Assessment of Tooth Shade After De- and Re-Hydration During Clinical Restorative Procedures

April 15, 2020 updated by: Sameh Abou-steit, Cairo University

Assessment of Tooth Shade After De- and Re-Hydration During Clinical Restorative Procedures (A Randomized Clinical Trial)

The aim of this study was to investigate any change in tooth color resulting from dehydration resulted from rubber dam application and the time required for any change to return to baseline and to investigate the nature of change and areas of the teeth most affected.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

Architecturally speaking, a smile comprises 60% of the weight of our face. Subconsciously, a smile has a visual impact on people appearance. Also statistically reveal that people place a high value on their smiles according to the American academy of cosmetic dentistry survey (AACD)2017. As the population becomes increasingly aware of the role teeth play in appearance, patients' expectations of aesthetics in contemporary dentistry are ever increasing. So practicing esthetic dentistry that is defined as reproducing natural looking teeth by creating perfect esthetic restorations has been for long time a strict challenge due to many materials' limitations impacting either shade integration or surface quality, and possibly colour stability.

Tooth colour was the main reason for patient dissatisfaction in a survey concerned with esthetic appearance.(1) Thus accurate shade measurement together with proper communication of tooth colour is integral to a successful aesthetic outcome.(2) It is compulsory that clinicians understand the light interaction with tooth structures as well as the proper histo-anatomic principles for a better material and shade selection during direct and indirect restorative procedures. Tooth structures form a complex optical medium for light as it passes through enamel, dentino-enamel complex and dentin in terms of gradient between transparency (complete transmission of light) and opacification (complete reflection of light).(3)Furthermore, this behavior changes over the years, as tissues change in morphology and composition. Comprehension of dynamic aging of tooth structures is a key for success when selecting the proper value and chromaticity for restorative materials.(4,5) Thus clinicians and technicians should have sufficient training in tooth shade selection. For achieving excellent esthetic outcomes there are four main contributing variables: Dynamic Light Interaction, Histo-anatomical Features, Smilography and the 9 Elements of visual synthesis.(3) In the modern dental practice, restoring the optical features of the intact tooth presents a challenging task, due to the inherent translucent nature of enamel, the dentinoenamel complex (DEC) and dentin. Translucent materials offer a significant color measurement challenge since they interact with light in a far more complex manner than most other materials. The old traditional visual estimation approaches that solely employ the Munsell color model system based on hue, chroma, and value (H/C/V) dominating the dental market appear to be insufficient when assigning the relevant information among the dental team members (clinician/technician/patient).(6) In 1931 The Commission Internationale de l'Eclairage (CIE) defined a standard light source, developed a standard observer and enabled the calculation of tri-stimulus x, y, z values, which represent how the human visual system responds to a given colour and allows us to transform spectral energy data into meaningful colour data. It should be noted that the DE in the L*a*b* colour space indicates the degree of colour difference not the direction of the colour difference. It is frequently interpreted in dental literature that a DE of 1 is the 50:50 perceptibility threshold. The hues of natural teeth tend to be in the yellow to yelloworange range, determined mainly by the colour of dentine, with enamel playing only a minor role through scattering at wavelengths in the blue range.(7) Instruments for clinical shade matching include spectrophotometers, colourimeters and digital imaging systems.(8) It has been reported that VITA Easyshade has to be the most reliable instrument in both in vitro and in vivo circumstances.(2) It has been reported that dehydration of teeth can make them appear whiter by increasing enamel opacity when examined by The Easyshade as the light can no longer scatter from hydroxyapatite crystal to crystal.(6,10,11)The resulted loss of translucency on dehydration therefore causes more reflection masking the color of the underlying dentine and thus appears lighter. Russell et al.(12) applied a rubber dam to the anterior teeth of seven subjects and allowed the teeth to dehydrate for 15 min that was measured using a spectrophotometer and further three spectrophotometric measurements were taken at 10 min intervals after removal of rubber dam and tooth rehydration. It was noticed that tooth colour had become lighter and less saturated after dehydration and the colour of the teeth returned to their baseline values 20 min after removal of the rubber dam. Most dental procedures cause some dehydration of teeth.(13-16) It is recommended to record the shade of teeth at the begining of the appointment but there is insufficient evidence in the dental literature to support it.(14) Color mismatch between restoration and natural teeth is a common complaint resulting in remake of restorations and increased expense.(2) As most dental procedures lead to dehydration of teeth which can alter their shade and may lead to errors in shade matching. And in order to avoid unacceptable mismatch of color between natural teeth and dental restoration, it is important that the shade matching procedure is carried out at the beginning of the appointment. Thus the aim of this study was to investigate any change in tooth color resulting from dehydration resulted from rubber dam application and the time required for any change to return to baseline and to investigate the nature of change and areas of the teeth most affected.

Study Type

Interventional

Enrollment (Anticipated)

10

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Cairo, Egypt, 11553
        • Recruiting
        • Faculty of Dentistry, Cairo Univerity
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 53 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients with unrestored intact maxillary central incisors with no tooth bleaching performed during the previous year.

Exclusion Criteria:

  • Presence of any restorations or fixed orthodontic appliance or any fixed retainers on central incisors

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Dehydration
Procedure: Dehydration
Dehydration of the natural tooth by tooth isolation
Experimental: Rehydration
Procedure: Rehydration
Rehydration

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical spectrophotometric assessment of tooth shade change
Time Frame: 10, 30, 40 and 60 minutes
Using Easyshade V clinical spectrophotometer
10, 30, 40 and 60 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cairo University

Investigators

  • Study Director: Ahmed El Zohairy, PhD, Head of Operative department

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

April 15, 2020

Primary Completion (Anticipated)

June 1, 2020

Study Completion (Anticipated)

June 1, 2020

Study Registration Dates

First Submitted

April 9, 2020

First Submitted That Met QC Criteria

April 15, 2020

First Posted (Actual)

April 16, 2020

Study Record Updates

Last Update Posted (Actual)

April 16, 2020

Last Update Submitted That Met QC Criteria

April 15, 2020

Last Verified

April 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • CEBD-2020-4-040

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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