Shading of ceramic crowns using digital tooth shade matching devices.

In the 1990s, there was great optimism due to the development of devices for measuring tooth shade. The frequently not so simple, visual determination of the shade of a tooth was to be done with the aid of a device which recognizes the shade and describes it accurately by reference to a color chart. However, the skepticism towards such devices was also great. It is known that the color effect frequently differs strongly when comparing a tooth from the shade guide with a metal ceramic crown, despite identical shade designation. Anyone who considers visual shade determination to be inadequate and places his hopes in digital shade matching devices will be disappointed. It is the shade-generating structures of the metal ceramic and frequently of the veneer layers that turn out to be too thin which, despite correct shade selection, cause a different color perception. Such problems have been reduced decisively with the development of fracture-proof hard porcelain caps (Vita In-Ceram) with optical characteristics similar to teeth. In addition, the Vita System 3D-Master tooth shade system developed in 1998 by Vita in cooperation with Dr. Hall from Australia, leads the practitioner to a better understanding of the primary tooth shade characteristics of "brightness (value)", "color intensity (chroma)" and "color (wave length of the visible light, hue)". These two innovations allow a more accurate estimate of the basic shade of a natural tooth (reference tooth) and the imitation in the laboratory of its natural, shade-generating structures. If digital shade measurement supplements the visual shade estimate, then a further improvement can be expected--especially in the recognition of the basic shade. Qualitative descriptions of subjective shade measurement of a natural tooth and of its imitation in the dental laboratory by ceramics can be found frequently in professional journals and publications. With digital tooth shade matching devices, which apart from the color code of the color chart also reproduce exact, colorimetric values, such work processes can be recorded quantitatively and objectively. Reports about this type of controlled shade determination and generation are found rarely in the literature, which is surprising in view of the large number of tooth shade matching devices and dental ceramic systems available. In the present paper, the influence of the individual ceramic layers on color perception is measured and described under standardized conditions. The creation of the basic shade as it results from the composition of the various ceramic layers is traced with a spectrophotometer. The Vita In-Ceram Alumina infiltration ceramic and the VitaVM7 veneer ceramic were selected as the ceramic system. MHT-SpectroShade and Vita Easyshade were used as shade matching devices.