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Fundamentals of Color: Shade Matching and
Communication in Esthetic Dentistry
Editorial Reviews
From Book News, Inc.
Illustrated throughout with high-quality clinical
photographs, this guide for dental professionals explains the basic science and
art of color as it applies to the shade matching process. It also describes the
many clinical elements that can affect t he perception of color and outlines the
processes of conventional and technology-based shade matching. A number of
clinical cases are included in the appendix. In addition to maintaining a
private practice, Chu teaches aesthetic dentistry at New York
University.Copyright © 2004 Book News, Inc., Portland, OR
Table of Contents:
Foreword vii
Preface ix
Chapter 1 Color Theory 1
The Physics of Color
Color Reproduction
Color in Dentistry
Chapter 2 Elements Affecting Color 19
Illumination
Contrast Effects
Viewer-Associated Effects
Restorative Materials Selection
Chapter 3 Conventional Shade Matching 51
Step-by-Step Process
Shade Guide Systems
Recommended Protocol
Special Considerations for Direct Composites
Chapter 4 Technology-Based Shade Matching 77
Development of Technological Shade Systems
Measurement Systems
Types of Technological Shade Systems
Step-by-Step Process
Recommended Protocol
Chapter 5 Recommended Shade-Matching Protocol 101
Seven Steps to a Successful Shade Match
Appendix: Clinical Cases 117
Single Anterior All-Ceramic (Procera) Crown
Single Anterior All-Ceramic (In-Ceram) Crown
Single Anterior Implant-Supported Metal-Ceramic Crown
Single Anterior Ceramic Laminate Veneer
Two Anterior All-Ceramic Crowns
Two Anterior All-Ceramic Crowns with One Anterior Metal-Ceramic Crown
Four Anterior Ceramic Laminate Veneers
Single Posterior All-Ceramic Crown
Ten Ceramic Laminate Veneers to Match Bleached Teeth
Two Anterior Direct Composite Restorations
Index 155
Foreword:
In the span of my dental career, dentistry has made spectacular improvements in
mimicking the natural colors of teeth with restorative materials. In the early
1960s, metal ceramics presented exciting new possibilities for tooth colors, as
well as soft tissue response, longevity, and esthetics. In general, clinicians
have had little understanding about color, and even less has been taught.
Several contemporary clinicians contributed enormously to our knowledge of the
art and science of color. There was Bruce Clark in the 1930s and then Robert C.
Sproull, Jack D. Preston, and Stephen F. Bergen in the 1970s.
John W. McLean, a giant in the dental profession, introduced us to high-strength
all-porcelain restorations with aluminous porcelain in 1965. The bar was raised
for color in dental porcelain. Artistic laboratory technicians made immense
progress with internal colors and the management of opacity and translucency. By
the 1990s, adhesive dentistry, composites, and myriad all-ceramic materials gave
us the artistic capacity to reproduce the colors and light response of natural
teeth.
The authors of this text, Stephen J. Chu, Alessandro Devigus, and Adam J.
Mieleszko, have made an outstanding contribution to the practice and theory of
color management in contemporary dentistry. Updating is a way of life, and the
flood of new materials and techniques makes this text all the more valuable to
students, general practitioners, and specialists. A concise introduction to
color theory and how it applies to dentistry is followed by important
information about elements affecting color to aid the clinician and technician
with problem solving. Special attention has been given to shade matching with a
step-by-step protocol. Direct composites and layering techniques receive careful
attention. In particular, the chapter on digitized shade-matching technology
provides the reader with valuable insight into color measurement technology and
its applications for laboratories and patients. Finally, an extensive
presentation of clinical cases from single anterior crowns and composites to
multiple anterior restorations is used to illustrate the full extent of the
text.
It should be noted that the science of color in dentistry always requires skill
by the user. In particular, there is a lack of standards in the production of
dental ceramic frits. The variables of hue, value, chroma, and translucency from
batch to batch and between companies require unusual artistic skills from
ceramists to produce prescriptive shades. Perfect shade measurement will not
produce comparable shade matching unless realistic standards are established by
manufacturers. In the meantime, we need to be especially empathetic to dental
laboratories until the science and art of color in dentistry come together.
The authors have produced a text that fulfills a genuine need on shade matching
and communication. I found it to be a refreshing approach to color and am
especially privileged to write this foreword.
Lloyd L. Miller, DMD
Clinical Professor
Graduate and Postgraduate Prosthodontics
Tufts University School of Dental Medicine
Boston, MA
Preface:
The study of color is an integral part of esthetic dentistry. If the color of a
restoration is off—even slightly—the mistake can be glaringly evident; it looks
fake, and the patient is unhappy. Obviously, this is an undesirable result.
Unfortunately, color is also tricky. Slight variances in shade play with our
eyes, our minds, and, ultimately, our dentistry. The illumination in the dental
treatment room, optical illusions, color blindness, nutrition, and fatigue are
among the dental professional’s ongoing obstacles to successful shade matching.
It is necessary to understand these challenges and the basic mechanisms of color
in order to achieve consistent esthetic shade results. However, most of the
dental literature on color theory does not further the reader’s understanding;
rather, it further compounds the complexity. Moreover, color education seems to
be absent within the dental school curriculum. What is needed is a resource that
distills all the data and breaks down the abstract science of color into the
essential details. This text was written to simplify the study of color and help
readers quantify and communicate shade easily and accurately.
Fundamentals of Color first explains the basics of color theory, then
illuminates the factors that can affect the perception of color. Next, the
recommended protocol for conventional and technology-based shade matching are
detailed separately. Finally, an approach combining both methods is outlined in
chapter 5, providing the reader with a technique that almost ensures an accurate
shade match the first time, every time. Throughout the text, there are hints and
tips to enhance the reader’s comprehension and clinical results. Also included
is an appendix describing clinical cases in which the recommended protocol was
followed to achieve esthetic and predictable results.
This book is intended for anyone seeking to gain a better understanding of the
complexities of shade matching, advance their esthetic dentistry skills, and
increase the natural quality of their restorative work. Although we are all
health care providers first, we are also artists. With a good working knowledge
of color, your artistry will become as natural as your dentistry.
Without the support, dedication, and passion of many people, this book would not
have been possible.
First, we would like to thank the people at X-Rite, Inc: Mike Ferrara, Tom
Nyenhuis, Kevin Aamodt, Jim Overbeck, and Shannon Gary, who greatly contributed
to our knowledge in the field of color science. We would also like to recognize
Dustin Ewing from MHT Optic Research for explaining the use of the SpectroShade
system. Thanks to Dr William Devisio and Bernal Stewart from Colgate-Palmolive
Co for the present and future collaborative clinical research projects in the
area of vital bleaching. To the Heraeus-Kulzer-Jelenko Co, especially Gerrit
Steen, Chris Holden, Dr Mark Pitel, and Dennis Fraioli, thank you for providing
the beautiful synthetic ceramic material used in the case restorations. We would
also like to recognize Steve Wright, from Lanmark Group, who helped distill our
thoughts and ideas in the writing of this body of knowledge. Special thanks to
the staff of Quintessence Publishing Co, who made this book into a reality.
We would also like to thank Dr Irfan Ahmad, whose contributions not only to this
book but also to the specialties of fixed prosthodontics, esthetic dentistry,
and dental photography have been an inspiration to practitioners globally. We
are indebted to Dr Didier Dietschi, whose research in direct restorative
composite materials has set the standards in resin composite color science, and
his colleagues, Dr Stephano Ardu and Ivo Krejci, for the direct restorative case
report they contributed to this book. Our appreciation also goes to Drs Stefan
Paul and Ed McLaren, whose previous and ongoing studies in the field of
technology-based color systems have considerably increased our knowledge base.
We would also like to thank Giordano Lombardi, CDT, whose technical skills,
techniques, and working relationship have solidified the highest standard of
excellence in the area of esthetic restorative dentistry in Switzerland.
Special thanks to Dr Galip Gürel (Istanbul, Turkey), whose textbook on ceramic
laminate veneers opened our eyes to the world of cosmetic restorative dentistry
and color. Thanks also to Assistant Dean Kendall Beachman and Dr Dennis Tarnow
at New York University College of Dentistry for their motivation and
inspiration. Finally, our appreciation goes to Jason Kim, CDT, for imparting his
knowledge and skill in the arena of color and translucency.
Stephen J. Chu, DMD, MSD, CDT, MDT
Director, Advanced and International CDE Programs in Aesthetic Dentistry
Clinical Associate Professor
Department of Implant Dentistry
Division of Reconstructive and Prosthodontic Sciences
New York University College of Dentistry
New York, New York
Alessandro Devigus, Dr med dent
Private Practice
Bülach, Switzerland
Adam J. Mieleszko, CDT
Ceramist
New York, New York
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