Chroma-dependence of CIEDE2000 acceptability thresholds for dentistry

OBJECTIVES

Determine visual 50:50% color difference acceptability thresholds (AT) for regions of the dental color space with varying chromaticity.

METHODS

A 40-observer panel belonging to two different groups (dentists and laypersons) evaluated 144 dental resin composites pairs (divided in three different sets of 48 pairs according to chroma value: Low Chroma (LC), Medium Chroma (MC) and High Chroma (HC) placed 40 cm away and inside of a viewing cabinet (D65 Standard light source; diffuse/0° geometry). A Takagi-Sugeno-Kang (TSK) fuzzy approximation was used for fitting the data points and calculate the 50:50% acceptability thresholds in CIEDE2000. A paired t-test was used to evaluate the statistical significance between thresholds differences and Bonferroni correction was applied.

RESULTS

The CIEDE2000 50:50% AT were ∆E00  = 2.84, ∆E00  = 2.31 and ∆E00  = 1.80 for LC, MC and HC sets of sample pairs, respectively. The 50:50% AT values were statistically significant between the different sets of sample pairs, as well as the 50:50% AT values obtained for different observer groups.

CONCLUSIONS

50:50% CIEDE2000 acceptability thresholds for dentistry are significantly different depending on the chromaticity of the samples. Observers show higher acceptability for more achromatic samples (low chroma value) than for more chromatic samples.

CLINICAL SIGNIFICANCE

The difference in the AT for distinct regions of the dental color space can assist professionals as a quality control tool to assess clinical performance and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization processes.

Coverage error of three resin composite systems to vital unrestored maxillary anterior teeth

OBJECTIVE

Define the color of anterior teeth of a selected population and correlate it (by using coverage error [CE] and the frequency of best match) with the final color of all possible enamel-dentine combinations of three different resin composite systems.

MATERIALS AND METHODS

Color of 636 vital unrestored anterior teeth (central incisors, lateral incisors and canines; n = 212) and disk specimens (12 mm diameter, varying thickness) corresponding to enamel-dentin combinations of all available enamel (0.5 mm and 1.0 mm thickness) and dentin shades (3.0 mm thickness) of Essentia, Enamel Plus HRi and IPS Empress Direct composite systems was measured using a clinical dental spectrophotometer (Spectroshade Micro). CE and frequency of best match for all composite systems were calculated for the measured in-vivo teeth color space.

RESULTS

Natural in-vivo teeth exhibit higher lightness when compared to enamel-dentin composite combinations, independently of the enamel thickness used. The best (lowest) CE was found for IPS Empress, while the highest values were found for Enamel Plus Hri independently of tooth type and enamel thickness (p < 0.001). The use of 0.5 mm instead of 1.0 mm enamel thickness within enamel-dentin composite combinations resulted in a lower CE for in-vivo tooth color (p < 0.001).

CONCLUSIONS

The color space defined by all possible enamel-dentin combinations of the studied resin composite systems does not fully match the color range of anterior teeth. All composite systems examined lack combinations with lightness values as high as the population's. IPS Empress Direct composite system represented better the in-vivo teeth color.

CLINICAL SIGNIFICANCE

The use of 0.5 mm enamel shade thickness is suggested when building layered restorations, as it provided better color coverage than using 1.0 mm thickness.

Development of Thickness-Dependent Predictive Methods for the Estimation of the CIEL*a*b* Color Coordinates of Monolithic and Layered Dental Resin Composites

Usually, dentin and enamel shades are layered in dental restorations with the purpose of mimicking the natural appearance of teeth. The main objective of this study was to develop and assess accuracy of a color-prediction method for both monolithic and layered dental resin-based composites with varying shades and under different illuminants. A total of 15 different shades of VITAPAN Excell, VITAPAN Dentine and VITA Physiodens as well as VITA Enamel of five different thicknesses (0.5-2.5 mm range) were used to manufacture monolithic and layered samples. A non-contact spectroradiometer with CIE 45∘/0∘ geometry was used to measure the color of all samples over a standard ceramic black background. Second-degree polynomial regression was used as predictive method for CIE-L*a*b* color coordinates. Performance of predictive models was tested using the CIEDE2000 total color difference formula (ΔE00), while accuracy was evaluated by comparative assessment of ΔE00 with corresponding 50:50% acceptability (AT00) and perceptibly (PT00) thresholds for dentistry. A mean color difference between measured (real) and predicted color of ΔE00=1.71, with 62.86% of the color differences below AT00 and 28.57% below PT00, was registered for monolithic samples. For bi-layered samples, the mean color difference was roughly ΔE00=0.50, with generally 100% and more than 85% of the estimations below AT00 and PT00, respectively. The predictive method allowed highly accurate color estimations for both monolithic and layered dental resin-based composites with varying thicknesses and under different illuminations. These results could be useful to maximize the clinical success of dental restorations.

Validation of a Hyperspectral Imaging System for Color Measurement of In-Vivo Dental Structures

A full comprehension of colorimetric relationships within and between teeth is key for aesthetic success of a dental restoration. In this sense, hyperspectral imaging can provide point-wise reliable measurements of the tooth surface, which can serve for this purpose. The aim of this study was to use a hyperspectral imaging system for the colorimetric characterization of 4 in-vivo maxillary anterior teeth and to cross-check the results with similar studies carried out with other measuring systems in order to validate the proposed capturing protocol. Hyperspectral reflectance images (Specim IQ), of the upper central (UCI) and lateral incisors (ULI), were captured on 30 participants. CIE-L*a*b* values were calculated for the incisal (I), middle (M) and cervical (C) third of each target tooth. ΔEab* and ΔE00 total color differences were computed between different tooth areas and adjacent teeth, and evaluated according to the perceptibility (PT) and acceptability (AT) thresholds for dentistry. Non-perceptible color differences were found between UCIs and ULIs. Mean color differences between UCI and ULI exceeded AT (ΔEab* = 7.39-7.42; ΔE00 = 5.71-5.74) in all cases. Large chromatic variations between I, M and C areas of the same tooth were registered (ΔEab* = 5.01-6.07 and ΔE00 = 4.07-5.03; ΔEab* = 5.80-8.16 and ΔE00 = 4.37-5.15; and ΔEab* = 5.42-5.92 and ΔE00 = 3.87-4.16 between C and M, C and I and M and I, respectively). The use of a hyperspectral camera has proven to be a reliable and effective method for color evaluation of in-vivo natural teeth.

Applications of artificial intelligence in dentistry: A comprehensive review

OBJECTIVE

To perform a comprehensive review of the use of artificial intelligence (AI) and machine learning (ML) in dentistry, providing the community with a broad insight on the different advances that these technologies and tools have produced, paying special attention to the area of esthetic dentistry and color research.

MATERIALS AND METHODS

The comprehensive review was conducted in MEDLINE/PubMed, Web of Science, and Scopus databases, for papers published in English language in the last 20 years.

RESULTS

Out of 3871 eligible papers, 120 were included for final appraisal. Study methodologies included deep learning (DL; n = 76), fuzzy logic (FL; n = 12), and other ML techniques (n = 32), which were mainly applied to disease identification, image segmentation, image correction, and biomimetic color analysis and modeling.

CONCLUSIONS

The insight provided by the present work has reported outstanding results in the design of high-performance decision support systems for the aforementioned areas. The future of digital dentistry goes through the design of integrated approaches providing personalized treatments to patients. In addition, esthetic dentistry can benefit from those advances by developing models allowing a complete characterization of tooth color, enhancing the accuracy of dental restorations.

CLINICAL SIGNIFICANCE

The use of AI and ML has an increasing impact on the dental profession and is complementing the development of digital technologies and tools, with a wide application in treatment planning and esthetic dentistry procedures.

The effects of thickness and shade on translucency parameters of contemporary, esthetic dental ceramics

OBJECTIVE

To analyze translucency variations among four different contemporary esthetic ceramic systems having different shades and thicknesses.

MATERIAL AND METHODS

Ceramic specimens having different shades and translucencies were tested: leucite reinforced glass-ceramic (ECAD), conventional feldspathic ceramic (Noritake), zirconia reinforced lithium silicate glass-ceramic (Suprinity) and hybrid ceramic (Enamic). Specimens of 0.6, 0.9, 1.2, 1.5 and 2.0-mm thickness (n = 3/group, 615 total) were prepared. Translucency (TP) and Relative Translucency (RTP) Parameters were calculated from spectroradiometric color readings. Effects of shade and thickness for a given system were statistically analyzed using MANOVA and Tukey post-hoc multiple comparisons tests. Translucency variations were assessed comparatively with literature-based perceptibility and acceptability thresholds.

RESULTS

TP/RTP values of all ceramic materials decreased with increasing thickness. The most translucent specimens were 0.6-mm thick ECAD HT-A3.5 (TP = 31.99) and ECAD HT-C2 (RTP = 23.75), while the least translucent was 2-mm thick Enamic T-3 M2 (TP = 7.27; RTP = 4.79). Thickness and material type significantly influenced translucency (p < 0.001). Noritake and ECAD LT showed similar translucency values, as well as Suprinity HT and ECAD LT.

CONCLUSIONS

For ceramic restorations thicker than 0.9-mm, any thickness increase of 0.3-0.5 mm produces a perceptible but clinically acceptable translucency variation. Increases in thickness larger than 0.6-mm will result in an unacceptable translucency shift. Dental practitioners need to recognize key factors that influence translucency of ceramic restorations in order to choose the optimal material, shade, translucency, and thickness suitable for different clinical scenarios. While shade plays a minor role in translucency variation, ceramic type and restoration thickness significantly affect overall translucency.

Color compatibility between dental structures and three different types of ceramic systems

BACKGROUND

To assess color compatibility between dental structures (human enamel and dentine) and three different types of ceramic systems.

METHODS

Samples (1 and 2 mm-thick) of extracted tooth (containing dentine and enamel areas) and three ceramic systems with different shades and opacities (HT-High Translucent, T-Translucent) were prepared for this study: Vita Suprinity-VS (HT, T; A1, A2, A3, A3.5, B2, C2, D2) (Vita Zahnfabrik); Vita Enamic-VE (HT, T; 1M1, 1M2, 2M2, 3M2) (Vita Zahnfabrik) and Noritake Super Porcelain EX-3-NKT (A1, A2, A3, A3.5, B2, C2, D2) (Kuraray Noritake Dental). Reflectance measurements of all samples were performed over black backgrounds using a non-contact spectroradiometer (SpectraScan PR-670, Photo Research) under a CIE 45°/0° geometry. CIE L*a*b* color parameters were measured and CIELAB/CIEDE2000 color differences (ΔE₀₀/ΔE^*_ab) and corresponding Coverage Error (CE) of ceramic system for dentine or enamel samples were calculated. Color data was analyzed using one-way ANOVA and post-hoc multiple comparisons tests. CE values were interpreted by comparisons with available 50:50% acceptability color threshold (AT) for dentistry.

RESULTS

Statistically significant differences in lightness were found among all ceramic systems and human dentine (p < 0.001), while no significant differences were registered between enamel and VSHT, T and VEHT. 1 mm dentine showed no statistical differences with VST and VSHT for a* coordinate, while 2 mm dentine showed no significant differences (p > 0.05) with VEHT. Thin samples (1 mm) of dentine and enamel showed significant statistical differences (p < 0.05) for b* coordinate with less translucent materials (NKT, VET and VST). For dentine samples, none of the ceramic materials provided a CE lower than AT. VSHT provided the best CE for 1 mm-thick (CE₀₀ = 1.7, CE_ab = 1.9) and for 2 mm-thick (CE₀₀ = 2.3; CE_ab = 2.5) enamel samples.

CONCLUSIONS

Color coordinates of evaluated esthetic ceramic systems were statistically different from those of human dentine in almost all cases. The evaluated ZrO₂ lithium silicate glass-ceramic (VS), with its two levels of translucency, provided lower CE values with human enamel samples while conventional feldspathic ceramic (NKT) and hybrid ceramic systems (VE) demonstrated a better color compatibility with dentin samples.

Impact of short-term dental dehydration on in-vivo dental color and whiteness

OBJECTIVE

To determine in-vivo chromatic and whiteness changes produced by short-term dental dehydration.

METHODS

Spectral reflectance of 452 upper incisors (226 centrals and 226 laterals) of 113 participants were measured using a spectroradiometer at baseline and after short-term dehydration (minutes 2, 4, 6, 8 and 10). CIE L*a*b* color coordinates (L*, a*, b*, C*_ab and h_ab) and whiteness index for dentistry (WI_D) were calculated. Color differences (ΔE₀₀, ΔE_ab^*) and whiteness differences (ΔWI_D) were computed and interpreted based on their respective 50:50% perceptibility (PT) and acceptability thresholds (AT). Statistical analysis was performed using the related samples Wilcoxon signed-rank test.

RESULTS

L* showed an increasing trend with dehydration, while a*, b*, C*_ab and h_ab have a decreasing tendency. All chromatic coordinates showed statistically significant differences (p < 0.003) at each interval of dehydration compared with baseline, except a* for all teeth. For ΔE₀₀ and ΔE_ab^* values were higher than PT after 2 min of teeth dehydration and higher than AT after 6 and 8 min, respectively. The percentage of teeth exceeding corresponding PT was higher than 50% after 2 min. WI_D index increased with dehydration time, while whiteness differences were clinically perceptible after 4 min. Statistically significant differences were found for WI_D between all dehydration intervals (except 8-10 min). The percentage of teeth exceeding whiteness PT was higher than 50% after 6 min of teeth dehydration.

CONCLUSIONS

Short-term dental dehydration produces clinically unacceptable changes in tooth color and clinically perceptible increase in tooth whiteness level.

CLINICAL SIGNIFICANCE

Clinical shade matching must be done within the first two minutes of any clinical procedure that requires precise chromatic determination but implies a risk of tooth dehydration.

Color, lightness, chroma, hue, and translucency adjustment potential of resin composites using CIEDE2000 color difference formula

OBJECTIVE

To evaluate color, lightness, chroma, hue, and translucency adjustment potential of resin composites using CIEDE2000 color difference formula.

METHODS

Three resin composites (Filtek Universal, Harmonize, and Omnichroma) were tested. Two types of specimens were prepared: an outer base shade with an inner hole filled with test shades and single-composite specimens of all shades. Spectrorradiometric reflectances measurements and subsequent CIELAB color coordinates and translucency parameter (TP) were performed. Color (CAP₀₀ ), lightness, chroma, hue, and translucency (TAP₀₀ ) adjustment potential using CIEDE2000 color difference were computed. Color and transparency differences among composite materials and shades were statistically tested (P < 0.05).

RESULTS

Positive CAP₀₀ and TAP₀₀ values were found for majority of tested materials. CAP₀₀ values ranged from -0.14 to 0.89, with the highest values found for Omnichroma (>0.75 in all cases). TAP₀₀ values ranged from -0.06 to 0.86 with significant translucency differences among dual and single specimens. Omnichroma exhibited the highest adjustment potential for all color dimensions studied.

CONCLUSIONS

Lightness, hue, chroma, and translucency adjustment potential have been introduced using CIEDE2000 color difference formula, and have shown their usefulness to evaluate blending effect in dentistry. Color coordinates and translucency adjustment potential were dependent on dental material. Omnichroma exhibited the most pronounced blending effect.

CLINICAL SIGNIFICANCE

Resin composites with increased color and translucency adjustment may simplify shade selection, making this process easier and less time consuming. Furthermore, these materials might facilitate challenging and complex color matching situations.

Gingival shade guides: Colorimetric and spectral modeling

OBJECTIVE

To design colorimetric and spectral models of gingival shade guides that adequately represent the color of human gingiva.

MATERIALS AND METHODS

A previously compiled database on the spectral reflectance of healthy keratinized gingiva was used for optimization. Coverage Error (CE) and Maximal Error (ME) were optimized using CIELAB and CIEDE2000 color difference formulas. A two-phase process included an FCM algorithm and a nonlinear optimization. A t test was used to compare the performance of the different numbers of clusters/tabs in gingival shade guide models (α = .05).

RESULTS

CIELAB CE and ME for shade guide models with 3 to 6 clusters ranged from 3.1 to 3.9 (P = .028 for 3 vs. 4; and P = .033 for 5 vs. 6 cluster/tab comparison), while the corresponding CIEDE2000 range was from 2.1 to 2.8 (P < .001 for 3 vs. 4 tabs; P < .025 for 4 vs. 5; and P = 0.029 for 5 vs. 6 tab comparisons). The percentage of data points exhibiting a CIELAB color difference lower than the acceptability threshold ranged from 48.7% to 71.4%, and from 52.9% to 82.4%. for CIEDE2000.

CONCLUSIONS

An increase in the number of clusters in the gingival shade guide models was associated with a decrease in coverage error (better match) to human gingiva. Gingival shade guide models with only 4 tabs provided a CIELAB and CIEDE2000 coverage error lower than the acceptability threshold for gingival color. Spectral clustering of human gingiva was determined to be valid. CIEDE2000 color difference formula outperformed the CIELAB formula in the optimization process.

CLINICAL SIGNIFICANCE

Providing a shade guide model with a small number of tabs and a coverage error lower than the 50:50% acceptability threshold would be an optimal solution for shade matching in dentistry. However, no actual gingival or tooth shade guide complies with this. The clustering method, with optimization of both Coverage Error and Maximal Error and spectral clustering that enables more reliable color formulation of cluster representatives of shade guide models, represents an advance when it comes to computer modeling in dentistry.

Influence of Bleaching and Aging Procedures on Color and Whiteness of Dental Composites

Bleaching can cause perceptible color changes on resin-based composite (RBC) restorations that may not be stable with aging. The objective of this study was to evaluate color stability and whiteness variations of RBCs after bleaching and aging procedures. Discs (10 mm in diameter and 1 mm thick) of shades A2 and A3 were fabricated from two RBCs (Filtek Z250 and Filtek Z350 XT) and divided into three subgroups (for each composite and shade) (n=5) as follows: control (no bleaching), at-home bleaching, and in-office bleaching. All specimens underwent an accelerated artificial aging up to 450 KJ/m2 and 900 KJ/m2 in an aging chamber (Suntest XXL+). A spectroradiometer (SpectraScan PR-670) was used to obtain CIE L*a*b* coordinates. CIEDE2000 color difference (ΔE00) and whiteness index for dentistry (WID) were used to evaluate color stability. Color and whiteness differences data were analyzed considering the 50:50% visual color difference thresholds (perceptibility [PT] and acceptability [AT]) and 50:50% whiteness thresholds (whiteness perceptibility [WPT] and whiteness acceptability [WAT]). Analysis of variance and Tukey tests (α=0.05) were used to statistically analyze the data. After bleaching, all specimens showed ΔE00 and ΔWID values below their corresponding acceptability thresholds (AT and WAT, respectively). After aging, L* and WID values decreased while b* values increased (p≤0.05), resulting in ΔE00 and ΔWID values above AT and WAT, respectively. Color changes after bleaching RBCs were clinically acceptable, while aging provoked clinically perceptible color changes.

Recent Advances in Color and Whiteness Evaluations in Dentistry

Background:

The final goal of color measurement or shade specification in dentistry is the reproduction by prosthetic materials of all important appearance characteristics of natural oral structures. The application of color science in dentistry is an objective way to measure and evaluate such structures and dental materials in clinical practice and dental research.

Methods:

Literature on color science was reviewed to present new metrics to evaluate color differences of dental materials and dental structures. Visual acceptability and perceptibility values of color differences are reviewed and new whiteness indexes to describe whiteness in dentistry are presented.

Results:

In the last decade, the CIELAB 50:50% perceptibility and acceptability thresholds were set to 1.2 and 2.7, respectively, and the CIEDE2000 50:50% perceptibility and acceptability thresholds were set to 0.8 and 1.8. The CIEDE2000 color-difference formula became increasingly popular in dentistry. Developments in color science have led to the description of tooth whiteness and changes in tooth whiteness based on whiteness indexes, with the most relevant being the WID whiteness index, which is a customized index based in CIELAB color space.

Conclusion:

The application of color science in dentistry has allowed the precise description of tooth color and whiteness. The revised and new CIEDE2000 color-difference formula is expected to fully replace the outdated CIELAB formula in almost all dental applications. Recent psychophysical studies have reported values of visual thresholds and new whiteness indexes, which can serve as quality control tools to guide the selection of esthetic dental materials, evaluate clinical performance, and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization.

Acceptability and perceptibility thresholds in dentistry: A comprehensive review of clinical and research applications

OBJECTIVE

The objective was to provide a literature review on perceptibility and acceptability thresholds in dentistry and corresponding recommendations.

OVERVIEW

A literature review on visual thresholds included findings on the judgments of the color and appearance of tooth-, gingiva- and skin-colored restorative dental materials. Discrepancies in study design contributed to inconsistencies in the research findings of some studies. These differences are related to (a) number of observers and inclusion criteria, (b) specimen number and size, (c) color measurement instrument and the setup and formulas used, (d) psychophysical experiment, (e) data processing (fitting method), and (f) % perceptibility or % acceptability values. A straightforward, consistent and practical model for the clinical and research application and interpretation of visual thresholds and recommended protocols for threshold research were provided.

CONCLUSIONS

Visual thresholds are of paramount importance as a quality control tool and guide the evaluation and selection of dental materials and their clinical performance. Although clinical shade matching conditions and method are rarely controlled, research on visual thresholds, especially when aiming to set standards for the profession, must be carefully planned and executed.

CLINICAL SIGNIFICANCE

Perceptibility and acceptability thresholds define visual match or mismatch of color, translucency, and whiteness in dentistry. Clinical and research findings cannot be fully interpreted in terms of real-life relevance without comparison with perceptibility and acceptability tolerances.

Whiteness difference thresholds in dentistry

OBJECTIVE

To determine the visual whiteness thresholds for esthetic dentistry using the whiteness index for dentistry based on CIELAB color space (WI_D).

METHODS

A total of 60 observers (Dentists and Laypersons; n=30) from three research sites participated in the study. A psychophysical experiment based on visual assessments of simulated images of teeth on a calibrated display was performed. Images of simulated upper central incisors (SUCI) were consecutively displayed in pairs (60) and the whiteness of each SUCI pair was compared. WI_D was used to calculate the visual thresholds (WPT- perceptibility threshold; and WAT- acceptability threshold) with 95% confidence intervals (CI) and a Takagi-Sugeno-Kang (TSK) Fuzzy Approximation model was used as fitting procedure. Data was statistical analyzed using paired t-test (α=0.05).

RESULTS

WPT and WAT were 0.72 (CI: 0.0-2.69; r²=0.52) and 2.62 (CI: 0.2-7+; r²=0.57) WI_D units, respectively. Significant differences (p<0.05) were found between WPT and WAT, and between dentist (WPT=0.46WI_D units; WAT=2.20 WI_D units) and layperson (WPT=0.94 WI_D units; WAT=2.95 WI_D units).

SIGNIFICANCE

The visual whiteness difference thresholds determined with WI_D index can serve as reference values for research and manufacturing of dental materials, and for clinical practice situations such as assessing the effectiveness of bleaching treatments.

Color Range and Color Distribution of Healthy Human Gingiva: a Prospective Clinical Study

The aim of this study is to compile a comprehensive database on color range and color distribution of healthy human gingiva by age, gender and ethnicity. Spectral reflection of keratinized gingiva at upper central incisors was measured by spectroradiometer and converted into CIELAB values. Lightness range (ΔL*) for all groups together was 26.8. Corresponding a* (green-red) and b* (blue-yellow) ranges (Δa* and Δb*) were 18.3 and 13.0. Significant differences (p < 0.05) were recorded by age for L* and a* coordinates, by gender for b* coordinate, and by ethnicity for L*, a* and b* coordinates. R(2)-values between color coordinates were 0.01 (L*/a*), 0.03 (L*/b*), and 0.12 (a*/b*). The smallest color differences were recorded between age groups 46-60 and 60 + (ΔE* = 0.9), and between Caucasians and Hispanics (ΔE* = 1.1). Color difference by gender was 1.3. When total L*a*b* ranges were divided into four equal segments, 51.7% of subjects had L* value within the third segment (from lightest to darkest), 47.1% had a* value within the third segment (from less red to redder), and 59.3% had b* value within the second segment (from less yellow to yellower). It was found that ethnicity and age had statistically significant influence on the color of human gingiva.

Predictive algorithms for determination of reflectance data from quantity of pigments within experimental dental resin composites

Background

Being able to estimate (predict) the final spectrum of reflectance of a biomaterial, especially when the final color and appearance are fundamental for their clinical success (as is the case of dental resin composites), could be a very useful tool for the industrial development of these type of materials. The main objective of this study was the development of predictive models which enable the determination of the reflectance spectrum of experimental dental resin composites based on type and quantity of pigments used in their chemical formulation.

Methods

49 types of experimental dental resin composites were formulated as a mixture of organic matrix, inorganic filler, photo activator and other components in minor quantities (accelerator, inhibitor, fluorescent agent and 4 types of pigments). Spectral reflectance of all samples were measured, before and after artificial chromatic aging, using a spectroradiometer. A Multiple Nonlinear Regression Model (MNLR) was used to predict the values of the Reflectance Factors values in the visible range (380 nm-780 nm), before and after aging, from % Pigment (%P1, %P2, %P3 and %P4) within the formulation.

Results

The average value of the prediction error of the model was 3.46% (SD: 1.82) across all wavelengths for samples before aging and 3.54% (SD: 1.17) for samples after aging. The differences found between the predicted and measured values of the chromatic coordinates are smaller than the acceptability threshold and, in some cases, are even below the perceptibility threshold.

Conclusions

Within the framework of this pilot study, the nonlinear predictive models developed allow the prediction, with a high degree of accuracy, of the reflectance spectrum of the experimental dental resin composites.

Optical behavior of dental zirconia and dentin analyzed by Kubelka-Munk theory

OBJECTIVES

To use the Kubelka-Munk theory to evaluate the scattering (S), absorption (K) and transmittance (T) of non-colored and colored dental zirconia systems and human (HD) and bovine (BD) dentins.

METHODS

Two zirconia systems were used: ZC- ZirCAD (Ivoclar Vivadent) and LV-LAVA (3M ESPE). Specimens from each ceramic system were divided into 3 groups (n=5): ZC1 and LV1 (non-colored); ZC2 and LV2 colored to shade A1, and ZC3 and LV3 colored to shade A3. Five human and bovine anterior teeth were flattened and polished through 1200 grit SiC paper to expose the superficial buccal dentin. All samples were prepared to a final thickness of 0.5 mm. Diffuse reflectance was measured against white and black backgrounds, using a spectroradiometer in a viewing booth with D65 illuminant and d/0° geometry. S and K coefficients and T were calculated using Kubelka-Munk's equations. Data was statistically analyzed using Kruskal-Wallis, Mann-Whitney tests, and VAF coefficient.

RESULTS

Spectral distributions of S, K and T were wavelength dependent. The spectral behavior of S and T was similar to HD (VAF≥96.80), even though they were statistically different (p≤0.05). The spectral behavior of K was also similar to HD, except for LV1 (VAF=38.62), yet all ceramics were statistically different from HD (p≤0.05). HD and BD showed similar values of S and T (p>0.05).

SIGNIFICANCE

The dental professional should consider the optical behavior differences between the zirconia systems evaluated and the human dentin to achieve optimal esthetics in restorative dentistry.

Digital image analysis method to assess the performance of conventional and self-limiting concepts in dentine caries removal

OBJECTIVE

To assess dentine caries removal effectiveness (CRE) and minimal invasiveness potential (MIP) of carbide and polymer burs.

METHODS

Sectioned carious molars were photographed. Digital images were taken, before and after caries removal, using a Digital Single Lens Reflex camera. The following regions of interest were measured using visual criteria: Residual Infected Dentine (RI), Residual Affected Dentine (RA), Removal Sound Dentine (RA), Prepared Cavity (PC) and Removed Sound Dentine (RS). CRE was determined on basis of: relative residual infected dentine (RI/II), relative residual carious-affected dentine (RA/IA) and total relative residual dentine (RI+RA/II-IA). MIP was determined on basis of: infected dentine cavity size (PC/II), total relative cavity size (PC/II+IA), and corrected relative cavity size (PC-RS/II+IA).

RESULTS

The polymer bur showed the highest preservation of carious-affected dentine after excavation, when the RA/IA ratio was studied. Both kind of burs showed similar values after assessing the RI/II and RI+RA/II-IA ratios. The infected dentine relative cavity size (PC/II) was higher when the carbide bur was used. Both burs attained similar PC/II+IA and PC-RS/II+IA ratios.

CONCLUSIONS

Polymer burs accomplished the concept of minimal-invasive dentistry, showing its self-limiting ability. The minimal-invasiveness potential showed that carbide burs resulted in the worst compromise between effective and selective infected-caries removal.

Influence of surface roughness on the color of dental-resin composites

This study deals with the influence of surface roughness on the color of resin composites. Ten resin composites (microfilled, hybrid, and microhybrid) were each polished with 500-grit, 1200-grit, 2000-grit, and 4000-grit SiC papers. The roughness parameter (R(a)) was measured using a Plμ confocal microscope, and field-emission scanning electron microscope (Fe-SEM) images were used to investigate filler morphology. Color was measured using a spectroradiometer and a D65 standard illuminant (geometry diffuse/0° specular component excluded (SCE) mode). Surface roughness decreased with grit number and was not influenced by filler size or size distribution. A significant influence of R(a) on lightness (L*) was found. Lightness increased with decreases in roughness, except for specimens that underwent polishing procedure 4 (PP4; 500-grit, 1200-grit, 2000-grit, and 4000-grit SiC papers consecutively). Generally, it was found that surface roughness influenced the color of resin composites. The composites that underwent PP1 (500-grit SiC paper) exhibited significant differences in chroma (C*), hue (h°), and lightness (L*) compared to composites that underwent PP3 (500-grit, 1200-grit, and 2000-grit SiC papers consecutively) and PP4. Color difference (∆E*) between the polishing procedures was within acceptability thresholds in dentistry.

Investigating a novel nanostructured fibrin-agarose biomaterial for human cornea tissue engineering: rheological properties

In this work, the rheological properties of the biomaterial fibrin with different agarose concentrations, used for the generation of a bioengineered human corneal stroma by tissue engineering, before and after using a nanostructuring technique, were analyzed. The transparency of these artificial human stromas was also investigated. The temporal evaluation of the properties of these biomaterials is essential for the design of functional biological human corneal replacements. The nanostructuring technique used for the generation of nanostructured corneal constructs (NCCs) had a major influence on the rheological properties of the fibrin-agarose corneal equivalents. For an oscillatory shear stress of 1 Hz, well in the order of the natural oscillations of the human cornea, the NCCs had viscoelasticity values higher than those of non-nanostructured corneal constructs (N-NCCs), but similar to those of an ex vivo native cornea. The model that most resembled the rheological behavior of the native cornea was a fibrin-0.1% agarose concentration nanostructured construct. In addition, this artificial cornea model displayed optimal levels of transparency, similar to the native tissue. All these properties indicate that the fibrin-0.1% agarose concentration nanostructured construct might serve as an adequate candidate for the generation of an artificial complete cornea, not only for transplanting use but also for conducting pharmaceutical testing and biomedical research.