The role of a REFLECTYS customised shade guide

THE ROLE OF A REFLECTYS CUSTOMISED SHADE GUIDE IN PRODUCING A SUCCESSFUL ANTERIOR COMPOSITE

Shade selection is a daily challenge for the dental practitioner. It is an important, if not decisive, stage responsible for the final aesthetic result of a restoration. At present, we aim to follow the Vitapan Classical shade guide, which represents the gold standard, as closely as possible. In this context, our aims were:

- firstly, to propose a customised shade guide for the Reflectys (ITENA Clinical) collection studied;
- secondly, to study the correlation between the different shades of composite resin obtained and the Vitapan Classical shade guide. This enabled us to present the enamel-dentine combinations resulting from this correlation and thus offer combinations that any practitioner could use. To illustrate this approach, we present a clinical case with reference to the combinations of the customised Reflectys (ITENA Clinical) shade guide used.

Colour selection in the dental surgery is a crucial stage in producing a successful composite resin restoration. We often speak of tooth shade matching. But given the three-dimensional nature of colour described by Munsell [1-3] and the various dimensions shown on the Vanini chromatic chart [4, 5], it is clear that this term is too limited to fully cover the task [6].

We should therefore speak of matching the colour of a tooth rather than its shade. This stage is generally carried out using shade guides, and thus becomes “operatordependent”. In addition, the stage is influenced by the background, which is responsible for its reproducibility and translation.

Further still, there is no universal agreement on standard shade matching techniques. Dental practitioners in fact refer to shade guides on a daily basis without ensuring they are familiar with the resin collection they are using. Furthermore, the tooth to be restored has two different aspects - enamel and dentine - but the shade guide does not show the combination of the two. Most dental surgeries use the Vitapan Classical shade guide for colour selection. This is the gold standard for colour selection. In this context, we experienced the following issues:

• We use the Vitapan Classical shade guide, in ceramic. The materials matched to it are not therefore of the same kind. We wanted to restore the tooth (enamel-dentine) with composite resin by matching that of the ceramics.
• At present, there is no reliable and reproducible correlation between the Vita shade guide and the (enamel-dentine) masses used in specific composite resin collections, except for the 3M matches developed by Style Italiano, which are specific to the Z350 resin.

Understanding and better capturing colour is by no means easy. How is it possible to use a simplified methodology to translate a perception of colour, which is a subjective physical sensation, into reliable and reproducible scientific data? How can we make colour matching a reproducible and predictable stage?
The aim of this article is to:

- propose a customised shade guide created from different (enamel-dentine) combinations for the Reflectys composite resin collection produced by ITENA Clinical;

- identify any correlation between this customised shade guide and the Vitapan Classical guide (tables 1 to 3, fig. 1);

- suggest (if there is any correlation) combinations of enamel-dentine shades for the collection studied;

- illustrate, using a clinical case, the stages of an anterior layering restoration using the combinations produced for the customised Reflectys shade guide as a basis for colour selection.