• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.2
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• pp.128-137
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• 2020

Over the last 30 years, the use of chairside computer-aided design (CAD) and computer-aided manufacturing (CAM) systems has evolved and has become increasingly popular in dentistry. Although CAD/CAM restorations have been used in the anterior dentition, satisfying the esthetic requirements of clinicians and patients, where the restorations are limited to the chairside, remains a challenge. To reproduce multi-shades of CAD/CAM restorations in the clinic, a preliminary experiment to express several shades on A2 lithium disilicate (LS2) blocks using a staining kit was performed. After measurement of the CIE L^*a^*b^* value of specimens, it was compared with that of the commercial shade guide. This report presents two cases with individual customization of shade and surface characterization of the CAD/CAM restorations using predictable methods based on the preliminary experimental data. The anatomical shape of restoration was obtained from 'copy and paste technique' and 'mirror image acquisition technique'. All treatment procedures and fabrication of restorations performed in this report were executed in the clinic itself.

• Journal of dental hygiene science
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• v.17 no.6
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• pp.481-486
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• 2017

The study aimed to compare the whitening efficacy of a strip and gel containing 2.9% hydrogen peroxide, using a tooth whitening light activator. The whitening effect was compared through in vitro and in vivo studies. In the in vitro study, we used stained hydroxyapatite (HAP) specimens as artificial teeth. HAP specimens were made using HAP powder and polyvinyl alcohol solution, and stained by modified Stookey's method. A whitening gel and whitening strip were applied to the respective specimens for 20 minutes, with a light activator. The color changes were measured using a colorimeter. In the in vivo study, one group (test 1) used the gel with a light activator and the other group (test 2) used a strip with the same activator for 15 minutes a day, for four consecutive days. An organoleptic evaluation using a Vita shade guide and instrumental evaluation using a Shade eye-NCC (Shofu Co., Japan) were performed. The color change values (${\Delta}E^*$) in the in vitro study revealed the strip with the light activator to be more effective than the gel with the same activator (p<0.001). In the in vivo study, even though there was no significant difference between the groups with respect to the ${\Delta}E^*$, using either the Shade eye-NCC or the Vita shade guide, the change in yellowness (${\Delta}b^*$) was statistically significant (p=0.024). In conclusion, test 2 group that used 2.9% hydrogen peroxide strip with a light activator, showed a tendency towards increased whitening than test 1 group that used the gel with the same activator; however further studies are needed to validate the above finding.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.4
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• pp.343-350
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• 2008

Purpose: The purpose of this study was to spectrophotometrically evaluate the shade difference between of maxillary and mandibular anterior teeth in the Korean by the standard of vita classical shade guide using $SpectroShade^{TM}$. Material and methods: In this study, the shades of healthy anterior teeth were examined and analyzed using the digital shade analysis of $SpectroShade^{TM}$. This study examined 80 individuals in their twenties, thirties, fourties, fifities ages and 40 males and 40 females, presenting 12 healthy, unrestored maxillary and mandibular anterior teeth. Tooth brushing and oral prophylaxis were performed prior to evaluation. The $SpectroShade^{TM}$ was used to acquire images of the 12 maxillary and mandibular anterior teeth. These images were analyzed using $SpectroShade^{TM}$ Software, and shade maps of each tooth were acquired. The shade difference of upper and lower, and gender differences and ages difference were investigated and analyzed with CIE $L^{*}a^{*}b^{*}$ color order system. One-Way ANOVA test was used to find out if there were significant differences between groups tested and Sheffe multiple comparison was used to identify where the differences were. Results: 1. Shade differences were significant (P < .05) between maxillary and mandibular central incisor, lateral incisor, canine. 2. No significant differences in shade distribution were seen between lateral incisors and central incisors. 3. Canine's shade difference were more significant than central incisor's and lateral incisors's. 4. No significant differences in shade distribution were seen between genders in maxillary and mandibulr central incisor, lateral incisor, canine. 5. No significant differences in shade distribution were seen in order of years in maxillary and mandibulr central incisor, lateral incisor, canine. Conclusions: The results of this study show that 1. Shade difference was founded in maxillary and mandibular anterior teeth and ${\Delta}E^{*}$ value was more than 2.0. 2. Canine's shade difference were more significant than central incisor's and lateral incisors's and between central incisors and lateral incisors shade differences were no significant. 3. No significant differences in shade distribution were seen between genders in maxillary and mandibular anterior teeth. 4. No significant differences in shade distribution were seen in order of years grade in maxillary and mandibular anterior teeth.

• International Journal of Oral Biology
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• v.41 no.4
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• pp.243-251
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• 2016

This study was undertaken to achieve a high bleaching efficacy with plasma, through longer application and reparative bleaching processes, by different shade evaluation methods. Extracted human teeth were divided into 6 groups (n=10). All teeth were treated in pairs. Low concentration of 15% carbamide peroxide (CP) was applied, with and without plasma, for 10, 20, and 30-min tooth bleaching, respectively. The bleaching procedure was repeated once daily for four days. The teeth were maintained in a moist environment provided by artificial saliva. The Vitapan Classical shade guide and Commission Internationale de L'Eclairage (CIELAB) color system were collectively used to measure the bleaching efficacy. Color evaluation was statistically analyzed using Student t-test and one-way analysis of variance (ANOVA) complemented by Tukey's test. Combining the plasma with 15% CP showed significantly greater color changes compared to bleaching without plasma (p<0.05). A high bleaching efficacy with plasma is proportional to the repetitive application and the treatment time. A 30-min application with plasma provided the best bleaching. Repetitive bleaching showed lower probability of color relapse of the bleached tooth. The color change by shade guide correlated with the changes in CIELAB color system. A value of 1 color change units (CCU) conversion factor for overall color change (${\Delta}E$) values comparisons was 3.724 values. The two measuring methods provide a more accurate correspondence of color change. The repetitive and longer application for tooth bleaching, combined with plasma, has a strong bleaching effect and produces whiter teeth.

• Restorative Dentistry and Endodontics
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• v.37 no.2
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• pp.84-89
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• 2012

Objectives: This study analyzed the difference in color caused by different thickness in enamel layer of composite resins when applied with single and layering placement technique, and evaluated if the results agreed with the shade guide from the manufacturers to verify reliability of the color matching process of the manufacturers. Materials and Methods: For single composite resin samples, 6 mm diameter and 4 mm thickness cylindrical samples were fabricated using Ceram-X mono (DENTSPLY DeTrey) and CIE $L^*a^*b^*$ values were measured with spectrophotometer. Same process was done for layering composite resin samples, making 3 dentinal shade samples, 4 mm thickness, for each shade using Ceram-X duo (DENTSPLY DeTrey) and enamel shade resins were layered in 2 mm thickness and CIE $L^*a^*b^*$ values were measured. These samples were ground to 0.2 mm thickness each time, and CIE $L^*a^*b^*$ values were measured to 1 mm thickness of enamel shade resin. Results: Color difference (${\Delta}E^*$) between single and layering composite resin was 1.37 minimum and 10.53 maximum when layering thicknesses were between 1 mm and 2 mm and 6 out of 10 same shade groups suggested by manufacturer showed remarkable color difference at any thickness (${\Delta}E^*$ > 3.3). Conclusion: When using Ceram-X mono and duo for composite resin restoration, following the manufacturer's instructions for choosing the shade is not appropriate, and more accurate information for Ceram-X duo is needed on the variation and expression of the shades depending on the thickness of the enamel.

• Restorative Dentistry and Endodontics
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• v.33 no.5
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• pp.463-471
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• 2008

This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test. In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p<.05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p<0.05). Compared to prebleaching status, the ${\Delta}E$ values at post bleaching condition were $4.35{\pm}1.38\;and\;5.08{\pm}1.34$ for the control and sealed groups, respectively. The ${\Delta}E$ values at check up were $3.73{\pm}1.95\;and\;4.38{\pm}2.08$ for the control and sealed groups. ${\Delta}E$ values were greater for the sealed group both after bleaching (p<.05) and at check up (p<.05). In conclusion, both ${\Delta}E$ and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.

• Journal of dental hygiene science
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• v.15 no.5
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• pp.577-584
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• 2015

The purpose of this study was to evaluate the effect of metal chloride infiltration treatment on color and strength changes of the yttria-stabilized tetragonal zirconia polycrystals (Y-TZP). Fifty disc specimens were prepared with a Y-TZP powder (ZPEX; Tosoh, Japan). Thirty different metal chloride solutions containing 0.03~0.08 wt% chromium and 0.03~0.07 wt% terbium ions were prepared. Presintered Y-TZP specimens were soaked in metal chloride coloring liquids for 3 minutes and sintered in air at $1,450^{\circ}C$ for 2 hours. The color of the specimens was measured with spectrophotometer and color difference (${\Delta}E^*$) was obtained based on the CIE $L^*$, $a^*$, $b^*$ color coordinate values. To evaluate the effect of metal chloride infiltration strength changes, the biaxial flexural test was performed at crosshead speed 0.5 mm/min. Colors of the sintered Y-TZP showed the colors of Vita shade guide A1, A2 and A3 with the infiltration of chromium and terbium chloride solutions. Density of the sintered Y-TZP increased by the infiltration of chromium and terbium chloride solutions. Bi-axial flexural strength of the sintered Y-TZP did not show statistically significant differences by the infiltration of chromium and terbium chloride solutions (p>0.05). Chromium and terbium chloride did not affect the crystal phase of zirconia, and all specimens showed tetragonal phase. Accordingly, this study suggests that chromium and terbium chlorides can make colored zirconia while adding in a liquid form. The color of colored zirconia differ from that of vita shade guide but it can use all ceramic restoration as substructure in dental clinic.

• Journal of Technologic Dentistry
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• v.32 no.4
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• pp.327-335
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• 2010

Purpose: The purpose of this study was to investigate the correlation between zirconia core thickness and color tone blocking of discolored tooth and metal post. Methods: For this study, we made 20-porcelain sample and 4-metal sample( liechtenstein IPS e.max) bonded to zirconia core of different thickness with cement(Relyx ARC-3M USA)for produce discolored. We measured the color-spectral characteristics, using Shadepilot equipment(Degudent USA).We measured it with Shadepilot equipment set by automated average mode in 3 times And applied the average value obtained from 2 times of measurement in the middle of each sample. Results: As a result of analysing color-spectral characteristics on zirconia core sample, Depending on the thickness of zirconia core, the value of brightness(${\Delta}L*$:color-spectral characteristic) was increased within limited range, value of ${\Delta}a*$, ${\Delta}b*$ was decrease. Conclusion: Consequently, we obtained the following results: Changes of sample color were observed depending on the thickness of zirconia, but the range of change did not exceed the scope range of shade guide. The case of metal posts, shade guide color D2 were observed in 0.5mm of zirconia core thickness. As a result, in case of porcelain, increasing the zirconia thickness of 0.3mm or more is unnecessary for color blocking effect, in case of metal post, considering the discolored tooth, thickness of zirconia with at least 0.5mm or more is recommended.

• Journal of Technologic Dentistry
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• v.43 no.4
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• pp.168-174
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• 2021

Purpose: This study was conducted to investigate alloys spectrophotometrically including yttrium of nickel-chromium (Ni-Cr) alloys, which are used as substitutes for the regulation of beryllium and provide helpful improvements in Ni-Cr alloys. Methods: Four groups of specimens (ZN, ZY, SN and EM) were prepared for analysis. Color parameters were measured with a spectrophotometer, and color difference (∆E^*) was calculated. The t-test and one-way analysis of variance test were used to determine significant difference, and the Tukey test was used to identify where the differences were. To measure the spectroscopic reflectivity, the spectroscopic reflectance was measured and converted into CIE L^*, a^*, b^* color system. Results: The ∆E^* value of each metal ceramic group after opaque firing of Ni-Cr alloy with and without yttrium was <2, and the total group color difference (∆E^*) was below 1 in the dentin ceramic all experimental group. However, the a^* and b^* values of the metal ceramic groups were higher than that in the lithium disilicate all ceramic group, and the chroma was higher than the natural tooth. The brightness of all experimental groups was similar to that of the shade guide sample. Conclusion: Yttrium added to Ni-Cr alloys showed similar CIE L^*, a^*, b^* values to Ni-Cr alloys that did not contain yttrium, indicating that yttrium had no effect on color in metallic ceramic systems.

• Restorative Dentistry and Endodontics
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• v.46 no.4
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• pp.47.1-47.9
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• 2021

Objectives: This study aimed to use a laboratory model to evaluate the efficacy of an experimental bleaching agent. Materials and Methods: The model used human extracted molars that were treated and measured for bleaching efficacy. Teeth (n = 50) were distributed into 5 groups: Negative control (NC): immersion in water for 8 hours; Nanofibers (NFs): Experimental titanium dioxide nanofibers with stirring and light activation for 8 hours; Whitestrips (WS): Crest 3D White Glamorous White Whitestrips, 2 applications daily for 30 minutes, 14 days; 1% hydrogen peroxide (HP) standard: 1% hydrogen peroxide for 8 hours; and 30% HP standard: 30% hydrogen peroxide for 8 hours. Instrumental measurements were performed using a spectrophotometer. Results were recorded at baseline, 1-day post-bleaching, and 1-week post-bleaching. Kruskal-Wallis procedure was used to determine differences in color change. Pearson correlation was used to evaluate the relationship between visual and instrumental measurements. Tests of hypotheses were 2-sided with alpha = 0.05. Results: There was no significant difference in color parameters (L1, a1, b1, and shade guide units [SGU]) at baseline (p > 0.05). There was a significant difference among the groups for overall color change (ΔE^*ab) and change in shade guide units (ΔSGU) at 1-day and 1-week post-bleaching (p < 0.05). The higher the HP concentration, the higher the color change as expressed in ΔSGU and ΔE^*ab. The negative control exceeded the perceptibility threshold of ΔE^* = 1.2 regardless of time point. NFs showed a decrease in chroma, but were not statistically different compared to the negative control. Conclusions: The laboratory model was successful in screening an experimental bleaching agent.