Color measurements as quality criteria for clinical shade matching of porcelain crowns.

STATEMENT OF PROBLEM The ability of a dentist to select and communicate an acceptable shade match to a dental laboratory may be the most important factor in esthetic restorative dentistry. PURPOSE The purpose of this study was to evaluate the use of instrumental color measurement in clinical shade matching of porcelain-fused-to-metal (PFM) and all-porcelain crowns. The relative effects of clinical and laboratory factors related to shade matching for PFM and all-porcelain crowns were also evaluated. MATERIALS AND METHOD Forty patients treatment planned to receive PFM or all-porcelain crowns made up the study population. The patients were randomly divided into two groups for shade selection: conventional visual assessment and photocolorimetric analysis. At the preparation appointment, a photograph was taken of the target tooth along with four shade guide tabs selected by the two visual observers. The crown was fabricated by either visual selection or by the lowest E* values determined from the photographs and a spectrophotometer. The same dental laboratory fabricated all 40 restorations. At the cementation appointment, clinical criteria were used to evaluate anatomy/contour, surface texture, and the amount of glaze as it relates to color perception before the restoration was cemented. RESULTS The mean E* between the reference tooth before preparation and the crown before cementation in the visual assessment group was 10.49 (+/- 14.6), whereas the mean E* in the photocolorimetric group was 8.99 (+/- 5.7). Analysis of data showed that the observers and the colorimetric technique were perfect (E* = 0) 41% of the time and varied (E* = 0.1 or higher) 59% of the time. Data collected further showed no significant difference or correlation between shade selection methods and the evaluated clinical criteria. CONCLUSIONS These results provide evidence that there is no significant difference in shade selection using the conventional visual assessment by two experienced clinicians or the photocolorimetric technique. CLINICAL SIGNIFICANCE The use of photocolorimetric analysis in shade selection can serve as a reliable alternative to conventional visual shade selection. This method is useful for clinicians who have difficulty with shade selection.