A comparison between visual, intraoral scanner, and spectrophotometer shade matching: A clinical study
Abstract
Statement of problem
Visual
 shade matching is subjective and a cause of concern for clinicians. 
Different measurement devices have been developed to assist in tooth 
color selection and to achieve better esthetic results. However, 
consensus is lacking as to which method of tooth shade selection 
provides more predictable results.
Purpose
The
 purpose of this clinical study was to compare the reliability of 
different visual and instrumental methods for dental shade matching.
Material and methods
Visual
 shade matching was performed by 3 experienced clinicians using 2 
different shade guides (VITA Classical A1-D4 and VITA Toothguide 
3D-MASTER with 29 tabs; VITA Zahnfabrik) with and without the aid of a 
light-correcting device (Smile Lite; Smile Line). An intraoral scanner 
(TRIOS; 3Shape A/S) and a spectrophotometer (VITA Easyshade Advance 4.0;
 VITA Zahnfabrik) were also used for color shade matching. The 
instrumental methods were repeated 3 times to determine repeatability. 
Shade-matching sessions for each method were performed under controlled 
lighting on the middle third of the maxillary right central incisor of 
28 participants. The Fleiss' kappa statistical test was used to assess 
the reliability of each method. The weighted kappa statistical test was 
used to assess the agreement between the shades matched by different 
methods (α=.05).
Results
Instrumental
 methods were more accurate than visual methods. The best performance 
was found for the intraoral scanner configured for the 3D-MASTER scale 
(Fleiss' kappa value of .874) and for the spectrophotometer configured 
for the VITA Classical scale (Fleiss' kappa value of .805). The best 
visual shade-matching method was the VITA Classical scale associated 
with the light-correcting device (Fleiss' kappa value of .322). The 
Classical scale without the light-correcting device showed the poorest 
reliability (Fleiss' kappa value of .177) (P<.05).
Conclusions
Instrumental methods for color shade matching were more reliable than the visual methods tested.

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