ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Digital Shade-Matching Systems Have Not Been Shown to Be More or Less Accurate or Precise Than Chair Side Visualization
Clinical Question Will a patient being treated with indirect dental restorations receive a more reproducible color match with a digital shade-matching system or with a clinician's chair side judgement using shade guide tabs?
Clinical Bottom Line There is a small improvement in the precision and accuracy of recording tooth color with a digital spectrophotometer when compared to direct visualization techniques. According to one recent systematic review, a spectrophotometer is the most accurate method, but digital shade-matching systems should serve as an adjunct to chair side visualization.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23034418Chen/201226 StudiesSystematic Review
Key resultsStudy heterogeneity prevented a statistical meta-analysis. 26 studies met inclusion criteria. 12 of 17 studies presenting data on precision reported results from spectrophotometric measurement, 9 of these 12 showed higher precision with spectrophotometers. 8 studies presented data on accuracy and all 3 that reported results from spectrophotometric measurement showed the greatest accuracy with spectrophotometers.
#2) 21830176Witkowski/201215 teethCase Series
Key resultsThere were no statistically significant differences between examiners or illumination conditions with regards to shade selection using a spectrophotometer. This demonstrates its reliability and precision.
Evidence Search (digital matching) AND ((tooth shade) NOT whitening)
Comments on
The Evidence
A lot of the evidence for this technology is industry-guided and does not present results for accuracy and precision in comparison to an appropriate gold standard. Some attempts were made in some studies to use these digital systems as the gold standard in order to more easily standardize a baseline. Chen et al. explained this downfall in the available literature but also clearly outline what standards should be evaluated in future studies – technology type, not brand, with respect to their precision and accuracy. Precision in this case is significantly easier to quantify (as evidenced by the Witkowski study) than accuracy, as the later is subjective. The Chen review should be used to guide further studies and, while it draws on 26 articles for a “systematic review”, its conclusions should be applied cautiously at this time.
Applicability The use of digital shade-match systems may be a helpful adjunct in recording tooth color and communicating with the laboratory, however, the technology is not universally applicable at this time and should not be used in place of careful visual evaluation.
Specialty/Discipline (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Tooth Shade, Spectrophotometer, Colorimeter
ID# 2528
Date of submission: 08/01/2013spacer
E-mail lambem@uthscsa.edu
Author E. Matthew Lamb
Co-author(s) Shiva Toghyani
Co-author(s) e-mail toghyani@uthscsa.edu
Faculty mentor/Co-author
Faculty mentor/Co-author e-mail
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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