Colour

Mohd Waseem Ahmed

 Color is something which makes an object more appealing, attractive and gives pleasure of observation
Color plays an important part in our lives, in visual experience, in art, as a metaphor for emotions- philosophical reflection

 Media-driven-emphasis on appearance and esthetic standard Smile: one the most important interactive communication skills of a person

You are never fully dressed without a smile Martin Charnin

 Aesthetic dentistry: create beautiful smile, with teeth of pleasing inherent proportions to one another, and pleasing tooth arrangement in harmony with gingiva, lips and face of patient
Surface form, translucency and Color 1931 Clark: we arent qualified to solve the problem of color

 The phenomenon of color is a psychophysical response to the physical interaction of light energy with an object, and the subjective experience of an individual observer
The property of a surface or substance due to the absorption of certain light rays and reflection of others within the range of wavelengths adequate to excite retinal receptors

Visible electromagnetic energy whose wavelength is measured in nanometers (nm)

Perception

Theories of color vision

Trichromatic theory

Opponent process theory

Trichromatic theory

Young and Helmholtz

Opponent-Process theory
Herring postulated 3 independent receptor types

The 3 classes of receptors were each assumed to be composed of a pair opponent color processes A white-black, green-red, blue-yellow receptor these three pairs produced all sort of combination of colors

 That for each of these 3 pairs , there occur three type of chemical in the retina in which two type of chemical reactions exist Adv- Explains the afterimage effect

 As eyes scan a scene- rapid and continuous change in chromatic sensitivity

Three phenomenon come into play Successive contrast

Simultaneous contrast
Color constancy

 Successive contrast: projection of negative after image occurs after staring at a colored object Effect of previously-viewed color fields ("inducing fields") on the appearance of the currently-viewed test field

 Simultaneous contrast: instantaneous change in chromatic sensitivity

characterized by a change in appearance of hue due to surrounding colors The more an object contrasts with its surrounds, the more visible it becomes

 A color is perceived to be brighter if it is surrounded by a complementary color or lighter if the background color is darker

 Color constancy:
Occurs coz we think of objects themselves as being colored Object seems to be of same color even if light received by eye changes

Color vision confusion

Commonly referred as Color blindness

Affects 8% males and 2% females

Two categories Genetic

Acquired

 Genetic Absence of cone type(s) Shift in spectral sensitivity

Loss of color-difference signals

Individuals suffer from reduction/absence of discrimination of reddish-greenish/bluishyellowish contents of color

 Acquired Color vision confusion

Emotion affects papillary diameter With aging comes a yellowing of cornea that affects blue and purple discrimination

 Diseases

Drugs

Diabetes Glaucoma Leukemia Addison disease Pernicious anemia Sickle cell anemia Multiple sclerosis Parkinson disease Liver disease Alcoholism

Analgesics Antibiotics Antihypertensives Sildenafil citrate Oral contraceptives

Optical properties of light

Color organization and specification

Color is 3 dimension in nature

Possible to pin point specific color in corrdinate system Various specification systems available, depends on field of person involved

1905 1916 1947 1955 1968 1962

Munsell System Ostwald System OSA-UCS DIN System Natural Color System (NCS) Coloroid Color System

 In dentistry
Munsell system Commission Internationale de lEclairage(CIE) l*a*b system

Munsell system
System of choice coz Worldwide recognition Consistency Flexibility Simplicity

 The 3 color attributes are

Hue: attribute of color by which it is recognized Chroma: depth of purity, commonly referred as saturation Value: luminous dimension(lightness)

 Color tree is a representation of the tridimensional organization of colors

 A colorless or achromatic axis extends through the center of the cylinder, pure white at the top, pure black at the bottom. A series of grays, progressing from black to white in equal visual steps, connects these extremities Colors (Hues) are arranged around this axis, and within each Hue, the colors are arranged in scales according to their lightness/darkness (Value) and their purity or strength (Chroma).

 Colors are purest on the outer skin of the cylinder, and they become progressively grayer as they approach the gray Value axis

Dimensions of color
Hue - it is that quality by which we distinguish one color family from another, as red from yellow, green from blue or purple. Each Hue is subdivided into ten segments, equally spaced visually (by psychologic criteria) from each other.

 To refer to a Hue in the Munsell system, the initials are used: R for red, YR for yellow-red, Y for yellow

 VALUE -is that quality by which we distinguish a light color from a dark color, Related to the achromatic (colorless) polar axis going through the Munsell color solid Infinite number of gradations of gray is possible Only nine Value (gray) steps are used in the Munsell system

 The black of the Value scale is assigned a Value of zero, the white a Value of 10

 Chroma-is that quality by which we distinguish a strong color from a weak one; the departure of a color sensation from that of white or gray The intensity of a distinctive Hue; color intensity. Chroma describes the amount of Hue in a color.

Low Chroma

High Chroma

Identification of color
The over-all format in common usage is

H V/C.
The H is preceded by a number to indicate the precise subdivision of the Hue. /12 Eg: 1 PB

 Most widely used color specification system By Commission Internationale de lEclairage (International Commission on Illumination) In 1931, refined 1976 Defines 3 essential components for perceiving a color illuminant , object and observer

 Defined a standard light source Developed a standard observer Enabled calculation of tristumulus values

TRISTIMULUS VALUES The Tristimulus Values of a color are the amounts of three primary colors in a threecomponent additive color model needed to match that test color. The tristimulus values are most often given in the CIE 1931 color space, in which they are denoted X, Y, and Z. 1976 CIE defined a color space(CIE lab)

 The CIE Lab colour space represents a uniform colour space Equal distances corresponding to equal perceived colour differences

 3 axes are L* a* and b* L* value is a measure of the lightness of an object Perfect black L*- zero & perfect reflecting diffuser L*- 100 a* value is a measure of redness (positive a*) or greenness (negative a*) b* value is a measure of yellowness (positive b* ) or blueness(negative b*)

Visual shade-matching environment

Light source is critically important Traditional natural daylight as the best color matching source Controlled lighting sources in dental operatory and lab should be balanced Spectrum visible range 380-780 nm, and color temperature 5500C and Color rendering Index >90

Types of light
Incandescent Light

Fluorescent Light
Natural Daylight
Most dental offices are outfitted with incandescent and fluorescent lights

Incandescent light
Emits high concentration of yellow waves Not suitable for shade matching Low Color Rendering Index (CRI)

Fluorescent light
Emits high concentration of blue waves Not suitable for shade matching CRI =(50-80)

Natural daylight
Northern daylight considered the best Closest to emitting the full spectrum of white light Used as the standard by which to judge other light sources CRI close to 100

Color rendering index

Defn: Quantitative measure of the ability of a light source to reproduce the color of various objects faithfully in comparison with an ideal or natural light source Light sources with a high CRI are desirable

 CRI = (0-100) Northern daylight (hence CRI) can be affected by

Time of day Cloud cover Humidity Pollution

CRI and time of day

Morning and evening

Shorter wavelengths scatter before penetrating atmosphere Daylight rich in yellow/orange, lacks blue/green

 Mid-day Hours around noon = ideal Incident daylight is most balanced within VLS Full spectrum of colors visible

Color temperature
Another light source reference standard Related to the color standard black body when heated Reported in degrees Kelvin (K)
1000K red 2000K yellow 5555K white 6500K northern daylight 8000K pale blue

Dependent on four factors which influence CRI

For the operatory.

Traditional recommendations for ambient lighting: 200 to 300 footcandles in operatory and 300 footcandles in dental lab 3:1 task to ambient light recommended Hand held devices Shade Wand(Aunthentic Products, SA, Texas) Hand Held(Greatlekeslighting, Bay City,Michigan) Shademat Visual- recently introduced

 Operatory should ve high Munsell Value and low Chroma Pastels and neutral grays- walls, staff clothing and pt drape

Practical guidelines
Pt- upright position with mouth at dentists eye level Lipstick removed, neutral pt drape Teeth silghtly apart and tongue retracted Shade tab be in same pane as the tooth Selection done before any intraoral procedure

 Value dimension selected first If trouble regarding hue-refer natural canine Second observer- 3 ft behind primary observer

Other optical properties

Transparency, Translucency & Opacity Related to Optical Absorption and Scattering Transparent- both nil Translucent- both low Opaque- either one or both high

 Gloss - angular selectivity of reflectance, involving surface reflected light, responsible for the degree to which reflected highlights or images of objects may be seen as superimposed on a surface.

OPALASCENCE A type of dichromism seen in highly dispersed systems with little opacity. The material appears yellowish-red in transmitted light and blue in the scattered light perpendicular to the transmitted light.. Eg: by adding a few droplets of milk to a glass of water: the milk looks bluish. If one looks through the milk at a light source, it looks yellowish-red.

IRIDESCENCE (goniochromism) property of certain surfaces which appear to change color as the angle of view changes. Eg: soap bubble

 caused by multiple reflections from multilayered, semi-transparent surfaces in which phase shift and interference of the reflections modulates the incident light (by amplifying or attenuating some frequencies more than others).

 FLUORESCENCE - is the emission of electromagnetic radiation by a substance that has absorbed radiation of a different wavelength. In most cases, absorption of light of a certain wavelength induces the emission of light with a larger wavelength (and lower energy).

 PHOSPHORESCENCE Unlike fluorescence, a phosphorescent material does not immediately re-emit the radiation it absorbs. absorbed radiation may be re-emitted at a lower intensity for up to several hours

Optical properties of human teeth

General considerations
The color of teeth is strongly determined by the dentin, enamel -translucent -plays a lesser role through scattering at wavelengths in the blue range. light scattering in dentin - by tubules, in enamel - by hydroxyapatite crystals

 The apparent color of the tooth - result of the reflectance from the dentin modified by the absorption, scattering, and thickness of the enamel-

 At the outermost incisal and proximal edges of teeth, the layer of enamel is backed only by its own curved surface; because of the interfacial reflection caused by the change in index of refraction this surface acts as a condensing mirror focused on the dentin

 Slightly more central to the tooth yet still near the incisal or proximal edges, translucent enamel may appear dark, because the effective backing is now the darkness within the oral cavity.

 Tooth surfaces are small and curved, which makes intraoral tooth color measurements complicated. The effects of surrounding tissues (gingival and perioral tissues) and background (oral cavity) further complicate these measurements

 Differences in tooth color occur between people, among teeth in same person and within same tooth. Color best represented by its middle third Lighter in women, less chromatic, less reddish Darker & more reddish with age Central incisors are the lightest

Other factors
Translucency More in enamel than dentin

 Opalescence associated with fine grained hydroxyapatite crystals light blue gray appearance at incisal edges/ occlusal surfaces, when viewed under reflected or ambient lighting In transmitted light, overall shade is reddish orange

Fluorescence Associated with organic components of dentin Bluish white fluorescence at 365 nm. Manufacturers use fluorophores (component of a molecule which causes a molecule to be fluorescent), like rare earths, to simulate this

 Phosphorescence due to tryptophan residues in enamel protein

 Color matching Visual Instrumental

Visual
Shade guides/color standards shade matching tools Types Tooth color standards (dental) color standards for oral soft tissues (gingival) color standards for facial prostheses (facial Ceramic Resin

Requirements of Shade guide

a logical arrangement in color space and an adequate distribution in color space. sufficient data points to fill the total volume. A shade guide based on the Munsell Color Order System could fulfill these requirements.

Brief history By Clark shade guide consisting of 60 ceramic tabs divided into 19 lightness levels, 6 chroma levels, and 3 hue levels.

 By Hall consisted of 27 ceramic tabs, 3 groups according to lightness level (Light, Medium, Dark). Each group consisted of 9 tabs, arranged according to chroma vertically (Weak, Medium, Strong) according to hue horizontally (Yellow, Central, Red) principles were later applied in the Vitapan 3D Master

Ceramic made guides

Vitapan Classical shade guide ( Vident, Calif) Vitapan 3-D Master Chromascop (Ivoclar Vivadent, NY) Vintage Halo ( Shofu Dental, Calif)

Resin made
It is always beneficial to use a shade guide made of the corresponding restorative material. Made of Single-layer or Multilayer resins Sometimes, the manufacturer provides a "recipe," based on the primarily chosen shade Esthet X ( Dentsply Caulk) Venus (Heraeus Kulzer) Tetric Cream (Ivoclar Vivadent, NY)

Vitapan classical shade guide

Gold standard tabs are divided into four groups, primary group division based on hue

group A reddish-brown, group B is reddish-yellow, group C is gray, group D is reddish-gray.

Red/Yellow

Yellow

Grey

Grey Red/Yellow

 Within the groups, tab arrangement is based on increasing chroma the more chromatic tabs are marked with higher numbers. Group A consists of five tabs (Al, A2, A3, A3.5, A4); groups B and C consist of four tabs each (Bl, B2, B3, B4 and CI, C2, C3, C4, respectively); and group D consists of three tabs (D2, D3, D4).

 The manufacturer also provides an alternative tab arrangement, claimed to be established according to degree of brightness (value scale) with no group division B1,A1, B2, D2, A2, C1, C2, D4, A3, D3, B3, A3.5, B4, C3, A4, C4.

Vitapan 3-D Master

26 tabs divided into 5 groups according to lightness Within the groups, tabs arranged according to chroma (vertically) & hue (horizontally). The first group consists of 2 tabs; the second, third, and fourth groups have 7 tabs each; and the fifth group consists of 3tabs.

 Tabs are marked in the following manner:

1M 2 The numbers (1, 2, 3, 4, 5) in front of the letters indicate group number & lightness level (lower number corresponds to higher lightness). The number below the group number designates chroma level (1, 1.5, 2, 2.5, 3) (the more chromatic tabs have higher numbers).

 The letter M designates the middle hue in each group, whereas the letters L and R designate greener (or yellowish) (Left) and redder (Right) tabs, respectively, as compared with the M tab. Three bleaching shades were additionally introduced (so 29 tabs in total) (0M1, 0M2, and 0M3;), high lightness (0), three levels of chroma (1, 2, 3), and medium hue (M).

VITA Linearguide 3-D Master

 Contains the same 29 shade samples as the Vita 3D-Master. Arranged linearly.

Inadequacies of shade guides

1. Range does not cover the entire color range of natural teeth; darker shades as well as shades belonging to the yellow-red part of the spectra are missing. 2. Color transitions from gingival to incisal third and from mesial to distal third do not correspond to natural teeth.

3. Tabs are not evenly arranged in the color solid; color difference between neighboring tabs is unequal.

Vita Classic

Vita 3-D master

4. Shade choice is sometimes narrow. 5. Color of resin shade tabs is not stable, especially if kept in some disinfectants. 6. Morphologic and optical characteristics of upper central incisors are not adequate for shade matching of all teeth, especially posteriors; separate color standards, with tabs resembling first premolar, are recommended for posterior region.

7. Tab arrangement and divisions into groups result in an unsatisfactory and sometimes confusing arrangement of the shade guide as a whole. 8. Tabs do not match restorative material: ceramic shade guides are made of glass porcelain 9. Tab root portion is highly chromatic, which could be a misleading factor in shade matching, hence need to be ground off

Not all of these faults apply to all shade guides. They have resulted in production of different custom shade guides and improvement of existing ones

Light Sources Color matching conditions

should be diffuse and comfortable to the eyes, allowing observers to perceive color accurately and comfortably. should be compatible with, or preferably the same, light source as in the dental laboratory daylight was initially thought to be the ideal light source for color matching now not recommended due to its inconstant color characteristics.

Quality of light source

Factors- CCT, SPD & CRI A Full-Spectrum Light Source, ( with color temperature close to 5500 K (D 65) & spectrally balanced throughout the visible spectrum) should be used. Defined as equivalent to daylight in Washington DC in the month of June, during hours of 12:00 noon to 1:00 pm, when there is a slightly overcast sky; CRI- 90 or more.

Quantity of Light Source

Adequate intensity of the ambient lighting in the dental operatory provides the dentist with visual comfort. According to one study, the recommended lighting intensity for the dental operatory is 200 to 300 fc, the ratio of Task Lighting to Ambient Light should not exceed 3:1; too high an illuminance level affects discrimination of small color differences.

 Optilume Trueshade (Optident, UK)

Features 0/45 Lighting Geometry conforming with

colour measurement standard eliminating specular reflections

 Color Corrected Light: emits light with a constant color temperature of 5500K Intensity of the light can be reduced for the accurate assessment of the value and the micro and macro morphology, whilst maintaining the required 5500K colour temperature.

 Because of possible occurrence of metamerism, the choice should be verified under different light sources and from different angles. Sometimes the patient's profession or the ambient conditions in which he or she spends most of the time may be important in choosing the light source to be used for shade matching.

Color Matching Environment

The ambient and direct lighting used for color matching scatters and reflects from surfaces before reaching the structure that it illuminates. To maintain the necessary lighting quality for color matching, the chroma of the environment should be carefully controlled.

 Recommendations Walls, staff & patient clothing have Munsell chroma value of 4 or less ( corresponds to pastel or neutral gray tones) Ceiling have a Munsell value of 9. Walls, cabinets etc.. have a Munsell value of 7 or more

Color Matching Method

Preliminary Procedures
Patients should be asked to remove anything that could distract the attention of the shade matching person (e.g., large jewelry, lipstick, eyeglasses, heavy rouge, facial makeup) before shade matching. Teeth whose color is to be matched should be cleaned beforehand to remove plaque & stains

 Tinted eyeglasses or contact lenses should not be worn during shade matching; colored lenses act as a filter and could affect color perception.

When???
At the beginning of the appointment Preparation of the tooth could cause accumulation of a debris layer on its surface The dentist's eyes get fatigued during the appointment Tooth dehydration could occur during the appointment because of the long time spent with the mouth open. This results in alteration of tooth lightness and chroma; more than 24 hours is needed to regain normal tooth coloration

Dentist's Position
A tooth should be viewed along its normal axis (the line of sight perpendicular to the surface), using a diffuse light source. The dentist's eyes should be on the level of the patient's tooth A working distance of 25 to 33 cm should be maintained.(lesser for young) With an angle of view of not less than 2 degree

Tab Placement
Parallel to the tooth whose shade is being matched, with the same relative edge position

 If possible in the same plane, not in front (appear lighter) not behind (appear darker)

 Tab carrier, especially if metal, should be along its normal axis

Time length & pauses

First impression, frequently the best match Trials should be limited to 5 seconds Stare at grey in between trials, not blue (afterimage effect)

Methods
Dimension by dimension method Method suggested by Rade D Paravina

Dimension by Dimension
HUE CHROMA VALUE Vitapan Classical, Ivoclar Chromascop CHROMA HUE VALUE Vintage Halo VALUE CHROMA HUE Vitapan 3D Master

Vita Classic Step 1 (Hue Selection)

Four categories representing hue
A, yellow-red B, yellow C, gray D, red-yellow-gray

Operator should select hue closest to that of natural tooth Use area of tooth highest in chroma for hue selection
Difficult to select hue for teeth low in chroma

Vita Classic Step 2 (Chroma Selection)

Hue selection has been made (B) Chroma is selected from gradations within the B tabs
B1, B2, B3, B4

Several comparisons should be made

Avoid retinal fatigue Rest eyes between comparisons (blue-gray)

Vita Classic Step 3 (Value Selection)

Use of second, value ordered shade guide is recommended Value oriented shade guide
B1, A1, B2, D2, A2, C1, C2, D4, A3, D3, B3, A3.5, B4, C3, A4, C4,

Value best determined by squinting with comparisons made at arms length

Decreases light Diminishes cone sensitivity, increases rod sensitivity Tooth fading first has a lower value

Vita Classic Step 4 (Final Check / Revision)

Potential Problem
Following value selection, tabs selected for hue and chroma may not coincide with shade tab selected for value

Vita Classic Step 4 (Final Check / Revision)

Possible Findings / Solutions
Value of shade tab < natural teeth
Select new shade tab with higher value Cannot increase value of restoration with extrinsic staining Will only increase opacity, light transmisison

Value of shade tab > natural teeth

Select new shade tab with lower value (or) Bridge difference with intrinsic or extrinsic staining

Vitapan 3-D Master

Step 1- Value determination

Hold shade guide to patients mouth at arms length Start with darkest group moving right to left Select Value group 1, 2, 3, 4, or 5

Step 2- Chroma selection

From your selected Value group, remove the middle tab (M) and spread the samples out like a fan Select one of the three shade samples to determine chroma

Step 3- Hue selection

Check whether the natural tooth is more yellowish or more reddish than the shade sample selected

Vita-3D Step 4
For more precise shade, intermediate levels for hue, value, and chroma can be given
2.5M2 = value between 2M2 and 3m2 3M1.5 = chroma between 3M1 and 3M2 3M2 / 3L2.5 = hue between 3M2 and 3L2.5

Modification
For more precise shade, intermediate levels for value, chroma, and hue can be given
2.5M2 = value between 2M2 and 3M2

 3M1.5 = chroma between 3M1 and 3M2

 3M2 / 3L2.5 = hue between 3M2 and 3L2.5

Intermediate values should be noted on the laboratory communication form

Disadvantages of Dimension by Dimension shade selection

Rade D Paravina states that, D by D method can be applied (besides some drawbacks) for tab arrangement, but shade selection is a totally different situation. Human eyes cannot perceive color dimensions separately. In color comparison, one does not perceive similarities but differences, which originate from the interaction of all color dimension differences and represented by their sum.

 Eg: if one knows that for a given set of samples, chroma is constant, but lightness and hue changes, it would be possible to arrange them D by D.

 Trying to discern color differences in individual color dimensions can confuse the observer.

Rade D Paravinas method

Suggests that the observer should reduce the number of potentially adequate tabs to between 2- 4 as quickly as possible by choosing tabs from same or different groups, separate them, Then choose the closest tab or combination of appropriate tabs.

 If there is no perfect match then choose a lighter or less chromatic tab, because it would be easier to do an extrinsic correction later.

Extended Range Shade Guides

Most shade guides do not cover all the colors in the natural dentition Some porcelain systems extend the typical range
Bleached shades

Dentin shades
Custom shade guides

Custom Shade Guide

Sometimes an exact match may be impossible. The extensive use of extrinsic surface staining has severe drawbacks. Extend the concept of a commercial shade guide with the creation of a custom shade guide. Infinite number of samples can be made by using different combinations of porcelain powders in varying distributions. very time consuming procedure limited to specialty practices.

Shade Mapping
Recommended even when good custom shade match exists Tooth is divided into
Three regions Nine segments

Each region is matched independently Further characterizations are sketched on diagram, may include
Craze lines Hypocalcifications Proximal discolorations Translucency

Matching other appearance attributes

Surface roughness, gloss & transluscency should be compared. If tab & tooth are not of same texture, both should be wetted with water. Any case do matching under both wet & dry conditions.

Instruments for color matching

Colorimeters Chromascan (Sterngold, Conn)- 1st color evaluation instrument specifically for dentistry. ShadeEye NCC Chromameter (Shofu Dental)

 Spectrophotometers Vita Easyshade (Vident, Canada)

measures a precise shade instantly and prescribes the best VITA shade under any lighting condition

 Digital imaging & spectrophotometry Spectroshade (MHT Optic research, Swiss) Most complex design, expensive

Color communication
Verbal & written instructions

 Custom made or modified shade tabs Images

taken perpendicular to ( highlights surface texture and geometric atrributes) and at an angle to the tooth.

Conclusion
A fine piece of art never goes unnoticed, but in dentistry, it should go unnoticed Creating a lifelike appearance in a restoration is certainly one of the most complex, challenging, and controversial tasks in dentistry. Even though unimportant in the physiological success of restoration, its the controlling factor in overall acceptance by the patient.

 Proper training is necessary for a proper color selection.

 Thank you