CLINICAL RESEARCH

Composite shade guides

and color matching

Gaetano Paolone, DDS

Private and referral practice, Rome, Italy.
Lecturer, Master of Endodontics and Restorative Dentistry, University of Siena, Italy

Giovanna Orsini, DDS, PhD

Associate Professor, Restorative Dentistry, School of Dentistry,
Polytechnic University of Marche, Ancona, Italy

Jordi Manauta, DDS

Private and referral practice, Chiavari, Italy

Walter Devoto, DDS

Private and referral practice, Sestri Levante, Italy
Lecturer, Master of Endodontics and Restorative Dentistry, University of Siena, Italy
Visiting Professor, University of Marseille, France and International University of Catalonia,
Barcelona, Spain

Angelo Putignano, MD, DDS

Professor, Restorative Dentistry; Head of Department of Endodontics and Operative Dentistry,
School of Dentistry, Polytechnic University of Marche, Ancona, Italy

Correspondence to: Prof Giovanna Orsini

Department of Clinical Sciences and Stomatology, Polytechnic University of Marche, Via Tronto 10, 60126 Ancona, Italy;

Tel: +39 071 220 6224; E-mail: giovorsini@yahoo.com

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Abstract
Finding reliable systems that can help
the clinician match the color of direct
composite restorations is often an is-
sue. After reviewing several composite
shade guides available on the market
and outlining their main characteristics
and limits (unrealistic specimen thick-
ness, not made with the same material
the clinician will use, only a few allow
to overlap enamel tabs on dentin ones),
paolone ET AL
the authors evaluated the reliability of a
system designed to produce self-made
standardized “tooth-shaped” shade
guide specimens. Small changes in com-
posite enamel thickness may determine
huge differences in esthetic outcomes.
In conclusion, the results showed that all
the specimens demonstrated compara-
ble enamel thickness in all the examined
areas (cervical, middle, incisal).
(Int J Esthet Dent 2014;9:162–180)
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Introduction
Composite is probably the most fre-
quently used material in daily practice.
It is used for direct restorations, indirect
restorations, closing diastemas, cemen-
tation, build-up, etc. Considering that
most of the time it is employed in esthet-
ic regions,1-9 it is very difficult to find reli-
able systems that can help the clinician
match the color of the restoration. Color
matching in dentistry has always been
an issue;10-13 in the world of composites
we also have several factors that give
rise to confusion.
First of all, there is no unification in
composite shade nomenclature. Every
company creates names for their com-
posite shades and most of the time
they use the same names of the VITA
shade guide. The market is riddled with
syringes named A1, A2, A3.5, etc, but
most of the time there is no accurate
match between a company color clas-
sification and the Vita shade guide.14-17
If we select the same shade (eg, A3) but
take them from different composite sys-
tems, we are confronted with a problem:
they are completely different from each
other.18
Fig 1    Chroma, hue, fluorescence, opacity/translucency of different brands of dentin composite.
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Differences are not just only related
to hue and chroma. Composite’s optical
properties19-21 (Fig  1) are in fact strongly
influenced by several factors: nature and
size of the filler; the material’s thickness;
fluorescence of the dentins; opacity de-
gree of the dentins; degree of translu-
cency of the enamels; opalescence of
the enamels; and refractive index of the
enamel. All these differences may also
arise within the same composite system.
These facts concur in making the
dentist less confident with direct esthet-
ic restorations because he/she tends to
think that esthetic outcomes are not pre-
dictable when using composites. This
often leads to non-conservative indirect
treatments, where shade taking issues
and esthetic outcomes are delegated to
dental technicians.
Moreover, there are big differences
between composite systems. Some
companies propose shades for den-
tin with the corresponding shade for
enamel, using the VITA classification
(eg, Dentin A2 and Enamel A2). Gen-
erally, VITA-based composite shade
guides do not exactly abide by the
VITA reference guide.22 Other compa-
nies propose universal dentins with dif-

ferent saturations and enamel masses
with different value. Other companies
have dentin, enamel and body masses.
In addition, in some composite systems
there are several “special” composite
masses that have extreme translucen-
cy like transparent and blue shades,
others have a high opacity (eg, they
are white), while others provide differ-
ent opalescence values.
Obviously, it is almost impossible to
describe all the characteristics con-
tained in a single mass with a single
name, but sometimes it seems that com-
panies prefer to focus on their commer-
cial strategies regarding names, pack-
aging and number of syringes.
A review of the composite
shade guides
Prefabricated shade guides
All the concerns exposed concerning
the naming of composite masses may
be eased using a composite system in
which a fine and understandable shade
guide is provided.
For example, if the ‘A2’ dentin of a
composite system does not match at all
with the Vita shade guide but the com-
pany provides a reliable shade guide,
color selection should not be an issue.
How reliable are shade guides pro-
vided by the companies for their com-
posite systems? Unfortunately, they
often are not.23-25 If the shade guides
that exist today on the market are ana-
lyzed, an enormous variety is revealed
(Fig  2).
All the shade guides that were ana-
lyzed were dissimilar from the others.
paolone ET AL
Fig 2    Some of the shade guides we analyzed.
Differences were due to the following
factors:
„„Material of the shade guide.
„„Type of support for the shade guide
specimen.
„„Shape of the specimen.
„„Thickness of the specimen.
The majority of the shade guides by com-
posite manufacturers are made of plas-
tic. Few are made of composite. Some
systems provide a ceramic shade guide.
Other systems are “paper” shade guides.
Analyzing the shank of the specimens,
there was metal, plastic and shankless
(for the stick-shaped and paper speci-
mens).
As for the thickness and the shape of
the specimens, there was also a vast va-
riety. Many had the color “painted” on a
plastic stand (Figs  3 and 4), and this re-
sults in the lack of thickness of the speci-
men; others have the shape of a com-
plete crown of a central incisor, although
they are exclusively dentin shades.
One shade guide had the upper cen-
tral incisor shape and every specimen
(Fig  5) was the result of a hypothetical
stratification of a body, a dentin and an
enamel mass, but no information was
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provided concerning the thickness of

the different layers.
Other guides in plastic have sticks
with different thickness for every shade
(Fig  6). Two shade guides had small and
thick specimens for dentin and thinner
and wider ones for enamel and opales-
cent masses (Figs  7 and 8). Only two
of the analyzed shade guides allowed
for the snap-on of enamel and dentin
masses (Fig  9). One of the shade guides
Fig 3    Many shade guides have “painted” speci- made of composite consisted of tapered
mens.
tabs with decreasing thickness (Fig  10).
Tabs can be overlapped for shade
taking, but the thinnest part of the mass-
es of dentin and enamel is in both cases
1  mm. Since enamel thicknesses wider
than 0.7  mm are rarely used clinically,
the overlapping opportunity of this kind
of shade guides seems redundant and
useless. On the contrary, since chroma-
ticity varies when increasing thickness,
dentin specimens with variable thick-
ness could be useful (Fig  11). Howev-
er, enamel and opalescent specimens
(Fig  12) can only offer an approximate
Fig 4    Many shade guides have “painted” speci-
idea and poor clinical benefits.
mens.

Fig 5    This shade guide is a result of a theoretical Fig 6    Plastic specimens with different thickness-
stratification, but there are no indications on thick- es.
ness for each layer.

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Fig 7    Dentin specimens made in ceramic. Fig 8   Enamel and opalescent specimens of the
same shade guide as Fig  7.

Fig 9    This shade guide is in composite and allows Fig 10   Tapered composite tabs both for dentin
the snap-on of enamels on dentins. and enamel.

Fig 11  In this shade guide dentin specimens Fig 12    Enamel and opalescent specimens for the
have variable thickness. same composite system as Fig  11 have the same
dentin thickness.

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If made in composite, a shade guide

can give some indications on the shades’
response depending on different speci-
men thickness when transilluminated
(Fig  13). Additionally, if observed with a
black light, we can check the material’s
fluorescence.
Having analyzed several shade
guides and studied them from the point
of view of clinical needs, the authors for-
mulated several considerations about
Fig 13    Tapered specimens’ behavior, when trans- the composite shade guides currently
illuminated.
available on the market:
„„Only few composite systems have a
shade guide of the same material that
sleeve the clinician will use.
spindle
„„Few shade guides have the possibility
to overlap enamel and dentin shade
specimens.
anvil
thimble „„No shade guides have specimens
with composite enamel cured over a
dentin mass.
„„Default thicknesses of specimens are
often useless, for example, being too
Fig 14    A micrometer.
thick for the enamel shades.
„„“Printed” shade guides are useless
since it is well known that composite
behaves differently with different thick-
zero (closed) position nesses either of dentin and enamel.
„„The shanks of the specimens some-
times divert the clinician’s attention.
This happens especially for the plastic
support surrounding flat specimens.
„„“Paper” shade guides are often print-
ed on glossy paper. This causes dis-
turbing reflections during shade-tak-
ing procedures.

Fig 15    First of all we have to check that the spin-

dle is on the zero position when the micrometer is
closed. It is possible to calibrate the micrometer
with the provided spanner. Adjustment is not man-
datory because the “error” can be added to every
measurement we will make.

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Self-made shade guide

using a micrometer

Because of all these limitations in com-

mercial shade guides, and since a
successful restoration is the result of a
three-dimensional interaction between a
translucent layer placed on an opaque
one, many clinicians have adopted the
practice of producing the shade guides
of the composites that they are going to
use themselves.26-28 “Self-made” shade Fig 16   The micrometer is unscrewed by about
5 to 6  mm. Dentin is placed between the anvil and
guides reflect the need for more reliable
the spindle.
commercial ones.
One method that can be used to pro-
duce your own custom-made shade 3.0  mm
guide is with a micrometer. The microm-
eter (Fig  14) is a cheap device incorpo-
rating a calibrated screw that is widely
used for precise measurements of small
distances in mechanical engineering.
With the help of the micrometer, we
can obtain round specimens with ex-
tremely precise thickness. We can also
Fig 17   The thimble is then closed until we can
overlap two (or more) materials curing read 3  mm on the sleeve. Composite is squeezed
one onto another (eg, enamel and den- and excesses can be easily removed.

tin). A step-by-step procedure on how

to make a shade specimen of a 3  mm
dentin and 0.5 mm enamel is described
in Figs  15 to 22.
Although this method is very precise
and reliable, it has some limitations:
„„It does not provide tooth-shaped
specimens that reproduce natural
convexities of dental surfaces.
„„The enamel layer (when enamel is
layered on dentin) is uniform so you
have to make several specimens to
check different behaviors for different Fig 18    Light curing is then performed all around
enamel thicknesses. the composite’s slot. The specimen’s wall will result
to be smoother if a transparent matrix band is rolled
around the fissure before curing.

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3.5  mm

Fig 19    The micrometer is opened once again and Fig 20    The thimble is twisted once again in order
the enamel composite is placed on one of the sides to close the micrometer until the value of 3.5  mm is
of the dentin disc. In this example an opaque high read.
value mass has been chosen for didactic purposes.

Fig 21  After enamel curing, the micrometer is Fig 22    The specimen is ready, it can be polished
opened in order to remove the specimen. and glued on a stand (eg, on a Microbrush, Micro-
brush International).

Self-made shade guide

with prefabricated molds

A system to create personalized shade

guides (My Shade Guide for compos-
ite, Smile Line) has recently been devel-
oped.
Positive and negative portions of a
matched-mold make up this system
(Fig  23). The negative portion is the one
that reproduces the vestibular enamel; it
Fig 23  Positive and negative portions of My is white and is made of semi-rigid plas-
Shade Guide. tic. The positive portion displays the

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Fig 24    Enamel composite is placed and spread
on the negative portion.
Fig 26   Once the two portions are coupled, we
must check that the flask remains closed by itself,
therefore assuring that the material is correctly dis-
tributed. Light curing is then performed through the
transparent portion.
shape of the dentinal body and is made
of transparent and soft silicon. Making a
specimen is quite simple, as described
in Figs  24 to 27.
The enamel layer has different enamel
thicknesses: the producer indicates an
0.2  mm thickness in the cervical third, an
0.5  mm thickness in the middle and an
0.7  mm thickness in the incisal portion
(Fig  28).
paolone ET AL
Fig 25    The positive portion is then coupled apply-
ing a gentle constant pressure in order to make the
enamel excesses flow away through the four vents
created on the negative impression.
Fig 27    The enamel “shell.”
Specimens can be obtained using
enamel and dentin masses from the
same composite systems or mixing
masses from various composite brands.
In this way, it is possible to understand
the response of different materials. More
elaborated inverse layering techniques
can be performed, adding a variety of
colors for special cases.
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Figures  29 to 34 show a clinical case

0  mm
in which the shade guide is made of the
same material that will be used for the
restorations. One more element to take
0.2  mm into consideration is that light scattering
and glare often affect shade-taking pro-
cedures.
dentin A polarized view7,29 removes glare
and shows the real color of the teeth and
the shade guide (Figs  35 and 36) con-
tributing to reduce the difference (ΔE)
between the tooth and the restoration
0.5  mm
color.

Aim of the study

enamel
0.7  mm
Fig 28  The system is designed to provide dif-
ferent enamel thicknesses: 0.2  mm in the cervical
third, 0.5  mm in the middle third and 0.7  mm in the
incisal portion.
As discussed above, a standardized
custom-made shade guide, with a vari-
able enamel thickness width and a tooth
shape, can help the clinician to better
understand the material’s behavior. The
clinician can easily reproduce the tooth’s
shade, knowing the composition of the
matching specimen.

Fig 29    Initial situation. Fig 30    Shade selection with a shade guide made
of the same composite in which the restoration will
be made. Natural gray background may help color
matching.

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Fig 31    Checking the silicone index. Fig 32    Layering interproximal walls.

Fig 33    Final result right after dental dam removal. Fig 34    Final result after rehydration.

Fig 35    Color matching with polarization. Fig 36    Color matching with flash light.

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Fig 37    Composites used in the study.
Fig 38    Composites were heated before use.
Fig 39    Every specimen was measured in the cer-
vical, middle and incisal areas.
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For this reason, shade-taking pro-
cedures should rely on a reliable and
reproducible specimen. If the compos-
ite enamel shell is thicker or thinner than
expected, there could be an unpredict-
able esthetic outcome.
Therefore, the objective of this study
was to test the reliability of the system
described above designed to produce
standardized “tooth-shaped” shade
guide specimens.
As outlined by several authors, com-
posite enamel thickness plays a primary
role in the esthetic outcome, so the study
was based on composite enamel shells
produced by the analyzed system.
The null hypotheses of the present
study were that:
„„The thickness of the enamel shell is
uniform;
„„The specimen’s thicknesses are not
influenced by the type of material.
Materials and methods
Since every composite has a different
handling (soft, hard, sticky) and in order
to verify whether the specimens’ thick-
ness could be influenced by the type
of material, different composite resin
brands were analyzed in this study. Six-
teen composites (enamel and incisal
ones) of different brands (Table  1) have
been included for the present study
(Fig  37).
My Shade Guide’s mold is made of
two portions: the enamel mold is white,
while the other mold is made of trans-
parent silicone and is characterized by
the dentinal body shape. The two parts
join together with the enamel composite
in between, and are used to make the
 paolone ET AL

Table 1  Cervical measurements

Product name Company Shade Mean Std. Dev. Min Max

Ceram-x Dentsply E1 0.32 0.04 0.28 0.35

Clearfil Majesty Kuraray

E 0.31 0.02 0.29 0.33
Esthetic Medical Inc.

ENAMEL plus
GDF GmbH GE1 0.32 0.04 0.28 0.35
HFO

Opallis FGM EA1 0.33 0.01 0.32 0.34

Filtek Supreme
3M ESPE A2 ENAMEL 0.30 0.03 0.28 0.33
XTE

Coltène
Miris 2 NT 0.38 0.02 0.35 0.39*
Whaledent

ENAMEL plus
GDF GmbH UE1 0.32 0.02 0.31 0.34
HRi

IPS Empress Ivoclar

Enamel D3 0.32 0.06 0.28 0.38
Direct Vivadent

Kerr
Herculite Ultra XL 0.29 0.03 0.26 0.32
Corporation

G-aenial GC Corporation AE 0.32 0.02 0.31 0.34

Heraeus Kulzer
Venus Diamond CL 0.30 0.05 0.25 0.35
GmbH

GRADIA DIRECT GC Corporation DT 0.30 0.04 0.26 0.34

Tokuyama
Estelite Σ Quick BW 0.30 0.01 0.29 0.31
Dental Corp.

Artiste Pentron Clinical A Enamel 0.31 0.01 0.3 0.32

Coltène White Opal-

SYNERGY D6 0.33 0.03 0.29 0.35
Whaledent escent

DeltaMed Incisal Me-

Renamel Microfill 0.29 0.01 0.28 0.3
GmbH dium

* t-test P = 0.034

enamel shells that represent the speci-
men of this study.
A standardized protocol has been
used to produce every specimen. Every
composite was placed in a composite
heater conditioner (Fig  38) (CHC, Com-
posite Heating Conditioner, Micerium).
After 30  min, a small amount of ma-
terial was taken from the heated syringe
and spread on to the white part of the
mold with a rounded obturator in order
to provide a uniform material thickness.
The two parts of the mold were coupled
and a little pressure was applied for 3  s

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Fig 40    A stable and reliable template was used to measure every specimen in the same point.
in the middle of the transparent portion
following the manufacturer’s instruc-
tions, while the mold was placed on a
laboratory dental vibrator (Vibrax 230V,
Renfert) running at a low frequency.
The mold was checked to see if the
two parts had been joined perfectly.
The procedure was repeated until cou-
pling was considered satisfactory, mak-
ing sure that every side of the mold was
“closed.”
A curing light was then applied in the
middle of the transparent portion of the
mold for 80  s in order to cure the com-
posite. After this, the mold was opened
and the shell was cured for another 40  s.
The enamel shells were carefully re-
moved from the white portion of the mold.
In order to measure the specimens’
thickness, a point micrometer was used
(SMPC25, Alpa). Every specimen was
produced by a single operator, who pro-
duced three specimens (enamel shells)
for every composite.
Every specimen was measured
(Fig  39) in the cervical, middle and in-
cisal areas in order to evaluate their
thickness. As a means to measure every
specimen in the same point, a stable and
reliable template was used (Fig  40). This
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template was made in composite (M7
CeramX, Dentsply) layered and cured
on the “buccal” portion of a specimen
isolated with Vaseline.
Results
Table  1 shows the mean changes (plus
standard deviations and minimum and
maximum) in cervical measurements,
showing that no significant differences
were observed (all P > 0.05), except
for one composite (Miris 2, P = 0.034).
Table  2 shows no significant differenc-
es across the measurements taken at
the middle area. Table  3 shows that no
significant differences were observed
when the measurements were taken at
the incisal area (all P > 0.05), except for
two composites (Enamel plus HRi, P =
0.019; Renamel Microfill, P = 0.020).
Discussion
Both the null hypothesis were accepted,
while all the specimens demonstrated
comparable enamel shell measure-
ments in all the examined areas.
 paolone ET AL

Table 2  Middle measurements

Product name Company Shade Mean Std. Dev. Min Max

Ceram-x Dentsply E1 0.52 0.03 0.5 0.55

Clearfil Majesty Kuraray Medical

E 0.53 0.02 0.51 0.55
Esthetic Inc.

ENAMEL plus HFO GDF GmbH GE1 0.52 0.06 0.47 0.58

Opallis FGM EA1 0.52 0.06 0.48 0.59

Filtek Supreme XTE 3M ESPE A2 ENAMEL 0.53 0.08 0.44 0.58

Miris 2 Coltène Whaledent NT 0.49 0.04 0.44 0.52

ENAMEL plus HRi GDF GmbH UE1 0.51 0.02 0.49 0.52

IPS Empress Direct Ivoclar Vivadent Enamel D3 0.48 0.05 0.44 0.54

Herculite Ultra Kerr Corporation XL 0.51 0.03 0.48 0.53

G-aenial GC Corporation AE 0.51 0.05 0.46 0.55

Heraeus Kulzer
Venus Diamond CL 0.55 0.06 0.47 0.59
GmbH

GRADIA DIRECT GC Corporation DT 0.50 0.04 0.46 0.54

Tokuyama Dental
Estelite Σ Quick BW 0.52 0.02 0.5 0.53
Corp.

Artiste Pentron Clinical A Enamel 0.54 0.06 0.49 0.6

White
SYNERGY D6 Coltène Whaledent 0.52 0.06 0.46 0.57
Opalescent

Renamel Microfill DeltaMed GmbH Incisal Medium 0.51 0.02 0.49 0.53

There are significant clinical advan- ence values of a prefabricated anatomic

tages when using the proposed cus-
tom-made shade guide. Classic shade
guides are composed by layered tabs,
but the user does not have control on
the enamel shell. Magne et al30 have
recently demonstrated that color differ-
dual-laminate shade guide (Miris 2) are
acceptable when compared to Vitapan
Classical and custom guides. They pro-
vided a comprehensive understanding
of the color with dentin alone, enamel
alone, or the dentin/enamel combination,

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Table 3  Incisal measurements

Product name Company Shade Mean Std. Dev. Min Max

Ceram-x Dentsply E1 0.70 0.02 0.68 0.72

Clearfil Majesty Kuraray Medical

E 0.73 0.02 0.72 0.75
Esthetic Inc.

ENAMEL plus HFO GDF GmbH GE1 0.69 0.04 0.65 0.73

Opallis FGM EA1 0.74 0.03 0.72 0.77

Filtek Supreme XTE 3M ESPE A2 ENAMEL 0.70 0.05 0.64 0.74

Miris 2 Coltène Whaledent NT 0.71 0.01 0.7 0.71

ENAMEL plus HRi GDF GmbH UE1 0.76 0.02 0.75 0.78*

IPS Empress Direct Ivoclar Vivadent Enamel D3 0.66 0.02 0.65 0.69

Herculite Ultra Kerr Corporation XL 0.71 0.01 0.7 0.72

G-aenial GC Corporation AE 0.71 0.04 0.68 0.75

Heraeus Kulzer
Venus Diamond CL 0.72 0.03 0.69 0.75
GmbH

GRADIA DIRECT GC Corporation DT 0.70 0.08 0.65 0.78

Tokuyama Dental
Estelite Σ Quick BW 0.72 0.05 0.69 0.78
Corp.

Artiste Pentron Clinical A Enamel 0.74 0.05 0.69 0.79

White
SYNERGY D6 Coltène Whaledent 0.74 0.05 0.68 0.78
Opalescent

Incisal
Renamel Microfill DeltaMed GmbH 0.74 0.01 0.73 0.75**
Medium

* t-test P = 0.019; ** t-test P = 0.020

however the described findings evaluat- cause it examined different brands of

ed only one brand of composite resins,
pointing out that additional works could
be performed to extend the matching
shades between other systems. There-
fore, the present study could represent
a valid contribution for the clinicians be-
composite resins, demonstrating that
matching shades among different sys-
tems could be available with predictable
layer thicknesses. Composite enamel
thickness plays a fundamental role in the
esthetic outcome of a restoration and

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this issue has been discussed by sev- Conclusion

eral authors.31-33 Schmeling et al report-
ed that value enamel composite optical
properties, such as translucency, for ex-
ample, was influenced by the value and
thickness of the enamel composite.31 In-
deed, the authors suggest that special
attention should be paid to the thickness
of the material used to reproduce trans-
lucency of natural tooth enamel.31
Friebel et al reported that the total
color impression could be shown to be
dependent on the sample thickness
and the transparency/translucency of
the single layers of enamel and dentin
materials.32 The authors reported also
that the influence of the cover layer on
the total color impression increases
distinctly with the layer thicknesses. In
fact, they experienced differences in
color impressions in composite enam-
el layers thinner (0.1  mm) and thicker
(1.4  mm) than the reference layer thick-
ness (0.4  mm).32
Vichi et al reported that layer thick-
ness and the proportion of dentinal thick-
nesses and translucent shade greatly
influence the final aspect of a multi-layer
composite restoration.33
As a result of all of these considerations,
the authors came to the conclusion that,
although a “perfect” shade guide is
very difficult to obtain, an effort to im-
prove current commercial shade guides
should be made.
A barely acceptable shade guide
should have the following requirements:
„„Specimens should be made of the
same materials that the clinician will
use, therefore in composite.
„„They should offer the capability to
overlap enamel and dentin speci-
mens interposing glycerin or, even
better, specimens should be already
cured together.
„„Thickness of the enamel should not
be unrealistic (0.7 mm maximum).
„„It should be possible to test the behav-
ior of different enamel thicknesses.
„„The shanks utilized for the specimens
should not interfere with shade selec-
tion.
„„They should provide for a standard-
ized shape, similar to the incisors, for
every specimen with predetermined
layer thicknesses.

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