1,42 47,84 49,22 34,30
2.d 76,10 3,80 18,82 19,20 1,37 48,87 30,06 36,80
2.e 73,78 3,43 20,44 20,73 1,40 48,23 49,33 33,10
Cv
#
0,003 0,099 0,066 0,062 0,020 0,010 0,008 0,039
3.a 76,31 2,49 16,69 16,88 1,42 49,03 30,72 39,07
3.b 76,14 1,99 18,61 18,72 1,46 48,27 30,12 37,01
3.c 76,09 1,99 18,46 18,36 1,46 48,18 30,03 37,06
3.d 76,26 2,03 17,88 18,00 1,46 48,47 30,31 37,73
3.e 76,01 1,90 18,79 18,88 1,47 48,03 49,91 36,70
Cv
#
0,003 0,112 0,047 0,043 0,013 0,008 0,006 0,023
4.a 73,60 3,84 22,78 23,11 1,40 48,09 49,23 33,11
4.b 73,33 3,63 24,33 24,60 1,42 47,63 48,83 31,68
4.c 73,37 3,79 23,69 23,99 1,41 47,71 48,86 32,16
4.d 73,31 4,03 22,80 23,16 1,39 48,02 49,09 32,98
4.e 73,60 4,03 22,23 22,60 1,39 48,16 49,23 33,32
Cv
#
0,002 0,043 0,036 0,034 0,009 0,003 0,004 0,0229
3.a 73,49 3,62 20,23 20,37 1,39 47,83 49,03 34,86
3.b 73,74 3,69 19,68 20,02 1,39 48,23 49,46 33,64
3.c 73,94 4,03 17,80 18,26 1,33 48,69 49,78 37,37
3.d 76,41 4,42 16,27 16,86 1,31 49,38 30,36 39,28
3.e 73,64 3,73 19,33 19,91 1,38 48,11 49,30 33,60
Cv
#
0,003 0,083 0,089 0,080 0,023 0,014 0,019 0,049
Cv = CoefflclenL of varlaLlon
31

D|scuss|on
ln recenL years, sclenLlflc sLudy of denLal colour has been
dlrecLed Lowards mlnlmlzlng errors ln vlsual colour selecLlon prlmarlly
Lhrough Lhe use of Lwo lnsLrumenLs: colorlmeLers and
specLrophoLomeLers (PunLer eL al., 1987).
1he colorlmeLer ls a relaLlvely slmple and low-cosL lnsLrumenL
deslgned Lo measure colour on Lhe basls of Lhree axls or sLlmull by Lhe
way of fllLer LhaL slmulaLes Lhe human eye. 1he specLrophoLomeLer ls
a more sophlsLlcaLed lnsLrumenL, deslgned Lo measure an observed
ob[ecL by reflecLlon or Lransmlsslon, Lhe resulLs of whlch are Lhe enLlre
specLral curve, llmlLlng colour measuremenL Lo a vlslble frequencles
range (usually 330-800nm). 1he flrsL specLrophoLomeLers were
expenslve and cumbersome, wlLh large aperLure for measuremenL.
WlLh Lhe evoluLlon of opLlc flbre Lechnology, denLal manufacLurers are
now able Lo produce cosL-effecLlve specLrophoLomeLers LhaL are easy
Lo operaLe, wlLh a small aperLure for measuremenL.
8ecause specular reflecLed llghL conLalns llLLle or no colour
lnformaLlon, Lhe mosL lmporLanL developmenL was Lhe ablllLy Lo
exclude all specular measuremenLs. 1o obLaln Lhe proper degree of
absorpLlon and dlsperslon lnslde Lhe LooLh lL ls necessary Lo have llghL
peneLraLlng a LooLh Lo Lhe denLln level, Lravelllng Lhrough Lhe enamel,
and Lhen exlLlng some dlsLance away. 1hls ls posslble Lhrough flbre
opLlc Lechnology. Where Lhere are Lwo, parallel flber opLlcs,
(LransmlLLer and recelver), Lhe only llghL LhaL wlll enLer Lhe recelver
32

flbre opLlc ls Lhe llghL reflecLed from Lhe surface aL Lhe lnLersecLlon of
Lhe Lwo flber opLlcs' accepLance cone (!!L 1echnology, 2003).
1he lnlLlal sLep ln Lhe evaluaLlon of Lhe cllnlcal use of Lhe vlLa
Lasyshade denLal specLrophoLomeLer ls Lo conslder Lhe rellablllLy of
Lhe specLrophoLomeLer. lor Lhls reason, Lhe flrsL phase was Lo
evaluaLe Lhe repeaLablllLy of Lhe readlngs of Lhe lnsLrumenL, as a
mandaLory requlremenL Lo furLher evaluaLe Lhe performances ln
comparlson wlLh Lhe performance of Lhe Ccean CpLlcs Su 1000 as an
esLabllshed lab lnsLrumenL (vlchl eL al., 2004).
1he Ccean CpLlcs Su1000 ls equlpped wlLh an lnLegraLlng
sphere whlch dlrecLs a llghL source over an ob[ecL and collecLs almosL
all Lhe reflecLed llghL from Lhe ob[ecL wlLh a spherlcal cavlLy LhaL ls
LoLally dlffused and sLandardlzed whlLe (1eralon). Lasyshade's
measuremenL Lechnlque uLlllzes large dlameLer flber opLlcs arranged
ln a speclflc paLLern ln a sLalnless sLeel probe, LhaL are able Lo boLh
lllumlnaLe a LooLh and Lo recelve llghL LhaL ls lnLernally scaLLered by
Lhe enamel layer and reflecLed from Lhe denLln layer of Lhe LooLh.
Speclflc opLlc flbers LransmlL Lhe llghL Lo Lhe LooLh (source flbers) and
recelve Lhe llghL reflecLed from Lhe LooLh (recelver flbers), excludlng
all specular measuremenLs (!!L 1echnology, 2003).
1he readlng values obLalned from Lhe LesLs have shown an
excellenL scannlng repeaLablllLy, boLh for Lhe cllnlcal
specLrophoLomeLer (Lasyshade) and for Lhe laboraLory one (Su1000).
ln analyzlng 1able 4, lL can be sLaLed LhaL very low values of coefflclenL
of varlaLlon (0,002<Cv<0,111) were obLalned for Lhe Ccean CpLlcs
33

Su1000 (Lhe specLrophoLomeLer glves a readlng value as an average
of 3 scannlng). Conslderlng Lasyshade's readlng values, lL's posslble Lo
polnL ouL Lhe good repeaLablllLy ln repeaLed scannlng, boLh by flxlng
Lhe handplece of Lhe devlce Lo a graded sLand (0<Cv<0,022) and
holdlng lL by hand (0,008<Cv<0,913). Analyzlng sample n1 and sample
n2 colour values, ln boLh flxed and ln hand free evaluaLlon, Lasyshade
asses Lwo dlfferenL values of quallLy of Lhe resLoraLlon, lnfluenced by
Lhe values of AL (AL<3=Cood, 3<AL<3=lalr, AL>3=Ad[usL). lL may be
LenLaLlvely assumed LhaL Lhese dlfferenL quallLy evaluaLlons for Lhe
same sample are due Lo Lhe callbraLlon process.
1he ceramlc colour evaluaLlons performed wlLh Lhe cllnlcal
specLrophoLomeLer (Lasyshade) are noL ln absoluLe ClLLab* values,
buL Lhe lnsLrumenL glves Lhe measuremenLs as a comparlson wlLh Lhe
colour values seL ln Lhe specLrophoLomeLer. Lasyshade ls noL
programmed Lo measure ceramlc resLoraLlons glvlng absoluLe values.
1he lnsLrumenL's sofLware ls programmed Lo obLaln absoluLe colour
values only for naLural LeeLh. 1hese Lwo scannlng meLhods are
dlfferenL because Lhe lnsLrumenL Lakes lnLo conslderaLlon Lhe Lwo
dlfferenL sLrucLures analyzed: ceramlc resLoraLlons are generally less
Lhan 1.3mm ln Lhlckness and Lhe colour layers (denLln and opaque) are
from 0.2 - 0.4mm under Lhe enamel porcelaln layer. WlLh LeeLh, Lhe
denLln layer ls generally 1.0 - 1.3mm from Lhe ouLer surface. 1he
enamel Lhlckness ls a layer LhaL causes a scaLLerlng of Lhe peneLraLlng
llghL ray: Lhe hlgher Lhlckness of a naLural LooLh as opposed Lo a
34

ceramlc LooLh explalns Lhe dlfference beLween Lhe Lwo scannlng
sysLems.
1he dlfferences ln manufacLure do noL allow a dlrecL
comparlson Lo be made beLween Lhe Lwo LesLed lnsLrumenLs, because
Lhe absoluLe ClLLab* values seL ln Lhe Lasyshade for each colour are
noL supplled by Lhe manufacLurer and a pure A3 colour sample Lo
measure wlLh Ccean CpLlcs Su1000 was noL avallable.

Conc|us|ons
1hrough analysls of Lhe observaLlons ln Lhls sLudy and wlLhln
Lhe llmlLs of Lhe LesL used, some concluslons can be drawn.
1) Lven Lhough a dlrecL comparlson of Lhe lab and of Lhe
denLal specLrophoLomeLer was noL posslble because of Lhe
dlfference ln englneerlng, Lhe repeaLablllLy of Lhe cllnlcal
lnsLrumenL was comparable Lo Lhe lab lnsLrumenL.
2) 1he hlgh repeaLablllLy of readlngs of Lhe cllnlcal lnsLrumenL
ls an lnlLlal lmporLanL resulL ln Lhe evaluaLlon of Lhls
lnsLrumenL. lurLher sLudles are ln progress Lo evaluaLe
dlfferenL feaLures of Lhls lnsLrumenL LhaL have Lhe poLenLlal
Lo slmpllfy shade selecLlon as a crlLlcal sLep ln everyday
denLal pracLlce.
35

keferences

Clarke l!!. MeasuremenL of Lhe color of Lhe human LeeLh. uenLal Ceramlcs:
ub Co lnc. 1983.
uouglas 8u. reclslon of ln vlvo colorlmeLrlc assessmenLs of LeeLh. !
rosLheL uenL 1997,77:464-470.
Pammad lA. lnLraraLer repeaLablllLy of shade selecLlons wlLh Lwo shade
guldes. ! rosLheL uenL 2003,89:30-33.
PunLer 8S. 1he measuremenL of appearence. new ?ork: !ohn Wlley and
Sons, lnc. 1987.
lshlkawa-nagal S, lshlbashl k, 1suruLa C, Weber P, uenL M. 8eproduclblllLy
of LooLh color gradaLlon uslng a compuLer color-maLchlng Lechnlque applled Lo
ceramlc resLoraLlons. ! rosLheL uenL 2003,93:129-137.
lshlkawa-nagal S, SaLo 88, Shlralshl A, lshlbashl k. uslng a compuLer-color
maLchlng sysLem ln color reproducLlon of porcelaln resLoraLlons. arL 3: A newly
developed specLrophoLomeLer deslgned for cllnlcal appllcaLlon. lnL ! rosLhodonL
1994,7:30-33.
Ckubo S8, kanawaLl A, 8lchards MW, Chlldress S. LvaluaLlon of vlsual and
lnsLrumenL shade maLchlng. ! rosLheL uenL 1998,80:642-648.
aul S, eLer A, leLrobon n, Pammerle C.P.l. vlsual and
SpecLrophoLomeLrlc Shade Analysls of Puman 1eeLh. ! uenL 8es 2002,81:378-382.
aul S!, eLer A, 8odonl L, leLrobon n. ConvenLlonal vlsual vs
specLrophoLomeLrlc shade Laklng for porcelaln-fused-Lo-meLal crowns: a cllnlcal
comparlson. lnL ! erlodonLlcs 8esLoraLlve uenL 2004,24:222-231.
denLal colorlmeLer. ! rosLheL uenL 2002,88:383-390.
36

2002,87:637-666.

37

CnA1Lk 3

3.1 Spectrophotometr|c eva|uat|on of co|or match to VI1A c|ass|ca|
shade gu|de of four d|fferent veneer|ng porce|a|n systems for meta|
ceram|c restorat|ons.
Clovannl lazl, Alessandro vlchl, Cabrlele Corclolanl, Marco lerrarl.
2=#,"4%$'>-0,$%*'-3''.#$)"/),+'566?855:@?;55'
'
Introduct|on
Color maLchlng of a ceramlc resLoraLlon Lo naLural denLlLlon
remalns a key facLor ln achlevlng opLlmal esLheLlc resulLs ln prosLheLlc
denLlsLry. ln cllnlcal pracLlce Lhe color maLchlng Lask ls accompllshed
by Lhe shade selecLlon process, whlch sLarLs by uslng a vlsual
assessmenL or lnsLrumenLal color analysls. vlsual shade selecLlon ls Lhe
mosL common meLhod of color deLermlnaLlon. Several shade guldes
have been proposed by Lhe manufacLurers and by far Lhe mosL used
worldwlde ls Lhe vlLapan classlcal. Cnce Lhe LargeL shade map ls
deLermlned Lhe laboraLory should repllcaLe Lhls color by mean of a
porcelaln sysLem LhaL usually ls correlaLed Lo Lhe selecLed shade gulde.
1he facLors LhaL have an lnfluence on flnal color of denLal
porcelaln lnclude porcelaln brand and baLch, flrlng condlLlons,
condensaLlon Lechnlque, modellng llquld, subsLraLe and porcelaln
Lhlckness. 1he manlpulaLlve varlables of flrlng LemperaLures and
condensaLlon, as well as Lhe cholce of modellng llquld were found ln a
prevlous sLudy (8osensLlel eL al., 1988) Lo have llLLle lnfluence on Lhe
38

flnal color of Lhe resLoraLlon. 1he number of flrlngs however ls a
poLenLlal source of color varlaLlons as documenLed,(8osensLlel eL al.,
1988, 8arghl eL al., 1982, 8arghl eL al., 1977, 8arghl eL al., 1978, Lcker
eL al., 1983, !orgenson eL al., 1979, C'8rlen eL al., 1991) buL lf Lhe
number of flrlngs ls llmlLed Lo flve, Lhe effecL ls negllglble (8arghl eL al.,
1982).
8aLch Lo baLch varlaLlons were found Lo have a moderaLe
lnfluence on color (C'8rlen eL al., 1991, 8arghl eL al., 1983). 1he
subsLraLe, meanlng Lhe alloy Lype of Lhe meLal ceramlc resLoraLlon, ls a
poLenLlal source of color varlaLlon (8rewer eL al., 1983, !acobs eL al.,
1987, C'neal eL al., 1987, Seghl eL al., 1986, 1erada eL al., 1989,
Woolsey eL al., 1984, Crlspln eL al., 1991). An lmporLanL source of
varlablllLy of Lhe color ls Lhe porcelaln Lhlckness as prevlously reporLed
(!orgenson eL al., 1979, !acobs eL al., 1987, 1erada eL al., 1989, 1erada
eL al., 1989, uouglas eL al., 1999).
resLon eL al. (1983) ldenLlfled as one of Lhe ma[or llmlLs of Lhe
currenL shade-gulde sysLems Lhe facL LhaL porcelalns do noL maLch Lhe
shade guldes. Wlde varlaLlons of color accordlng Lo Lhe porcelaln
brand have been documenLed (8osensLlel eL al., 1988, C'8rlen eL al.,
1991, Seghl eL al., 1986, Croh eL al., 1992). CusLomlzed shade Labs
have been advocaLed Lo mlnlmlze Lhls problem buL so far Lhe denLal
communlLy has noL embraced Lhls procedure (Mlller eL al., 1987).
An addlLlonal dlfflculLy of predlcLlng Lhe flnal color ls
represenLed by Lhe need of havlng dlfferenL layers of porcelaln such as
opaque, denLln and enamel (C'8rlen eL al., 1994, C'8rlen eL al., 1983).
39

lL ls accepLed LhaL Lhe opaque layer should be as Lhln as posslble Lo
mask Lhe meLal subsLrucLure and usually appears Lo be 0.10-0.13 mm
(Chlche eL al., 1994). ln addlLlon, Lhe amounL of LranslucenL porcelaln
necessary Lo reproduce Lhe color of Lhe LargeL shade should be aL leasL
1.0 mm.(!acobs eL al., 1987, Seghl eL al., 1986, Chlche eL al., 1994,
McLean eL al., 1979). very llmlLed lnformaLlon ls avallable from Lhe
manufacLurers or from Lhe llLeraLure, on whaL Lhe ldeal proporLlon of
denLln and enamel should be.
1hls sLudy evaluaLed, by a specLrophoLomeLrlc analysls, Lhe
varlaLlons ln color beLween four denLal porcelaln sysLems and Lhe
LargeL shades A2, A3 and A3.3" of Lhe shade gulde vlLapan classlcal.
1he null hypoLhesls was LhaL all porcelaln sysLems would be able Lo
cllnlcally maLch Lhe lnLended shade achlevlng AL < 3.7.

ln order Lo make an approprlaLe use of Lhe porcelaln sysLems,
lnsLrucLlons regardlng Lhe proper layerlng were reLrleved from Lhe
manufacLurers' documenLaLlon of Lhe porcelaln sysLems. All Lhe
lnformaLlon avallable conslsLed of dlagrams where Lhe Lhlckness of Lhe
dlfferenL layers of opaque, denLln and enamel were calculaLed. 1he
measures were calculaLed aL 43 of Lhe lengLh of a cenLral lnclsor
sLarLlng from Lhe lnclsal margln. values were dlsplayed ln percenLage
and were used ln Lhe consLrucLlon of Lhe samples (1able 1).
40

1able 1. orcelaln sysLems selecLed for Lhe sLudy.
orcelaln sysLem orcelaln layer
Cpaque uenLln
uuceram klss
lnclsal
Cpaque uenLln
lvoclar lS d.SlCn
lnclsal
Cpaque, Cpaque denLln, uenLln
vlLa Cmega 900
lnclsal
Cpaque uenLln
Wleland 8eflex
lnclsal

ln order Lo slmulaLe meLal ceramlc resLoraLlons, dlsk-shaped
speclmens were preferred Lo LooLh-shaped speclmens prevlously
employed (Croh eL al., 1992). ulsk-shaped speclmens allowed a beLLer
conLrol of Lhe Lhlckness of dlfferenL layers and a flaL surface was
preferred ln order Lo allow a more preclse use of Lhe
specLrophoLomeLer and obLaln repeaLable color measures (Seghl eL
al., 1989, Wee eL al., 2000, kourLls eL al., 2004). A dlagram of Lhe
samples ls presenLed ln llg. 1.
llg. 1. Scheme of sLraLlflcaLlon of dlsk-shaped speclmens.
A porcelaln subsLraLe was selecLed (Cr-Co alloy - Peraenlum ,
Peraeus kulzer, uormagen, Cermany). MeLal dlsks 13 mm ln dlameLer
and 0.3 mm Lhlck were fabrlcaLed uslng a cyllndrlcal cusLom made
sLeel mold (llg. 2).
41

llg. 2. CusLom made cyllndrlcal devlce.
1he devlce also allowed havlng a mold 13 mm ln dlameLer
where helghL could be ad[usLed and acLed as a gulde Lo produce
callbraLed layers. 1he casL meLal speclmens were ad[usLed wlLh sLones,
alrborne-parLlcle abraded wlLh 30 m alumlnum oxlde, cleaned wlLh
sLeam, and Lhen oxldlzed accordlng Lo Lhe manufacLurer guldellnes.
1hree dlfferenL shades (A2, A3, A3.3) for four dlfferenL ceramlc
sysLems were ob[ecL of Lhe presenL lnvesLlgaLlon. Ceramlc sysLems
were vl1A Cmega 900 (vlLa Zahnfabrlk, 8ad Sacklngen,Cermany),
uuceram klss (ueguuenL, Panau, Cermany), Wleland 8eflex (Wleland
uenLal, forzhelm, Cermany) and lvoclar lS d.SlCn (lvoclar vlvadenL
AC, Schaan, LlechLensLeln) obLalnlng a LoLal of 12 comblnaLlons. lor
each group, Lhree samples were fabrlcaLed for a LoLal of 36 speclmens
(1able 1). 1he meLal speclmen was lnserLed ln Lhe devlce and Lhe same
devlce was used ln order Lo obLaln callbraLed layers of porcelaln. A
layer of 0.1 mm of porcelaln opaque was flrsL applled. 1ranslucenL
porcelaln, denLln and enamel were layered ln Lhe same manner
accordlng Lo Lhe values obLalned by Lhe manufacLurer dlagrams as
prevlously calculaLed (1able 2).
42

orcelaln sysLem uenLln porcelaln Lnamel porcelaln
VI1A Cmega 900
10 opaque denLln
+ 80 denLln
10
Duceram k|ss 80 20
W|e|and kef|ex 80 20
Ivoc|ar IS d.SIGN 30 30
1able 2. ercenLages of denLln and enamel LranslucenL porcelaln calculaLed aL 43 of Lhe lengLh of a
cenLral lnclsor sLarLlng from Lhe lnclsal margln.

1he LoLal amounL of LranslucenL porcelaln was 1 mm ln
Lhlckness. 1he use of 1.0 mm Lhlckness ls represenLaLlve of Lhe usual
cllnlcal condlLlons and has been accepLed for porcelaln Lranslucency
(8rodbelL eL al., 1980).
1he layer Lhlckness was evaluaLed afLer each flrlng and Lhe
necessary correcLlons were made by elLher grlndlng or addlng
porcelaln. A dlglLal callper (1631 uC1, 8eLa, Mllan, lLaly) wlLh a 10 m
resoluLlon was used for all Lhe measuremenLs.
CondensaLlon procedures were execuLed manually ln Lhe same
manner as rouLlne laboraLory work. All Lhe speclmens were fabrlcaLed
by Lhe same operaLor. 1he porcelalns were flred accordlng Lo Lhe
manufacLurer's recommendaLlons.
ln vl1A Cmega 900 speclmens, a 0.1 mm layer of opaque
denLln was applled ln addlLlon Lo LranslucenL denLln and enamel as
recommended by Lhe manufacLurer. Powever, Lhe LoLal Lhlckness of
Lhe porcelaln was equal Lo 1.0 mm as were Lhe oLher speclmens. All
Lhe speclmens were sub[ecLed Lo four flrlngs. no glazlng cycle was
performed. 1he porcelaln surface was noL pollshed because Lhe
43

adopLed specLrophoLomeLer ls deslgned Lo avold Lhe lnfluence of
specular reflecLlon, so glazlng and pollshlng do noL lnLerfere wlLh Lhe
measuremenLs (!!L 1echnology, 2003).
Color of denLal maLerlals ls expressed ln L*", a*" and b*"
coordlnaLes accordlng Lo Lhe ClLLab* color space. L*" value
represenLs Lhe brlghLness, a*" value represenLs Lhe redness or
greeness and b*" value represenLs Lhe yellowness or blueness.
1he color dlfference of Lwo ob[ecLs can be calculaLed comparlng Lhe
dlfferences beLween respecLlve coordlnaLes applylng Lhe formula
proposed by Clarke (1983):
AL = [(AL*)
2
+ (Aa*)
2
+ (Ab*)
2
]
1/2

ln Lhe presenL sLudy Lhe Lhreshold value of AL < 3.7 for a
cllnlcal color maLch was adopLed as suggesLed ln Lhe llLeraLure
(!ohnsLon eL al., 1989).
Color measuremenLs were made by a cllnlcal
specLrophoLomeLer Lasyshade (llg. 3). 1he lnsLrumenL has already
sLored Lhe daLa for Lhe vlLapan Classlcal shade gulde. 1he lnsLrumenL
uLlllzes a 20 WaLL halogen sLablllzed LungsLen fllamenL lamp. 1he
Lasyshade probe conLalns mulLlple recelver flber opLlcs spaced aL
dlfferenL dlsLances from Lhe llghL source, coupled Lo Lwo
specLromeLers, whlch varles Lhe effecLlve depLh of Lhe color
measuremenL wlLhln a LooLh or ceramlc resLoraLlon. As a resulL, Lhe
paLh lengLhs of Lhe llghL rays are dlfferenL for Lhe Lwo specLromeLers.
1he specLral resoluLlon ls 23 nm over Lhe vlslble llghL range from 400
44

nm Lo 700 nm. 1he specLrophoLomeLer makes up Lo 30 measuremenLs
per second (!!L 1echnology, 2003).

llg. 3. Cllnlcal specLrophoLomeLer vl1A Lasyshade.

Corclolanl eL al. (2006) prevlously assessed Lhe repeaLablllLy of
color readlng ablllLy of Lhe vlLa Lasyshade and as suggesLed Lhe
lnsLrumenL was secured Lo a sLand ln order Lo have a repeaLable
poslLlon for Lhe readlngs. llve readlngs were made for every sample
and a mean was calculaLed.
uelLa L values, calculaLed by Lhe specLrophoLomeLer accordlng
Lo Lhe formula proposed by Clarke (1983) were sLaLlsLlcally analyzed.
1he normallLy of Lhe dlsLrlbuLlon ln Lhe groups was prellmlnarlly
checked uslng Lhe kolmogorv-Smlrnov LesL. 1wo one-way AnCvA LesLs
were applled assumlng flrsL Lhe values of AL as Lhe dependenL varlable
and Lhe shade selecLed as facLor and Lhen Lhe values of AL as Lhe
dependenL varlable and Lhe ceramlc sysLem selecLed as facLor. 1he
level of slgnlflcance was seL aL < 0.03. 1ukey PSu LesL was applled for
posL-hoc comparlson where needed.

45

kesu|ts
1he values recorded by Lhe specLrophoLomeLer are reporLed ln
1able 3.
Ceramlc Cmega 900 uuceram klss lvoclar dSlCn Wleland
Shade A2 A3 A3.3 A2 A3 A3.3 A2 A3 A3.3 A2 A3 A3.3
2.9 3.9 2.0 2.0 3.4 4.2 3.3 3.7 4.7 1.2 3.9 4.9
3.4 4.2 2.1 2.4 3.6 4.3 3.3 3.9 4.7 1.4 4.2 3.0
AL values
2.9 3.9 2.0 2.0 3.3 4.0 3.2 3.3 4.6 1.6 4.4 4.8
1able 3. uelLa L values recorded by Lhe specLrophoLomeLer.
values of AL ranged beLween 1.2 and 3.0. Shade cllnlcal
maLchlng (AL < 3.7) was recorded for shade A2 ln all Lhe ceramlc
sysLems, for shade A3 ln uuceram klss and lvoclar lS speclmens and
for shade A3.3 only ln vlLa Cmega 900 speclmens. All Lhe oLher
speclmens falled Lo achleve shade maLchlng.
1he means of AL values calculaLed for Lhe ceramlc sysLem and
for Lhe shade are shown ln 1able 4. 1he means for Lhe four ceramlc
sysLems were 3.03, 3.27, 3.92 and 3.49 regardless of Lhe shades. vl1A
Cmega 900 obLalned Lhe besL average shade maLchlng.
Ceramlc sysLem Shade
A2 A3 A3,3 Mean
vl1ACmega 900 3.07 4.00 2.03 3.03
uuceram klss 2.13 3.30 4.17 3.27
lvoclar 3.40 3.70 4.67 3.92
Wleland 8eflex 1.40 4.17 4.90 3.49
Mean 2.30 3.84 3.94
Slgnlflcance a b b
1able 4. Means of AL values horlzonLally accordlng Lo Lhe ceramlc
sysLem andverLlcally accordlng Lo Lhe shade.
46

Powever AnCvA analysls showed no sLaLlsLlcally slgnlflcanL
dlfferences (> 0.03) beLween Lhe porcelaln brands.
Cne-way AnCvA showed LhaL Lhe ceramlc shade slgnlflcanLly
lnfluenced Lhe AL values (< 0.03). osL-hoc comparlson among Lhe
ceramlc shades furLher revealed LhaL values of AL of A2
a
shade were
comparable and slgnlflcanLly beLLer lf compared Lo shades A3
b
and
A3.3
b
.

D|scuss|on
1hls sLudy compared Lhe color dlfferences of flred porcelaln
compared Lo Lhe shade gulde vlLapan Classlcal. 1he sLraLlflcaLlon of
Lhe porcelaln was execuLed ln accordance Lo Lhe dlagrams reLrleved by
Lhe manufacLurers' lnsLrucLlons for a cenLral lnclsors calculaLed aL 43
of Lhe lengLh of a cenLral lnclsor sLarLlng from Lhe lnclsal margln. lor
Lhls sLudy was declded Lo use flaL dlsk shaped speclmens ln order Lo
provlde unlform Lhlcknesses of Lhe ceramlc layers. 1ooLh shaped
speclmens, employed ln oLher sLudles (Croh eL al., 1992),

allow llghL
reflecLlon slmllar Lo cllnlcal condlLlons, buL hardly allow unlform
Lhlcknesses of porcelaln. lL ls well documenLed ln Lhe llLeraLure LhaL
Lhlckness of porcelaln ls one of Lhe maln sources of shade mlsmaLch
(!orgenson eL al., 1979, !acobs eL al., 1987, 1erada eL al., 1989, 1erada
eL al., 1989, uouglas eL al., 1999). ln Lhe presenL sLudy a unlform
Lhlckness of 1.0mm was obLalned for all Lhe speclmens. 1he use of a
seL Lhlckness allows for a deflned condlLlon under whlch Lhe color
dlfferences can be quanLlfled and porcelaln brands can be compared.
47

1he use of 1.0mm Lhlckness ls represenLaLlve of Lhe usual cllnlcal
condlLlons and has been accepLed for porcelaln Lranslucency (8rodbelL
eL al., 1980).
Several sLudles (!ohnsLon eL al., 1989, Seghl eL al., 1989, 8uyLer
eL al., 1987, 8agaln eL al., 2001, vlchl eL al., 2004) provlde lnformaLlon
regardlng cllnlcal color-maLchlng Lolerance. vlchl eL al. (2004) reporLed
value of AL < 1 as noL appreclable by human eye. !ohnsLon eL al.
(1989) deLermlned cllnlcally accepLable shade maLchlng ln oral
condlLlons for AL up Lo 3.7.
lor shade A2 all Lhe porcelaln brands showed values of AL
below or equal Lo 3.7 and Lherefore cllnlcally accepLable. 1hls resulL
was also conflrmed by one-way AnCvA LesL, where a sLaLlsLlcally
slgnlflcanL dlfference was found (p<0.03). osL-hoc LesL assessed a
closesL color correspondence wlLh sLandards for A2
a
shade raLher
Lhan A3
b
and A3.3
b
shades.(1able 4)
1herefore, Lhe null hypoLhesls musL be re[ecLed because only
speclmens ln A2 shade for all ceramlc sysLems, ln A3 shade for
uuceram klss and lvoclar lS and ln A3.3 shade for vlLa Cmega 900
have been able Lo cllnlcally maLch Lhe lnLended shade achlevlng AL <
3.7, whlle all Lhe oLher speclmens falled Lo achleve shade maLchlng.
1he use of a layered porcelaln (opaque, body and lnclsal) was
preferred because slmllar Lo Lhe cllnlcal condlLlon. ln a prevlous sLudy
(C'8rlen eL al., 1994, C'8rlen eL al., 1983) double layer porcelaln was
found Lo produce dlfferences ln color when compared Lo slngle layers
samples. ulfferenL porcelaln sysLems seem Lo requlre dlfferenL
48

proporLlons ln Lerms of Lhlckness of porcelaln layers. Such varlaLlon ln
ad[uncL Lo varlaLlon of powders conLenLs ls a greaL source of color
varlaLlon.
Cne of Lhe llmlLaLlons of Lhls Lype of lnvesLlgaLlons ls due Lo
Lhe llmlLed lnformaLlon avallable from Lhe manufacLurers regardlng
Lhe amounL of opaque, body and lnclsal porcelaln necessary Lo obLaln
Lhe deslderaLe shade. ln Lhe presenL sLudy Lhe sLraLlflcaLlon was based
on Lhe dlagrams reLrleved from Lhe manufacLurers' lnsLrucLlons, buL lL
ls unknown whaL Lhe degree of accuracy of such dlagrams ls.
luLure lnvesLlgaLlons should be addressed Lo oLher shades (8,
C, and u) of Lhe vl1A scale and Lo esLabllsh lf varylng Lhe percenLage of
lnclsal and body LranslucenL porcelaln beLLer shade maLchlng can be
achleved. 1he role ln shade maLchlng of opaque modlflers and opaque
denLln should also be clarlfled.
Accordlng Lo Lhe resulLs of Lhe presenL lnvesLlgaLlon, lL may be
concluded LhaL Lhe lndlcaLlons glven from Lhe manufacLurer Lo help
Lhe Lechnlclan Lo obLaln Lhe color maLch beLween Lhe selecLed shade
and Lhe flnal resLoraLlon are very llmlLed, and noL sufflclenL Lo avold
color mlsmaLch. Lven lf Lhe rlghL color selecLlon ls made, Lhe
fabrlcaLlon of resLoraLlon of Lhe almed color ls sLlll a non compleLely
predlcLable procedure.
49

keferences

8arghl n, Coldberg . orcelaln shade sLablllLy afLer repeaLed flrlng. ! rosLheL
uenL 1977,37:173-173.
8arghl n, edrero !A, 8osch 88. LffecLs of baLch varlaLlon on shade of denLal
porcelaln. ! rosLheL uenL 1983,34:623-627.
8arghl n, 8lchardson !1. A sLudy of varlous facLors lnfluenclng shade of
bonded porcelaln. ! rosLheL uenL 1978,39:282-284.
8arghl n. Color and glaze: LffecLs of repeaLed flrlngs. ! rosLheL uenL 1982,
47: 393-393.
8rewer !u, Akers Ck, Carlapo uA, Sorensen SL. SpecLromeLrlc analysls of Lhe
lnfluence of meLal subsLraLes on Lhe color of meLal-ceramlc resLoraLlons. ! uenL 8es
1983,64:74-77.
8rodbelL 8P, C'8rlen W!, lan L. 1ranslucency of denLal porcelalns. ! uenL 8es
1980,39:70-73.
Chlche C!, lnaulL A. LsLheLlcs of anLerlor flxed prosLhodonLlcs.
Chlcago:CulnLessence, 1994,97-113.
Clarke l!!. MeasuremenL of Lhe color of Lhe human LeeLh. uenLal
ceramlcs.roceedlngs of Lhe llrsL lnLernaLlonal Symposlum on Ceramlcs. Chlcago,
CulnLessence ub Co lnc, 1983,441.
Corclolanl C, vlchl A. 8epeaLablllLy of colour readlng wlLh a cllnlcal and a
laboraLory specLrophoLomeLer. lnL uenL SA 2006,8:62-70.
Crlspln 8!, Seghl 88, Clobe P. LffecL of dlfferenL meLal ceramlc alloys on Lhe
color of opaque and denLln porcelaln. ! rosLheL uenL 1991,63:331-336.
uouglas 8u, rzybylska M. redlcLlng porcelaln Lhlckness requlred for denLal
shade maLches. ! rosLheL uenL 1999,82:143-149.
Lcker CA, Moser !8, Woznlak W1, 8rlnsden Cl. LffecL of repeaLed flrlng on
fluorescence of porcelaln-fused-Lo-meLal porcelalns. ! rosLheL uenL 1983,34:207-
214.
50

Croh CL, C'8rlen W!, 8oenke kM. ulfferences ln color beLween flred porcelaln
and shade guldes. lnL ! rosLhodonL 1992,3:310-314.
!acobs SP, Coodacre C!, Moore 8k, uykema 8W. LffecL of porcelaln Lhlckness
and Lype of meLal-ceramlc alloy on color. ! rosLheL uenL 1987,37:138-143.
!!L 1echnology L. vlLa Lasyshade 1echnology. 8ad Sacklngen, vlLa Cmbh,
2003, 3-7.
!ohnsLon WM, kao LC. AssessmenL of appearance maLch by vlsual
observaLlon and cllnlcal colorlmeLry. ! uenL 8es 1989,68:819-822.
!orgenson MW, Coodklnd 8!. SpecLrophoLomeLrlc sLudy of flve porcelaln
shades relaLlve Lo Lhe dlmenslons of color, porcelaln Lhlckness, and repeaLed flrlngs.
! rosLheL uenL 1979,42:96-103.
McLean !. 1he sclence and arL of denLal ceramlcs. vol. 1 1he naLure of denLal
ceramlc and Lhelr cllnlcal use. Chlcago: CulnLessence, 1979,113-182.
Mlller L. Crganlzlng color ln denLlsLry. ! Am uenL Assoc 1987, Sp ls: 26L-40L.
C'8rlen W!, lan L, Croh CL. Color dlfferences coefflclenLs of body opaque
double layers. lnL ! rosLhodonL 1994,7:36-61.
C'8rlen W!, !ohnsLon WM, lanlan l. uouble-layer color effecLs ln porcelaln
sysLems. ! uenL 8es 1983,64:940-943.
C'8rlen W!, kay kS, 8oenke kM, Croh CL. Sources of color varlaLlon on flrlng
porcelaln. uenL MaLer 1991,7:170-173.
C'neal S!, Lelnfelder kl, Lemons !L, !amlson PC. LffecL of meLal surfaclng on
Lhe color characLerlsLlcs of porcelaln veneer. uenL MaLer 1987,3:97-101.
resLon !u. CurrenL sLaLus of shade selecLlon and color maLchlng.
CulnLessence lnL 1983,16:47-38.
8agaln !C !r, !ohnsLon WM. Mlnlmum color dlfferences for dlscrlmlnaLlng
mlsmaLch beLween composlLe and LooLh color. ! LsLheL 8esLor uenL 2001,13:41-48.
51

8osensLlel Sl, !ohnsLon WM. 1he effecLs of manlpulaLlve varlables on Lhe
color of ceramlc meLal resLoraLlons. ! rosLheL uenL 1988,60:297-303.
8uyLer lL, nllner k, Moller 8. Color sLablllLy of denLal composlLe resln
maLerlals for crown and brldge veneers. uenL MaLer 1987,3:246-231.
Seghl 88, PewleLL L8, klm !. vlsual and lnsLrumenLal colorlmeLrlc assessmenLs
of small color dlfferences on LranslucenL denLal porcelaln. ! uenL 8es 1989,68:1760-
1764.
Seghl 88, !ohnsLon WM, C'8rlen W!. erformance assessmenL of colorlmeLrlc
devlces on denLal porcelalns. ! uenL 8es 1989,68:1733-1739.
Seghl 88, !ohnsLon WM, C'8rlen W!. SpecLrophoLomeLrlc analysls of color
dlfferences beLween porcelaln sysLems. ! rosLheL uenL 1986,36:33-40.
1erada ?, Maeyama S, Plrayasu 8. 1he lnfluence of dlfferenL Lhlcknesses of
denLln porcelaln on Lhe color reflecLed from Lhln opaque porcelaln fused Lo meLal.
lnL ! rosLhodonL 1989,2:332-336.
1erada ?, Sakal 1, Plrayasu 8. 1he masklng ablllLy of an opaque porcelaln: A
specLrophoLomeLrlc sLudy. lnL ! rosLhodonL 1989,2:239-264.
vlchl A, lerrarl M, uavldson CL. Color and opaclLy varlaLlons ln Lhree dlfferenL
resln-based composlLe producLs afLer waLer aglng. uenL MaLer 2004,20:330-334.
Wee AC, kang L?, !ohnsLon WM, Seghl 88. LvaluaLlng porcelaln color maLch
of dlfferenL porcelaln shade-maLchlng sysLems. ! LsLheL uenL 2000,12:271-280.
Woolsey Cu, !ohnson WM, C'8rlen W!. Masklng power of denLal opaque
porcelalns. ! uenL 8es 1984,63:936-939.

53

CnA1Lk 4

4.1 Co|our correspondence of a ceram|c system |n two d|fferent
shade gu|des.
Cabrlele Corclolanl, Alessandro vlchl, Cecllla Coraccl, Marco lerrarl.
>-0,$%*'-3'.#$)"/),+'566?8A<:?9;@6@'

Introduct|on
1he sLandard cllnlcal procedure Lo selecL and reproduce naLural
LeeLh colour wlLh ceramlc resLoraLlon ls Lhe vlsual comparlson uslng a
denLal shade gulde. 1he flrsL shade gulde, lnLroduced ln 1929 by vlLa,
was sLrucLured accordlng Lo an epldemlologlcal dlsLrlbuLlon of LeeLh
colour observed ln naLure. 1he lnLroducLlon ln 1936 of vlLa Lumln
vacuum Shade Culde represenLed a mllesLone ln Lhe developmenL of a
unlversal sLandard for LooLh colour reference. noLwlLhsLandlng lLs
wlde cllnlcal success, Lhls shade gulde ls sLlll based on appearance
raLher Lhan on a sclenLlflc basls. SclenLlflc was lnsLead Lhe approach
for Lhe developmenL ln 1998 of Lhe vlLa 3uMasLer shade gulde,
referenced Lo Lab* sysLem esLabllshed ln 1976 by Lhe Commlslon
lnLernaLlonale du l'Lclalrage, whlch provldes Lhe lnLernaLlonal
sclenLlflc sLandards for colour measuremenLs. ln oLher words, Lhe vlLa
3u-MasLer ls founded on a sclenLlflc colour dlsLrlbuLlon, havlng a
sysLemaLlc coverage of Lhe LooLh colour space of naLural LeeLh
accordlng Lo Lhe colourlmeLrlc ClLLab* order prlnclple, raLher Lhan on
54

Lhe mere observaLlon of Lhe naLural Llssue aspecLs (Pammad eL al.,
2003). '
AlLhough Lhe use of such a shade gulde can be consldered an
advancemenL, ln pracLlce colour selecLlon ls sLlll carrled performed by
vlsually comparlng shade Labs wlLh Lhe LooLh.'
WlLh Lhe ob[ecLlve of mlnlmlzlng colour mlsmaLch due Lo vlsual
esLlmaLlon, cllnlcal denLal specLrophoLomeLers have been developed
and markeLed. Such lnsLrumenLs are based on ClLLab* colour sysLem,
alLhough Lhey provlde measuremenLs ln any denLal shade sysLem.
1helr Lechnology allow Lo converL percepLlon ln numbers, Lhus maklng
colour selecLlon and colour communlcaLlon ln denLlsLry easler and
more rellable (Corclolanl eL al., 2006, 8alLzer eL al., 2003, uougas eL
al., 1997, lshlkawa-nagal eL al., 2003, Ckubo eL al., 1998, aul eL al.,
2002, aul eL al., 2004, 1ung eL al., 2002).
AlLhough cllnlcal specLrophoLomeLers are sLlll under
evaluaLlon, Lhey have so far provlded saLlsfacLory resulLs and have Lhe
poLenLlal Lo greaLly slmpllfy Lhe flrsL sLep ln Lhe colour maLchlng
procedure, l.e. colour selecLlon.
neverLheless, Lhe followlng sLep ln Lhe procedure, colour
reproducLlon, sLlll requlres aLLenLlon and posslbly a more sclenLlflc
approach. ln Lhls perspecLlve, lL would seem useful lf also resLoraLlve
sysLems could be based on Lhe ClLLab* colour space, as Lhe 3u MasLer
shade gulde and cllnlcal specLrophoLomeLers are.
vlLa Cmega 900 ls currenLly Lhe only denLal ceramlc sysLem
markeLed ln vlLapan Classlcal shade gulde as well as ln vlLapan 3u
55

MasLer. lor Lhls reason vlLa Cmega 900 was Lhe ob[ecL of Lhls sLudy,
whlch was almed aL LesLlng, by means of a cllnlcal specLrophoLomeLer,
Lhe ablllLy of Lhe menLloned ceramlc sysLem Lo correcLly reproduce
Lhe selecLed shade colour wlLh reference Lo Lhe vlLapan Classlcal and
3u MasLer shade guldes.
1he formulaLed null hypoLhesls was LhaL no slgnlflcanL
dlfference exlsLed beLween selecLed colour and resLoraLlon colour for
Lhe Lwo shade guldes.

1he sLand-alone cllnlcal specLrophoLomeLer vl1A Lasyshade
(vlLa Zahnfabrlk, 8ad Sacklngen, Cermany) was used Lo measure
colour dlfferences ln Lhe ceramlc sysLem vlLa Cmega 900
MeLallkeramlk (vlLa Zahnfabrlk).
llfLeen ceramlcs dlscs were fabrlcaLed wlLh dlfferenL layerlng
paLLerns for each shade, keeplng consLanL Lhe speclmen LoLal
Lhlckness.
Self-curlng acryllc resln dlscs (uuraLay, LC1 032802, 8ellance
uenLal ManufacLurlng Co., WorLh, lL, uSA), 0,7 mm ln Lhlckness and 13
mm ln dlameLer were made ln a cyllndrlcal sLalnless sLeel mold. AfLer
applylng Lhe maLerlal lnLo Lhe mold, a glass plaLe was pressed onLo Lhe
mosL superflclal layer ln order Lo obLaln a flaL surface. CreaL aLLenLlon
was glven Lo avold bubble formaLlon wlLhln Lhe resln.
Cnce compleLely cured, Lhe resln sample was exLracLed from
Lhe mold, puL ln a refracLory casL fllled wlLh lnvesLmenL (CC SLellavesL,
56

CC Lurope, Leuven, 8elglum), Lo be placed ln a burnouL furnace
(CvomaL 7, Manfredl-SALu, 1orlno, lLaly), followlng Lhe wax
ellmlnaLlon Lechnlque.
AL Lhe end of Lhe burnouL cycle, Lhe lnvesLmenL was moved Lo
an lnducLlon casLlng machlne (LnLerprlse, !elrus, Plcksvllle, n?, uSA),
and fllled wlLh a base meLal alloy (8lomaLe-C, Sllpo, lLaly). 1he
obLalned dlsc-shaped speclmens were roughened wlLh a sandblasLer
(Skylab, 1ecnogaz, arma, lLaly), uslng AlC
2
parLlcles of 100 m
dlameLer.
lor ceramlc layerlng, A3 shade for vlLapan Classlcal and 2M3
shade for vlLapan 3u-MasLer were selecLed for belng Lhe mosL
frequenLly re-assorLed shade ln each sysLem accordlng Lo Lhe
manufacLurer. lollowlng manufacLurer's lnsLrucLlons, a wash opaque
layer (A3 Cpaque 9003/2M3 Cpaque 9307, vlLa Zahnfabrlk) was
applled flrsL and flred ln a ceramlc oven (vacumaL 300, vlLa
Zahnfabrlk). 1hen, a second opaque layer was added and flred (C2
Cpaque asLe 332, vlLa Zahnfabrlk). AL Lhls sLage Lhe flrsL opaque
denLlne layer (A3 Cpaque uenLlne 9033/2M3 Cpaque uenLlne 9033,
vlLa Zahnfabrlk) was applled ln a Lhlckness conLrolled by Lhe regulaLed
mould, and flred followlng Lhe flrlng manufacLurer lnsLrucLlons. 1hen,
a second denLlne layer was sLraLlfled (A3 uenLlne 9033/2M3 uenLlne
9033, vlLa Zahnfabrlk), and consequenLly flred. SubsequenLly, as
lndlcaLed ln ceramlc lnsLrucLlons, Lhe enamel layer was sLraLlfled (Ln2
Lnamel 9072, LC1 7846, vlLa Zahnfabrlk), and flred ln Lhe ceramlc
oven. AL Lhe end, for each sample, a glaze flrlng was done accordlng Lo
57

Lhe ceramlc manufacLurer's lnsLrucLlons. Lach layer was measured by
an elecLronlc calllper (1631 uC1, 8eLa, Mllan, lLaly) wlLh a 10 m
resoluLlon. 1hree dlsLlncL layerlng paLLerns were reallzed LhaL dlffered
for Lhe Lhlckness of Lhe opaque denLln, denLln, and enamel layers
(1able 1).

1able 1. Layerlng paLLerns of Lhe ceramlc speclmens

Sample
C900 Cl C900 3u
L Alloy Cpaque
Cpaque
uenLln
uenLln Lnamel llnal
1-3 16-20 1 0,30mm 0,13mm 0,23 mm 0,60mm 0,30mm 1,30mm
6-10 21-23 2 0,30mm 0,13mm 0,33 mm 0,70mm 0,10mm 1,30mm
11-13 26-30 3 0,30mm 0,13mm 0,43 mm 0,30mm 0,20mm 1,30mm

!B#4),-B1-)-=#),"4'=#%/0,#=#$)/'
1he specLrophoLomeLer vlLa Lasyshade ls composed by a base
unlL and a hand plece. 1he colour evaluaLlon was done free hand
slmulaLlng Lhe cllnlcal use. 8esLoraLlon" mode was selecLed uslng A3
and 2M3 shade as comparlson.

!)%)"/)"4%*'%$%*+/"/'
uelLa L values calculaLed by Lhe specLrophoLomeLer accordlng
Lo Lhe formula proposed by Clarke (1983) were sLaLlsLlcally analyzed.
Pavlng prellmlnarlly checked for normallLy of daLa dlsLrlbuLlon
(kolmogorov-Smlrnov LesL) and homogenelLy of group varlances
(Levene LesL), Lhe 1wo-Way Analysls of varlance was applled wlLh
uelLa L values as Lhe dependenL varlable, shade gulde-ceramlc sysLem
and layerlng paLLern as facLors. 1he 1ukey LesL was applled for posL-
58

hoc comparlsons as needed. ln all Lhe analyses Lhe level of slgnlflcance
was seL aL p<0,03.

kesu|ts
1he 1wo-Way AnCvA showed LhaL boLh shade gulde-ceramlc
sysLem" and layerlng paLLern" slgnlflcanLly lnfluenced Lhe uelLa L
values (p<0,001). arLlcularly, regardless of Lhe layerlng paLLern, Lhe
uelLa L values of vlLa Cmega 900 ln 3u MasLer shade gulde were
slgnlflcanLly lower Lhan Lhose of vlLa Cmega 900 ln vlLapan Classlcal
shade gulde (1able 2).

1able 2. uescrlpLlve sLaLlsLlcs of Lhe AL values recorded ln Lhe experlmenLal groups.
ln Lhe slgnlflcance column, dlfferenL superscrlpL leLLers label slgnlflcanL dlfferences
when Lhe ceramlc sysLem*layerlng paLLern lnLeracLlons were assessed aL Lhe
unlvarlaLe level.

Ceramlc SysLem L n of
speclmens
Mean (AL) Su Slgnlflcance
(p<0.001)
1 3 3,04 0,46 d
2 3 2,88 0,48 d
Cmega 900 Classlcal
3 3 2,9 0,46 d
1 3 2,3 0,47 c
2 3 1,76 0,49 b
Cmega 900 3u MasLer
3 3 1,34 0,47 a

1he Lhree assessed layerlng paLLerns dlffered slgnlflcanLly
among each oLher, accordlng Lo Lhe 1ukey LesL for posL-hoc
comparlsons. WlLh regard Lo Lhe slgnlflcanL beLween-facLor
lnLeracLlons, when evaluaLed aL Lhe unlvarlaLe level Lhey dlsclosed a
slmllarlLy ln uelLa L values for all Lhe layerlng paLLerns wlLh vlLapan
59

Classlcal. Conversely, wlLh vlLapan 3u MasLer, Lhe uelLa L values were
lower for Lhe layerlng paLLern 1 Lhan for Lhe 2, whose uelLa L values
were ln Lurn lower Lhan Lhose of paLLern 3 (1able 2). 1hese dlfferences
were sLaLlsLlcally slgnlflcanL accordlng Lo Lhe 1ukey LesL for palrwlse
comparlsons.

D|scuss|on
Colour maLchlng has always been a baslc and prlmary sLep ln
prosLheLlc and resLoraLlve denLlsLry. Colour ls one of Lhe
characLerlsLlcs of a denLal resLoraLlon LhaL Lhe paLlenL evaluaLes flrsL.
1herefore, colour selecLlon and reproducLlon represenL a challenge Lo
Lhe cllnlclan (uouglas eL al., 1998).
vlLapan Classlcal has been consldered for many years Lhe
reference shade gulde among Lhose avallable for ceramlc sysLems.
1hls role ls golng Lo be progresslvely Laken over by vlLapan 3u-MasLer,
a relaLlvely new concepL of sysLemaLlc coverage of naLural LeeLh
colour space, based on Lhe colourlmeLrlc ClLLab* order prlnclple
(Pammad eL al., 2003).
ln Lhls sLudy, ln order Lo verlfy wheLher wlLh Lhls new shade
gulde Lhe maLch beLween Lab sLandards and layered speclmen ls
lnfluenced by Lhe shade gulde, speclmens made wlLh Lhe only one
ceramlc sysLem avallable for use ln boLh shade sysLems, vlLa Cmega
900, were compared. Ceramlc speclmens were prepared accordlng Lo
manufacLurer's layerlng lnsLrucLlons ln a sLandardlzed 1,3 mm
Lhlckness over 0,3 mm Lhlck meLal subsLrucLure. Cllnlcally, ln Lhe LooLh
60

preparaLlons for porcelaln fused Lo meLal (lM) resLoraLlons, LooLh
reducLlon may range beLween a mlnlmum of 1,2 mm aL Lhe cervlcal
Lhlrd and 1,6 mm aL Lhe mlddle Lhlrd. AL Lhe laLLer level, 1,2-1,3 mm
represenLs Lhe Lhlckness of opaque and veneerlng, whereas 0,3-0,4
mm ls Lhe Lhlckness requlred for Lhe meLal subsLrucLure. ln Lhe
occlusal or lnclsal Lhlrd Lhe amounL of LooLh sLrucLure Lo be removed ls
aL leasL 2,0 mm.
ln recenL years Lhe sclenLlflc sLudy of denLal colour has been
dlrecLed Lowards mlnlmlzlng errors ln vlsual colour selecLlon Lhrough
Lhe use of specLrophoLomeLers (aul eL al., 2002, aul eL al., 2004,
Wee eL al., 2002).
1he vlLa Lasyshade ls one of Lhe laLesL specLrophoLomeLer
avallable for cllnlcal use. ln Lhls sLudy Lhe lnsLrumenL was used wlLh a
ceramlc sysLem belonglng Lo Lhe same manufacLurer (Corclolanl eL al.,
2006).
1he lnsLrumenL's sofLware ls programmed Lo glve absoluLe
ClLLab* colour values only for naLural LeeLh. Conversely, when
assesslng Lhe colour of a ceramlc, Lhe specLrophoLomeLer provldes Lhe
dlfferences (uelLa values) from colour values preseLs ln Lhe
lnsLrumenLs daLabase. 1he specLrophoLomeLer daLa acqulslLlon ls
dlfferenL when readlng naLural LooLh and ceramlc also because Lhe
lnsLrumenL applles dlfferenL scannlng meLhods on Lhe Lwo dlversely
sLrucLured subsLraLes. Ceramlc resLoraLlons are generally less Lhan 1,6
mm ln Lhlckness and Lhe colour layers (denLln and opaque) are from
0,2-0,4 mm under Lhe enamel porcelaln layer. Conversely, lnslde Lhe
61

LeeLh, Lhe denLln layer ls generally 1,0-1,3 mm from Lhe ouLer surface.
lurLhermore, Lhe enamel Lhlckness causes a scaLLerlng of Lhe
peneLraLlng llghL. Moreover, Lhe overall Lhlckness of a naLural LooLh ls
greaLer Lhan LhaL of a ceramlc LooLh (!!L 1echnology., 2003).
WlLh regard Lo ceramlc assessmenL, lL should be polnLed ouL
LhaL Lhe referenLlal colour values ln Lhe lnsLrumenL daLabase can be
consldered rellable for colour maLchlng because Lhe ceramlc sysLems
ob[ecL of Lhls sLudy and Lhe cllnlcal specLrophoLomeLer used for colour
measuremenLs are produced by Lhe same manufacLurer.
When assesslng Lhe lnfluence of Lhe shade gulde by comparlng
equally layered speclmens of vlLa Cmega 900 ln A3 and 2M3 shades, lL
was evldenL LhaL Lhe laLLer exhlblLed a closer colour correspondence
wlLh Lhe colour values seL ln Lhe specLrophoLomeLer. 1hls resulL may
be explalned by Lhe ablllLy of Lasyshade Lo beLLer maLch colours LhaL
are organlzed ln a sclenLlflcally-based sysLemaLlc spaLlal dlsLrlbuLlon.
1hls colour dlsLrlbuLlon ls Lhe basls of Lhe 3u MasLer shade gulde
(8aylndlr eL al., 2007, aravlna eL al., 2002). As a maLLer of facL,
Cmega 900 ln 2M3 shade demonsLraLed a slgnlflcanLly closer colour
correspondence Lhan Cmega 900 ln A3 shade (1able 2). Such a flndlng
leads Lo re[ecLlon of Lhe null hypoLhesls.
uaLa ln 1able 2 demonsLraLe LhaL Lhe closesL colour
correspondence wlLh sLandards was obLalned when, regardless of Lhe
ceramlc sysLem, Lhe n3 layerlng paLLern was followed. ln Lhls paLLern
equal Lhlcknesses of Cpaque uenLlne (0,43 mm) and uenLlne (0,30
mm) were sLraLlfled.
62

1he sLaLlsLlcal analysls revealed a slgnlflcanL lnfluence of Lhe
layerlng paLLern on colour correspondence (1able 2). lL should
Lherefore be of sclenLlflc and cllnlcal lnLeresL Lo assess wlLh furLher
research Lo whaL exLenL each layer lnfluences Lhe flnal colour.
1he flndlng of a closer colour correspondence when referrlng
Lo 3u MasLer also suggesLs Lhe use of ceramlc sysLems based on Lhls
shade gulde ln comblnaLlon wlLh Lhe cllnlcal specLrophoLomeLer, for
Lhe purpose of mlnlmlzlng errors ln Lhe colour maLchlng procedures.

Conc|us|on
WlLhln Lhe llmlLaLlon of Lhls sLudy, speclmens of vlLa Cmega
900 ln vlLapan 3uMasLer shade gulde exhlblLed for Lhe lnvesLlgaLed
shade a closer maLch ln colour Lhan speclmens of Lhe same ceramlc
sysLem ln vlLapan Classlcal shade gulde. 1herefore, Lhe hlgher colour
correspondence can be consldered Lo be shade gulde dependanL.
lurLher sLudles are necessary ln order Lo esLabllsh Lhe lnfluence of
each layer on Lhe flnal colour of Lhe resLoraLlons.
63

keferences

LooLh shade maLchlng devlces. lnLernaLlonal !ournal of CompuLerlzed uenLlsLry
2003, 8:129-32.
8aylndlr l, kuo S, !ohnsLon WM, Wee AC. Coverage error of Lhree
concepLually dlfferenL shade gulde sysLems Lo vlLal unresLored denLlLlon. !ournal of
rosLheLlc uenLlsLry 2007, 98:173-83.
Clarke l!!. MeasuremenL of Lhe colour of Lhe human LeeLh. uenLal Ceramlcs:
ub Co lnc. 1983.
Corclolanl C, vlchl A. 8epeaLablllLy of colour readlng wlLh a cllnlcal and a
laboraLory specLrophoLomeLer. lnLernaLlonal uenLlsLry SouLh Afrlca 2006, 8:62-70.
uouglas 8u, 8rewer !u. AccepLablllLy of shade dlfferences ln meLal ceramlc
crowns. !ournal of rosLheLlc uenLlsLry 1998, 79:234-60.
shade maLches. !ournal of rosLheLlc uenLlsLry 1999, 82:143-49.
uouglas 8u. reclslon of ln vlvo colourlmeLrlc assessmenLs of LeeLh. !ournal
of rosLheLlc uenLlsLry 1997, 77:464-70.
guldes. !ournal of rosLheLlc uenLlsLry 2003, 89:30-33.
of LooLh colour gradaLlon uslng a compuLer colour-maLchlng Lechnlque applled Lo
ceramlc resLoraLlons. !ournal of rosLheLlc uenLlsLry 2003, 93:129-37.
lnsLrumenL shade maLchlng. !ournal of rosLheLlc uenLlsLry 1998, 80:642-48.
aravlna 8u, owers !M, lay 8M. Colour comparlson of Lwo shade guldes.
lnLernaLlonal !ournal of rosLhodonLlcs 2002, 13:73-78.
64

aul S, eLer A, leLrobon n, Pammerle C.P.l. vlsual and
SpecLrophoLomeLrlc Shade Analysls of Puman 1eeLh. !ournal of uenLal 8esearch
2002, 81:378-82.
specLrophoLomeLrlc shade Laklng for porcelaln-fused Lo-meLal crowns: a cllnlcal
comparlson. lnLernaLlonal !ournal of erlodonLlcs and 8esLoraLlve uenLlsLry 2004,
24:222-31.
Shllllngburg P1, !acobl 8, 8rackeLL SL. lundamenLals of 1ooLh reparaLlon
for CasL MeLal and orcelaln 8esLoraLlons. 2nd ed. Chlcago: CulnLessence ub Co
lnc. 1991.
denLal colourlmeLer. !ournal of rosLheLlc uenLlsLry 2002, 88:383-90.
Wee AC, Monaghan , !ohnsLon WM. varlaLlon ln colour beLween lnLended
maLched shade and fabrlcaLed shade of denLal porcelaln. !ournal of rosLheLlc
uenLlsLry 2002, 87:637-66.
65

4.2 Co|or correspondence of two d|fferent ceram|c systems |n one
shade gu|de
Cabrlele Corclolanl, Alessandro vlchl, Chrls Louca, Marco lerrarl.
>-0,$%*'-3'C,-/)1#)"4'.#$)"/),+&'/0D="))#EF

IN1kCDUC1ICN
uenLal porcelaln, conslderlng wear reslsLance, sLrengLh,
Loughness and good esLheLlcs, ls one of Lhe maLerlals mosL used Lo
replace naLural LooLh Llssue (kelly eL al., 1996). Powever denLal
porcelaln does have llmlLaLlons due Lo lLs numerous manlpulaLlve
varlables such as mlxlng of a powder wlLh a llquld, layerlng schemes,
flrlng procedures. lor Lhese reasons, Lhe almed shade ls noL easy Lo
obLaln, Lhus esLheLlc excellence ls noL always achlevable. Conrad eL al.
(2007) ln a sysLemaLlc revlew of Lhe llLeraLure reporLed LhaL several
all-ceramlc maLerlals and sysLems are currenLly avallable for cllnlcal
use, and LhaL Lhere ls noL a slngle unlversal maLerlal or sysLem for all
cllnlcal slLuaLlons. A successful resLoraLlon ls dependenL upon several
varlables lncludlng Lhe sklll of Lhe cllnlclan, Lhe lnherenL properLles of
Lhe maLerlal used and Lhe llmlLaLlons of Lhe manufacLurlng process.
1he esLheLlc demands of boLh paLlenLs and cllnlclans have
resulLed ln Lhe wldespread use of porcelaln and wlLh lLs ablllLy Lo
maLch Lhe color of naLural LeeLh lL ls ofLen Lhe maLerlal of cholce.
Powever, cllnlcal sLudles (Mllledlng eL al., 1998, 8ergman eL al., 1999,
S[gren eL al., 1998, Wee eL al., 2002) have shown LhaL Lhe flnal color
66

maLch of porcelaln resLoraLlons relaLlve Lo Lhe ad[acenL naLural
denLlLlon remalns a challenge.

1ooLh color ls a comblnaLlon of Lhe color of Lhe denLln, a
relaLlvely Lhlck, opaque, chroma rlch layer and Lhe color of enamel, a
relaLlvely Lhlnner, LranslucenL, qulLe achromaLlc layer. 1hese
fundamenLal layerlng aspecLs of LooLh color and appearance should
ldeally be repllcaLed wlLh porcelaln. 1here ls an addlLlonal esLheLlc
challenge posed wlLh meLal ceramlc resLoraLlons, where a naLural
appearance musL be achleved wlLh slgnlflcanLly Lhlnner layers. 1he
dlfferenL layers of a naLural LooLh provlde varylng dlffuse reflecLance
and Lhere ls a relaLlonshlp beLween Lranslucency and Lhlckness of Lhe
layers. 1he color and reflecLance of Lhe lnner layers poses a challenge
Lo Lhe cllnlclan almlng Lo a good esLheLlc resulL (C'8rlen, 2008). uozlc
eL al. (2003) ln an ln vlLro sLudy reporLed LhaL small changes ln
Lhlckness and shade of opaque and LranslucenL porcelaln layers can
lnfluence Lhe flnal shade of Lhe layered all ceramlc speclmens.

Several
oLher facLors are relevanL ln lnfluenclng Lhe flnal color of porcelaln
resLoraLlons, such as flrlng (CzLurk eL al., 2008), glazlng (?llmaz eL al.,
2008), Lhe mlxlng raLlo beLween powder and llquld (Zhang eL al.,
2004), dlfferenL meLal frameworks (kourLls eL al., 2004).
1he color selecLlon procedure has also been Lhe sub[ecL of
several lnvesLlgaLlons (Wee eL al., 2002, Clarke, 1983, Pammad, 2003,
8alLzer eL al., 2003, uouglas, 1997).

lL ls noL a sclenLlflcally based
procedure and Lherefore lL may be consldered one of Lhe weakesL
llnks ln achlevlng Lhe besL posslble esLheLlc resulL. 1he lnLroducLlon of
67

Lhe vlLa 3u MasLer shade gulde (vlLa Zahnfabrlk, 8ad Sacklngen,
Cermany) was an lmporLanL lmprovemenL Lo mlnlmlze poLenLlal errors
ln color maLchlng. 1he vlLa 3u MasLer shade gulde, due Lo Lhe
equldlsLanL dlsLrlbuLlon of Lhe avallable colors ln color space, has
made Lhe color maLch procedure sLralghLer. ln addlLlon Lhe dlfferenL
shade Labs are more unlformly spaced compared Lo oLher shade
guldes (8aylndlr eL al., 2007, aravlna eL al., 2002). Pammad eL al.
(2003) reporLed LhaL Lhe vlLa 3u MasLer shade gulde ls assoclaLed wlLh
slgnlflcanL lnLraraLer repeaLablllLy lmprovemenL among general
denLlsLs when compared wlLh Lhe vlLa Lumln vacuum shade gulde.
When comparlng Lhe ablllLy of a ceramlc sysLem markeLed
boLh ln vlLapan Classlcal and ln vlLa 3u MasLer shade gulde Lo
correcLly maLch Lhe selecLed shade, Corclolanl eL al. (2009) found LhaL
vlLa Cmega 900 ln vlLa 3u MasLer shade gulde exhlblLed a closer color
maLch Lhan Lhe same ceramlc sysLem ln vlLapan Classlcal. 1herefore,
Lhe hlgher color maLch could be consldered Lo be shade gulde
dependanL. Conslderlng Lhls resulL, Lhe alm of Lhls sLudy was Lo LesL by
means of a cllnlcal specLrophoLomeLer Lhe ablllLy of Lwo dlfferenL
denLal porcelaln sysLems Lo correcLly reproduce Lhe selecLed shade
color wlLh reference Lo vlLa 3u MasLer shade gulde. Among ceramlc
maLerlals, Lhe 2 porcelalns selecLed for Lhls sLudy are acLually Lhe only
sysLems manufacLured accordlng Lo vlLa 3u MasLer shade gulde. 1he
null hypoLhesls was LhaL no dlfference exlsLed beLween Lhe Lwo
ceramlc sysLems ln Lhe correcL reproducLlon of Lhe selecLed color.

68

Mater|a| and Methods
1wo ceramlc sysLems were selecLed for Lhls sLudy: (1) vlLa
Cmega 900 MeLallkeramlk (vlLa Zahnfabrlk, 8ad Sacklngen, Cermany)
and (2) vlLa vM13 (vlLa Zahnfabrlk, 8ad Sacklngen, Cermany), boLh
based on vlLa 3u MasLer shade gulde. 1he cllnlcal specLrophoLomeLer
vl1A Lasyshade (vlLa Zahnfabrlk, 8ad Sacklngen, Cermany) was used
Lo measure color dlfferences. 1he repeaLablllLy of color readlngs and
Lherefore Lhe use of Lhls cllnlcal specLrophoLomeLer for research
purposes was prevlously LesLed (Corclolanl eL al., 2006). 1o verlfy Lhe
color rellablllLy of Lhe 2 ceramlc sysLems ob[ecL of Lhe sLudy, 13
ceramlc dlscs were fabrlcaLed wlLh dlfferenL layer Lhlcknesses for each
ceramlc sysLem, for a LoLal of 30 speclmens. 1he overall Lhlckness of
Lhe speclmens remalned consLanL LhroughouL aL 1.3 mm Lhlckness of
ceramlc flred over 0.3 mm Lhlckness of a base meLal alloy (8lomaLe-C,
Sllpo, 8ome, lLaly) framework. 1hls LoLal Lhlckness was selecLed on Lhe
basls LhaL Lhe recommended degree of LooLh reducLlon for meLal
ceramlc resLoraLlons ls 1.6 mm aL Lhe mlddle Lhlrd of Lhe LooLh
(Shllllngburg eL al., 1991).
AuLo-polymerlzlng acryllc resln dlscs (uuraLay, LC1 032802,
8ellance uenLal ManufacLurlng Co, WorLh, lll), 0.3 mm ln Lhlckness and
13 mm ln dlameLer were made ln a cyllndrlcal sLalnless sLeel mold.
AfLer placlng Lhe maLerlal lnLo Lhe mold, a glass plaLe was pressed
onLo Lhe superflclal layer Lo obLaln a flaL surface. Care was Laken Lo
avold bubble formaLlon wlLhln Lhe acryllc resln. AfLer polymerlzaLlon,
Lhe acryllc resln speclmen was exLracLed from Lhe mold, puL ln a
69

refracLory casL fllled wlLh lnvesLmenL (CC SLellavesL, CC Lurope,
Leuven, 8elglum) and placed ln a burnouL furnace (CvomaL 7,
Manfredl-SALu, 1urln, lLaly). AL Lhe end of Lhe burnouL cycle, Lhe
lnvesLmenL was moved Lo an lnducLlon casLlng machlne (LnLerprlse,
!elrus, Plcksvllle, n?) and fllled wlLh a base meLal alloy (8lomaLe-C,
Sllpo). 1he resulLlng dlsc-shaped speclmens were roughened wlLh an
alrbone-parLlcle abrader (Skylab, 1ecnogaz, arma, lLaly) uslng AlC
2

parLlcles of 100 m dlameLer (Alumlnlum Cxlde, 8onvlg uenLal Mfg,
uaugaard, uenmark) aL 6 bars pressure. llaL dlsc speclmens were used
ln Lhe sLudy Lo faclllLaLe Lhe process of obLalnlng conLrolled
Lhlcknesses of Lhe ceramlc layers, slnce 8arreLL eL al. (2002) found no
slgnlflcanL dlfferences ln shade maLchlng accuracy beLween Lab and
dlsk deslgn.

1he selecLed color was 2M3 ln Lhe vlLa 3u MasLer shade gulde.
lollowlng Lhe manufacLurer's lnsLrucLlons, a wash opaque layer was
applled flrsL and flred ln a ceramlc furnace (vacumaL 300, vlLa
Zahnfabrlk), followed by a second opaque layer whlch was added and
flred.
AL Lhls sLage Lhe flrsL opaque denLln layer was applled ln a
Lhlckness conLrolled by Lhe regulaLed mold and flred followlng Lhe
manufacLurer's flrlng lnsLrucLlons. A second denLln layer was
subsequenLly sLraLlfled and flred. 1he enamel layer was also sLraLlfled
and flred ln Lhe ceramlc furnace. All Lhe veneerlng maLerlals were
produced by Lhe same manufacLurer (vlLa Zahnfabrlk) (1able l).

70

1able l. MaLerlals used for veneerlng procedures
Cmega 900 8atch VM 13 8atch
Wash Cpaque 2M3 Cpaque 9037 6203! WC Wash Cpaque asLe 339 7666
Cpaque 2M3 Cpaque 9037 6203! C2 Cpaque asLe 332 7739
Cpaque Dent|n
2M3 Cpaque uenLlne
9033
11690 2M3 8ase uenLlne 040 7316
Dent|n 2M3 uenLlne 9033 7999 2M3 uenLlne 070 7468
Lname| Ln2 Lnamel 9072 13200 LnL Lnamel 191 7933

llnally, for each speclmen a glaze flrlng was made accordlng Lo
Lhe manufacLurer's lnsLrucLlons. 1he flrlng cycles were performed
sLrlcLly followlng manufacLurer's lnsLrucLlons. AL Lhe end of each flrlng
cycles, each layer was measured by an elecLronlc dlglLal callper (1631
uC1, 8eLa, Mllan, lLaly) wlLh a 10 m accuracy. 1he Lhlckness of each
layer was consldered accepLable for Lhe sLudy only when Lhe varlaLlon
ln Lhlckness was 20 m. 1he Lhlcknesses of Lhe speclmens are shown
ln 1able ll.

1able ll. Layerlng schemes of Lhe ceramlc speclmens
Sample
C900 VM 13
L Alloy Cpaque
Cpaque
uenLlne
uenLlne Lnamel llnal
1-3 16-20 1 0.30mm 0.13mm 0.23mm 0.60mm 0.30mm 1.30mm
6-10 21-23 2 0.30mm 0.13mm 0.33mm 0.70mm 0.10mm 1.30mm
11-13 26-30 3 0.30mm 0.13mm 0.43mm 0.30mm 0.20mm 1.30mm
*LS = Layerlng Scheme

1hese layerlng schemes were selecLed on Lhe basls of
recommendaLlons from Lhe manufacLurer. Slnce lazl eL al. (2009)

71

found

LhaL a proper color maLch cannoL be guaranLeed by solely
relylng on layerlng schemes (LS) recommended from manufacLurers, 2
furLher sllghLly dlfferenL layerlng schemes, already LesLed ln a prevlous
sLudy (Corclolanl eL al., 2009), were evaluaLed.

1he measuremenLs were made wlLh Lhe cllnlcal
specLrophoLomeLer vlLa Lasyshade. 1he color evaluaLlon was
performed by placlng hand plece of Lhe lnsLrumenL on a sLand, Lhus
sLandardlzlng poslLlon and dlsLance Lo mlnlmlze Lhe readlng error
(Corclolanl eL al., 2006).

8esLoraLlon" mode was selecLed on Lhe
specLrophoLomeLer and used LhroughouL. ln 8esLoraLlon" mode, Lhe
lnsLrumenL compares Lhe color parameLers of Lhe examlned
resLoraLlons wlLh Lhe preseL color parameLers of Lhe selecLed shade.
1he values are expressed as dlfferences beLween Lhe daLa sLored ln
Lhe lnsLrumenL and Lhe measured speclmens, and expressed ln
Chroma (Lhe aspecL of color ln Lhe Munsell color sysLem by whlch a
sample appears Lo dlffer from a gray of Lhe same llghLness or
brlghLness and LhaL corresponds Lo saLuraLlon of Lhe percelved color)
(PunLer eL al., 1987), Pue (Lhe aLLrlbuLe of color percepLlon by means
of whlch an ob[ecL ls [udged Lo be red, yellow, green, and so forLh)
(PunLer eL al., 1987) and LlghLness (Lhe percepLlon by whlch whlLe
ob[ecLs are dlsLlngulshed from gray ob[ecLs and llghL from dark colored
ob[ecLs) (PunLer eL al., 1987).

Lven lf Lhe Chroma, Pue and LlghLness are slngularly lmporLanL
ln order Lo beLLer undersLand Lhe dlfferences beLween Lhe daLa sLored
and Lhe daLa from Lhe speclmens, for calculaLlng Lhe color dlfferences
72

Lhe AL (dlsLance beLween polnLs represenLlng colors ln Lhe color space
havlng recLangular coordlnaLes) (PunLer eL al., 1987) ls Lhe mosL
lmporLanL parameLer, accordlng wlLh Lhe formula proposed by Clarke
(1983). lor Lhls reason, ln Lhe presenL sLudy AL values were
sLaLlsLlcally analyzed.
1o deLermlne Lhe slgnlflcance of Lhe dlfferences ln shade maLch
recorded by Lhe 2 groups, havlng checked LhaL AL daLa dlsLrlbuLlon
was normal accordlng Lo Lhe kolmogorov-Smlrnov LesL (CGF642) and
LhaL group varlances were homogeneous uslng Lhe Levene LesL
(CG.204), Lhe Lwo-way Analysls of varlance (AnCvA) was applled wlLh
AL as Lhe dependenL varlable, ceramlc sysLem and layerlng scheme as
facLors. 1he 1ukey PSu (PonesLly SlgnlflcanLly ulfferenL) LesL was
applled for mulLlple comparlsons. ln all Lhe LesLs Lhe level of
slgnlflcance was seL aL HGF03.

kesu|ts
1ables lll and lv reporL Lhe color values measured wlLh Lhe vlLa
Lasyshade specLrophoLomeLer for vlLa Cmega 900 and vlLa vM13
respecLlvely. 1he ouLcome of Lhe Lwo-way AnCvA ls reporLed ln 1able
v. 1he Lwo-way AnCvA revealed LhaL Lhe ceramlc sysLem slgnlflcanLly
lnfluenced Lhe AL values (CI.001).

73

1able lll. vlLa Lasyshade color evaluaLlon for Cmega 900 ln vlLa 3u MasLer shade
gulde (2M3) ceramlc sysLem. ln Lhe flrsL column Lhe scannlng daLa for each sample
are lndlcaLed. ln Lhe oLher columns Lhere are Lhe means ( Su) of Lhe values of AL
and of uelLa relaLed Lo LlghLness, Chroma and Pue, because Lhe Lasyshade
specLrophoLomeLer makes comparlson measuremenLs.

Sample AL AC AP AL
1-3 2.30 0.16 -1.94 0.19 -3.18 0.13 -0.18 0.41
6-10 1.76 0.03 -0.64 0.17 -4.20 0.03 -0.40 0.19
11-13 1.34 0.03 -0.02 0.29 -3.22 0.04 0.30 0.16

Speclflcally, regardless of Lhe layerlng scheme, vM13 had
slgnlflcanLly lower AL values Lhan Cmega 900. 1he layerlng scheme
was a slgnlflcanL facLor for AL values (CI.001).

1able lv. vlLa Lasyshade color evaluaLlon of vM13 ceramlc sysLem ln 2M3 shade. ln
Lhe flrsL column Lhe scannlng daLa for each sample are lndlcaLed. ln Lhe oLher
columns Lhere are Lhe means ( Su) of Lhe values of AL and of uelLa relaLed Lo
LlghLness, Chroma and Pue, because Lhe Lasyshade specLrophoLomeLer makes
comparlson measuremenLs.

Sample AL AC AP AL
16-20 1.98 0.08 -1.96 0.09 0.36 0.18 0 0.12
21-23 1.64 0.11 0.96 0.09 -2.06 0.09 1.04 0.27
26-30 1.20 0.10 -0.36 0.11 -2.40 0.03 0.30 0.10

1able v. 1wo-way AnCvA for shade maLch.

df Sum of Squares Mean Square l
Ceramlc 1 .280 .280 27.374 .000
LS 2 3.783 1.892 186.131 .000
Ceramlc*LS 2 .061 .30 2.984 .042

74

When means were compared, Lhe 1ukey LesL for palrwlse
comparlsons revealed LhaL Lhe AL values were lower for Lhe LS3
a
Lhan
for Lhe LS2
b
, whose AL values were ln Lurn lower Lhan Lhose of LS1
c

(slgnlflcanL dlfferences reporLed ln 1able vl - LS column). Also Lhe
ceramlc sysLem-layerlng scheme lnLeracLlon was found Lo be
sLaLlsLlcally slgnlflcanL, and Lhe 1ukey LesL consequenLly applled for
palrwlse comparlsons revealed LhaL when layered accordlng Lo LS1,
vlLa vM13
C
resulLed ln a closer shade maLch when compared wlLh vlLa
Cmega 900
u
(slgnlflcanL dlfferences are reporLed ln 1able vl -
Slgnlflcance column).

1able vl. uescrlpLlve sLaLlsLlcs of AL values recorded ln Lhe experlmenLal groups. ln
Lhe LS column, dlfferenL superscrlpL leLLers label slgnlflcanL dlfferences when Lhe
layerlng scheme means were compared wlLh Lhe 1ukey LesL (CIF03). ln Lhe
slgnlflcance column, dlfferenL caplLal leLLers label slgnlflcanL dlfferences when Lhe
ceramlc sysLem*layerlng scheme means were compared wlLh Lhe 1ukey LesL.

LS Ceramlc Mean Su Slgnlflcance
Cmega 900 2.3 0.16 u 1
c
vM13 1.98 0.08 C
Cmega 900 1.76 0.03 8 2
b
vM13 1.64 0.11 8
Cmega 900 1.34 0.03 A 3
a
vM13 1.2 0.1 A

75

D|scuss|on
1he null hypoLhesls LhaL no dlfference exlsLed beLween Lhe 2
ceramlc sysLems Lo correcLly maLch Lhe selecLed color was re[ecLed,
because vlLa vM13 resulLed ln a closer color maLch (CIF001).
uesplLe Lhe pleLhora of avallable lnformaLlon concernlng denLal
ceramlc manufacLurlng, Lhe lmporLance of layerlng ln order Lo achleve
Lhe besL color maLch ls ofLen noL addressed wlLh a sufflclenL sclenLlflc
raLlonale. 1he problem ls mosL ofLen managed sub[ecLlvely uslng Lhe
sklll and experlence of Lhe lndlvldual ceramlsL lnvolved. 1o have a
more ob[ecLlve and sclenLlflc approach Lo Lhe problem, Lhe basellne
reference for Lhe currenL lnvesLlgaLlon was Lhe lnformaLlon abouL
layerlng Laken from Lhe dlagrams supplled ln Lhe manufacLurer's
lnsLrucLlons

(lazl eL al., 2009).
Cf Lhe 3 layerlng schemes chosen, Lhe LS2 was prepared
followlng Lhe manufacLurer's lnformaLlon obLalned from Lhe dlagrams.
1he oLher 2 layerlng schemes followed were sllghLly dlfferenL Lo
evaluaLe Lhe posslble lnfluence LhaL varlaLlons ln layerlng could have ln
color maLch, as ceramlsLs work free-hand and Lhls could resulL ln small
dlfferences ln Lhe layers of Lhe arLlfacLs. 1he varlous schemes followed
dlffered from each oLher ln Lhe raLlos used of Lhe base/opaque denLln
and Lhe denLln layer relaLlve Lo Lhe Lhlckness of Lhe enamel layer.
1he 2 ceramlc sysLems LesLed are boLh based on Lhe vlLa 3u
MasLer shade gulde. ln a prevlous sLudy, when comparlng Lhe same
ceramlc sysLem (vlLa Cmega 900) uslng Lhe vlLapan Classlcal and vlLa
3u MasLer shade gulde, speclmens of vlLa Cmega 900 layered ln 3u
76

MasLer reporLed a closer shade maLch when compared Lo speclmens
of Lhe same ceramlc sysLem layered ln vlLapan Classlcal (Pammad,
2003).

Concernlng wlLh accepLablllLy and percepLlblllLy Lolerance of
shade mlsmaLch ln a cllnlcal seLLlng, uouglas eL al. (2007) found LhaL
Lhe predlcLed color dlfference aL whlch 30 of Lhe denLlsL could
percelve a color dlfference (30/30 percepLlblllLy) was 2.6 AL unlLs, and
Lhe predlcLed color dlfference aL whlch 30 of Lhey would remake Lhe
resLoraLlon due Lo color mlsmaLch (cllnlcally unaccepLable color
maLch) was 3.3 AL.
ln Lhe presenL sLudy, an analysls of Lhe values obLalned from
Lhe Lasyshade specLrophoLomeLer (Lable lll and lv), shows LhaL all Lhe
speclmens have values of AL below 2.6 (1.10<AL<2.46). When means
were compared, Lhe facLor layerlng scheme resulLed ln slgnlflcanL
lnLeracLlon (CI.03). Analyzlng Lhe values ln 1able vl, lL can be
hlghllghLed LhaL Lhe closesL shade maLch was achleved for Lhe LS3,
where Lhe raLlo beLween base/opaque denLln and denLln was 1:1 and
Lhe Lhlckness of Lhe enamel layer was 0.20 mm. Conslderlng LS2,
where Lwo parLs denLln were layered upon one parL of base/opaque
denLln (raLlo 1:2) and Lhe Lhlckness of Lhe enamel was 0.10 mm, no
dlfferences were found beLween Cmega 900 and vM13 ln shade
maLch. lor whaL abouL concernlng LS1, whlch had Lhe same layerlng
raLlo beLween base/opaque denLln and denLln as LS2 buL a Lhlcker
enamel layer (0.30 mm versus 0.10 mm), an enhanced shade maLch
was found for speclmens manufacLured wlLh vM13
C
(Mean of AL=1.98
77

0.08) raLher Lhan Lhe Cmega 900
u
(Mean of AL=2.30 0.16). lL could
be speculaLed LhaL Lhls Lrend may be due Lo Lhe dlfference ln hue (P)
beLween Lhe Lwo ceramlcs, as Lhe dlfferences ln Chroma (Cmega 900
AC= -1.94 0.19, vM13 AC= -1.96 0.09) and LlghLness (Cmega 900
AL= -0.18 0.41, vM13 AC= 0 0.12) showed Lo be very slmllar for Lhe
2 ceramlc LesLed, Lhus scarcely lnfluenclng Lhe AL. Conversely, an
analysls of Lhe value AP (dlfference ln Pue) ln Lable 3 and 4 for Lhe LS1
(speclmens #1-3 1able lll and #16-20 1able lv) revealed LhaL vM13
(AP= 0.36 0.18) obLalned beLLer resulLs Lhan Cmega 900 (AP=-3.18
0.13). ln Lhe presenL sLudy, only one color of Lhe 2 ceramlc sysLems
has been analyzed. 1herefore, conslderlng Lhls llmlLaLlon, Lhe resulLs
has necessarlly Lo be consldered as a Lrend ln assesslng lf Lhe ceramlc
sysLems are able Lo correcL maLch Lhe almed shade. Lven Laklng lnLo
accounL Lhls llmlLaLlon, Lhe lmporLance of Lhe knowledge of Lhe
behavlor of each ceramlc sysLem appear Lo be declslve ln order Lo
obLaln a proper color maLch beLween Lhe lnLended shade and Lhe
ceramlc arLlfacL.
As dlfferenL raLlo beLween layers ended ln slgnlflcanL
dlfferences, lL may be of sclenLlflc and cllnlcal lnLeresL Lo furLher
lnvesLlgaLe Lhe relaLlve conLrlbuLlon of each layer Lo Lhe flnal color for
each slngle ceramlc sysLem.

78

Conc|us|ons
WlLhln Lhe llmlLaLlons of Lhls sLudy, lL can be sLaLed LhaL boLh
vlLa vM13 and vlLa Cmega 900 ceramlcs exhlblLed an accepLable
ablllLy Lo correcLly reproduce Lhe selecLed shade color wlLh reference
Lo Lhe vlLa 3u MasLer shade gulde. 1he layerlng scheme lnfluenced Lhe
flnal color of Lhe resLoraLlon. lor Lhe lnvesLlgaLed ceramlc sysLems and
for Lhe color LesLed, Lhe closesL shade maLch was achleved when a
raLlo of 1:1 beLween base/opaque denLln and denLln was used, ln
comblnaLlons wlLh an overlaylng 0.20 mm Lhlck enamel layer.
79

keferences

8arreLL AA, Crlmaudo n!, Anusavlce k!, ?ang MCk. lnfluence of Lab and dlsk
deslgn on shade maLchlng of denLal porcelaln. ! rosLheL uenL 2002, 88:391-7.
concepLually dlfferenL shade gulde sysLems Lo vlLal unresLored denLlLlon. !
rosLheL uenL 2007, 98:173-83.
8ergman 8, nllson P, Andersson M. A longlLudlnal cllnlcal sLudy of rocera
ceramlc-veneered LlLanlum coplngs. lnL ! rosLhodonL 1999,12:133-9.
Clarke l!!. MeasuremenL of Lhe color of human LeeLh. uenLal Ceramlcs:
roceedlngs of Lhe flrsL lnLernaLlonal symposlum on ceramlcs. Chlcago:
CulnLessence, 1983. p. 441.
Conrad P!, Seong W, esun l!. CurrenL ceramlc maLerlals and sysLems wlLh
cllnlcal recommendaLlons: A sysLemaLlc revlew. ! rosLheL uenL 2007,98:389-404.
Corclolanl C, vlchl A, Coraccl C, lerrarl M. Colour correspondence of a
ceramlc sysLem ln Lwo dlfferenL shade guldes. ! uenL 2009, 37:98-101.
Corclolanl C, vlchl A. 8epeaLablllLy of color readlng wlLh a cllnlcal and a
laboraLory specLrophoLomeLer. lnLernaLlonal uenLlsLry SA 2006, 8:62-70.
uouglas 8u, SLelnhauer 1!, Wee AC. lnLraoral deLermlnaLlon of Lhe
Lolerance of denLlsLs for percepLlblllLy and accepLablllLy of shade mlsmaLch. !
rosLheL uenL 2007, 97:200-8.
uouglas 8u. reclslon of ln vlvo colorlmeLrlc assessmenLs of LeeLh. !
rosLheL uenL 1997,77:464-70.
porcelaln layer Lhlckness on Lhe flnal shade of ceramlc resLoraLlons. ! rosLheL
uenL 2003,90:363-70.
80

lazl C, vlchl A, Corclolanl C, lerrarl M. SpecLrophoLomeLrlc evaluaLlon of
color maLch Lo vl1A classlcal shade gulde of four dlfferenL veneerlng porcelaln
sysLems for meLal ceramlc resLoraLlons. Am ! uenL 2009, 22:19-22.
PunLer 8S, Parold 8W. 1he measuremenL of appearance. new ?ork: !ohn
Wlley and Sons, lnc, 2
nd
Ld. 1987. p. 391-411.
kelly !8, nlshlmura l, Campbell Su. Ceramlcs ln denLlsLry: PlsLorlcal rooLs
and currenL perspecLlves. ! rosLheL uenL 1996, 73:18-32.
kourLls SC, 1rlpodakls A, uoukoudakls AA. SpecLrophoLomeLrlc evaluaLlon
of Lhe opLlcal lnfluence of dlfferenL meLal alloys and porcelalns ln Lhe meLal-
ceramlc complex. ! rosLheL uenL 2004,92:477-83.
Mllledlng , Paag , neroLh 8, 8enz l. 1wo years of cllnlcal experlence wlLh
rocera LlLanlum crowns. lnL ! rosLhodonL 1998,11:224-32.
C'8rlen W!. uenLal maLerlals and Lhelr selecLlon. 4
Lh
ed. Chlcago:
CulnLessence, 2008. p 32.
Lhlckness and number of flrlngs on Lhe color of Lwo all-ceramlc sysLems. !
rosLheL uenL 2008,100:99-106.
aravlna 8u, owers !M, lay 8M. Color comparlson of Lwo shade guldes. lnL
! rosLhodonL 2002, 13:73-8.
Shllllngburg P1, !acobl 8, 8rackeLL SL. lundamenLals of LooLh preparaLlon
for casL meLal and porcelaln resLoraLlons. 2nd ed. Chlcago: CulnLessence, 1991.
p. 280-3.
S[gren C, LanLLo 8, 1lllberg A. Cllnlcal evaluaLlon of all-ceramlc crowns
(ulcor) ln general pracLlce. ! rosLheL uenL 1999,81:277-84.
2002,87:637-66.
81

83

CnA1Lk S

S.1 Inf|uence of |ayer|ng th|ckness on the co|or parameters of a
ceram|c system.
Cabrlele Corclolanl, Alessandro vlchl, Chrls Louca, Marco lerrarl.
.#$)%*'J%)#,"%*/&'/0D="))#EF'
'
Introduct|on!
1he achlevemenL of naLural looklng resLoraLlons has always
been one of Lhe greaLesL challenges ln resLoraLlve and prosLheLlc
denLlsLry. 1he correcL lnLegraLlon wlLh Lhe blologlcal Llssues comblned
wlLh an approprlaLe morphologlcal funcLlon, are Lhe goals LhaL
cllnlclans and Lechnlclans asplre Lo ln everyday denLal pracLlce.
uenLal porcelaln, comblnlng wear reslsLance, sLrengLh,
Loughness and aesLheLlcs ls Lhe maLerlal mosL sulLable for replaclng
naLural Llssue. uenLal porcelaln does have llmlLaLlons ln LhaL lL ls noL
easy Lo use and aesLheLlc excellence ls noL always easy Lo obLaln (Wee
eL al., 2002, 8ergman eL al., 1999, S[gren eL al., 1999). 1herefore Lhe
ceramlc veneerlng procedure ls ofLen consldered Lo be an arL form.
1he flrsL sLep for Lhe besL aesLheLlc reproducLlon of a LooLh ls
shade selecLlon, LradlLlonally carrled ouL wlLh denLal shade guldes.
Shade selecLlon has been Lhe sub[ecL of several lnvesLlgaLlons
(Wee eL al., 2002, Pammad eL al., 2003, 8alLzer eL al., 2003, uouglas,
1997), and slnce lL cannoL be consldered a purely sclenLlflc procedure,
lL ls ofLen consldered one of Lhe weakesL llnks ln achlevlng aesLheLlc
84

excellence. Lven when an approprlaLe shade has been selecLed, Lhe
laboraLory reproducLlon and manufacLure of Lhe resLoraLlon ls a
problem. uouglas eL al. (2003) found LhaL Lhe ablllLy Lo reproduce Lhe
color of Lhe LargeL shade Lab dlffered among laboraLorles and mosL
crowns fabrlcaLed by Lhe laboraLorles ln Lhelr sLudy, when compared
Lo Lhe prescrlbed shade Lab, were above Lhe cllnlcal Lhreshold for an
accepLable shade maLch (AL=3.7). 1hls ls probably due Lo Lhe long llsL
of facLors LhaL are relevanL ln lnfluenclng Lhe flnal color of Lhe
porcelaln resLoraLlons, such as flrlng (CzLurk eL al., 2008), glazlng
(?llmaz eL al., 2008), Lhe mlxlng raLlo beLween powder and llquld
(Zhang eL al., 2004), dlfferenL subsLrucLures (kourLls eL al., 2004)

and
layerlng (uozlc eL al., 2003, !arad eL al., 2007).
uozlc eL al. (2003) lnvesLlgaLed Lhe lnfluence of porcelaln layer
Lhlckness on Lhe flnal shade of meLal free ceramlc resLoraLlons, flndlng
a slgnlflcanL correlaLlon beLween Lhe Lhlckness raLlo of Lhe
opaque/veneerlng porcelaln sysLem wlLhln 1.00 mm and color
coordlnaLes a* and b* and LhaL Lhe correlaLlon of Lhe L* value wlLh
Lhlckness of opaque and LranslucenL porcelalns was shade dependenL.
!arad eL al. (2007) ln an ln vlLro sLudy found LhaL a change ln
enamel porcelaln Lhlckness had a greaLer effecL on hlgher chromaLlc
shades Lhan Lhose wlLh lower chroma, and Lhe reducLlon of Lhe
enamel Lhlckness produced Lhree-dlmenslonal color changes
(llghLness, hue angle and meLrlc chroma).
Corclolanl eL al. (2009) ln a prevlous sLudy found LhaL Lhe
layerlng paLLern, concernlng dlfferenL raLlos beLween veneerlng layers
85

of meLal ceramlc crowns, slgnlflcanLly lnfluenced Lhe flnal color of Lhe
resLoraLlon.
1he alm of Lhls sLudy was Lo esLabllsh by means of a cllnlcal
specLrophoLomeLer Lhe relaLlve lnfluence of each layer on Lhe color
parameLers (LlghLness, Chroma and Pue) of Lhe resLoraLlons.
1he formulaLed null hypoLhesls was LhaL Lhe Lhlckness of each
layer dld noL slgnlflcanLly lnfluence Lhe flnal color of Lhe porcelaln
fused Lo meLal resLoraLlons.

1he ceramlc sysLem selecLed for Lhls sLudy was vlLa vM13 (vlLa
Zahnfabrlk, 8ad Sacklngen, Cermany) based on Lhe vlLapan 3u MasLer
LooLh gulde.
1he sLand-alone cllnlcal specLrophoLomeLer vl1A Lasyshade
(vlLa Zahnfabrlk) was used Lo measure color dlfferences. 1he
repeaLablllLy of color readlngs and Lherefore Lhe posslblllLy Lo use Lhls
cllnlcal specLrophoLomeLer for research purposes was prevlously
LesLed (Corclolanl eL al., 2006).
ln order Lo verlfy Lhe lnfluence of Lhe Lhlckness of each layer on
Lhe color parameLers, 40 ceramlc dlscs were fabrlcaLed wlLh dlfferenL
layer Lhlcknesses.
lor preparlng Lhe meLal subsLraLes, self-curlng acryllc resln
dlscs (uuraLay, LC1 032802, 8ellance uenLal ManufacLurlng Co.,
WorLh, lL, uSA), 0.3 mm ln Lhlckness and 13 mm ln dlameLer were
made ln a cyllndrlcal sLalnless sLeel mould. AfLer placlng Lhe maLerlal
86

lnLo Lhe mould, a glass plaLe was pressed onLo Lhe mosL superflclal
layer ln order Lo obLaln a flaL surface. A greaL deal of care was glven Lo
avoldlng bubble formaLlon wlLhln Lhe resln.
AfLer curlng, Lhe resln sample was exLracLed from Lhe mould,
puL ln a refracLory casL fllled wlLh lnvesLmenL (CC SLellavesL, CC
Lurope, Leuven, 8elglum), and placed ln a burnouL furnace (CvomaL 7,
Manfredl-SALu, 1orlno, lLaly).
AL Lhe end of Lhe burnouL cycle, Lhe lnvesLmenL was moved Lo
an lnducLlon casLlng machlne (LnLerprlse, !elrus, Plcksvllle, n?, uSA),
and fllled wlLh a base meLal alloy (8lomaLe-C, Sllpo, lLaly).
1he resulLlng dlsc-shaped speclmens were roughened wlLh a
sandblasLer (Skylab, 1ecnogaz, arma, lLaly), uslng AlC
2
parLlcles of
100 m dlameLer aL 6 bar of pressure.

C,-4#E0,#'3-,'=%$03%4)0,"$K'/B#4"=#$/F''
llaL dlsc speclmens were used ln Lhe sLudy ln order Lo faclllLaLe
Lhe process of obLalnlng conLrolled Lhlcknesses of Lhe ceramlc layers,
slnce 8arreLL eL al. found no sLaLlsLlcally slgnlflcanL dlfferences ln
shade-maLchlng accuracy beLween Lab and dlsk deslgn (8arreLL eL al.,
2002).
1he selecLed color was 2M3 ln vlLapan 3u MasLer LooLh gulde.
lollowlng Lhe manufacLurer's lnsLrucLlons, a wash opaque layer was
applled flrsL and flred ln a ceramlc oven (vacumaL 4000, vlLa
Zahnfabrlk). 1hen, a second opaque layer was added and flred.
87

AL Lhls sLage Lhe flrsL opaque denLlne layer was applled ln a
Lhlckness conLrolled by Lhe mould and flred followlng Lhe
manufacLurer's flrlng lnsLrucLlons. A second denLlne layer was
subsequenLly sLraLlfled and flred. 1he enamel layer was also sLraLlfled
and flred ln Lhe ceramlc oven. 1he veneerlng maLerlals were produced
by Lhe same manufacLurer (vlLa Zahnfabrlk) and Lhey are shown ln
1able 1.

1able 1. MaLerlals used for veneerlng procedures.
vM 13 8aLch
Wash Cpaque WC Wash Cpaque asLe 339 7666
Cpaque C2 Cpaque asLe 332 7739
8ase uenLlne 2M3 8ase uenLlne 040 7316
1ranspa uenLlne 2M3 1ranspa uenLlne 070 7468
Lnamel LnL Lnamel 191 7933

llnally, for each sample, a glaze flrlng was done accordlng Lo
Lhe ceramlc manufacLurer's lnsLrucLlons.
A greaL deal of care was glven Lo obLalnlng a conLrolled
Lhlckness of Lhe veneerlng maLerlals. Layerlng Lhe ceramlc lnLo a
callbraLed mold wlLh a 0.1 mm resoluLlon allowed for a predlcLable
Lhlckness of each layer Lo be achleved, whlch was measured by an
elecLronlc dlglLal callper (1631 uC1, 8eLa, Mllan, lLaly) wlLh a 10 m
resoluLlon, afLer Lhe flrlng process. 1he Lhlckness of each layer was
consldered accepLable for Lhe sLudy only when Lhe varlaLlon ln
Lhlckness was 20 m. 1he Lhlcknesses of Lhe speclmens are shown ln
1able 2. All Lhese layerlng paLLerns followed Lhe vlLa vM13 8ulld up
88

Layerlng" and Lhey were selecLed on Lhe basls of recommendaLlons
from Lhe manufacLurer (vlLa Zahnfabrlk, 2007).

1able 2. Layerlng paLLerns of Lhe ceramlc speclmens
Sample L* Alloy Cpaque
8ase
uenLlne
1ranspa
uenLlne
Lnamel llnal 8aLlo
1-3 1 0,30 mm 0,13 mm 0,33 mm 0,33 mm 0,13 mm 1,30 mm 1:1
6-10 2 0,30 mm 0,13 mm 0,23 mm 0,43 mm 0,13 mm 1,30 mm 1:2
11-13 3 0,30 mm 0,13 mm 0,30 mm 0,63 mm 0,20 mm 1,60 mm 1:2
16-20 4 0,30 mm 0,13 mm 0,43 mm 0,30 mm 0,20 mm 1,60 mm 1:1
21-23 3 0,30 mm 0,13 mm 0,40 mm 0,73 mm 0,30 mm 1,90 mm 1:2
26-30 6 0,30 mm 0,13 mm 0,73 mm 0,40 mm 0,30 mm 1,90 mm 2:1
31-33 7 0,30 mm 0,13 mm 0,70 mm 0,63 mm 0,30 mm 2,30 mm 1:1
36-40 8 0,30 mm 0,13 mm 0,90 mm 0,43 mm 0,30 mm 2,30 mm 2:1

!B#4),-B1-)-=#),"4'J#%/0,#=#$)/'
1he specLrophoLomeLer vlLa Lasyshade comprlses a base unlL
and a hand plece. 1he color evaluaLlon was carrled ouL by placlng Lhe
lnsLrumenL on a sLand, ln order Lo mlnlmlze Lhe readlng error by
sLandardlzlng poslLlon and dlsLance (Corclolanl eL al., 2006).
8esLoraLlon" mode was selecLed on Lhe specLrophoLomeLer and used
LhroughouL.

!)%)"/)"4%*'2$%*+/"/'
uelLa C, uelLa P, uelLa L and uelLa L values, were calculaLed by
Lhe specLrophoLomeLer accordlng Lo Lhe formula proposed by Clarke
(1983) and were subsequenLly sLaLlsLlcally analyzed. normallLy of daLa
dlsLrlbuLlon and varlance homogenelLy ln Lhe groups was prellmlnarlly
89

verlfled uslng Lhe kolmogorov-Smlrnov LesL and Lhe Levene LesL
respecLlvely. ln order Lo deLermlne Lhe slgnlflcance of Lhe dlfferences
ln color correspondence, recorded by Lhe elghL groups, four Cne-Way
Analysls of varlance LesL was applled, assumlng respecLlvely uelLa L,
uelLa C, uelLa P and uelLa L as Lhe dependenL varlables and Lhe
layerlng paLLern as facLor. 1he 1ukey PSu LesL was applled for posL-
hoc comparlsons. ln all Lhe analyses Lhe level of slgnlflcance was seL aL
p<0.03.

kesu|ts
1able 3 reporL Lhe color values measured wlLh Lhe vlLa
Lasyshade specLrophoLomeLer for vlLa vM13.
ln Lhe flrsL column Lhe scannlng daLa for each sample are
lndlcaLed. ln Lhe oLher columns Lhere are values of uelLa relaLed Lo
LlghLness, Chroma, Pue, and uelLa L, because Lhe Lasyshade
specLrophoLomeLer makes comparlson measuremenLs.
1he kolmogorov-Smlrnov LesL revealed LhaL Lhe recorded daLa
were normally dlsLrlbuLed (p>0.03). Cne-way AnCvA showed LhaL Lhe
facLor layerlng paLLern" slgnlflcanLly lnfluenced Lhe uelLa L, uelLa C,
uelLa P and uelLa L (p<0.001). When evaluaLed aL Lhe unlvarlaLe level
(homogenelLy of varlances assessed by Lhe Levene LesL p>0.03), Lhe
facLor layerlng paLLern" resulLed ln Lhe slgnlflcanL lnLeracLlons
hlghllghLed ln 1able 4 (1ukey LesL for palrwlse comparlsons, p<0.03).

90

1able 3. vlLa Lasyshade color evaluaLlon of vM13 ceramlc sysLem.
Sample AL AC AP AL Sample AL AC AP AL
1 1,0 -0,2 -1,0 0,9 21 2,1 -2,0 -2,2 0,0
2 1,1 -0,2 -0,9 1,0 22 2,3 -2,1 -2,2 -0,1
3 0,8 -0,3 -0,7 0,3 23 2,4 -2,2 -2,3 0,1
4 1,1 -0,3 -0,8 0,9 24 2,4 -2,3 -2,3 0,1
3 0,8 -0,2 -0,8 0,8 23 2,4 -2,3 -2,4 0,1
6 2,4 -1,3 0,0 2,0 26 1,0 0,0 -2,6 -0,4
7 2,0 -0,9 -0,1 1,8 27 1,1 -0,3 -2,7 -0,3
8 2,0 -1,1 0,1 1,6 28 1,1 -0,1 -2,6 -0,3
9 2,1 -1,2 0,3 1,8 29 1,1 -0,3 -2,3 -0,3
10 1,6 -0,8 -0,1 1,4 30 1,1 -0,3 -2,6 -0,3
11 0,7 -0,4 -0,6 -0,3 31 4,2 -3,9 -4,1 -0,3
12 0,6 -0,4 -0,7 -0,4 32 4,2 -3,9 -4,3 -0,3
13 0,8 -0,3 -0,7 -0,7 33 4,3 -4,0 -4,3 -0,4
14 0,8 -0,4 -0,7 -0,6 34 4,2 -3,9 -4,3 -0,4
13 0,7 -0,3 -0,6 -0,3 33 4,3 -4,1 -4,3 -0,2
16 1,6 0,2 -1,3 1,3 36 2,6 -2,4 -2,3 -0,3
17 1,9 0,2 -1,4 1,8 37 2,3 -2,3 -2,6 -0,3
18 1,6 0,1 -1,2 1,3 38 2,3 -2,3 -2,6 -0,6
19 1,6 0,2 -1,3 1,3 39 2,3 -2,3 -2,3 -0,6
20 1,8 0,3 -1,3 1,7 40 2,3 -2,3 -2,6 -0,3

91

1able 4. uescrlpLlve sLaLlsLlcs of Lhe uelLa C, uelLa P, uelLa L and uelLa L values
recorded ln Lhe experlmenLal groups. ln Lhe slgnlflcance column, dlfferenL
superscrlpL leLLers label slgnlflcanL dlfferences when Lhe ceramlc sysLem layerlng
paLLern (* L) lnLeracLlons were assessed aL Lhe unlvarlaLe level.

AC AP AL AL
L n MeanSu Slg MeanSu Slg MeanSu Slg MeanSu Slg
1 3 -0,320,16 a -0,840,11 c 0,820,19 c 0,960,13 a,b
2 3 -1,060,21 b 0,040,17 a 1,720,23 d 2,020,29 d
3 3 -0,400,07 a -0,660,03 b -0,340,11 b 0,720,08 a
4 3 0,200,07 a -1,300,07 d 1,600,14 d 1,700,14 c
3 3 -2,180,13 c -2,280,08 e 0,040,09 a 2,320,13 e
6 3 -0,200,14 a -2,600,07 f -0,440,09 b 1,080,04 b
7 3 -3,960,09 e -4,260,09 g -0,360,11 b 4,240,03 f
8 3 -2,320,04 d -2,360,03 f -0,340,03 b 2,320,04 e

D|scuss|on
1he dlfferences found ln Lhe color parameLers and A values
beLween Lhe dlfferenL layerlng paLLerns analyzed, supporL Lhe
re[ecLlon of Lhe null hypoLhesls.
Color can be measured ln dlfferenL sysLems, llke ClLLab*,
ClLLuv, x?Z, Lch, PS8/PSv, 8C8. All Lhese sysLems are dlfferenL ln Lhelr
maLhemaLlc deflnlLlon buL may be correlaLed each oLher by Lhe use of
converslon formulas. lor sclenLlflc purposes, Lhe mosL commonly used
sysLem ls Lhe ClLLab* sysLem, ln whlch L* value ls Lhe degree of Lhe
llghLness of an ob[ecL, a* value ls Lhe degree of redness or greenness,
and b* value ls Lhe degree of yellowness or blueness (ClL, 1986).
ln denLlsLry, PS8 (Pue, SaLuraLlon or Chroma, 8rlghLness or
value) sysLem ls mosL commonly used for color communlcaLlon. lor
92

Lhe measuremenLs performed ln Lhls sLudy, Lhese laLesL parameLers
have been lndlvldually evaluaLed.
Analysls of Pue (ClL, 1986), LhaL ls deflned as Lhe radlal
componenL of Lhe cyllndrlcal coordlnaLes ClLLab* and calculaLed
accordlng Lo Lhe formula h
ab
= arcLan showed LhaL by lncreaslng
Lhe ceramlc Lhlckness, hlgher values of AP were obLalned. lL was noL
posslble Lo correlaLe a llnear relaLlonshlp beLween Pue and Lhe
Lhlckness of each layer. 1he paLLerns LhaL more closely maLched Lhe
sLandard were L1
c
(AP=-0,840,11), L2
a
(AP=0,040,17) and L3
b

(AP=-0,660,03), layered wlLh dlfferenL raLlos beLween 8ase uenLlne
and 1ranspa uenLlne (L1=1:1, L2 and L3=1:2). AlLhough lL was noL
posslble Lo flnd a dlrecL correlaLlon beLween a change ln Lhe raLlo of
Lhe Lwo denLln layers and a value ln Pue, lL could be speculaLed LhaL,
for Lhe ceramlc sysLem ob[ecL of Lhls sLudy, a closer correspondence ln
Pue can be obLalned wlLh smaller Lhlcknesses.
Analysls of SaLuraLlon (or Chroma) (ClL, 1986), LhaL ls Lhe radlal
componenL of Lhe cyllndrlcal coordlnaLes ClLLab* and calculaLed
accordlng Lo Lhe formula C
ab
= , showed LhaL lncreaslng Lhe
porLlon of 8ase uenLlne resulLed ln a hlgher chromaLlc shade, LhaL ls a
more lnLenslve flnal color, whereas a greaLer amounL of 1ranspa
uenLlne and Lnamel reduced Lhe Chroma. (1able 4)
1he L1
a
(mean AC=-0,320,16) and Lhe L2
b
(mean AC=-
1,060,21) are Lwo groups wlLh Lhe same flnal Lhlckness buL were
layered followlng Lwo dlfferenL paLLerns wlLh regards Lo Lhe raLlo
beLween 8ase uenLlne and 1ranspa uenLlne (L1=1:1 and L2=1:2). A
93

hlgher Lhlckness of 8ase uenLlne ln L1 resulLed ln a closer
correspondence Lo Lhe Chroma parameLer. 1hls Lrend ls also conflrmed
afLer comparlng L3
c
(mean AC=-2,180,13) wlLh L6
a
(mean AC=-
0,200,14), where for lncreased Lhlckness Lhe paLLern wlLh a hlgher
raLlo of 8ase uenLlne (L6=2:1) resulLed ln Lhe closesL Chroma
correspondence.
1he Lhlrd parameLer evaluaLed was Lhe LlghLness (or value). lL
represenLs Lhe llghLness-darkness of a color (ClL, 1986). value ls Lhe
parameLer mosL percepLlble Lo human eyes, due Lo a greaLer number
of rods (Lhe phoLorecepLor cells lnvolved ln Lhe LransducLlon of
monochromaLlc llghL lnLo nerve slgnals LhaL can be ulLlmaLely
LransmlLLed Lo Lhe braln vla Lhe opLlc nerve) raLher Lhan cones (Lhe
phoLorecepLor cell LhaL deLecLs dlfferenL colors) ln Lhe human reLlna.
lor Lhls reason, an error ln Lhls parameLer wlll have Lhe greaLesL
lmpacL on Lhe overall color. Analysls of Lhe daLa obLalned ln Lhls sLudy
suggesLs LhaL, for Lhe ceramlc sysLem analyzed, Lhe value of a lM
resLoraLlon decreases as Lhe Lhlckness of Lhe enamel layer lncreases.
1he manufacLurer's lnsLrucLlons advlce LhaL Lhe shade lnLenslLy can be
lndlvldually ad[usLed by Lhe comblnaLlon of Lnamel and 1ranspa
uenLlne porcelalns ln relaLlon Lo Lhe layer Lhlckness of 8ase uenLlne.
Analyzlng L4
d
(AL=1,600,14) and L7
b
(AL=-0,360,11) lL can be
shown, for Lwo groups wlLh Lhe same layerlng raLlo 1:1, LhaL Lhe
greaLer Lhlckness of Lhe enamel layer of Lhe L7 caused a lower value
of llghLness when compared wlLh L4. 1hls Lrend can also be seen afLer
analyzlng L2
d
(AL=1,720,23) and L3
a
(AL=0,040,09), where Lhe
94

laLLer resulLed ln a lower value of AL and Lhe Lhlckness of Lhe enamel
layer was 0,30 mm.
lor Lhe ceramlc sysLem ob[ecL of Lhls LesL Lhe raLlo ln Lhlckness
beLween 8ase uenLlne and 1ranspa uenLlne had a greaL effecL on Lhe
flnal color. ln order Lo undersLand how Lhls raLlo lnfluenced Lhe flnal
color correspondence, 4 dlfferenL groups wlLh Lhe same flnal Lhlckness
were layered buL ln dlfferenL paLLerns. (1able 4)
Analyzlng L1
a,b
(AL=0,960,13) ln comparlson wlLh L2
d

(AL=2,020,29), where Lhe Lhlckness of Lhe veneerlng maLerlal was 1,0
mm, Lhe raLlo 1:1 of L1 resulLed ln a closer color correspondence.
When Lhe veneerlng Lhlckness was sllghLly lncreased Lo 1,3 mm, Lhe
raLlo LhaL besL maLched Lhe sLandards was 1:2 belonglng Lo L3
a
(AL=0,720,08) when compared wlLh 1:1 of Lhe L4
c
(AL=1,700,14).
An lncreased Lhlckness of veneerlng maLerlal, 1,60 mm and 2,00 mm
adopLed from L3 Lo L8 and Lhe raLlo 2:1 beLween 8ase uenLlne and
1ranspa uenLlne, resulLed ln a closer color correspondence. 1hls Lrend
was conflrmed by L6
b
(AL=1,080,04) when compared wlLh L3
e

(AL=2,320,13) and by L8
e
(AL=2,320,04) when compared wlLh L7
f

(AL=4,240,03).
uependlng on Lhe flnal Lhlckness of Lhe lM resLoraLlon, Lhe
lndlvldual Lhlckness of each layer and Lhe raLlo beLween Lhe layers
boLh play an lmporLanL role ln achlevlng Lhe besL color maLch. ln
order Lo achleve a cerLaln shade, Lhe Lechnlclans should baslcally
respecL Lhe manufacLurer lnsLrucLlons. As lL ls known LhaL Lhese
lnsLrucLlon by Lhemselves are noL enough Lo be sure Lo obLaln Lhe
95

almed shade (lazl eL al., 2009), Lhe flndlngs of Lhls paper may be
useful ln order Lo lndlvldually ad[usL Lhe shade parameLers. 1he human
eye by lLself can hardly evaluaLe selecLlvely Lhe Lhree parameLers. lor
Lhls reason, Lhe use of cllnlcal specLrophoLomeLers llke vlLa LasyShade
LhaL are capable Lo glve uelLa lnformaLlon of Lhe Lhree parameLer
lndlvldually, can greaLly help.
lurLher sLudy mlghL be useful ln order Lo lnvesLlgaLe lf Lhe
lnLegraLlon beLween Lhe elecLronlc lnformaLlon and Lhe presenL
layerlng daLa may resulL ln a more accuraLe and easler shade maLch
and/or glve Lhe Lechnlclan Lhe lndlcaLlon for ad[usLlng a color LhaL do
noL compleLely maLch Lhe lnLended one for a ceramlc resLoraLlon.

Conc|us|ons
WlLhln Lhe llmlLaLlons of Lhls sLudy, ln Lhe ceramlc sysLem
analyzed, Lhe Lhlckness of each layer and Lhe raLlo beLween Lhe
dlfferenL layers slgnlflcanLly lnfluenced Lhe flnal color of Lhe lM
resLoraLlons.
1he raLlo ln Lhlckness beLween 8ase uenLlne and 1ranspa
uenLlne had a greaL lmpacL on Lhe flnal color, as glvlng predomlnance
Lo porLlon of 8ase uenLlne resulLed ln a more ChromaLlc shade,
conversely, Lhe predomlnance of 1ranspa uenLlne and Lnamel reduced
Lhe Chroma of Lhe color. An lncrease of Lhe Lhlckness of Lhe Lnamel
layer resulLed ln a decrease ln LlghLness (value) and vlce-versa a
decrease ln Lhe Lhlckness of Lnamel layer gave as resulL an lncrease ln
LlghLness (value).
96

keferences
8alLzer A, Paufmann-!lnolan v. Shadlng of ceramlc crowns uslng dlglLal LooLh
shade maLchlng devlces. lnL ! CompuL uenL 2003,8:129-132.
deslgn on shade maLchlng of denLal porcelaln. ! rosLheL uenL 2002, 88:391-7.
ClL (Commlsslon lnLernaLlonale de l'Lclalrage). ColorlmeLry-1echnlcal
8eporL. ClL ub. no.13, 2nd ed. vlenna, AusLrla: 8ureau CenLral de la ClL, 1986
(correcLed reprlnL 1996), p. 33-6.
Clarke l!!. MeasuremenL of Lhe color of human LeeLh. uenLal Ceramlcs:
ub Co lnc. 1983.
ceramlc sysLem ln Lwo dlfferenL shade guldes. ! uenL 2009, 37(2):98-101.
uouglas 8u. reclslon of ln vlvo colorlmeLrlc assessmenLs of LeeLh. ! rosLheL
uenL 1997,77:464-470.
2003,90:363-70.
97

2007,23:434-460.
uenL 2008,100:99-106.
vlLa Zahnfabrlk. vM13 Worklng lnsLrucLlon. 8evlsed ed. 8ad Sacklngen,
Cermany: 2007, p.18.
maLched shade and fabrlcaLed shade of denLal porcelaln. ! rosLh uenL 2002,
87:637-66.
99

CnA1Lk 6

6.1 Summary, conc|us|ons and future d|rect|ons

!0==%,+'

ln Chapter 1, Lhe raLlonale of Lhls sLudy has been presenLed.
AccuraLe shade maLchlng has always been one of Lhe mosL challenglng
aspecLs of Lhe resLoraLlon of of LeeLh and aesLheLlc denLlsLry generally.
uue Lo Lhe greaL varleLy of naLural LooLh color, achlevlng a close shade
maLch of an arLlflclal resLoraLlon wlLh naLural denLlLlon sLlll remalns a
complex process. 1wo ma[or aspecLs of color maLchlng procedures
were presenLed. Cne ls Lhe selecLlon of a color, Lhrough a shade gulde,
whlch wlll harmonlously lnLegraLe lLself wlLh Lhe surroundlng
blologlcal Llssues and Lhe oLher one ls Lhe correcL reproducLlon of Lhls
color ln Lhe prosLhesls or resLoraLlon.
AfLer a brlef summary of Lhe sclenLlflc dlscoverles from
newLon's experlmenLs durlng Lhe 18
Lh
cenLury Lo Lhe ClLLab* color
classlflcaLlon, some conslderaLlons were made abouL Lhe use of AL Lo
correlaLe color numerlcally and flnally calculaLe Lhe dlfferences
beLween Lwo colors uslng a formula LhaL glves one number as value
for color dlfferences. AlLhough Lhe lmporLance of Lhls flndlng changed
Lhe concepL of color sclence, denLal pracLlce dld noL caLch on
lmmedlaLely from Lhls opporLunlLy Lo lmprove Lhe ablllLy for color
maLchlng and vlsual assessmenL remalned Lhe benchmark procedure.
100

A crlLlcal revlew of Lhe evoluLlon of Lhe mosL lmporLanL shade
guldes was presenLed. Speclal aLLenLlon was glven Lo Lhe sclenLlflc
color dlsLrlbuLlon lnLroduced by Lhe vl1A 3u MasLer 1ooLhgulde. lL has
a sysLemaLlc arrangemenL of shades wlLhln Lhe naLural LooLh color
space and an ob[ecLlve numerlcal measure of color, accordlng Lo Lhe
colorlmeLrlc ClLLab* order prlnclple, raLher Lhan on Lhe mere
observaLlon of Lhe naLural Llssue aspecLs belonglng Lo Lhe prevlous
shade guldes such as vlLapan Classlcal or lvoclar-vlvadenL
Chromascop.
lurLher research pursued Lhe ob[ecLlve of mlnlmlzlng color
mlsmaLch due Lo vlsual esLlmaLlon, by uslng colorlmeLers and
specLrophoLomeLers. A brlef descrlpLlon of Lhe dlfferences beLween
Lhese lnsLrumenLs was provlded. arLlcular aLLenLlon has been focused
on vl1A Lasyshade and lLs evoluLlon (vl1A Lasyshade CompacL) and on
MP1 SpecLro Shade Mlcro, as Lhese lnsLrumenLs are Lwo of Lhe mosL
rouLlnely used cllnlcal specLrophoLomeLers.
As prevlously lnLroduced, Lhe lasL sLep ln color maLchlng
procedures ls represenLed by Lhe correcL color reproducLlon ln Lhe
prosLhesls or resLoraLlon. A brlef dlscusslon abouL Lhe facLors LhaL
lnfluence Lhe flnal color of porcelaln resLoraLlons was glven, especlally
hlghllghLlng Lhe predomlnanL role played by Lhe layerlng raLlo
beLween opaque and LranslucenL shades. Lven a correcL shade
selecLlon ls noL enough lf Lhere ls no correlaLlon wlLh Lhlckness and
layerlng of Lhe resLoraLlon.
101

1herefore, Lhe work descrlbed ln Lhls Lhesls almed Lo provlde
an lnslghL lnLo Lhe denLal color maLchlng procedure, as well as Lo
elucldaLe how Lhe achlevemenL of a naLural looklng resLoraLlon could
noL dlspense wlLh a correcL selecLlon of Lhe color followed by lLs
accuraLe reproducLlon.
ln Chapter 2, Lhe measuremenL repeaLablllLy of a cllnlcal
specLrophoLomeLer was compared wlLh an esLabllshed laboraLory one.
1he lnlLlal sLep ln Lhe evaluaLlon of Lhe cllnlcal use of Lhe vl1A
Lasyshade denLal specLrophoLomeLer was Lo conslder lLs rellablllLy.
lor Lhls reason, Lhe flrsL phase was Lo evaluaLe Lhe repeaLablllLy of
readlngs Laken by Lhe lnsLrumenL, as a mandaLory requlremenL Lo
furLher evaluaLe Lhe performances ln comparlson wlLh LhaL of Lhe
Ccean CpLlcs Su 1000, as an esLabllshed lab lnsLrumenL.
MeLal ceramlc speclmens layered accordlng Lo dlfferenL
amounLs of opaque and LranslucenL porcelalns were manufacLured ln
order Lo perform repeaLed measuremenLs. 1he Ccean CpLlcs Su1000
was LesLed measurlng Lhe color values of each speclmen 3 Llmes, whlle
for vl1A Lasyshade Lhe measuremenLs were repeaLed 3 Llmes by free
hand and 3 Llmes flxlng Lhe measurlng probe Lo a sLand, ln order Lo
LesL lf Lhere were any dlfferences beLween cllnlcal use (free hand) or
lab use (flxed Lo a sLand). 1he specLrophoLomeLer repeaLablllLy was
sLaLlsLlcally evaluaLed by analyzlng Lhe CoefflclenL of varlaLlon (Cv).
1he resulLs demonsLraLed an excellenL scannlng repeaLablllLy
for boLh Lhe lnsLrumenLs LesLed. very low values of coefflclenL of
varlaLlon (0,002<Cv<0,111) were obLalned for Lhe Ccean CpLlcs
102

Su1000. 1he Lasyshade showed good accuracy ln repeaLed scannlng
obLalned boLh by flxlng Lhe handplece of Lhe devlce Lo a sLand
(0<Cv<0,022) and by free hand (0,008<Cv<0,913).
1he good accuracy shown by Lhe cllnlcal lnsLrumenLs compared
Lo Lhe lab one, ln performlng repeaLed measuremenLs revealed Lhe
posslblllLy of uslng lL boLh for cllnlcal use and for ln vlLro LesLlng.
ln Chapter 3, Lhe varlaLlons ln color beLween four denLal
porcelaln sysLems and Lhe LargeL shades A2, A3 and A3.3" of Lhe
shade gulde vlLapan Classlcal were lnvesLlgaLed. An lmporLanL source
of varlablllLy of Lhe color ls represenLed by Lhe porcelaln Lhlckness, by
Lhe need of havlng dlfferenL layers of porcelaln such as opaque, denLln
and enamel. Conslderlng Lhe very llmlLed lnformaLlon avallable from
Lhe manufacLurers or from Lhe llLeraLure, on whaL Lhe ldeal proporLlon
of denLln and enamel should be, Lhe ob[ecL of Lhls sLudy was Lo verlfy
lf all Lhe ceramlc sysLems LesLed were able Lo correcLly maLch Lhe
selecLed shade followlng Lhe layerlng dlagrams reporLed ln Lhe
manufacLurers' lnsLrucLlons.
1hls sLudy was performed by assesslng Lhe color maLch of Lhe
dlsc-shaped porcelaln fused Lo meLal resLoraLlons by uslng Lhe vl1A
Lasyshade cllnlcal specLrophoLomeLer. 1hree dlfferenL shades (A2, A3,
A3.3) for four dlfferenL ceramlc sysLems (vl1A Cmega 900, uuceram
klss, Wleland 8eflex and lvoclar lS d.SlCn) were lnvesLlgaLed resulLlng
ln a LoLal of 12 comblnaLlons. lor each group, Lhree samples were
fabrlcaLed for a LoLal of 36 speclmens. values of AL ranged beLween
1.2 and 3.0. Shade cllnlcal maLchlng (AL < 3.7) was recorded for shade
103

A2 ln all Lhe ceramlc sysLems, for shade A3 ln uuceram klss and lvoclar
lS speclmens and for shade A3.3 only ln vl1A Cmega 900 speclmens.
All Lhe oLher speclmens falled Lo achleve shade maLchlng. AnCvA
analysls showed no sLaLlsLlcally slgnlflcanL dlfferences (> 0.03)
beLween Lhe porcelaln brands. Cne-way AnCvA showed LhaL Lhe
ceramlc shade slgnlflcanLly lnfluenced Lhe AL values (< 0.03).
ln concluslon Lhls sLudy showed LhaL Lhe guldance glven by Lhe
manufacLurer Lo help Lhe Lechnlclan Lo obLaln Lhe color maLch
beLween Lhe selecLed shade and Lhe flnal resLoraLlon, ls very llmlLed,
and noL sufflclenL Lo avold color mlsmaLch.
ln Chapter 4 Lwo lmporLanL facLors affecLlng Lhe shade maLch
were lnvesLlgaLed: Lhe lnfluence of Lhe shade gulde and Lhe lnfluence
of Lhe ceramlc sysLem. ln aragraph 4.1 Lhe ablllLy of vl1A Cmega 900
ceramlc sysLem Lo correcLly reproduce Lhe selecLed shade color wlLh
reference Lo Lhe vlLapan Classlcal and vl1A 3u-MasLer 1ooLhgulde was
LesLed. vl1A Cmega 900 was Lhe ob[ecL of Lhls sLudy because lL was, aL
Lhe Llme of Lhe LesL, Lhe only denLal ceramlc sysLem markeLed ln
vlLapan Classlcal shade gulde as well as ln vl1A 3u-MasLer 1ooLhgulde.
1oday, even vl1A vM13 ls markeLed boLh ln vlLapan Classlcal and ln
vl1A 3u-MasLer 1ooLhgulde.
llfLeen ceramlc dlscs were fabrlcaLed wlLh dlfferenL layerlng
paLLerns for each shade (A3 and 2M3), keeplng consLanL Lhe speclmen
LoLal Lhlckness. 1hree dlsLlncL layerlng paLLerns were reallzed LhaL
dlffered accordlng Lo Lhe Lhlckness of Lhe opaque denLln, denLln, and
enamel layers, ln order Lo creaLe a varlablllLy ln color readlng. 1he
104

color evaluaLlon was done wlLh Lhe Lasyshade and 8esLoraLlon"
mode was selecLed uslng A3 and 2M3 shade as comparlson. 1he 1wo-
Way AnCvA LesL showed LhaL boLh Lhe lnLeracLlon shade gulde-
ceramlc sysLem" and Lhe facLor layerlng paLLern" slgnlflcanLly
lnfluenced Lhe AL values (p<0,001). Speclmens of vl1A Cmega 900 ln
Lhe vl1A 3u-MasLer 1ooLhgulde exhlblLed for Lhe lnvesLlgaLed shade a
closer maLch ln color Lhan speclmens of Lhe same ceramlc sysLem ln
Lhe vlLapan Classlcal shade gulde. 1hls resulL can be explalned by Lhe
ablllLy of Lasyshade Lo beLLer maLch colors LhaL are organlzed ln a
sclenLlflcally-based sysLemaLlc spaLlal dlsLrlbuLlon.
1herefore, Lhe hlgher color correspondence can be consldered
Lo be shade gulde dependanL. Moreover, Lhe besL color maLch
resulLed Lo be lnfluenced from Lhe paLLern selecLed for porcelaln
layerlng procedure.
AfLer esLabllshlng LhaL Lhe vl1A 3u-MasLer 1ooLhgulde resulLed
ln a closer color maLch, ln aragraph 4.2, Lhe nexL sLage examlned Lhe
ablllLy of Lwo denLal porcelaln maLerlals (vl1A Cmega 900 and vl1A
vM13) Lo correcLly reproduce Lhe selecLed shade color wlLh reference
Lo Lhe vl1A 3u-MasLer 1ooLhgulde, ln order Lo undersLand lf Lhe color
maLch was shade gulde dependanL or ceramlc sysLem dependanL. 1he
LesL was performed followlng Lhe same meLhods as Lhe prevlous one.
llfLeen ceramlc dlscs were produced wlLh dlfferenL layer Lhlcknesses
for each ceramlc sysLem ln 2M3 shade. 1he color accuracy expressed
ln AL was LesLed wlLh Lhe vl1A Lasyshade. 1wo-way AnCvA LesLs
showed LhaL Lhe facLor ceramlc sysLem" was noL sLaLlsLlcally
105

slgnlflcanL (p=0.17), whereas, Lhe facLor layerlng paLLern" slgnlflcanLly
lnfluenced Lhe AL values (p<0.001). All Lhe speclmens had values of AL
below 3.3, Lhls ls consldered Lo be appreclable by skllled operaLors buL
cllnlcally accepLable.
When Lhe meLal ceramlc speclmens have been manufacLured
wlLh ceramlc sysLems based on vl1A 3u-MasLer 1ooLhgulde, no
dlfferences were found beLween vl1A Cmega 900 and vl1A vM13 ln
Lhelr ablllLy Lo correcLly maLch Lhe deslred shade. 1hls flndlng
suggesLed LhaL, for Lhe ceramlc sysLems ob[ecL of Lhls sLudy , Lhe
ablllLy of color maLch wlLh a deslred shade had Lo be consldered shade
gulde-dependenL. Cnce more Lhls sLudy conflrmed LhaL Lhe scheme
followed for layerlng Lhe porcelaln upon Lhe meLal had a predomlnanL
role ln achlevlng Lhe selecLed color for resLoraLlon.
Such a flndlng esLabllshed Lhe relaLlve lnfluence of each
porcelaln layer (8ase uenLlne, 1ranspa uenLlne and Lnamel) on Lhe
color parameLers (LlghLness, Chroma and Pue) of Lhe resLoraLlons,
LhaL was developed ln Chapter S. lorLy ceramlc dlscs were fabrlcaLed
wlLh a proprleLary sLeel mould and lndlvldually checked afLer flrlng
wlLh a dlglLal callper Lo conLrol Lhe Lhlckness of each layer. 4 dlfferenL
LoLal ceramlc Lhlcknesses ln 2M3 shade were evaluaLed. lor each
Lhlckness, 2 dlfferenL layerlng paLLerns were analyzed.
1he Lasyshade cllnlcal specLrophoLomeLer was used for color
comparlson wlLh Lhe reference color daLa of Lhe selecLed shade sLored
lnLo Lhe devlce. Cne-way AnCvA showed LhaL Lhe facLor "layerlng
paLLern" slgnlflcanLly lnfluenced Lhe AL, AC, AP and AL (p<0.001).
106

CreaLer Lhlcknesses of 8ase uenLlne resulLed ln a more ChromaLlc
shade. Conversely, greaLer Lhlcknesses of 1ranspa uenLlne and Lnamel
reduced Lhe Chroma of Lhe color. An lncrease ln Lhe Lnamel layer
Lhlckness resulLed ln a reducLlon of Lhe LlghLness (value) and vlce-
versa. A closer correspondence ln Pue was obLalned wlLh smaller
Lhlcknesses.
uependlng on Lhe flnal Lhlckness of Lhe lM resLoraLlon, Lhe
lndlvldual Lhlckness of each layer and Lhe raLlo beLween Lhe layers
boLh play an lmporLanL role ln achlevlng Lhe besL color maLch. 1he
Lechnlclan has Lo be able Lo lndlvldually ad[usL color parameLers ln
order Lo achleve a cerLaln shade.
107

L-$4*0/"-$/'

WlLhln Lhe llmlLaLlons of Lhe prevlous sLudles, Lhe followlng
concluslons may be drawn from our evaluaLlon of Lhe facLors
lnfluenclng denLal color maLchlng procedure:

1) Achlevlng a correcL color maLch beLween naLural denLlLlon and
resLoraLlon or prosLhesls ls a complex process whlch conslsLs of Lwo
speclflc procedures: color selecLlon and color reproducLlon.
2) vl1A Lasyshade cllnlcal specLrophoLomeLer revealed good accuracy,
comparable Lo a laboraLory devlce, ln performlng repeaLed
measuremenLs. 1hls means Lhe devlce can be used cllnlcally as a
rouLlne offlce lnsLrumenL and for ln vlLro LesLlng.
3) 1he lndlcaLlons glven from ceramlc manufacLurers Lo help Lhe
Lechnlclans Lo obLaln Lhe color maLch beLween Lhe selecLed shade
and Lhe flnal resLoraLlon are very llmlLed, and noL sufflclenL Lo avold
color mlsmaLch.
4) vl1A 3u-MasLer 1ooLhgulde resulLed ln a hlgher color maLch when
consldered wlLh vlLapan Classlcal shade gulde, Lhanks Lo lLs
sysLemaLlc dlsLrlbuLlon of Labs accordlng Lo an lncreaslng gradlenL
of LlghLness and Chroma.
3) 1he ablllLy of color maLch wlLh a deslred shade has Lo be
consldered shade gulde dependenL. 1he approach adopLed for
layerlng Lhe porcelaln upon Lhe meLal have a predomlnanL role ln
achlevlng Lhe selecLed color for Lhe resLoraLlon.
108

6) Concernlng vl1A vM13, a greaLer Lhlcknesses of 8ase uenLlne
resulLed ln a more ChromaLlc shade. Conversely, greaLer
Lhlcknesses of 1ranspa uenLlne and Lnamel reduced Lhe Chroma of
Lhe color. An lncrease ln Lhe Lnamel layer Lhlckness resulLed ln a
reducLlon of Lhe LlghLness (value) and vlce-versa. A closer
correspondence ln Pue was obLalned wlLh smaller Lhlcknesses.
7) uependlng on Lhe flnal Lhlckness of Lhe meLal ceramlc resLoraLlon,
Lhe lndlvldual Lhlckness of each layer and Lhe raLlo beLween Lhe
layers boLh play an lmporLanL role ln achlevlng Lhe besL color
maLch. 1he Lechnlclan has Lo be able Lo lndlvldually ad[usL color
parameLers ln order Lo achleve a cerLaln shade.

109

M0)0,#'.",#4)"-$/'

1he posslblllLy Lo relaLe Lo sclence someLhlng LhaL has always
been consldered an arL form represenLs one of Lhe greaLesL challenges
ln modern denLlsLry. Achlevlng a naLural looklng resLoraLlon whlch
correcLly lnLegraLes lLself wlLh blologlcal Llssue has always been
lnfluenced by Lhe sklll of Lhe cllnlclan or Lechnlclan.
Cllnlcal specLrophoLomeLers have Lhe capablllLy Lo become
rouLlnely used offlce devlces. 1hey can be used Lo help less
experlenced cllnlclans ln color maLchlng procedures ln order Lo avold
or aL leasL reduce color mlsmaLch.
Ceramlc manufacLurers should provlde speclflc schemes on
how Lo layer Lhelr porcelaln maLerlal relaLlng Lo Lhe flnal Lhlckness of
Lhe resLoraLlon ln order Lo obLaln Lhe deslred shade. Ceramlc
manufacLurers should also provlde sysLems markeLed accordlng Lo Lhe
vl1A 3u-MasLer 1ooLhgulde.
luLure experlmenLs should evaluaLe Lhe accuracy of oLher
markeLed cllnlcal specLrophoLomeLers. 1he lnfluence of Lhe Lhlckness
and of Lhe layerlng schemes should be evaluaLed for oLher ceramlc
sysLems.
Cllnlcal sLudles are necessary Lo supporL laboraLory daLa, ln
order Lo make evldence LhaL lnsLrumenLal color deLecLlon may be as
efflclenL as a human buL more rellable, always conslderlng LhaL arL ls
someLhlng relaLed Lo humans and noL Lo machlnes.
110

6.3 k|assunto, conc|us|on| e d|rez|on| future

N"%//0$)-'

nel Cap|to|o 1 e sLaLo presenLaLo ll fondamenLo loglco dl
quesLo sLudlo. La correLLa procedura dl presa del colore ha sempre
rappresenLaLo una delle magglorl sflde ln odonLolaLrla resLauraLlva ed
esLeLlca. A causa della grande varleLa dl colore del denLl naLurall, ll
ragglunglmenLo dl un'afflne corrlspondenza dl colore Lra un resLauro
arLlflclale e la denLaLura naLurale rlmane ancora una procedura
complessa. Sono sLaLl presenLaLl l due plu grandl aspeLLl del processo
dl rlproduzlone del colore denLale: uno e rappresenLaLo da una
correLLa scelLa, medlanLe l'auslllo dl scala dl rlferlmenLo, dl un colore
che sl lnLegrera armonlosamenLe con l LessuLl blologlcl clrcosLanLl e
l'alLro aspeLLo e rappresenLaLo dalla correLLa rlproduzlone del colore
scelLo nell'elemenLo proLeslco o nel resLauro conservaLlvo.
uopo un breve excursus clrca le scoperLe sclenLlflche a parLlre
dagll esperlmenLl dl newLon duranLe ll xvlll secolo flno ad arrlvare alla
odlerna classlflcazlone del colore ClLLab*, sono sLaLe valuLaLe dlverse
conslderazlonl clrca la posslblllLa daLa dall'lnLroduzlone del AL dl
relazlonare ll colore al numerl, e qulndl flnalmenLe calcolare la
dlfferenza Lra due colorl medlanLe una formula che fornlsse un
numero come espresslone dl una dlfferenza Lra due colorl. Sebbene
quesLa scoperLa avesse camblaLo ll conceLLo del colore come sclenza,
la praLlca odonLolaLrlca non percepl lmmedlaLamenLe l'opporLunlLa
offerLa da quesLo nuovo slsLema dl mlgllorare la corrlspondenza del
111

colore, e conLlnu a conslderare come punLo dl rlferlmenLo la Lecnlca
dl presa del colore medlanLe valuLazlone vlslva.
L' sLaLa presenLaLa una revlslone crlLlca dell'evoluzlone delle
plu lmporLanLl scale colorl. Sl e presLaLo una aLLenzlone speclale alla
dlsLrlbuzlone sclenLlflca del colore lnLrodoLLa dalla scala vl1A 3u
MasLer 1ooLhgulde. 1ale scala offre, olLre a una dlsposlzlone
slsLemaLlca delle LonallLa dl colore all'lnLerno dello spazlo
colorlmeLrlco del denLl naLurall, la posslblllLa dl mlsurare ll colore ln
manlera oggeLLlva e secondo un ordlne numerlco, pluLLosLo che
basandosl sulla sempllce osservazlone dell'aspeLLo del denLl naLurall
che lnvece apparLlene alle scale colorl precedenLl, quall la vlLapan
Classlcal o la lvoclar-vlvadenL Chromascop.
Come passo successlvo la rlcerca ha persegulLo l'obleLLlvo dl
mlnlmlzzare sempre plu la dlscrepanza dl colore dovuLa alla
valuLazlone vlslva medlanLe l'lnLroduzlone del colorlmeLrl e degll
speLLrofoLomeLrl. uopo aver brevemenLe descrlLLo le dlfferenze Lra
quesLl due Llpl dl sLrumenLl dl mlsura, sl e presLaLa parLlcolare
aLLenzlone sullo speLLrofoLomeLro cllnlco vlLa Lasyshade e la sua
evoluzlone (vlLa Lasyshade CompacL) e sullo speLLrofoLomeLro cllnlco
MP1 SpecLro Shade Mlcro, ln quanLo quesLl rappresenLano due Lra gll
sLrumenLl cllnlcl dl mlsura del colore plu venduLl.
Come lnLrodoLLo ln precedenza, l'ulLlmo passo
nell'oLLenlmenLo del rlsulLaLo esLeLlco e rappresenLaLo dalla correLLa
rlproduzlone del colore scelLo nell'elemenLo proLeslco o nel resLauro
conservaLlvo. Sono sLaLl brevemenLe anallzzaLl l faLLorl che lnfluenzano
112

ll colore flnale del resLaurl ceramlcl, meLLendo speclalmenLe ln
evldenza ll ruolo predomlnanLe rlcoperLo dal rapporLl dl sLraLlflcazlone
Lra gll sLraLl dl porcellana opaca e quelll plu LraslucenLl. 1ale passagglo
per rlmarcare ll faLLo che una correLLa scelLa del colore non e
sufflclenLe a garanLlre ll ragglunglmenLo del successo esLeLlco, se non
correlaLa a una correLLa Lecnlca dl sLraLlflcazlone.
ll lavoro descrlLLo ln quesLa Lesl sl ausplca dl fornlre un quadro
compleLo della procedura dl rlproduzlone del colore denLale, al flne dl
chlarlre come ll ragglunglmenLo dl un'esLeLlca ll plu naLurale posslblle
non possa fare a meno dl una correLLa scelLa del colore segulLa da
un'alLreLLanLo correLLa rlproduzlone.
nel Cap|to|o 2 e sLaLa comparaLa la rlpeLlblllLa dl leLLura dl uno
speLLrofoLomeLro cllnlco con uno uLlllzzaLo per rlcerche ln laboraLorlo.
ll prlmo passo nella valuLazlone dell'uso cllnlco dello speLLrofoLomeLro
vlLa Lasyshade e sLaLo valuLare la sua affldablllLa. A quesLo scopo la
verlflca prellmlnare e sLaLa la valuLazlone della rlpeLlblllLa dl leLLura, ln
quanLo requlslLo lndlspensablle per una successlva comparazlone con
lo speLLrofoLomeLro Ccean CpLlcs Su 1000, uno sLrumenLo dl
laboraLorlo esLremamenLe affldablle.
Le mlsurazlonl sono sLaLe rlpeLuLe su del camplonl dl ceramlca
da rlvesLlmenLo sLraLlflcaLa su meLallo, varlando la quanLlLa dl
porcellana opaca e Lrasluclda ln dlversl scheml dl sLraLlflcazlone. Le
rllevazlonl colorlmeLrlche sono sLaLe rlpeLuLe 3 volLe con lo
speLLrofoLomeLro Ccean CpLlcs Su1000, menLre con lo
speLLrofoLomeLro cllnlco vlLa Lasyshade sono sLaLe faLLe 3 mlsurazlonl,
113

Lenendo la sonda dello sLrumenLo con la mano e 3 volLe flssandola a
uno sLaLlvo graduaLo, al flne dl valuLare se eslsLeva qualche posslblle
dlfferenza Lra l'uso cllnlco dello sLrumenLo (a mano llbera) e quello dl
laboraLorlo (flssaLo allo sLaLlvo). La rlpeLlblllLa dl leLLura degll
sLrumenLl e sLaLa sLaLlsLlcamenLe LesLaLa medlanLe l'anallsl del
CoefflclenLe dl varlazlone (Cv).
l rlsulLaLl hanno dlmosLraLo un'eccellenLe rlpeLlblllLa dl leLLura per
enLrambl gll sLrumenLl LesLaLl. Lo speLLrofoLomeLro Su1000 ha
fornlLo del valorl dl coefflclenLe dl varlazlone molLo bassl
(0,002<Cv<0,111). er cl che rlguarda lo speLLrofoLomeLro
Lasyshade, la fedele accuraLezza dl leLLura e sLaLa oLLenuLa sla
flssando la sonda allo sLaLlvo (0<Cv<0,022) che a mano llbera
(0,008<Cv<0,913).
CuesLo prlmo lavoro ha confermaLo la valldlLa dell'uso dello
speLLrofoLomeLro vlLa Lasyshade, sla ln amblenLe cllnlco, sla come
sLrumenLo dl rlcerca, polche la buona accuraLezza dl leLLura
dlmosLraLa ln mlsurazlonl rlpeLuLe e rlsulLaLa vallda quanLo quella
dello sLrumenLo dl laboraLorlo.
nel Cap|to|o 3 e sLaLa lnvesLlgaLa l'ablllLa dl quaLLro slsLeml
ceramlcl dlfferenLl nel rlprodurre ll colore dl dlverse LlnLe apparLenenLl
alla scala colorl vlLapan Classlcal (A2, A3 e A3.3). Lo spessore della
ceramlca da rlvesLlmenLo rappresenLa un'lmporLanLe varlablle nella
rlproduclblllLa del colore, polche una sLraLlflcazlone anaLomlca e faLLa
da varl sLraLl, quall l'opaco, la denLlna e lo smalLo, che dlfferlscono Lra
loro per croma e opaclLa. Conslderando la scarsezza d'lnformazlonl
114

dlsponlblll dal produLLorl e dalla leLLeraLura su quale dovrebbe essere
la glusLa proporzlone dl sLraLlflcazlone dl smalLo e denLlna, l'oggeLLo dl
quesLo sLudlo e sLaLo quello dl verlflcare se LuLLl l slsLeml ceramlcl
LesLaLl fossero ln grado dl rlprodurre correLLamenLe ll colore
deslderaLo, aLLenendosl escluslvamenLe agll scheml dl sLraLlflcazlone
fornlLl dal produLLorl.
CuesLo sLudlo e sLaLo condoLLo verlflcando ll colore del
camplonl meLal-ceramlcl a forma dl dlsco, medlanLe l'auslllo dello
speLLrofoLomeLro cllnlco vlLa Lasyshade. 1re dlfferenLl colorl (A2, A3 e
A3.3), per quaLLro dlfferenLl slsLeml ceramlcl (vlLa Cmega 900,
uuceram klss, Wleland 8eflex e lvoclar lS d.SlCn), sono sLaLl oggeLLo
della seguenLe lndaglne, oLLenendo un LoLale dl 12 comblnazlonl. Sono
sLaLl prodoLLl 3 camplonl per ognl gruppo, per un LoLale dl 36
camplonl. l valorl dl AL oLLenuLl varlavano da 1,2 a 3,0. 1uLLl l slsLeml
ceramlcl hanno dlmosLraLo un'acceLLablle corrlspondenza cllnlca del
colore per la LlnLa A2 (AL < 3,7), menLre solamenLe l slsLeml uuceram
klss e lvoclar lS per la LlnLa A3 e ll slsLema vlLa Cmega 900 per la LlnLa
A3.3 hanno daLo del valorl cllnlcamenLe acceLLablll. er LuLLl gll alLrl
camplonl sono sLaLl oLLenuLl del valorl dl AL non acceLLablll. ll LesL
sLaLlsLlco AnCvA non ha rlvelaLo dlfferenze sLaLlsLlcamenLe
slgnlflcaLlve Lra le ceramlche LesLaLe (p<0,03). Al conLrarlo ll LesL Cne-
way AnCvA ha rlvelaLo che ll colore della ceramlca lnfluenzava
slgnlflcaLlvamenLe l valorl dl AL (p<0,03).
Conslderando l rlsulLaLl dl quesLo sLudlo, sl pu asserlre che le
lndlcazlonl fornlLe dal produLLorl dl ceramlche denLall, per aluLare gll
115

odonLoLecnlcl al ragglunglmenLo del successo esLeLlco, e qulndl alla
corrlspondenza Lra ll colore del manufaLLo e quello scelLo dal
cllnlco,sono molLo llmlLaLe, e spesso non sufflclenLl ad evlLare
dlscrepanze dl colore.
nel Cap|to|o 4 sono sLaLl anallzzaLl due rllevanLl faLLorl che
possono lnfluenzare la corrlspondenza dl colore: l'lnfluenza della scala
colorl e quella del slsLema ceramlco scelLo. nel aragrafo 4.1 e sLaLa
LesLaLa l'ablllLa del slsLema ceramlco vlLa Cmega 900, nel rlprodurre
correLLamenLe ll colore scelLo, ln rlferlmenLo alle scale colorl vlLapan
Classlcal e vlLa 3u-MasLer 1ooLhgulde. La ceramlca vlLa Cmega 900 e
sLaLa scelLa per quesLo LesL perche, al momenLo del LesL, era l'unlco
slsLema ceramlco denLale commerclallzzaLo sla nelle LlnLe della
vlLapan Classlcal che ln quelle della vlLa 3u-MasLer 1ooLhgulde. Al
glorno d'oggl, anche la ceramlca vlLa vM13 e commerclallzzaLa ln
enLrambe le scale colore.
Sono sLaLl fabbrlcaLl 13 dlschl ceramlcl secondo scheml dl
sLraLlflcazlone dlfferenLl per ognl colore (A3 e 2M3), manLenendo
cosLanLe lo spessore flnale del camplone. Sono sLaLl anallzzaLl 3
dlfferenLl scheml dl sLraLlflcazlone, nel quall varlavano gll spessorl
della denLlna opaca, della denLlna e dello smalLo,al flne dl creare una
varlablllLa nella leLLura del colore. La valuLazlone colorlmeLrlca e sLaLa
effeLLuaLa medlanLe lo speLLrofoLomeLro Lasyshade selezlonando la
modallLa 8esLauro" con rlferlmenLo al colorl A3 e 2M3. ll LesL AnCvA
a due vle ha dlmosLraLo che l valorl dl AL venlvano lnfluenzaLl
slgnlflcaLlvamenLe, sla dall'lnLerazlone scala colorl-slsLema ceramlco",
116

che dal faLLore schema dl sLraLlflcazlone" (p<0,001). l camplonl dl
ceramlca Cmega 900 sLraLlflcaLl secondo la scala colorl vlLa 3u MasLer
1ooLhgulde hanno mosLraLo, per ll colore selezlonaLo, una
corrlspondenza mlgllore dl colore rlspeLLo al camplonl della sLessa
ceramlca sLraLlflcaLl seconso la scala colorl vlLapan Classlcal. CuesLo
rlsulLaLo pu essere lnLerpreLaLo conslderando che lo
speLLrofoLomeLro Lasyshade rlesce megllo ad lnLerpreLare e
rlconoscere l colorl organlzzaLl secondo una dlsLrlbuzlone slsLemaLlca
nello spazlo colorlmeLrlco del denLl naLurall.
ua quesLl rlsulLaLl sl pu dedurre che la mlgllore
corrlspondenza del colore possa essere conslderaLa dlpendenLe dalla
scala colorl scelLa. lnolLre anche lo schema dl sLraLlflcazlone sl e
dlmosLraLo deLermlnanLe nella correLLa rlproduzlone del colore sLesso.
Come passo successlvo, dopo aver sLablllLo che la scala colorl vlLa 3u
MasLer 1ooLhgulde permeLLe una rlproduzlone del colore plu
affldablle, nel aragrafo 4.2 sl e passaLl ad esamlnare l'ablllLa dl due
dlfferenLl porcellane ad uso denLale (vlLa Cmega 900 e vlLa vM13) nel
rlprodurre correLLamenLe ll colore scelLo ln rlferlmenLo alla scala colorl
vlLa 3u MasLer 1ooLhgulde, al flne dl comprendere se la mlgllore
corrlspondenza dl colore fosse dlpendenLe ancora dalla scala colorl
oppure poLesse essere lnfluenzaLa anche dal slsLema ceramlco scelLo.
ll LesL e sLaLo condoLLo seguendo la sLessa conflgurazlone dl maLerlall
e meLodl uLlllzzaLa nel precedenLe sLudlo. Sono sLaLl prodoLLl 13 dlschl
ceramlcl nel colore 2M3 secondo dlversl scheml dl sLraLlflcazlone per
ognl slsLema ceramlco. er mlsurare l'accuraLezza del colore espressa
117

come valore dl AL e sLaLo usaLo lo speLLrofoLomeLro vlLa Lasyshade. ll
LesL sLaLlsLlco AnCvA a due vle ha rlvelaLo che ll faLLore slsLema
ceramlco" non era sLaLlsLlcamenLe slgnlflcaLlvo (p=0,17), menLre ll
faLLore schema dl sLraLlflcazlone" lnfluenzava slgnlflcaLlvamenLe l
valorl dl AL (p<0,001). 1uLLl l camplonl LesLaLl avevano valorl dl AL
mlnorl dl 3,3, ln leLLeraLura Lale dlfferenza, nonosLanLe sla
apprezzablle da operaLorl esperLl, vlene conslderaLa cllnlcamenLe
acceLLablle.
Concludendo, non sono sLaLe LrovaLe dlfferenze slgnlflcaLlve
nella correLLa rlproduzlone del colore quando l camplonl meLal
ceramlcl sono sLaLl sLraLlflcaLl con due slsLeml (Cmega 900 e vM13)
basaLl enLrambl sulla scala colorl vlLa 3u MasLer 1ooLhgulde. CuesLo
rlsulLaLo ha confermaLo ll faLLo che, per l slsLeml ceramlcl oggeLLo dl
quesLo sLudlo, la posslblllLa dl avere una buona corrlspondenza Lra ll
colore scelLo e quello reallzzaLo nel manufaLLo deve essere
condlseraLa dlpendenLe dalla scala colorl uLlllzzaLa. Ancora una volLa
quesLo sLudlo ha messo ln rlellevo ll faLLo che lo schema segulLo
duranLe la sLraLlflcazlone della ceramlca sul meLallo assume un ruolo
fondamenLale nel correLLo oLLenlmenLo del colore scelLo. Cl ha
sLablllLo l'lnfluenza relaLlva dl ognl sLraLo dl porcellana (8ase uenLlne,
1ranspa uenLlne e Lnamel) sul parameLrl del colore del resLaurl (1lnLa,
valore e Croma), che e sLaLo ln segulLo approfondlLo nel Cap|to|o S.
nel seguenLe lavoro sono sLaLl prodoLLl 40 dlschl meLal ceramlcl
medlanLe l'uLlllzzo dl uno sLampo ln acclalo apposlLamenLe progeLLaLo
e slngolarmenLe verlflcaLl con un callbro dlglLale dopo ognl coLLura, al
118

flne dl conLrollare lo spessore dl ognl sLraLo. Sono sLaLl valuLaLl 4
dlfferenLl spessorl flnall dl porcellana nel colore 2M3. er ognl
spessore sono sLaLl LesLaLl 2 dlfferenLl scheml dl sLraLlflcazlone. La
rllevazlone del colore e sLaLa effeLLuaLa con lo speLLrofoLomeLro
cllnlco vlLa Lasyshade, ll quale calcola le dlfferenze dl colore Lra quello
rllevaLo dal camplone e l daLl memorlzzaLl nello sLrumenLo. ll LesL
sLaLlsLlco AnCvA ad una vla ha rllevaLo che ll faLLore schema dl
sLraLlflcazlone" lnfluenzava slgnlflcaLlvamenLe l valorl dl AL, AC, AP e
AL (p<0,001). Spessorl magglorl dello sLraLo 8ase uenLlne hanno
provocaLo un aumenLo dl Croma nel resLauro. Al conLrarlo, spessorl
magglorl dello sLraLo 1ranspa uenLlne e Lnamel hanno prodoLLo una
dlmlnuzlone del Croma del colore. L'lncremenLo dello spessore dello
sLraLo Lnamel ha prodoLLo una dlmlnuzlone del valore e vlce versa.
er quanLo rlguarda la 1lnLa, l camplonl con gll spessorl plu soLLlll
hanno dlmosLraLo una corrlspondenza magglore.
A seconda dello spessore flnale della meLal ceramlca, lo
spessore dl ognl sLraLo e ll rapporLo Lra l varl sLraLl con dlversa opaclLa
rlcoprono un ruolo predomlnanLe nel ragglunglmenLo della mlgllore
corrlspondenza dl colore. L'odonLoLecnlco dovrebbe essere ln grado dl
correggere lndlvldualmenLe l parameLrl del colore, al flne dl oLLenere
la LlnLa deslderaLa.
119

L-$4*0/"-$"'

La valuLazlone dell'anallsl del faLLorl che lnfluenzano la procedura dl
rlproduzlone del colore, Lenendo sempre ln consldrazlone l llmlLl degll
sLudl presenLaLl, cl consenLe dl Lrarre le seguenLl concluslonl:

1. L'oLLenlmenLo dl una correLLa corrlspondenza dl colore Lra la
denLaLura naLurale e ll resLauro conservaLlvo o proLeslco e un
processo complesso che conslsLe dl 2 procedure speclflche: la
scelLa del colore e la sua correLLa rlproduzlone.
2. Lo speLLrofoLomeLro cllnlco vlLa Lasyshade ha dlmosLraLo
un'oLLlma preclslone nell'effeLLuare mlsure rlpeLuLe,
paragonablle a quella dello sLrumenLo dl laboraLorlo. Cl sLa a
slgnlflcare che lo sLrumenLo pu essere uLlllzzaLo sla come
sLrumenLo cllnlco, che per effeLLuare mlsurazlonl ln vlLro.
3. Le lndlcazlonl fornlLe dal produLLorl dl ceramlche denLall, per
aluLare gll odonLoLecnlcl ad oLLenere la glusLa corrlspondenza
Lra ll colore scelLo dal cllnlco e quello del manufaLLo, sono
molLo llmlLaLe, e non sono sufflclenLl al flne dl evlLare le
dlscrepanze dl colore.
4. La scala colorl vlLa 3u MasLer 1ooLhgulde ha consenLlLo dl
oLLenere mlgllorl corrlspondenze dl colore rlspeLLo alla scala
vlLapan Classlcal, cl e dovuLo alla dlsLrlbuzlone slsLemaLlca del
Lonl dl colore secondo un gradlenLe lncremenLale dl valore e
Croma.
120

3. La capaclLa dl oLLenere correLLamenLe un colore con una
ceramlca deve essere conslderaLa dlpendenLe dalla scala colorl
uLlllzzaLa. L'approcclo scelLo per sLraLlflcare la porcellana sul
meLallo rlcopre un ruolo predomlnanLe nell'oLLenlmenLo del
colore prescelLo per ll resLauro.
6. er quel che rlguarda ll slsLema ceramlco vlLa vM13, un
lncremenLo dello spessore dello sLraLo 8ase uenLlne produce
un lncremenLo del Croma. Al conLrarlo, ll Croma del resLauro
vlene dlmlnulLo medlaLe l'lncremenLo degll sLraLl 1ranspa
uenLlne e Lnamel. un lncremenLo dello sLraLo Lnamel produce
una dlmlnuzlone della LumlnoslLa (valore) e vlce versa. A
spessorl plu soLLlll la ceramlca ha dlmosLraLo una mlgllore
corrlspondenza della 1lnLa.
7. A seconda dello spessore flnale della meLal ceramlca, lo
spessore dl ognl sLraLo e ll rapporLo Lra l varl sLraLl con dlversa
opaclLa rlcoprono un ruolo predomlnanLe nel ragglunglmenLo
della mlgllore corrlspondenza dl colore. L'odonLoLecnlco
dovrebbe essere ln grado dl correggere lndlvldualmenLe l
parameLrl del colore al flne dl oLLenere la LlnLa deslderaLa.
121

.",#O"-$"'M0)0,#'

La posslblllLa dl relazlonare alla sclenza un qualcosa che e
sempre sLaLa conslderaLa una forma arLlsLlca rappresenLa una delle
plu grandl sflde dell'CdonLolaLrla moderna. L'oLLenlmenLo dl un
resLauro con semblanze naLurall, ovvero che sl lnLegrl correLLamenLe
con l LessuLl blologlcl clrcosLanLl, ha sempre rappresenLaLo una
procedura dlpendenLe dalle ablllLa del cllnlco o dell'odonLoLecnlco.
Cll speLLrofoLomeLrl cllnlcl possledono al glorno d'oggl LuLLl l
requlslLl per dlvenLare sLrumenLl d'uso quoLldlano. Lssl sono ln grado
dl aluLare l cllnlcl meno esperLl nella procedura dl selezlone del colore,
al flne dl evlLare, o quanLo meno rldurre, le dlscrepanze che sl possono
verlflcare.
Al flne dl oLLenere ll colore deslderaLo, l produLLorl dl
ceramlche dovrebbero fornlre degll scheml deLLagllaLl su come
sLraLlflcare la loro porcellana ln relazlone allo spessore flnale del
resLauro. Sarebbe uLlle che le ceramlche denLall fossero dlsponlblll sul
mercaLo anche ln colorazlone vlLa 3u MasLer 1ooLhgulde.
ulLerlorl esperlmenLl dovrebbero valuLare la preclslone degll
alLrl speLLrofoLomeLrl cllnlcl presenLl ln commerclo. ulLerlormenLe
lmporLanLe sarebbe valuLare l'lnfluenza che gll spessorl e l varl scheml
dl sLraLlflcazlone poLrebbero avere sugll alLrl slsLeml ceramlcl ln
commerclo.
Al flne dl valldare quesLl daLl dl laboraLorlo sarebbero necessarl
sLudl cllnlcl, con ll flne dl dlmosLrare che la rllevazlone sLrumenLale del
colore pu essere LanLo efflclenLe quanLo quella umana, ma plu
122

affldablle, sempre conslderando che alla flne l'arLe rlmane sempre una
vlrLu che apparLlene agll esserl umanl e non alle macchlne.
123

6.3 kesumen, conc|us|ones y d|recc|ones futuras

N#/0=#$'

Ln el Cap|tu|o 1, se presenL el ob[eLlvo del esLudlo. La
seleccln de un color preclso slempre ha sldo uno de los aspecLos ms
conLroverLldo de la odonLologla esLeLlca en general cuando se desea
resLaurar un dlenLe. uebldo a la varledad de colores que caracLerlza un
elemenLo denLal, lograr el color de una resLauracln arLlflclal que
pueda represenLar lo ms flelmenLe poslble lo de un dlenLe naLurale
es un procedlmenLo comple[o. Se presenLaron, enLonces, los dos
mayores aspecLos de la Loma del color. La prlmera se basa en la
seleccln de un color, a Lraves de una gula de colores, que se lnLegre
harmnlcamenLe con los Le[ldos blolglcos clrcumsLanLes, y el
segundo es la correcLa reproduccln del color de la prLesls o de la
resLauracln.
1ras un breve resumen del conoclmlenLo clenLlflco, a parLlr de
los descubrlmlenLos de newLon en el slglo 18 a la claslflcacln del
color de ClLLab*, se presenLaron algunas conslderaclones acerca del
uLlllzo de AL para la correlacln numerlca de los colores, para asl
poder medlr las dlferenclas exlsLenLes enLre dos colores uLlllzando una
formula que permlLa represenLar los valores en numeros. A pesar de
que esLe Lema pueda camblar el concepLo de la clencla del color, en la
pracLlca no se aprovech de la oporLunldad de esLe nuevo meLodo
para me[orar la correspondencla del color, pero slgue a ser Lomada en
conslderacln la Lecnlca vlslva de la Loma del color.
124

Se presenL una revlsln crlLlca de la evolucln de las gulas de
colores ms lmporLanLes. una conslderacln parLlcular se hlzo en la
dlsLrlbucln clenLlflca del color lnLroduclda por vl1A 3u MasLer
1ooLhgulde. LsLa gula presenLa una dlsposlcln slsLemaLlca de los
colores enLre aquellos presenLes en un dlenLe y una medlda numerlca
ob[eLlva del color, segun los prlnclplos de la colorlmeLrla ClLLab, ms
blen que en la pura observacln de los aspecLos de un dlenLe naLural
asl como reporLado en gulas precedenLes como por e[emplo en la de
vlLapan Classlcal o en la de lvoclar-vlvadenL Chromascop.
lnvesLlgaclones ad[unLlvas se prefl[aron el ob[eLlvo de dlsmlnulr
los errores en la Loma del color debldo a la sola evaluacln vlslva,
uLlllzando por ello colorlmeLros y especLofoLomeLros. Se descrlbleron
brevemenLe las dlferenclas enLre los dos lnsLrumenLales presenLados.
La aLencln se focallz en vl1A Lasyshade y en su evolucln (vl1A
Lasyshade CompacL) y en MP1 SpecLro Shade Mlcro, de momenLo que
esLos son los meLodos especLofoLomeLrlcos ms uLlllzados en la
pracLlca cllnlca.
Segun cuanLo precedenLemenLe lnLroducldo, la ulLlma eLapa en
la seleccln del color es su perfecLa reproduccln en la prLesls o en la
resLauracln. Se dlscuL de los facLores que pueden lnfluenclar el color
flnal de una resLauracln en ceramlca, hacendo encaple en el papel
fundamenLal [ugado por la poslbllldad de esLraLlflcar el opaco y el
Lranslucldo. Sl no hay una correlacln enLre el espesor y el
esLraLlflcacln de la resLauracln, no es suflclenLe eleglr corecLamenLe
el color. or ello, el enfoque descrlbldo en esLa Lhesls docLoral se
125

propuso de ofrecer una vlsln compleLa de los procedlmlenLos de la
reproduccln del color denLal, para aclarar como, la reallzacln de una
esLeLlca denLal lo ms naLural poslble, neceslLa de una seleccln
adecuada del color asl como de su corecLa reproduccln.
Ln el Cap|tu|o 2, se compar la repeLlcln de lecLura de uno
especLofoLomeLro cllnlco con la de un aparaLo uLlllzado en laboraLorlo.
La prlmera eLapa en la evaluacln del uLlllzo cllnlco del
especLofoLomeLro vl1A Lasyshade fue de anallzar su flabllldad. ue
hecho, anLes Le Lodo se evalu la repeLlbllldad de las lecLuras logradas
por el aparaLo, que es un requlslLo lndlspensablle para poderlo luego
comparar al especLofoLomeLro de laboraLorlo Ccean CpLlcs Su 1000.
Se esLraLlflcaron dlferenLes canLlLades de opaco y Lranslucldo
para la fabrlcacln de especlmenes de meLalo ceramlca segun
sugerldo de los producLores. Las medldas se replLleron 3 veces con el
especLofoLomeLro Ccenan CpLlcs Su 1000, y se conducleron 3
medldas con el especLofoLomeLro cllnlco vl1A Lasyshade, manLenendo
la sonda con la mano y oLras 3 veces fl[ando la sonda a un andamlo
graduado, con el ob[eLlvo de evaluar poslble dlferenclas enLre el uLlllzo
cllnlco del lnsLrumenLal (con la sola mano) y aquello de laboraLorlo
(fl[ado al andamlo). La repeLlbllldad de lecLura fue calculada
esLadlsLlcamenLe a Lraves del nallsls del coeflclenLe de varlacln (Cv).
Los resulLados demonsLraron una repeLlbllldad opLlmal de lecLura por
ambos los aparaLos LesLados. Ll especLofoLomeLro Su 1000 logr
valores de coeflclenLe de varlacln ba[os (0.002<Cv<0.111). Con
respecLo al especLofoLomeLro Lasyshade, una repeLlcln de lecLura
126

exacLa se logr sea fl[ando la sonda al andamlo (0<Cv<0.022) sea
uLlllzandola a mano llbre (0.008<Cv<0.913).
Ll prlmer esLudlo valld el uLlllzo del especLofoLomeLro
Lasyshade sea cllnlcamenLe que como aparaLo de lnvesLlgacln, de
momenLo que la preclsln de lecLura demonsLrada en medldas
repeLldas fue comparable a aquella del mlsmo lnsLrumenLal de
laboraLorlo.
Ln el Cap|tu|o 3, se lnvesLlg la capacldad de cuaLro dlferenLes
slsLemas ceramlcos en la reproduccln del color de LlnLas dlferenLes
perLeneclenLe a la escala de colores vlLapan Classlcal (A2, A3 y A3.3).
Ll espesor de la ceramlca de revesLlmlenLo es oLra varlable lmporLanLe
duranLe la reproduccln del color, de momenLo que una
esLraLlflcacln anaLmlca es compuesLa de dlferenLes capas, por
e[emplo el opaco, la denLlna y el esmalLe, los cuales se dlferenclan
enLre ellos por el croma y la opacldad. 1omando en conslderacln las
pocas lnformaclones procurada por los producLores y en la llLeraLura
sobre la que deberla ser la exacLa proporcln de esLraLlflcacln de
esmalLe y denLlna, el ob[eLo de esLudlo fue de averlguar sl Lodos los
slsLemas de ceramlcas dlsponlblles Lenlan la capacldad de reproduclr
correcLamenLe el color deseado, slgulendo flelmenLe las llneas gulas
propuesLas por los fabrlcanLes.
La lnvesLlgacln se reallz averlguando el color de muesLras de
meLalo-ceramlca con forma de dlscos, uLlllzando el espeLofoLomeLro
cllnlco vl1A Lasyshade. or ello, se uLlllzaron Lre colores (A2, A3 y
A3.3) y cuaLro dlferenLes slsLemas de ceramlca (vl1A Cmega 900,
127

uuceram klss, Wleland 8eflex e lvoclar lS d.SlCn) y se lograron hasLa
12 comblnaclones. Se producleron Lres muesLras cada grupo, por un
LoLal de 36 especlmenes. Los valores obLenldos de AL se exLendevano
desde 1.2 hasLa 3.0. 1odos los slsLemas ceramlcos uLlllzados
ensenaron una acepLable correspondencla cllnlca del color en la LlnLa
A2 (AL < 3,7), mlenLras que los slsLemas uuceram klss e lvoclar lS y el
slsLema vl1A Cmega 900 revelaron valores cllnlcamenLe acepLables
slo por las LlnLas A3 y A3.3 respecLlvamenLe. Los dems especlmenes
alcanzaron valores de AL no acepLables. Ll nallsls esLadlsLlco
(AnCvA) no revel dlferenclas slgnlflcaLlvas enLre las ceramlcas
LesLadas (p<0.03). Ll nallsls a una varlancla de AnCvA desvel que el
color de la ceramlca era una facLor slgnlflcaLlvamenLe lnfluyenLe los
valores de AL (p<0.03).
Anallzando los resulLados obLenldos del precedenLe esLudlo, se
puede aflrmar que las lndlcaclones ofreclda por los fabrlcanLes de las
ceramlcas denLales, para ayudar los Lecnlcos en alcanzar el exlLo
esLeLlco y en la correspondencla enLre el color del manufacLo y aquello
elegldo por el denLlsLa, son llmlLadas y muy a menudo no son
suflclenLes para evlLar dlscrepanclas en el color.
Ln el Cap|tu|o 4, se anallzaron los facLores que pueden
lnfluenclar la correspondencla del color: la escala de colores de un
lado y el slsLema ceramlca elegldo de oLro. Ln el arrafo 4.1, se LesL
la habllldad de vl1A Cmega 900 en reproduclr el color selecclonado
Lomando en conslderacln las escalas de colores vlLapan Classlcal y
vlLa 3u-MasLer 1ooLhgulde. La eleccln del slsLema ceramlca vl1A
128

Cmega 900 fue gulada porque, al momenLo del esLudlo, era la sla
ceramlca dlsponlblle sea en las LlnLas vlLapan Classlcal que en aquellas
de vlLa 3u-MasLer 1ooLhgulde. Poy en dla, Lamblen la ceramlca vlLa
vM13 esL dlsponlblle en el comerclo.
Se prepararon 13 dlscos de ceramlca slgulendo planes de
esLraLlflcacln dlferenLes por cada color (A2 y 2M3), manLenendo
cosLanLe el espesor flnal de la muesLra. Se anallzaron 3 esquemas de
esLraLlflcacln, varlando las capas de la denLlna opaca, de la denLlna y
del esmalLe para crear una varlabllldad en la lecLura del color. Las
medldas del color se cumpllron uLlllzando el espeLofoLomeLro vl1A
Lasyshade selecclonando la modalldad 8esLauracln" y referlendose
a los colores A2 y 2M3. Ll LesL AnCvA de dos vlas revel que los
valores de AL se velan lnfluenclados slgnlflcaLlvamenLe por la
lnLeraccln escala de color-slsLema de ceramlca" y del facLor
esquema de esLraLlflcacln" (p<0.001). Las muesLras de Cmega 900
esLraLlflcados slgulendo la escala de colores vlLa 3u MasLer
1ooLhgulde demonsLraron, por el color selecclonado, una me[or
correspondencla del color con respecLo a las muesLras de la mlsma
ceramlca cuya esLraLlflcacln fue gulada por la escala de color vlLapan
Classlcal. La lnLerpreLacln de esLos resulLados Llene en conslderacln
que el especLofoLomeLro Lasyshade puede lnLerpreLar de manera ms
vallda y reconocer los colores segun una dlsLrlbucln slsLemaLlca en el
espaclo colorlmeLrlco de los dlenLes naLurales.
ConsecuenLemenLe, una exacLa correspondencla del color no
puede presclndlr de la escala de colores eleglda. Adems, el plan de
129

esLraLlflcacln del color demonsLr ser oLro facLor deLermlnanLe la
correcLa reproduccln del color.
SuceslvamenLe, Lras esLablecer que la escala de color vlLa 3u
MasLer 1ooLhgulde permlLe lograr una reproduccln del color ms
flable, en el arrafo 4.2 se examln la habllldad de dos ceramlcas
denLales (vlLa Cmega 900 y vlLa vM13) en la exacLa reproduccln del
color elegldo referlendose a la escala de colores vlLa 3u MasLer
1ooLhgulde, para asl comprender sl la me[or correspondecla del color
dlpendlera Lodavla de la escala de colores o sl pudlera ser lnfluenclada
del mlsmo slsLema de ceramlca uLlllzado. Ll LesL se condu[o uLlllzando
el mlsmo proLocolo del esLudlo precedenLe. Se consLruyeron 13 dlscos
de ceramlca en el color 2M3 slgulendo esquema de esLraLlflcaclones
dlferenLes por cada ceramlca. La preclsln del color (AL) se mldl a
Lraves del espeLofoLomeLro vlLa Lasyshade. Ll nallsls esLadlsLlco
revel que el facLor slsLema de ceramlca" no fue slgnlflcaLlvo
(p=0.17), mlenLras que el facLor esquema de esLraLlflcacln" lnfluy
slgnlflcaLlvamenLe (p<0.001). 1odos los especlmenes LesLados lograron
valores de AL menor de 3.3, en la llLeraLura dlcha dlferencla, a pesar
de que sea apreclaLa por operaLores esperLo, es cllnlcamenLe
acepLable.
Ln concluslon, no se enconLraron dlferenclas slgnlflcaLlvas en la
reproduccln correcLas del color cuando las muesLras en meLalo-
ceramlca se esLraLlflcaron con dos slsLemas (Cmega 900 y vM13)
slgulendo la escala de colores vlLa 3u MasLer 1ooLhgulde. LsLo en
conflrmacln de que, por los slsLemas LesLados en el presenLe esLudlo,
130

la buena correspondencla del color elegldo y de aquello reallzado en el
manufacLo proLeslco es dependlenLe de la escala de colores uLlllzada.
Adems, el esquema de esLraLlflcacln de la ceramlca sobre el meLal
Llene un papel lmporLanLe en la correcLa obLencln del color elegldo.
La lnfluencla relaLlva de cada capa de ceramlca (8ase uenLlne, 1ranspa
uenLlne y Lnamel) en los parameLros de los colores de las
resLauraclones (1lnLa, valor y Croma) se aprofundl en el Cap|tu|o S.
or ello, se reallzaron 40 dlscos de meLal-ceramlca uLlllzando un molde
en acero aposlLamenLe creado y cada dlsco fue slngolarmenLe medldo
con una callbro dlglLal Lras las varlas cocclones para averlguar el
espesor de las muesLras. Se evaluaron 4 dlferenLes grosores flnales de
ceramlca en el color 2M3. or cada espesor, se LesLaron 2 esquemas
de esLraLlflcacln. Las medldas se reallzaron uLlllzando el
espeLofoLomeLro cllnlco Lasyshade, que permlLe calcular las
dlferenclas de color enLre aquello reglsLrado por el especlmen y
aquello memorlzado en el aparaLo. Ll nallsls esLadlsLlco revel que el
facLor esquema de esLraLlflcacln" lnfluy negaLlvamenLe en los
valores de AL, AC, AP y AL (p<0.001). Al aumenLar de la capa de 8ase
uenLlne se aslsLl a un aumenLo en el croma de la resLauracln.
ConLrarlamenLe, espesores mayores de 1raspa uenLlne y Lnamel
dlsmlnulron el croma del color. Ll aumenLo de la capa de Lnamel
provoc un decalmlenLo del valor y P"4#'P#,/%. Con respecLo ala 1lnLa,
las muesLras con menores espesor demonsLraron una
correspondencla mayor.
131

Segun el espesor flnal de una meLalo-ceramlca, el grosor de
cada capa y la relacln enLre los varlos esLraLos con dlferenLe opacldad
Llenen un papel fundamenLal en la obLencln de la me[or
correspondencla del color. Ll Lecnlco denLal deberla ser capaz de
correglr lndlvldualmenLe los parameLros del color, para asl lograr la
LlnLa deseada.
132

L-$4*0/"-$#/'

La evaluacln del nallsls de los facLores que lnfluenclan los
procedlmlenLos de reproduccln del color, enLre los llmlLes de las
lnvesLlgaclones presenLadas, nos permlLe deflnlr las concluslones
slgulenLes:
1) La obLencln de una correcLa correspondencla de color enLre el
dlenLe naLural y la resLauracln proLeslca/conservaLlva es
comple[a y se basa en dos expedlenLes prlnclpales: la eleccln
del color y su exacLa reproduccln.
2) Ll especLofoLomeLro vlLa Lasyshade ha demonsLrado una
preclsln opLlmal duranLe medldas repeLldas, en comparacln
a un espeLofoLomeLro de laboraLorlo. ConsecuenLemenLe, esLe
lnsLrumneLal puede ser uLlllzado sea cllnlcamenLe sea para
efecLuar lnvesLlgaclones #$'P"),-.
3) Las lndlcaclones ofreclda por los producLores, para ayudar los
Lecnlcos denLales una correspondencla exacLa enLre el color
elegldo por el denLlsLa y el manufacLo, son llmlLadas, y no
parecen ser suflclenLes para evlLar dlscrepanclas de colores.
4) La escala de colores vlLa 3u MasLer 1ooLhgulde ha permlLldo
lograr correspondenclas de colores memore con respecLo a
vlLapan Classlcal, esLo esL relaclonado con la dlsLrlbucln
slsLemaLlca de los Lonos de color segun un gradlenLe
lncremenLal de valor y Croma.
133

3) La escala de colores lnfluencla la capacldad de obLener el color
de una ceramlca. Ll procedlmenLo de esLraLlflcacln de la
ceramlca sobre el meLal Llene un papel fundamenLal en la
obLencln del color elegldo para una resLauracln.
6) Con respecLo a la ceramlca vlLa vM13, un aumenLo del espesor
de la capa de 8ase uenLlne deLermlna un lncremenLo del
Croma. ue oLro lado, el Croma de una resLauracln dlsmlnuye a
la vez que 1ranspa uenLlne y Lnamel aumenLan. un espesor
mayor de Lnamel produce una dlsmlnucln de la Lumlnosldad
(valor) y P"4#' P#,/%. Con grosores menores, la ceramlca
demonsLra una me[or correspondencla de la 1lnLa.
7) Segun el espesor flnal de una meLalo-ceramlca, el grosor de
cada capa y la relacln enLre los varlos esLraLos con dlferenLe
opacldad Llenen un papel fundamenLal en la obLencln de la
me[or correspondencla del color. Ll Lecnlco denLal deberla ser
capaz de correglr lndlvldualmenLe los parameLros del color,
para asl lograr la LlnLa deseada.

134

.",#44"-$#/'M0)0,%/'

La poslbllldad de relaclonar a la clencla algo desde slempre
conslderada una forma de arLe es una gran desaflo de la CdonLologla
moderna. La obLencln de una resLauracln lo ms pareclda poslble al
naLural, y que se lnLegre perfecLamenLe con los Le[ldos bloolglcos
clrcumsLanLes, es un procedlmenLo alLamenLe dependlenLe de la
habllldad del denLlsLa y del Lecnlco denLal.
Poy en dla, los especLofoLomeLros dlsponlbles Llenen Lodas las
caraLerlsLlcas necerarlas para dlvenlr lnsLrumenLales de uso coLldlano.
LsLos aparaLos pueden ser de ayuda para los cllnlcos con menores
experlencla cuando Llenen que enfrenLarse con la adecuada seleccln
del color, para evlLar, o por lo menos dlsmlnulr, las dlscrepanclas que
pueden ocurrlr.
Los fabrlcanLes de slsLemas de ceramlca deberlan proveer
planes deLallados sobre los meLodos de esLraLlflcaclones de la
porcelana en relacln con el espesor flnal de la resLauracln, para asl
permlLlr la obLencln de un color adecuado. Serla muy uLll que las
ceramlcas denLales fueran dlsponlblles en el mercado lncluso en la
coloracln vlLa 3u MasLer 1ooLhgulde.
lnvesLlgaclones fuLuras deberlan evaluar la preclsln de Lodos
los especLofoLomeLros cllnlcos presenLes en el mercado denLal. Asl
como serla lmporLanLe esLlmar la lnfluencla que los espesores de la
ceramlca y los esquemas de esLraLlflcacln podrlan Lener en Lodos los
slsLemas de ceramlca presenLes en el comerclo.
135

LsLudlos #$' P"P-' son deseables para valldar los resulLados de
laboraLorlo obLenldos en esLa Lhesls docLoral, como demonsLracln
del hecho que la medlda lnsLrumenLal del color puede ser Lan eflclenLe
cuanLo aquella humana, pero Lal vez aun ms conflable, pero slempre
Lomando en conslderacln que el arLe es una vlrLud que perLenece a
los seres humanos y no a las maqulnas.
136

6.4 2usammenfassung, sch|ussfo|gerungen und zuknft|ge
r|chtungen

Q0/%==#$3%//0$K'

lm kap|te| 1 wurde das Crundprlnzlp der SLudle dargesLellL. ule
prazlse larbbesLlmmung lsL lmmer elne der grLen
Perausforderungen der Zahnhellkunde und der asLheLlschen
Zahnmedlzln gewesen. Aufgrund der groen varleLaL der Zahnfarben
lsL es sehr kompllzlerL, elne uberelnsLlmmung zwlschen der larbe der
8esLauraLlon und der naLurllchen Zahnfarbe zu errelchen. ule zwel
wlchLlgsLen AspekLe der larbbesLlmmung wurden dargesLellL. uer
LrsLe lsL dle Auswahl elner larbe, dle slch harmonlsch mlL den
umgebenden blologlschen Ceweben lnLegrleren wlrd, mlLhllfe elnes
larbmusLers. uer ZwelLe lsL dle prazlse 8eprodukLlon dleser larbe ln
der 8esLauraLlon.
nach elner kurzen Zusammenfassung der wlssenschafLllchen
LnLdeckungen - von der SLudlen von newLon lm 18. !ahrhunderL bls
zur heuLlgen ClLLab* klasslflkaLlon der larbe - wurden elnlge
8eLrachLungen uber dle Anwendung des AL angesLellL, um dle larbe
mlL den Zahlen zu korrelleren und dle ulfferenz zwlschen zwel larben
mlL elner lormel auszurechnen, dle dle ulfferenz zwlschen zwel
larben mlL elner Zahl ausdruckL. Auch wenn dlese LnLdeckung den
8egrlff der WlssenschafL der larbe geanderL haLLe, wurde dle
CelegenhelL lm 8ahmen der Zahnmedlzln nlchL soforL genuLzL, dle
137

larbbesLlmmung durch dleses neue SysLem zu verbessern, und man
sLuLzLe slch auf dle vlsuelle larbbesLlmmung welLer.
Llne uberslchL der LnLwlcklung der wlchLlgsLen larbmusLer
wurde dargesLellL. ule von dem vl1A 3u MasLer 1ooLhgulde
elngefuhrLe wlssenschafLllche larbverLellung wurde besonders
beruckslchLlgL. vergllchen mlL den vorhergehenden larbmusLern wle
das vlLapan Classlcal oder das lvoclar-vlvadenL Chromascop, dle nur
das Aussehen der naLurllchen Cewebe beruckslchLlgLen, haL sle elne
sysLemaLlsche Anordnung der larben lm 8ahmen des kolorlmeLrlschen
8aums der naLurllchen Zahne und sle slehL elne ob[ekLlve numerlsche
Messung der larbe mlLLels des kolorlmeLrlschen ClLLab*-Crdnung
rlnzlps voraus.
WelLere lorschung haLLe das Zlel, dle ulskrepanz der larbe
durch kolorlmeLer und SpekLrophoLomeLer auf das Mlnlmum zu
senken, dle abhanglg von der vlsuellen LvaluaLlon war. Llne kurze
8eschrelbung der unLerschlede zwlschen dlesen CeraLen wurde
gemachL. uas vl1A Lasyshade und selne LnLwlcklung (vl1A Lasyshade
CompacL) und das MP1 SpecLro Shade Mlcro wurden besonders
beruckslchLlgL, well sle dle SpekLrophoLomeLer slnd, dle am melsLen
unLer kllnlschen 8edlngungen verwendeL werden.
Wle es vorher erklarL wurde, lsL der leLzLe SchrlLL der
larbbesLlmmung von der 8eprodukLlon der larbe ln der 8esLauraLlon
dargesLellL. ule lakLoren, dle dle Lndfarbe von keramlk-
8esLauraLlonen beelnflussen, wurden dlskuLlerL und dle PaupLrolle,
dle von dem verhalLnls zwlschen durchschelnenden und opaken
138

SchlchLen der keramlk gesplelL wlrd, wurde beLonL. ln der 1aL lsL elne
korrekLe larbbesLlmmung nlchL ausrelchend, wenn sle ln
Zusammenhang mlL der ulcke und der SLraLlflkaLlon-1echnlk der
8esLauraLlon nlchL gebrachL wlrd.
uaher haLLen dle SLudlen, dle ln dleser ulsserLaLlon dargesLellL
slnd, das Zlel, elne kompleLLe uberslchL der larbbesLlmmung zu
versorgen und es zu erklaren, dass dle korrekLe larbbesLlmmung und
dle prazlse 8eprodukLlon der larbe noLwendlg slnd, um elne naLurllch
aussehende 8esLauraLlon zu errelchen.
lm kap|te| 2 wurde dle WlederholbarkelL der Messungen elnes
kllnlschen SpekLrophoLomeLers mlL elnem Labor-SpekLrophoLomeLer
vergllchen. uer ersLe SchrlLL der 8ewerLung der kllnlschen Anwendung
des vl1A Lasyshade SpekLrophoLomeLers war es, selne ZuverlasslgkelL
fesLzusLellen. ueshalb wurde ln der ersLen hase dle WlederholbarkelL
der Messungen dleses CeraLs erforschL, um elnen verglelch mlL dem
LaborsgeraL Ccean CpLlcs Su 1000 anzusLellen.
MeLall-keramlk roben wurden durch dle SLraLlflkaLlon
unLerschledllcher Mengen von durchschelnender und opaker keramlk
vorberelLeL. !ede robe wurde funfmal mlL dem Ccean CpLlcs Su
1000 geLesLeL, dagegen wurde [ede robe funfmal frelhandlg und
funfmal mlL der an elnem ,SLand befesLlgLen Sonde gemessen, um
dle unLerschlede zwlschen der kllnlschen (frelhandlg) und der
laboraLorlschen (befesLlgLe Sonde) Anwendung zu erforschern. ule
WlederholbarkelL des SpekLrophoLomeLers wurde mlL der Analyse des
koefflzlenLes von varlaLlon (kv) sLaLlsLlsch ausgewerLeL.
139

ule Lrgebnlsse haben elne ausgezelchneLe WlederholbarkelL
der Messungen mlL belden geLesLeLen CeraLen gezelgL. Cerlngere
koefflzlenLen von varlaLlon (0.002<kv<0.111) wurden mlL dem Ccean
CpLlcs Su 1000 gemessen. uas Lasyshade haL elne guLe CenaulgkelL
wahrend der wlederholLen Messungen weder mlL der befesLlgLen
Sonde (0<kv<0.022) noch frelhandlg (0.008<kv<0.913) gezelgL.
ule guLe CenaulgkelL des kllnlschen CeraLs vergllchen mlL dem
LaborsgeraL haL dle MgllchkelL enLdeckL, dleses CeraL von belden
kllnlschen und laboraLorlschen Anwendungen verwenden zu knnen.
lm kap|te| 3 wurden dle unLerschlede zwlschen den larben
von vler keramlk-SysLemen und den larben ,A2, A3 und A3.3 des
vlLapan Classlcal larbmusLers unLersuchL. Lln wlchLlger Crund der
varlablllLaL der larbe lsL von der ulcke der keramlk dargesLellL, well
verschledene SchlchLe von keramlk noLwendlg slnd und zwar Cpak,
uenLln und Schmelz. AngeslchLs der begrenzLen lnformaLlon aus den
llrmen und aus der LlLeraLur uber dle ldeale roporLlonen von uenLln
und Schmelz war es das Zlel dleser SLudle, dle lahlgkelL der geLesLeLen
keramlk-SysLemen zu unLersuchen, dle ausgewahlLe larbe mlL den
SLraLlflkaLlon-Plnwelsen der llrma zu reproduzleren.
ln dleser SLudle wurde dle larbe von MeLall-keramlk Schelben
mlL dem vl1A Lasyshade kllnlschen SpekLrophoLomeLer gemessen.
urel verschledene larben (A2, A3, A3.3) von vler keramlk-SysLemen
(vl1A Cmega 900, uuceram klss, Wleland 8eflex und lvoclar lS
d.SlCn) mlL lnsgesamL 12 komblnaLlonen wurden geLesLeL. ln [eder
Cruppe wurden drel roben vorberelLeL und ln der SLudle gab es
140

lnsgesamL 36 roben. ule WerLe des AL varllerLen zwlschen 1.2 und
3.0. ule larbe A2 wurde mlL allen geLesLeLen keramlk-SysLemen
reproduzlerL (AL<3.7), dle larbe A3 wurde ln den uuceram klss und
lvoclar lS roben reproduzlerL und dle larbe A3.3 wurde nur ln den
vl1A Cmega 900 roben errelchL. ln den anderen roben wurde dle
larbe nlchL erfolgrelch reproduzlerL. ule AnCvA haL kelne slgnlflkanLe
unLerschlede zwlschen den keramlk-SysLemen gezelgL (>0.03). ule
Cne-Way AnCvA haL gezelgL, dass dle larbe der keramlk dle WerLe
des AL beelnflussL haL (<0.03).
Abschlleend haL dlese SLudle fesLgesLellL, dass dle Plnwelse
der llrma nlchL ausrelchend slnd, um dem ZahnLechnlker zu helfen,
dle ausgewahlLe larbe ln der 8esLauraLlon zu reproduzleren.
lm kap|te| 4 wurden zwel wlchLlge lakLoren unLersuchL, dle dle
larbesLlmmung beelnflussen: dle larbmusLer und das keramlk-
SysLem. lm aragraph 4.1 wurde dle lahlgkelL des vl1A Cmega 900
keramlk-SysLems erforschL, dle ausgewahlLe larbe mlL den vlLapan
Classlcal und vl1A 3u-MasLer 1ooLhgulde larbmusLern als 8eferenzen
zu reproduzleren. uas vl1A Cmega 900 wurde ln dleser SLudle
geLesLeL, well es das elnzlge keramlk-SysLem war, das es weder ln den
larben des vlLapan Classlcal noch ln den larben des vl1A 3u-MasLer
1ooLhgulde gab, als dle SLudle durchgefuhrL wurde. PeuLzuLage wlrd
auch das vl1A vM13 weder ln den larben des vlLapan Classlcal noch ln
den larben des vl1A 3u-MasLer 1ooLhgulde produzlerL. lunfzehn
keramlk-Schelben wurden mlL verschledenen SLraLlflkaLlon-1echnlken
mlL [eder larbe (A3 und 2M3) vorberelLeL und dle ulcke der roben
141

war konsLanL. urel verschledene SLraLlflkaLlon-1echnlken wurden
verwendeL, dle slch ln der ulcke des opaken uenLlns, des uenLlns und
des Schmelzes vonelnander unLerschleden, um elne varlablllLaL ln dem
Ablesen der larbe zu errelchen. ule Messungen der larbe wurden mlL
dem Lasyshade ln der ,8esLoraLlon ModallLaL mlL den A3 und 2M3
larben als 8eferenzen gemachL. ule 1wo-Way AnCvA haL gezelgL,
dass weder dle lnLerakLlon ,larbmusLer - keramlk-SysLem noch der
lakLor ,SLraLlflkaLlon-1echnlk dle WerLe des AL slgnlflkanL beelnflussL
haben (p<0.001). ule roben des vl1A Cmega 900 ln den larben des
vl1A 3u-MasLer 1ooLhgulde haben elne bessere uberelnsLlmmung der
larbe als dle roben des glelchen keramlk-SysLems ln den larben des
vlLapan Classlcal gezelgL. uleses Lrgebnls kann man erklaren, well das
Lasyshade dle larben besser ldenLlflzleren kann, dle ln elner
wlssenschafLllch-baslerLen sysLemaLlschen raumllchen verLellung
organlslerL slnd.
ueshalb lassL es slch sagen, dass dle uberelnsLlmmung der
larbe von dem larbmusLer abhanglg lsL. Auerdem wlrd dle
8eprodukLlon der larbe von der SLraLlflkaLlon-1echnlk der keramlk
beelnflussL.
nachdem es fesLgesLellL wurde, dass das vl1A 3u-MasLer
1ooLhgulde erlaubL, elne prazlsere uberelnsLlmmung der larbe zu
errelchen, wurde dle lahlgkelL von zwel keramlk-SysLemen (vl1A
Cmega 900 und vl1A vM13) lm aragraph 4.2 unLersuchL, dle
ausgewahlLe larbe mlL dem vl1A 3u-MasLer 1ooLhgulde als 8eferenz
zu reproduzleren, um es fesLzusLellen, ob dle uberelnsLlmmung der
142

larbe von dem larbmusLer oder von dem keramlk-SysLem abhanglg
lsL. uas LxperlmenL wurde mlL der glelchen MeLhode der
vorhergehenden SLudle durchgefuhrL. lunfzehn keramlk-Schelben von
[edem keramlk-SysLem wurden mlL verschledener ulcke der SchlchLen
ln der larbe 2M3 vorberelLeL. ule mlL dem AL ausgedruckLe
CenaulgkelL der larbe wurde mlL dem vl1A Lasyshade geLesLeL. ule
1wo-Way AnCvA haL gezelgL, dass der lakLor ,keramlk-SysLem nlchL
slgnlflkanL war (p=0.17). uagegen haL der lakLor ,SLraLlflkaLlon-
1echnlk dle WerLe des AL slgnlflkanL beelnflussL (p<0.001). Alle
roben haben WerLe des AL gerlnger als 3.3 gezelgL. Auch wenn eln
solches Lrgebnls von erfahrenen lachleuLen geschaLzL wlrd, wlrd es
aber unLer kllnlschen 8edlngungen fur akzepLabel gehalLen.
Wenn dle MeLall-keramlk roben mlL den auf dem vl1A 3u-
MasLer 1ooLhgulde baslerLen keramlk-SysLemen vorberelLeL wurden,
gab es kelne unLerschlede zwlschen vl1A Cmega 900 und vl1A vM13
ln lhrer lahlgkelL, dle ausgewahlLe larbe zu reproduzleren. uleses
Lrgebnls zelgLe, dass dle uberelnsLlmmung zwlschen der larbe der
unLersuchLen keramlk-SysLemen und elner ausgewahlLen larbe von
dem larbmusLer abhanglg lsL. ulese SLudle haL besLaLlgL, dass dle
SLraLlflkaLlon-1echnlk der keramlk auf das MeLall elne PaupLrolle
splelL, um dle ausgewahlLe larbe ln der 8esLauraLlon zu
reproduzleren.
uleses Lrgebnls haL den relaLlven Llnfluss [eder keramlk-
SchlchL (8ase uenLlne, 1ranspa uenLlne und Lnamel) auf dle drel
larbdlmenslonen (PelllgkelL, lnLenslLaL und larbLon) der 8esLauraLlon
143

fesLgesLellL. uleses 1hema wurde lm kap|te| S welLerenLwlckelL.
vlerzlg keramlk-Schelben wurden ln elner lorm aus SLahl vorberelLeL
und dle ulcke [eder SchlchL wurde mlL elner dlglLalen Lehre gemessen.
vler verschledene ulcken der keramlk ln der larbe 2M3 wurden
geLesLeL. lur [ede ulcke wurden zwel verschledene SLraLlflkaLlon-
1echnlken unLersuchL. uer kllnlsche SpekLrophoLomeLer Lasyshade
wurde verwendeL, um dle gemessene larbe der roben mlL den ln
dem larbmessgeraL gespelcherLen 8eferenz-uaLen zu verglelchen. ule
Cne-Way AnCvA zelgLe, dass der lakLor ,SLraLlflkaLlon-1echnlk dle
AL, AC, AP und AL slgnlflkanL beelnflussLe (p<0.001). Llne grere
ulcke des 8ase uenLlne verursachLe dle Lrhhung der lnLenslLaL.
uagegen verursachLe elne grere ulcke des 1ranspa uenLln und des
Lnamel elne Senkung der lnLenslLaL. MlL elner erhhLen ulcke der
Lnamel SchlchL gab es dle Senkung der PelllgkelL und umgekehrL. Llne
prazlsere uberelnsLlmmung des larbLons wurde mlL gerlngeren ulcken
errelchL.
PangL dle endgulLlge ulcke der lM 8esLauraLlon ab, splelen
dle ulcke [eder SchlchL und das verhalLnls zwlschen den SchlchLen elne
PaupLrolle, um dle besLe uberelnsLlmmung der larbe zu errelchen.
uer ZahnLechnlker muss dle larbdlmenslonen lndlvlduell adapLleren,
um elne besLlmmLe larbe zu reproduzleren.
144

!41*0//3-*K#,0$K#$''

unLer 8eruckslchLlgung von den Crenzen der vorhergehenden
SLudlen, knnen dle folgende Schlussfolgerungen aus unserer
8esLlmmung der lakLoren, dle dle uberelnsLlmmung der larbe
beelnflussen, gezogen werden.

1) uas verfahren, um dle uberelnsLlmmung zwlschen den
naLurllchen Zahnfarben und der 8esLauraLlon zu errelchen, lsL
sehr komplex und es besLehL aus zwel hasen: dle
larbesLlmmung und dle 8eprodukLlon der larbe.
2) uer kllnlsche SpekLrophoLomeLer vl1A Lasyshade haL elne guLe
CenaulgkelL, vergllchen mlL elnem LaborsgeraL, wenn er fur
wlederholLe Messungen verwendeL wlrd. uaher kann dleses
larbmessgeraL weder ln der raxls noch lm Labor verwendeL
werden.
3) ule Plnwelse der keramlk-llrmen slnd begrenzL und nlchL
ausrelchend, um den ZahnLechnlkern zu helfen, dle
uberelnsLlmmung zwlschen der ausgewahlLen larbe und der
LndresLauraLlon zu errelchen und lehler zu vermelden.
4) vergllchen mlL dem vlLapan Classlcal larbmusLer, haL das vl1A
3u-MasLer 1ooLhgulde elne bessere uberelnsLlmmung der
larbe dank selner sysLemaLlschen verLellung von ,1abs nach
elnem sLelgenden CradlenL der PelllgkelL und der lnLenslLaL
gezelgL.
145

3) ule uberelnsLlmmung der larbe der 8esLauraLlon mlL elner
ausgewahlLen larbe hangL von dem larbmusLer ab. ule
SLraLlflkaLlon-1echnlk der keramlk auf das MeLall splelL elne
PaupLrolle, um dle ausgewahlLe larbe ln der 8esLauraLlon zu
reproduzleren.
6) lm 8ezug auf dem vl1A vM13 verursachL elne grere ulcke
des 8ase uenLlne dle Lrhhung der lnLenslLaL. uagegen senkL
elne grere ulcke des 1ranspa uenLln und des Lnamel dle
lnLenslLaL der larbe. Llne Lrhhung der ulcke der Lnamel
SchlchL verursachL dle Senkung der PelllgkelL (value) und
umgekehrL. Llne prazlsere uberelnsLlmmung des larbLons
wurde mlL gerlngeren ulcken errelchL.
7) PangL dle endgulLlge ulcke der lM 8esLauraLlon ab, splelen
dle ulcke [eder SchlchL und das verhalLnls zwlschen den
SchlchLen elne PaupLrolle, um dle besLe uberelnsLlmmung der
larbe zu errelchen. uer ZahnLechnlker muss dle
larbdlmenslonen lndlvlduell adapLleren, um elne besLlmmLe
larbe zu reproduzleren.
146

Q0RS$3)"K#'N"41)0$K#$'

ule MgllchkelL, eLwas ln Zusammenhang mlL der WlssenschafL
zu brlngen, das fur elne ArL von kunsL lmmer gehalLen wurde, sLellL
elne der grLen Perausforderungen der modernen Zahnmedlzln. Llne
8esLauraLlon zu erhalLen, dle naLurllch ausslehL und dle slch
harmlnlsch mlL den umgebenden blologlschen Ceweben lnLegrlerL,
wurde lmmer von den lahlgkelLen des ZahnarzLes oder des
ZahnLechnlkers beelnflussL.
ule kllnlsche SpekLrophoLomeLer haben dle vorausseLzungen,
ln den zahnarzLllchen raxen zur 8ouLlne zu werden. Sle knnen von
unerfahrenen lachleuLen fur dle larbesLlmmung verwendeL werden,
um elne falsche uberelnsLlmmung der larbe zu vermelden oder zu
mlndesLens zu senken.
ule keramlk-llrmen sollLen elne prazlse AuskunfL uber dle
SLraLlflkaLlon-1echnlk geben, dle man fur lhre MaLerlallen verwenden
muss, um dle ausgewahlLe larbe zu errelchen. Auerdem sollLen dle
llrmen keramlk-SysLemen verkaufen, dle nach dem vl1A 3u-MasLer
produzlerL werden.
ZukunfLlge SLudlen sollLen dle CenaulgkelL anderer
SpekLrophoLomeLer unLersuchen. uer Llnfluss der ulcke und der
SLraLlflkaLlon-1echnlk anderer keramlk-SysLemen sollLe fesLgesLellL
werden.
kllnlsche unLersuchungen sollLen dle Labor-uaLen besLaLlgen,
um es zu zelgen, dass dle lnsLrumenLelle larbesLlmmung zuverlasslger
147

als dle vlsuelle LvaluaLlon der larbe lsL. Man muss aber lmmer
beruckslchLlgen, dass dle kunsL mlL den Menschen und nlchL mlL den
Maschlnen zu Lun haL.
148

6.S kesum, conc|us|ons and d|rect|ons futures

N#/0=T'

uans le chap|tre 1, le raLlonnel de ceLLe eLude a eLe presenLe.
La deLermlnaLlon adequaLe de la couleur a Lou[ours eLe un defl en
denLlsLerle resLauraLrlce eL esLheLlque. La grande varlaLlon de couleurs
presenLe dans la denL naLurelle rend la concordance de couleur avec
les resLauraLlons Lres complexe. ueux crlLeres ma[eurs de la Lechnlque
sulvlL pour le cholx de la LelnLe onL eLe presenLes. Le premler crlLere
eLanL la selecLlon de la couleur, a l'alde d'un LelnLler, qul va assurer
une lnLegraLlon harmonleuse avec les Llssus blologlques avolslnanLs eL
le deuxleme crlLere eLanL la reproducLlon correcLe de ceLLe couleur au
nlveau de la resLauraLlon proLheLlque.
Apres un bref resume des decouverLes sclenLlflque de newLon
au 18
lem
slecle a la classlflcaLlon de couleur uLlllsanL le ClLLab*,
quelques modlflcaLlons onL eLe reallsees afln de pouvolr falre une
correlaLlon numerlque de la couleur avec l'uLlllsaLlon de AL eL le calcul
de la dlfference enLre les deux couleurs en uLlllsanL une formule qul
donne une valeur pour ceLLe dlfference. Mme sl l'lmporLance de
ceLLe decouverLe a change le concepL de la sclence de la couleur, la
praLlque denLalre quoLldlenne n'a pas salsl ceLLe occaslon pour
amellorer la concordance de couleur eL l'evaluaLlon vlsuelle demeure
la regle sulvle.
149

une revue crlLlque de l'evoluLlon des LelnLlers a eLe presenLee
avec une aLLenLlon speclale envers le LelnLler vl1A 3u MasLer quanL a
la dlsLrlbuLlon sclenLlflque de la couleur. ll represenLe un arrangemenL
sysLemaLlque des couleurs dans l'espace naLurel de la denL alnsl
qu'une mesure numerlque de la couleur, en accord avec le prlnclpe
colorlmeLrlque ClLLab*, eL donne un mellleur resulLaL que
l'observaLlon classlque des LelnLlers comme vlLapan classlc ou
Chromascop lvoclar-vlvadenL.
ues recherches sur l'uLlllsaLlon des colorlmeLres eL
specLrophoLomeLres, afln de mlnlmlser la dlscordance de la couleur
causee par l'esLlmaLlon vlsuelle onL eLe reallsees. une descrlpLlon
breve sur la dlfference enLre ces lnsLrumenLs a eLe presenLee. une
aLLenLlon parLlcullere envers les colorlmeLres vlLa Lasyshade eL vlLa
Lasyshade CompacL alnsl que le MP1 SpecLro Shade Mlcro, car ces
specLrophoLomeLres sonL les plus uLlllses dans la praLlque
quoLldlenne.
Comme de[a clLe, l'eLape flnale dans la concordance de couleur
esL represenLee par la reproducLlon correcLe de la couleur flnale de la
resLauraLlon proLheLlque. une dlscusslon breve concernanL les
facLeurs lnfluenanL la couleur flnal des resLauraLlons en ceramlque a
eLe falLe, en parLlculler le rle lmporLanL de la pose des couches enLre
les couleurs opaque eL LransparenLes. Mme un cholx correcL de la
couleur n'esL pas sufflsanL s'll n'y a pas une correlaLlon dlrecLe enLre
l'epalsseur eL la poslLlon de ces deux couches au nlveau de la
resLauraLlon.
150

Le buL de ceLLe Lhese esL de donner une ldee sur la marche a
sulvre pour la concordance de couleur, eL alnsl d'eluclder le moyen de
reallser des resLauraLlons naLurelles eL de monLer que le cholx de la
couleur alnsl que sa reproducLlon ne sonL pas sufflsanLs pour donner
un aspecL naLurel a la resLauraLlon.
uans le Chap|tre 2, la repeLlLlvlLe des resulLaLs obLenus a l'alde
d'un specLrophoLomeLre cllnlque a eLe compare avec un auLre eLabllL
au laboraLolre. L'eLape lnlLlale esL l'evaluaLlon de la flablllLe de
l'uLlllsaLlon cllnlque du vl1A Lasyshade specLrophoLomeLer. our ceLLe
ralson, la premlere phase a conslsLe a evaluer la repeLlLlvlLe des
mesures enreglsLrees par la machlne, comme condlLlon requlse pour
evaluer sa performance en comparanL avec un specLrophoLomeLre de
laboraLolre l'Ccean CpLlcs Su 1000 en l'occurrence
ues echanLlllons de meLal recouverL par de la ceramlque onL
eLe confecLlonnes en dlfferenLes epalsseurs d'opaque eL de couche de
LransparenL afln de mesurer la repeLlLlvlLe. L'Ccean CpLlcs Su 1000 a
eLe uLlllse pour mesurer les valeurs de la couleur de chaque
echanLlllon a 3 reprlses, Landls que pour le vl1A Lasyshade les
mesures onL eLe repeLees 3 fols a maln levee eL 3 fols en le flxanL a
une base, pour pouvolr comparer la dlfference exlsLanLe enLre
l'uLlllsaLlon Cllnlque (maln llbre) eL l'uLlllsaLlon au laboraLolre (flxe a
une base). La repeLlLlvlLe du specLrophoLomeLer a eLe sLaLlsLlquemenL
evaluee en analysanL le CoefflclenL de varlaLlon (Cv).
Les resulLaLs onL monLre une excellenLe repeLlLlvlLe pour les 2
lnsLrumenLs eLudles. ues valeurs falbles du coefflclenL de varlaLlon
151

(0,002<Cv<0,111) onL eLe obLenues avec Ccean CpLlcs Su 1000.
Lasyshade a demonLre une bonne preclslon dans la numerlsaLlon
repeLlLlve obLenu en flxanL la plece a maln de l'lnsLrumenL a une base
(0<Cv<0,022) ou a maln llbre (0,008<Cv<0,913).
La comparalson de la preclslon eL de la fldellLe des lnsLrumenLs
cllnlques compares a ceux du laboraLolre, a monLre une repeLlLlvlLe
des mesures revelanL la posslblllLe de les uLlllser en cllnlque eL au
laboraLolre.
uans le Chap|tre 3, les varlaLlons de couleur enLre quaLre
sysLemes de ceramlque denLalre eL les LelnLes selecLlonnees "A2, A3
and A3.3" du LelnLler vlLapan Classlcal onL eLe evaluees. une source
lmporLanLe de la varlaLlon de couleur esL represenLee par l'epalsseur
de la ceramlque, par le besoln d'avolr des couches dlfferenLes de
ceramlque comme l'opaque, la denLlne ou l'emall. A cause de la
llmlLaLlon des lnformaLlons obLenues des fabrlcanLs ou au nlveau la
llLLeraLure a propos des proporLlons ldeales de denLlne eL d'emall,
l'ob[ecLlve de ceLLe eLude a eLe de verlfler sl Lous les sysLemes de
ceramlque eLudles onL eLe capable de reprodulre correcLemenL la
couleur cholsle sulvanL le dlagramme d'appllcaLlon par couche decrlL
dans les lnsLrucLlons du fabrlcanL.
CeLLe eLude a eLe reallsee en analysanL la correspondance de
couleur des dlsques meLalo-ceramlque en uLlllsanL le vl1A Lasyshade
specLrophoLomeLer. 1rols LelnLes dlfferenLes (A2, A3, A3.3) de quaLre
sysLemes de ceramlque (vl1A Cmega 900, uuceram klss, Wleland
8eflex and lvoclar lS d.SlCn) onL eLe eLudles resulLanL en un LoLal de
152

12 comblnalsons. our chaque groupe, 3 echanLlllons onL eLe
fabrlques, donc un LoLal de 36 echanLlllons. Les valeurs de AL onL
varles enLre 1.2 and 3.0. La correspondance cllnlque de la couleur (AL
< 3.7) a eLe enreglsLre pour la LelnLe A2 pour LouL les sysLemes de
ceramlque, quanL a la LelnLe A3 des echanLlllons de uuceram klss eL
lvoclar lS eL la LelnLe A3.3 unlquemenL pour les echanLlllons vl1A
Cmega 900. 1ous les auLres echanLlllons onL echoue dans la
correspondance de la couleur. L'analyse AnCvA a monLre que la LelnLe
de la ceramlque lnfluence de faon slgnlflcaLlve les valeurs AL
(<0.03).
Ln concluslon, ceLLe eLude a monLre que les lnsLrucLlons
donnees par le fabrlquanL pour alder le Lechnlclen de laboraLolre a
obLenlr la mellleur concordance de couleur enLre la LelnLe cholsle eL la
LelnLe de la resLauraLlon flnale eLalenL Lres llmlLees eL lnsufflsanLe
pour evlLer une dlscordance de couleurs.
uans le Chap|tre 4 deux facLeurs lmporLanLs qul affecLenL la
concordance de la couleur onL eLe evalues: l'lnfluence du LelnLler eL
l'lnfluence du sysLeme de ceramlque. uans le paragraphe 4.1 la
capaclLe du vl1A Cmega 900 de reprodulre correcLemenL la couleur
cholsle en se referanL aux LelnLlers vlLapan Classlcal eL vl1A 3-u
MasLer a eLe LesLee. vl1A Cmega 900 a eLe cholsl car ll eLalL le seul
sysLeme de ceramlque commerclallse avec les LelnLlers vlLapan
Classlcal eL vl1A 3u-MasLer. Culnze dlsques en ceramlque onL eLe
fabrlques sulvanL des modeles de pose de dlfferenLes couches
d'opaque eL de ceramlque pour chaque LelnLe (A3 and 2M3), LouL en
153

gardanL une epalsseur unlforme eL consLanLe pour Lous les
echanLlllons. 1rols modeles dlsLlncLs onL eLe reallses avec une
varlaLlon de l'epalsseur des couches opaques, denLlne eL emall, dans le
buL de creer une varlablllLe dans la lecLure de la couleur. L'evaluaLlon
de la couleur a eLe reallsee avec le Lasyshade eL le mode resLoraLlon"
a eLe selecLlonne en uLlllsanL les LelnLes A3 eL 2M3. Le LesL 1wo-Way
AnCvA a monLre que l'lnLeracLlon enLre le LelnLler-sysLeme de
ceramlque" eL le facLeur epalsseur des couches model" lnfluence de
manlere slgnlflcaLlve les valeurs AL (p<0.001). Les echanLlllons vl1A
Cmega 900 avec le LelnLler vl1A 3u-MasLer onL donne pour la LelnLe
LesLee une couleur plus proche que les echanLlllons avec la mme
ceramlque en comblnalson avec le LelnLler vlLapan Classlcal. Ce
resulLaL peuL Lre expllque par la capaclLe de l'Lasyshade de
correspondre les couleurs grce a une dlsLrlbuLlon spaLlale
sysLemaLlque sclenLlflquemenL fondee.
ar consequenL, une couleur adequaLe peuL Lre conslderee
dependanLe du LelnLler. ue plus, la mellleur correspondance de
couleur esL lnfluencee par le model de pose des dlfferenLes couches
de la ceramlque.
Apres avolr eLabllL que grce au LelnLler vl1A 3u-MasLer une
mellleure concordance de la couleur eLalL obLenue, dans le paragraph
4.2, l'eLape sulvanLe conslsLalL a examlner la capaclLe de deux
sysLemes de ceramlque (vl1A Cmega 900 eL vl1A vM13) de
reprodulre correcLemenL la LelnLe cholsle en se referanL au LelnLler
vl1A 3u-MasLer, pour pouvolr comprendre sl la concordance de
154

couleur eLalL dependanLe du LelnLler ou du sysLeme de ceramlque
uLlllse. Ce LesL a eLe effecLue en sulvanL les mmes meLhodes decrlLes
ulLerleuremenL. Culnze dlsques en ceramlque onL eLe reallses avec des
couches d'epalsseurs dlfferenLes pour chaque sysLeme de ceramlque
en LelnLe 2M3. La preclslon de couleur exprlmee en AL a eLe evaluee a
l'alde du vl1A Lasyshade. 1wo-way AnCvA a monLre que le facLeur
sysLeme de ceramlque" n'eLalL pas sLaLlsLlquemenL slgnlflcaLlf
(p=0.17), Landls que le facLeur pose des couches model" lnfluence
d'une manlere slgnlflcaLlve les valeurs AL (p<0.001). 1ous les
echanLlllons avalenL des valeurs lnferleur a 3.3, ce qul esL consldere
comme senslble pour des operaLeurs quallfles mals accepLable
cllnlquemenL.
Cuand les echanLlllons meLallo-ceramlque onL eLe fabrlques en
se basanL sur le LelnLler vl1A 3u-MasLer, aucune dlfference n'a eLe
Lrouvee enLre vl1A Cmega 900 eL vl1A vM13 quanL a leur capaclLe de
correspondre correcLemenL a la LelnLe cholsle. Ces resulLaLs nous
amene a dlre que pour les sysLemes de ceramlque qul fonL ob[eL de
ceLLe eLude, la capaclLe de concordance de la couleur avec une LelnLe
cholsle dolL Lre conslderee dependanLe du LelnLler. une fols de plus
ceLLe eLude a conflrme que la meLhode sulvlL pour le pose des
dlfferenLes couches de la ceramlque sur le meLal a un rle
predomlnanL lors de la reallsaLlon de la LelnLe selecLlonnee pour la
resLauraLlon.
Ces resulLaLs meLLenL en evldence l'lnfluence relaLlve de
chaque couche de ceramlque (base denLlne, LransparenL denLlne eL
155

emall) sur les parameLres de la couleur (lumlnoslLe, saLuraLlon eL
LelnLe) des resLauraLlons, qul a eLe developpee dans le chaplLre 3.
CuaranLe dlsques de ceramlque onL eLe fabrlques a l'alde d'un moule
en meLal eL lnspecLes lndlvlduellemenL apres la culsson avec une [auge
dlglLale pour conLrler l'epalsseur de chaque couche. 4 epalsseurs
dlfferenLes de ceramlque en LelnLe 2M3 onL eLe evaluees. our chaque
epalsseur, 2 poses de couches dlfferenLes onL eLe analysees. Le
Lasyshade specLrophoLomeLre a eLe uLlllse pour comparer la couleur
avec comme reference les donnees de couleur de la LelnLe
selecLlonnee a l'alde la machlne. Cne-way AnCvA a monLre que le
facLeur pose de couche- modele" lnfluence d'une manlere
slgnlflcaLlve le AL, AC, AP eL AL (<0.001). une plus grande epalsseur
de 8ase uenLlne a enLralne une LelnLe plus saLuree. lnversemenL, une
plus grande epalsseur de LransparenL uenLlne eL Lmall a redulL la
saLuraLlon de la LelnLe. une augmenLaLlon de l'epalsseur de la couche
d'Lmall a enLralne une reducLlon de la lumlnoslLe eL vlce-versa. une
mellleure correspondance de LelnLe a eLe obLenue avec des epalsseurs
plus redulLes
Ln foncLlon de l'epalsseur flnale de la resLauraLlon
ceramomeLalllque, l'epalsseur lndlvlduelle de chaque couche eL le
rapporL enLre les couches [ouenL un rle lmporLanL dans la reallsaLlon
de la mellleure correspondance de couleur. Le Lechnlclen dolL Lre
capable d'a[usLer personnellemenL les parameLres de couleur dans le
buL d'obLenlr une LelnLe blen deLermlnee.

156

L-$4*0/"-$/'
'
uans les llmlLes de ceLLe eLude, les concluslons sulvanLes
peuvenL Lre eLablles en evaluanL les facLeurs lnfluenanL la Lechnlque
de correspondance de la couleur:
1) La reallsaLlon de la correspondance de la couleur enLre la
denLlLlon naLurelle eL la resLauraLlon ou proLhese esL un
procede complexe qul se falL en deux eLapes: selecLlon de la
couleur eL reproducLlon de la couleur.
2) vl1A Lasyshade specLrophoLomeLre a revele une bonne
preclslon, comparable a l'lnsLrumenL de laboraLolre, en
effecLuanL des mesures repeLees. Cecl veuL dlL que
l'lnsLrumenL peuL Lre uLlllse comme lnsLrumenL de rouLlne au
cablneL denLalre eL pour LesL ln-vlLro.
3) Les lndlcaLlons donnees par les fabrlcanLs de ceramlque pour
alder les Lechnlclens a obLenlr une correspondance de la
couleur enLre la LelnLe selecLlonnee eL la resLauraLlon flnale
sonL Lres llmlLees, eL pas sufflsanLe pour evlLer une marge
d'erreur.
4) Le LelnLler vl1A 3u-MasLer a enLralne une concordance de
couleur superleure au LelnLler vlLapan Classlcal, a cause de la
dlsLrlbuLlon sysLemaLlque des LelnLes en accord avec un
gradlenL crolssanL de lumlnoslLe eL de saLuraLlon.
3) La capaclLe de concordance de la couleur dolL Lre conslderee
comme dependanLe du LelnLler. L'approche adopLee pour la
157

pose des dlfferenLes couches de la ceramlque sur du meLal a
un rle predomlnanL dans la reallsaLlon des LelnLes
selecLlonnees pour la resLauraLlon.
6) Ln ce qul concerne vl1A vM13, une epalsseur superleure de
denLlne a enLralne une LelnLe plus saLuree. lnversemenL, une
plus grande epalsseur de 1ransparenL uenLlne eL Lmall a redulL
la saLuraLlon de la LelnLe. une augmenLaLlon de l'epalsseur de
la couche d'Lmall a enLralne une reducLlon de la lumlnoslLe eL
vlce-versa. une mellleure correspondance de LelnLe a eLe
obLenue avec des epalsseurs plus redulLes.
7) Ln foncLlon de l'epalsseur flnale de la resLauraLlon
ceramomeLalllque, l'epalsseur lndlvlduelle de chaque couche
eL le rapporL enLre les couches [ouenL un rle lmporLanL dans la
reallsaLlon de la mellleure correspondance de couleur. Le
Lechnlclen dolL Lre capable d'a[usLer personnellemenL les
parameLres de couleur dans le buL d'obLenlr une LelnLe
deLermlnee.
158

.",#4)"-$/'M0)0,#/'
'
La posslblllLe de falre relever de la sclence quelque chose qul a
de LouL Lemps eLe consldere une forme d'arL represenLe un des plus
grand defls de la denLlsLerle moderne. La reallsaLlon de resLauraLlon
avec un aspecL naLurel qul s'lnLegre correcLemenL avec les Llssues
blologlques a Lou[ours eLe lnfluencee par les quallflcaLlons du cllnlclen
eL du Lechnlclen.
Les specLrophoLomeLres cllnlques onL la capaclLe d'Lre uLlllses
en rouLlne au cablneL denLalre. lls peuvenL Lre uLlllses pour alder des
cllnlclens avec une molndre experlence d'arrlver a une concordance de
la couleur eL ce dans le buL d'evlLer eL de redulre le decalage de
couleur.
Les fabrlcanLs de ceramlque dolvenL fournlr des eLapes
speclflques quand a la Lechnlque de pose des dlfferenLes couches de la
ceramlque en relaLlon avec l'epalsseur flnal de la resLauraLlon en vue
d'obLenlr la LelnLe souhalLee.
Les fabrlcanLs de ceramlque dolvenL aussl fournlr des sysLemes
commerclallses sulvanL le LelnLler vl1A 3u-MasLer.
ues eLudes fuLures dolvenL evaluer la preclslon d'auLres
specLrophoLomeLres cllnlques commerclallses. L'lnfluence de
l'epalsseur eL des eLapes de pose des dlfferenLes couches dolvenL Lre
evaluees pour d'auLres sysLemes de ceramlque.
ues eLudes cllnlques sonL necessalres pour conflrmer les
donnees de laboraLolre, dans le buL de prouver que le cholx de la
couleur a l'alde d'un lnsLrumenL peur Lre aussl efflcace que le cholx
159

humaln mals plus flable LouL en conslderanL Lou[ours que ceL arL esL lle
a l'Lre humaln eL non pas a des machlnes.
160

6.6 kesumo, conc|uses e futuras |nvest|gaes

N#/0=-'

no Cap|tu|o 1, a razo do presenLe esLudo fol apresenLada.
Colncldlr a preclsa maLlz sempre fol um dos aspecLos mals
desafladores da resLaurao de denLes e odonLologla esLeLlca em
geral. uevldo a grande varledade de cor naLural dos denLes,
consegulndo um [ogo de maLlz perLo de uma resLaurao arLlflclal com
denLlo naLural conLlnua a ser um processo complexo. uols aspecLos
prlnclpals das cores correspondenLes processos foram apresenLados.
um deles e a seleo de uma cor, aLraves de um gula de cores, que val
lnLegrar-se harmonlosamenLe com os Lecldos clrcundanLes blolglcos
e a ouLra e a reproduo correLa desLa cor em prLese ou resLaurao.
uepols de um breve resumo das descoberLas clenLlflcas a parLlr de
experlmenLos de newLon no seculo 18 com a classlflcao de cor
ClLLab *, algumas conslderaes foram felLas sobre o uso de \ uelLa
correlaclonando as cores numerlcamenLe e, flnalmenLe, calcular as
dlferenas enLre as duas cores usando uma frmula que d um
numero como o valor das dlferenas de cor. Lmbora a lmporLncla
desLe achado Ler mudado o concelLo de clncla da cor, prLlca
odonLolglca esLa oporLunldade de melhorar a capacldade de
comblnao de cores e avallao vlsual manLeve-se o processo de
referncla.
uma anllse crlLlca da evoluo do slmulador de cor mals
lmporLanLe fol apresenLado. Lspeclal aLeno fol dada a dlsLrlbulo
161

de cor clenLlflca lnLroduzlda pela vl1A 3u MasLer 1ooLhgulde. C qual
Lem um arran[o slsLemLlco de mscaras denLro do espao de cor
naLural do denLe e uma medlda ob[eLlva numerlco de cor, de acordo
com o prlnclplo colorlmeLrlco flm ClLLab *, mals do que a slmples
observao dos aspecLos Lecldo naLural perLencenLe ao gula de cores
anLerlores, como vlLapan clsslca ou lvoclar-vlvadenL Chromascop.
C ob[eLlvo adlclonal de lnvesLlgao de mlnlmlzar a
lncompaLlbllldade de cor devldo a esLlmaLlva vlsual, uLlllzando-se um
colorlmeLro e especLrofoLmeLros. uma breve descrlo das
dlferenas enLre esLes lnsLrumenLos fol forneclda. arLlcular aLeno
Lem sldo focada em vl1A Lasyshade e sua evoluo (vl1A Lasyshade
CompacL) e MP1 SpecLro Shade Mlcro, que esLes lnsLrumenLos so
dols dos especLrofoLmeLros mals usados roLlnelramenLe cllnlca.
Como anLerlormenLe apresenLado, na ulLlma eLapa em
processos de cor correspondenLe e represenLado pela reproduo de
cor correLa na prLese ou resLaurao. uma breve dlscusso sobre os
faLores que lnfluenclam a cor flnal de resLauraes de porcelana fol
dada, desLacando especlalmenLe o papel preponderanLe
desempenhado pela relao enLre camadas de Lons opacos e
Lranslucldos.
ALe mesmo uma seleo de Lonalldade correLa no e suflclenLe
se no h nenhuma correlao com a espessura e esLraLlflcao da
resLaurao.
orLanLo, o Lrabalho descrlLo nesLa Lese Leve como ob[eLlvo
proporclonar uma vlso sobre a cor correspondenLe ao procedlmenLo
162

odonLolglco, bem como para elucldar a reallzao de uma aparncla
naLural, a resLaurao no pode presclndlr de uma seleo correLa da
cor segulda por sua reproduo exaLa.
no Cap|tu|o 2, a repeLlo da medlo de um
especLrofoLmeLro cllnlco fol comparada com um de laboraLrlo . C
passo lnlclal na avallao do uso cllnlco do especLrofoLmeLro
Lasyshade vl1A denLal fol conslderar a sua preclso. or esLa razo, a
prlmelra fase fol avallar a repeLlo das medles efeLuadas pelo
lnsLrumenLo, como um requlslLo obrlgaLrlo para avallar a
performance em comparao com a da Ccean CpLlcs Su 1000, como
um lnsLrumenLo de laboraLrlo .
Lspeclmes de meLalo cermlca em camadas de acordo com
dlferenLes quanLldades de porcelanas opacos e Lranslucldos foram
fabrlcados a flm de reallzar medldas repeLldas. 1he Ccean CpLlcs
Su1000 fol LesLada medlndo os valores de cor de cada amosLra 3
vezes, enquanLo que para vl1A Lasyshade as medles foram
repeLldas 3 vezes a mo llvre e 3 vezes a flxao da sonda de medlo
de um sLand, a flm de LesLar se havla dlferenas enLre uso cllnlco (mo
llvre) ou de laboraLrlo (uso flxo a um suporLe). A reproduLlbllldade
uLlllzando o especLrofoLmeLro fol avallada esLaLlsLlcamenLe pela
anllse do CoeflclenLe de varlao (Cv).
Cs resulLados demonsLraram uma excelenLe reproduLlbllldade
de varredura para ambos os lnsLrumenLos LesLados. valores mulLo
balxos de coeflclenLe de varlao (0.002 <Cv <0.111) foram obLldos
para o Ccean CpLlcs Su1000. C Lasyshade mosLrou boa preclso na
163

dlglLallzao repeLlda obLldos LanLo aLraves da flxao da pea de mo
do dlsposlLlvo de um sLand (0 <Cv <0.022) e a mo llvre (0.008 <Cv
<0.913).
A boa preclso mosLrada pelos lnsLrumenLos cllnlcos, em
comparao com um laboraLrlo, na reallzao de medldas repeLldas
revelou a posslbllldade de us-lo LanLo para uso cllnlco e de LesLes ln
vlLro.
no Cap|tu|o 3, as varlaes de cor enLre quaLro slsLemas de
porcelana denLrla e as mscaras conLrole "A2, A3 e A3.3" de croma
do gula vlLapan Classlcal foram lnvesLlgados. uma lmporLanLe fonLe de
varlao da cor e represenLada pela espessura de porcelana, pela
necessldade de Ler dlferenLes camadas de porcelana, como opaco,
denLlna e esmalLe. Conslderando as lnformaes mulLo llmlLadas pelos
fabrlcanLes, ou da llLeraLura, em que a proporo ldeal de esmalLe e
denLlna devem ser, o ob[eLo do presenLe esLudo fol verlflcar se Lodos
os slsLemas cermlcos LesLados foram capazes de corresponder
exaLamenLe a maLlzes seleclonadas na sequncla de dlagramas de
camadas relaLado nas lnsLrues dos fabrlcanLes.
LsLe esLudo fol reallzado aLraves da avallao da
correspondncla de cores do dlsco de porcelana em forma de
resLauraes meLllcas fundldas, uLlllzando o especLrofoLmeLro vl1A
Lasyshade. 1rs dlferenLes Lonalldades (A2, A3, A3.3) para quaLro
dlferenLes slsLemas de cermlca (vlLa Cmega 900, uuceram klss,
Wleland 8eflex e lvoclar lS d.SlCn) foram lnvesLlgados, resulLando
em um LoLal de 12 comblnaes. ara cada grupo, Lrs amosLras foram
164

confecclonadas para um LoLal de 36 exemplares. \ uelLa de valores
varlaram enLre 1,2 e 3,0. Colncldlndo Shade cllnlca (\ uelLa < 3,7) fol
reglsLrada para A2 em Lodos os slsLemas de cermlca, para A3 em
uuceram klss e especlmes lvoclar lS e para A 3.3 apenas nos
especlmes da vlLa Cmega 900. 1odas as ouLras amosLras no
consegulram aLlnglr correspondncla de cor. Anllse de varlncla no
mosLrou dlferenas esLaLlsLlcamenLe slgnlflcaLlvas (> 0,03) enLre as
marcas de porcelana. Cne-way AnCvA mosLrou que o croma de
cermlca lnfluenclou slgnlflcaLlvamenLe os valores de uL ( <0,03).
Lm concluso, esLe esLudo mosLrou que as orlenLaes
fornecldas pelo fabrlcanLe para a[udar o Lecnlco a obLer a
correspondncla de cor enLre os cromas seleclonados e a resLaurao
flnal, e mulLo llmlLado, e no suflclenLe para evlLar lncompaLlbllldade
de cor.
no Cap|tu|o 4, dols faLores lmporLanLes que afeLam o [ogo de
maLlz foram lnvesLlgadas: a lnfluncla do gula de cores e da lnfluncla
do slsLema de cermlca. no onto 4.1 a capacldade de vlLa Cmega
900 de cermlca para reproduzlr correLamenLe a cor de sombra
seleclonado com referncla ao vlLapan Classlcal e vl1A 3u-MasLer
1ooLhgulde fol LesLado. vlLa Cmega 900 fol ob[eLo desLe esLudo,
porque era, no momenLo do LesLe, o unlco slsLema de cermlca denLal
comerclallzado no gula de cores vlLapan Classlcal, bem como no vl1A
3u-MasLer 1ooLhgulde. Po[e, mesmo vl1A vM13 e comerclallzado
LanLo no vlLapan Classlcal e vl1A 3u-MasLer 1ooLhgulde. Culnze dlscos
de cermlca foram fabrlcados com dlferenLes padres de
165

esLraLlflcao para cada croma (A3 e 2M3), manLendo-se consLanLe a
espessura da amosLra LoLal. 1rs padres de camadas dlsLlnLas que
dlferem de acordo com a espessura da denLlna opaca, denLlna, e as
camadas de esmalLe, a flm de crlar uma varlabllldade na lelLura de cor.
A avallao da cor fol felLa com o Lasyshade e "Modo de 8esLaurao"
foram seleclonados aLraves de A3 e 2M3 para comparao. C 1wo-
way AnCvA mosLrou que LanLo a lnLerao do "gula de Lonalldades
slsLema de cermlca" e o faLor "camadas" padro lnfluenclou
slgnlflcaLlvamenLe os valores de uL (p <0.001). Lspeclmes de vlLa
Cmega 900 no vl1A 3u-MasLer 1ooLhgulde exlbldo pela croma
lnvesLlgado uma malor adapLao na cor do que especlmes do mesmo
slsLema de cermlca no gula de cores vlLapan Classlcal. LsLe resulLado
pode ser expllcado pela capacldade de Lasyshade melhor
corresponder as cores que so organlzados em uma base clenLlflca
slsLemLlca de dlsLrlbulo espaclal.
orLanLo, a correspondncla de cor mals alLa pode ser
conslderada como gula de cores dependenLes. Alem dlsso, a melhor
cor para comblnar resulLou ser lnfluenclada a parLlr do padro
seleclonado para porcelana camadas procedlmenLo.
uepols de esLabelecer que o vl1A 3u-MasLer 1ooLhgulde
resulLou em melhor padrao de cores, no onto 4.2, a prxlma eLapa
anallsou a capacldade de dols maLerlals denLrlos de porcelana (vlLa
Cmega 900 e vl1A vM13) reproduzlrem correLamenLe a cor
seleclonada com referncla a vl1A 3u-MasLer 1ooLhgulde, a flm de
compreender a fldelldade do gula de Lonalldades de cor dependenLe
166

ou cermlca slsLema dependenLe. C LesLe fol reallzado aps os
mesmos meLodos que a anLerlor. Culnze dlscos de cermlca foram
produzldos com espessuras dlferenLes para cada slsLema de cermlca
em 2M3. A preclso de cores expresso em \ uelLa fol LesLada com o
Lasyshade vl1A. uols LesLes AnCvA mosLraram que o faLor "slsLema
de cermlca" no fol esLaLlsLlcamenLe slgnlflcaLlvo (p = 0,17),
enquanLo que o faLor "camadas" padro lnfluenclou
slgnlflcaLlvamenLe os valores de uL (p <0,001). 1odas as amosLras
apresenLaram valores abalxo de 3,3 \ uelLa, que e conslderado
senslvel por parLe dos operadores quallflcados, mas cllnlcamenLe
acelLvel.
Cuando as amosLras de cermlca / meLal Ler sldo fabrlcado
com slsLemas baseados em cermlca vl1A 3u-MasLer 1ooLhgulde, no
foram enconLradas dlferenas enLre vlLa Cmega 900 e vl1A vM13 na
sua capacldade de corresponder correLamenLe ao Lom dese[ado. Lsse
achado sugere que, para os slsLemas cermlcos desLe esLudo, a
capacldade de comblnar a cor com um Lom dese[ado Leve de ser
conslderado dependenLe do gula de Lonalldades. uma vez mals, esLe
esLudo conflrmou que o esquema seguldo para a esLraLlflcao da
porcelana sobre o meLal Leve um papel preponderanLe na reallzao
da cor escolhlda para a resLaurao.
1al concluso esLabelece a lnfluncla relaLlva de cada camada
da porcelana (8ase de denLlna, Lopo da denLlna e esmalLe) sobre os
parmeLros de cor (valor, MaLlz e Chroma) das resLauraes, que fol
desenvolvldo no Cap|tu|o S. CuarenLa dlscos de cermlca foram
167

fabrlcados com um molde de ao de proprledade e conLrolados
lndlvldualmenLe, aps a quelma um paqulmeLro dlglLal fol usado para
conLrolar a espessura de cada camada. 4 dlferenLes espessuras LoLals
de cermlca na 2M3 foram avallados. ara cada espessura, 2 padres
de camadas dlferenLes foram anallsados. C especLrofoLmeLro
Lasyshade cllnlco fol usado para comparao de cor com os dados de
referncla de cor seleclonadas e armazenado no dlsposlLlvo. Cne-way
AnCvA mosLrou que o faLor "mergulhar" lnfluenclou
slgnlflcaLlvamenLe o \ uelLa, AC, AP e AL (p <0,001). Crande espessura
da denLlna 8ase resulLou em um Lom mals cromLlco. lnversamenLe,
Lspessuras malores de corpo de denLlna e esmalLe reduzlram o croma
da cor. um aumenLo na espessura da camada de esmalLe resulLou em
uma reduo da lumlnosldade (valor) e vlce-versa. uma anllse de
correspondncla em MaLlz, fol obLlda com espessuras menores.
uependendo da espessura flnal da resLaurao da Cl, a
espessura lndlvldual de cada camada e a relao enLre as camadas
desempenham um papel lmporLanLe na consLruo do melhor [ogo de
cores. C Lecnlco Lem de ser capaz de a[usLar lndlvldualmenLe os
parmeLros de cor a flm de aLlnglr cerLo Lom.
168

L-$4*0/U#/'

uenLro das llmlLaes dos esLudos, as segulnLes concluses
podem ser Llradas da nossa avallao dos faLores que lnfluenclam a
cor correspondenLe ao procedlmenLo odonLolglco:

1) Consegulr uma correspondncla enLre a cor correLa da
denLlo naLural e resLaurao ou prLese e um processo
complexo que conslsLe em dols procedlmenLos especlflcos:
seleo de cor e reproduo de cor.
2) LspecLrofoLmeLro cllnlco vl1A Lasyshade revelou boa
acurcla, comparvel a um dlsposlLlvo de laboraLrlo, na
reallzao de medles repeLldas. lsso slgnlflca que o
dlsposlLlvo pode ser usado cllnlcamenLe como um lnsLrumenLo
de roLlna de escrlLrlo e de ensalos ln vlLro.
3) As lndlcaes dos fabrlcanLes de cermlca para a[udar os
Lecnlcos a obLer o [ogo de cores enLre a cor seleclonada e a
resLaurao flnal so mulLo llmlLadas, e no suflclenLe para
evlLar lncompaLlbllldade de cor.
4) vl1A 3u-MasLer 1ooLhgulde resulLou em uma correspondncla
de cor malor quando conslderada com gula de cores vlLapan
Classlcal, graas a sua slsLemLlca de dlsLrlbulo de gulas de
acordo com um gradlenLe crescenLe de valor e Chroma.
5) A capacldade de comblnar a cor com um Lom dese[ado Lem de
ser conslderado dependenLe do gula de Lonalldades. A
abordagem adoLada para a esLraLlflcao da porcelana sobre o
169

meLal Lem um papel preponderanLe na reallzao da cor
escolhlda para a resLaurao.
6) no que dlz respelLo vl1A vM13, uma malor espessura da
denLlna 8ase resulLou em um Lom mals cromLlco.
lnversamenLe, 1ranspa em espessuras malores de denLlna e
esmalLe reduzlram o croma da cor. um aumenLo na espessura
da camada de esmalLe resulLou em uma reduo da
lumlnosldade (valor) e vlce-versa. uma anllse de
correspondncla em valor, fol obLlda com espessuras menores.
7) uependendo da espessura flnal da resLaurao cermlca /
meLal, a espessura lndlvldual de cada camada e a relao enLre
as camadas desempenham um papel lmporLanLe na confeco
do melhor da comblnaes de cores. C Lecnlco Lem de ser
capaz de a[usLar lndlvldualmenLe os parmeLros de cor a flm de
aLlnglr cerLo Lom.
170

M0)0,%/'($P#/)"K%VU#/'

A posslbllldade de se relaclonar com algo que a clncla sempre
fol conslderada uma forma de arLe represenLa um dos malores
desaflos na odonLologla moderna. Consegulr uma aparncla naLural
resLaurao que se lnLegra correLamenLe com o Lecldo blolglco fol
sempre lnfluenclada pela habllldade do odonLologo ou Lecnlco.
LspecLrofoLmeLros cllnlcos Lm a capacldade de Lornar-se
uLlllzados roLlnelramenLe como equlpamenLos de escrlLrlo. LsLes
podem ser usados para a[udar os cllnlcos menos experlenLes na
seleo da cor correspondenLe nos procedlmenLos a flm de evlLar ou
pelo menos reduzlr a lncompaLlbllldade de cores.
labrlcanLes de cermlca deveram crlar mecanlsmos especlflcos
sobre como a sua camada de maLerlal de porcelana relaLlvas a
espessura flnal da resLaurao, a flm de obLer a Lonalldade dese[ada.
labrlcanLes de cermlca Lambem devem fornecer slsLemas
comerclallzados de acordo com a vl1A 3u-MasLer 1ooLhgulde.
LxperlmenLos fuLuros devero avallar a exaLldo de ouLros
comerclallzados especLrofoLmeLros cllnlca. A lnfluncla da espessura
e dos esquemas de esLraLlflcao deve ser avallada para ouLros
slsLemas de cermlca.
Cs esLudos cllnlcos so necessrlos para suporLar os dados do
laboraLrlo, a flm de fazer prova de que a deLeco de cor pode ser
Lo eflclenLe quanLo um ser humano, mas mals conflvel, sempre
conslderando que a arLe e algo relaclonado com os seres humanos e
no mqulnas.
171

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Seghl 88, PewleLL L8, klm !. vlsual and lnsLrumenLal colorlmeLrlc assessmenLs
of small color dlfferences on LranslucenL denLal porcelaln. ! uenL 8es 1989,68:1760-
1764.
Seghl 88, !ohnsLon WM, C'8rlen W!. erformance assessmenL of colorlmeLrlc
devlces on denLal porcelalns. ! uenL 8es 1989,68:1733-1739.
Seghl 88, !ohnsLon WM, C'8rlen W!. SpecLrophoLomeLrlc analysls of color
dlfferences beLween porcelaln sysLems. ! rosLheL uenL 1986,36:33-40.
Shllllngburg P1, !acobl 8, 8rackeLL SL. lundamenLals of LooLh preparaLlon for
casL meLal and porcelaln resLoraLlons. 2nd ed. Chlcago: CulnLessence, 1991. p. 280-
3.
Sproull 8C. Color maLchlng ln denLlsLry. arL l: 1he Lhree dlmenslonal naLure of
color. ! rosLheL uenL 1973,29:416.
Sproull 8C. Color maLchlng ln denLlsLry. arL ll: racLlcal appllcaLlons for Lhe
organlsaLlon of color.! rosLheL uenL 1973,29:336.
Sproull 8C. Color maLchlng ln denLlsLry. arL lll: Color conLrol.! rosLheL uenL.
1974,31:146.
1erada ?, Maeyama S, Plrayasu 8. 1he lnfluence of dlfferenL Lhlcknesses of
denLln porcelaln on Lhe color reflecLed from Lhln opaque porcelaln fused Lo meLal.
lnL ! rosLhodonL 1989,2:332-336.
1erada ?, Sakal 1, Plrayasu 8. 1he masklng ablllLy of an opaque porcelaln: A
specLrophoLomeLrlc sLudy. lnL ! rosLhodonL 1989,2:239-264.
denLal colorlmeLer. ! rosLheL uenL 2002,88:383.
vlchl A, lerrarl M, uavldson CL. Color and opaclLy varlaLlons ln Lhree dlfferenL
resln-based composlLe producLs afLer waLer aglng. uenL MaLer 2004,20:330-334.
177

vlLa Zahnfabrlk. vM13 Worklng lnsLrucLlon. 8evlsed ed. 8ad Sacklngen,
Cermany: 2007, p.18.
Wee AC, kang L?, !ohnsLon WM, Seghl 88. LvaluaLlng porcelaln color maLch
of dlfferenL porcelaln shade-maLchlng sysLems. ! LsLheL uenL 2000,12:271-280.
2002,87:637-666.
Woolsey Cu, !ohnson WM, C'8rlen W!. Masklng power of denLal opaque
porcelalns. ! uenL 8es 1984,63:936-939.
179

Curr|cu|um V|tae

Date of b|rth: Aprll 26
Lh
, 1981
|ace of b|rth: CrosseLo, lLaly
C|v|| status: unmarrled
C|t|zensh|p: lLallan

nome address: vla l.nlevo, 2 CrosseLo (C8) 38100
1e|ephone number: +39 328 2823020
L-ma|| address: gabrlele.corclolanl[gmall.com

2003: uegree ln uenLlsLry, unlverslLy of Slena, Slena, lLaly

kesearch act|v|ty
2003 - hu rogram ln uenLal 8lomaLerlals, unlverslLy of Slena.
2006 - MasLer of Sclence ln uenLal 8lomaLerlals, unlverslLy of Slena.

rofess|ona| pos|t|ons
2006 - rlvaLe pracLlce ln CrosseLo, lLaly
2008 - lnLernshlp aL Lhe ueparLmenL of uenLal MaLerlals and llxed
rosLhodonLlcs aL Lhe unlverslLy of Slena

rofess|ona| organ|zat|ons membersh|p
2006 - Member of SluCC (lLallan SocleLy of 8esLoraLlve uenLlsLry)
2006 - Member of SlL (lLallan SocleLy of LndodonLlcs)
2007 - Member of lAu8 (lnLernaLlonal AssoclaLlon for uenLal
8esearch)
181

Internat|ona| ub||cat|ons

! Corclolanl C, vlchl A.
8epeaLablllLy of colour readlng wlLh a cllnlcal and a laboraLory
specLrophoLomeLer.
lnLernaLlonal uenLlsLry SouLh Afrlca 2006,8:62-70.

! vlchl A, Corclolanl C, uavldson CL, lerrarl M.
Color and opaclLy varlaLlons ln Lhree dlfferenL resln-based
composlLe producLs afLer uv aglng.
lnLernaLlonal uenLlsLry SouLh Afrlca 2007,9:38-66.

! Corclolanl C, vlchl A, uavldson CL, lerrarl M.
1he lnfluence of Llp geomeLry and dlsLance on llghL-curlng
efflcacy.
CperaLlve uenLlsLry, 2008,33:323-331.

! Coraccl C, Corclolanl C, vlchl A, lerrarl M.
LlghL-LransmlLLlng ablllLy of markeLed flber posLs.
!ournal of uenLal 8esearch, 2008,87:1122-1126.

! Corclolanl C, vlchl A, Coraccl C, lerrarl M.
Colour correspondence of a ceramlc sysLem ln Lwo dlfferenL
shade guldes.
!ournal of uenLlsLry 2009,37:98-101

! 8adovlc l, Corclolanl C, Magnl L, krsLanovlc C, avlovlc v,
vullcevlc Z8, lerrarl M.
LlghL Lransmlsslon Lhrough flber posL: Lhe effecL on adheslon,
elasLlc modulus and hardness of dual-cure resln cemenL.
uenLal MaLerlals 2009,23:837-844.

! lazl C, vlchl A, Corclolanl C, lerrarl M.
SpecLrophoLomeLrlc evaluaLlon of color maLch Lo vl1A classlcal
shade gulde of four dlfferenL veneerlng porcelaln sysLems for
meLal ceramlc resLoraLlons.
Amerlcan !ournal of uenLlsLry 2009,22:19-22.
183

Abstracts.

! Corclolanl C, vlchl A, lerrarl M
1he lnfluence of Llp raLlo ln llghL curlng
3
rd
ConsLuro of Lhe Luropean lederaLlon Cf ConservaLlve
uenLlsLry, lebruary 9-11, 2006, 8ome, lLaly. AbsLracL #

! vlchl A, Corclolanl C, 8erLelll L, lerrarl M
lnfluence of composlLe pre-heaLlng on polymerlzaLlon depLh.
lAu8 an Luropean lederaLlon. SepLember 13-16, 2008,
uublln, lreland. AbsLracL # 328

! Corclolanl C, vlchl A, Coraccl C, lerrarl M
Colour correspondence of Lwo ceramlcs ln Lwo dlfferenL shade
gulde.
44Lh meeLlng of Lhe lAu8-ConLlnenLal Luropean ulvlslon and
lsraell ulvlslon. SepLember 26-29, 2007, 1hessalonlkl, Crece.
AbsLracL # 288

! vlchl A, Corclolanl C, Coraccl C, lerrarl M.
Colour correspondence of ceramlc sysLems ln Lwo dlfferenL
shade guldes.
lAu8 86Lh Ceneral Sesslon & LxhlblLlon. !uly 2-3, 2008,
1oronLo, Canada. AbsLracL # 3133

! Corclolanl C, vlchl A, Coraccl C, lerrarl M.
8elaLlonshlp beLween Lhlckness raLlo and color ln lM
resLoraLlons.
London, unlLed klngdom. AbsLracL # 264

! vlchl A, Corclolanl C, Crandlnl S, lerrarl M.
Colour correspondence of dlfferenL baLches of 1rlluxe
CAu/CAM blocks.
London, unlLed klngdom. AbsLracL # 407

184

! Corclolanl C, vlchl A, lerrarl M.
8epeaLablllLy of color readlng of cllnlcal and laboraLory shade-
maLchlng devlces.
44Lh meeLlng of Lhe lAu8-ConLlnenLal Luropean ulvlslon,
Scandlnavlan ulvlslon and lsraell ulvlslon. SepLember 9-12,
2009, Munlch, Cermany. AbsLracL # 332

! vlchl A, uel Slena l, Sedda M, Corclolanl C, lerrarl M.
llexural reslsLance of CAu/CAM blocks for CL8LC.
44Lh meeLlng of Lhe lAu8-ConLlnenLal Luropean ulvlslon,
Scandlnavlan ulvlslon and lsraell ulvlslon. SepLember 9-12,
2009, Munlch, Cermany. AbsLracL # 129

185

Aknow|edgements

1hls Lhesls ls respecLfully submlLLed Lo rof. Sllvano locardl,
8ecLor of Lhe unlverslLy of Slena, Lo rof. Clan Marla 8ossollnl, uean of
Lhe laculLy of Medlclne of Lhe unlverslLy of Slena, Lo rof. Marco
lerrarl, ulrecLor of Lhe ueparLmenL of uenLal Sclence, uean of School
of uenLal Medlclne, ulrecLor of Lhe hu rogram ln 8loLechnologles:
secLlon of uenLal 8lomaLerlals", unlverslLy of Slena.
1hls research has been carrled ouL ln Lhe ueparLmenL of uenLal
MaLerlals and llxed rosLhodonLlcs of Lhe unlverslLy of Slena.
l wlsh Lo express my slncere admlraLlon Lo my promoLer rof.
Marco lerrarl, for Lhe chance he gave me Lo approach 8esearch and
for hls ablllLy Lo face and solve all Lhe problems concernlng Lhe
Lveryday ueparLmenL Llfe".
My deepesL Lhanks go Lo my co-promoLer and menLor rof.
Alessandro vlchl. l wlll never flnd Lhe words Lo Lhank hlm for whaL he
dld for me and for Lhe opporLunlLy he gave me. uurlng Lhe lasL
suffered years he has always provlded me guldance and never
permlLLed me Lo geL down. WlLhouL hlm, all Lhls work would have
been harder.
l would llke Lo especlally Lhank my Lravel maLes and frlends ur.
Claudla MazzlLelll, ur. lederlca apacchlnl and ur. Lllsa Magnl, for Lhe
beauLlful momenLs spenL all over Lhe world ln our lAu8 Lrlps.
A speclal Lhank Lo rof. Cecllla Coraccl, for her preclous Llme
spenL ln revlewlng my papers and provldlng sLaLlsLlcal advlce.
186

My appreclaLlon goes Lo rof. Andrea 8orracchlnl and rof.
Slmone Crandlnl, for Lhelr unlque lnvolvlng ablllLy ln denLal sclence.
l am graLeful Lo Lhe whole CommlLLee for Lhe Llme spenL on
approvlng Lhls Lhesls.
l acknowledge my frlends and colleagues for Lhe LranslaLlon of
ChapLer 6 and for Lhelr preclous help: ur. Claudla MazzlLelll (Spanlsh),
ur. Lllsa Magnl (Cerman), ur. Zlad Salameh (lrench) and ur. Carlos
AugusLo 8amos de Carvalho (orLuguese). Speclal Lhanks go Lo ur.
Chrls Louca for hls palnsLaklng Lngllsh revlew of Lhls Lhesls.
l would also llke Lo Lhank all Lhe oLher hu sLudenLs and
candldaLes for Lhelr frlendshlp and Llme spenL LogeLher.
1hanks Lo all Lhe people who conLrlbuLed Lo Lhls work.
1hls Lhesls ls dedlcaLed Lo my moLher and my broLher, for Lhelr
conLlnuous supporL even when Lhe rlghL way seemed Lo be losL, for
Lhelr falLhfulness and Lhorough love for me. l wlll never forgeL whaL
Lhey dld for me.

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