Judgments of appearance matching by means of the visual criteria established by the United States Public Health Service (USPHS) and by means of an extended visual rating scale were determined for composite resin veneer restorations and their comparison teeth. Using a colorimeter of 45 degrees/0 degrees geometry and the CIELAB color order system we used the color of the restorations and comparison teeth to calculate a color difference for every visual rating. Statistically significant relationships were found between each of the two visual rating systems and the color differences. The average CIELAB color difference of those ratings judged a match by the USPHS criteria was found to be 3.7. However, the overlap in ranges of the color differences for those comparisons rated matches and mismatches indicates the importance of other factors in appearance matching, such as translucency and the effects of other surrounding visual stimuli. The extended visual rating scale offers no advantages to the more broadly defined criteria established by the USPHS.

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The purposes of this study were to evaluate the CIELAB, CMC (2:1), and CMC (1:1) formulas to identify which provides the best indicator for acceptability of small color differences in the esthetic dental restorative materials, to determine if different groups of observers have different levels of acceptability, and to estimate the color difference that would indicate acceptability between a restoration and an adjacent tooth. The subject population of human observers was divided into four groups, each containing 12 subjects. The composition of the groups were: Group 1, dental auxiliaries and hygienists; Group 2, dentists; Group 3, dental materials scientists; and Group 4, patients. A color vision screening test was administered to each subject to ensure that only observers with normal color vision were evaluated. A composite resin color discrimination test was developed specifically for this study. This test was composed of six sets of discs fabricated from dental composite resin restorative materials. Each set consisted of one standard disc representing tooth color. In each set, six discs representing composite resin restorations were matched to the standard disc for a total of 36 pairings in the test. Color differences between the standard discs and the restoration discs were calculated in CIELAB, CMC (1:1), and CMC (2:1) color units. The subjects were asked to evaluate the composite resin materials as to acceptability of color differences between the disc pairs. The data were analyzed by logistic regression analysis for each observer and by each ⌬E formula to generate receiver operating characteristics (ROC) curves. The areas under these ROC curves were calculated and ranked. ANOVA and Tukey's Studentized Range (HSD) Test were applied to the ranks. In regard to the acceptance of dental restorations based solely on color difference, the CMC (1:1) color difference formula gave better correlation than the CIELAB formula for small color differences in the esthetic dental restorative materials. There were significant differences found between the experiment groups in regard to acceptability of color differences using the CMC (1:1) and CIELAB formulas. The dental hygienist/auxiliaries group proved to be more discriminating in accepting differences between tooth and composite resin restorative material color than patients. The mean 50:50 ⌬E replacement points for all subjects were 2.29 and 2.72 color units for the CMC (1:1) and CIELAB formulas, respectively.

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The selection of an appropriate material that duplicates the appearance of natural tooth structure is very important in restorative dentistry. Photometric and colorimetric analysis techniques offer great potential as a tool for aiding in the duplication process. The degree to which these techniques will be useful depends on the accuracy and precision with which they can be applied to translucent as well as opaque surfaces. The purpose of this investigation was to evaluate the performance of three currently-available photometric devices. The performance capabilities of the instruments were tested on various shades of opaque and translucent dental porcelain surfaces. The performance tests were designed for evaluation of the accuracy and precision of the instrument relative to a well-studied reference instrument. CIELAB color difference metrics were used for the performance analysis. The results revealed that each of the photometric instruments evaluated was capable of producing color measurements with precision. However, the degree of accuracy with which the color measurements were made varied depending on the instrument used and the type of material surface being measured. A photo-electric tristimulus colorimeter showed the best overall performance on the porcelain surfaces, supporting its use as a valuable tool for evaluating color in dentistry.

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