Ask Marty: What is the best device for shade selection for composites and crowns?

Sep 9, 2009

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Q: What is the best device for helping in shade selection for composites and crowns?

A: Picking the correct shade of a restoration can be one of the more difficult things a dentist does. Trying to match a central incisor to a crown can mean multiple visits to meet the patient's expectations.

Dentists have tried many ways to convey the colors and characterizations to the dental laboratory technician. It started with a crude drawing with callouts and has progressed to digital photography. But shade matching is still not an exact science.

But now a number of different techniques and tools are available to help you get the shade right! A low-tech solution is the Ladder. This reference guide, which looks like a big paint chart you might get from Home Depot or a local paint store, was created for dentist-to-ceramist communication of tooth features.

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The ClearMatch system from Clarity Dental.

The images are categorized, color-coded by category, and encoded for easy reference and clear communication. In my opinion, the guide is the most accurate and consistent system of images available today -- depicting a comprehensive array of translucency, characterizations, surface anatomy, chroma, value, and variations.

Another option is ClearMatch from Clarity Dental, a shade analysis and communication tool designed for dentists and dental laboratories. It is a software-only system that allows users to take a digital photo and use their existing PC to perform highly accurate analyses of shade, value, and anatomical features of teeth. This means letting the computer adjust the hues and color imbalances from the original picture. The tab holder uses white and black to set the reference levels.

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The Ritelite device from AdDent.

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The Crystaleye system from Olympus.

Another device is the Ritelite from AdDent. This is a small, six light-emitting diode (LED) device that produces light to simulate north sky daylight (5500° K). It sells for less than $200 and makes conventional shade matching easier. I use the Ritelite and it is very well-built.

A higher-tech device for shade matching is the spectrophotometer, a photometer that measures light intensity as a function of color. Some devices measure a point, while others can determine color of an entire tooth. Examples of point devices are the Shade X from X-Rite, which sells for less than $1,000, and the Vita Easy Shade from Vident.

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The Vita Easy Shade device from Vident.

The most expensive and, in my opinion, best shade-matching device is the Crystaleye from Olympus. It is a color analysis system that can accurately analyze tooth colors simply by photographing the patient's teeth. Prostheses manufactured in the laboratory can be photographed in a specially designed dental jaw model, allowing comparisons in the same environment as in the oral cavity.

Still, after looking at all these different devices that can aid in shade selection, the ultimate device is the human eye. In the end, what it looks like to the patient and doctor is all that matters.

Martin Jablow, D.M.D., is a practicing dentist and a self-professed technophile who lectures and blogs on a variety of technologies used in dentistry (dentechblog.blogspot.com). If you have a technology question for Dr. Jablow, e-mail it to us at [email protected].