Dentaltown June 2018 - 99
There are a few factors that affect the final
restoration shade.
1. Appearance analyses indicate
substantial variation between same
shades from different brands. (Fig.
2). Different thickness of the same
composite may present differently in
shade and masking ability.
2. The underlying tooth reflects on the
composite and will affect the final
shade.
3. A gray appearance of the composite
can be caused by the projection of
darkness in the oral cavity.4
4. Light curing and polishing changes
the final shade and lowers the value
(varying by brand and shade).5-6
Here are five steps to overcome the
challenge of creating a natural-looking
restoration.
1: Keep it simple!
Spectrophotometry conf irms that
90 percent of patients will present with an
A hue. It is advised to reduce your composite
inventory and avoid having too many shades
in your armamentarium. The most common
shades are A1, A2, A3, A3.5, A4, B1, bleach
white and translucent.
2: Divide your composites
into roughly three groups.
Low-value composites (e.g., Clearfi l
Majesty Esthetic from Kuraray; Gaenial Universal Flow from GC America)
exhibit a light-diffusion property similar
to natural tooth structure, with excellent
tooth-blending properties. These composites
are recommended for small enamel fi xes,
Class V, and cases when maximum blending
with no masking is required. Using low-value
composites in thick layers may appear grayer
in appearance.
Medium-value composites (e.g., Venus
from Kulzer; Vit-l-escence from Ultradent)
are used in many aesthetic cases. When
applied in approx. 0.5mm thickness or
more, they can mask, and at the same time
incorporate, a "chameleon effect."
High-value composites (e.g., Amaris
from Voco; Gradia from GC America)
are used in a thin layer, present with high
opacity and masking capabilities, like in
cases where changing the underlying tooth
color is required with minimal composite
thickness, and without having to use opaques.
These are only suggestions, because one
brand can also incorporate all three groups
in its range.
Fig. 1
3: Be familiar with your
composites' shade capabilities.
It's advisable not to change composite
brands too often, as it takes time to get
familiar with each one's composite shade
and value characteristics.
4: Prepare individual shade guides.
When selecting a composite shade to
match a tooth, a common mistake is using
a ceramic shade guide that's fabricated
from materials that differ entirely from the
composites. Therefore, it is advised to create
an individual, custom-made composite shade
guide that will generate an accurate and
realistic representation of the composites on
Fig. 2: The same B1 shade
of composite from different
manufacturers will appear
different in shade and value.
dentaltown.com \\ JUNE 2018
99
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