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The Optical Characteristics of Natural Teeth

Understanding the properties of light and color will help communicate shade
prescriptions to the laboratory for optimal results.
By James Fondriest, DDS
Matching one or two artificial restorations to a highly characterized natural dentition
can be a challenging procedure for the dentist/technician team. The capability to
appraise and fully share the appropriate information from the operatory to a distant
laboratory can be greatly enhanced by learning the language of color and the optical
characteristics specific to teeth. It is difficult to duplicate nature in ceramics if the
clinician cannot describe or fully illustrate what he or she sees in the shade-matching
process. This article should give the reader a better understanding of how light
interacts with a natural tooth, and to give the dentist/technician team the nomenclature
to best describe it.

Hue
Synonyms for hue are color, cast, shade, tint, or tone. Hue is specified as the dominant
range of wavelengths in the visible spectrum that yields a perceived color (Figure 1).
Because hue is a biologic and psychological interpretation of the combination of the
wavelengths reflected back from an object to the observer, the exact wavelength of the
perceived color may not even be present.1 The lower the intensity of the hue, the
harder it is to distinguish.2 In this age of highly bleached teeth, where little color
exists, it is becoming less important to document the hue.

Chroma
Chroma is the measure of how much color is present. 2 When brown pigment is placed
into white powdered porcelain, the mixture takes on a brown hue. Each time more
brown pigment is added, the strength or saturation (chroma) of the brown color
increases but the mixture is still the same brown hue. As the powder becomes more
saturated with brown pigment, the mixture appears darker, so the increase in chroma
has a corresponding change in value. As chroma increases, the value decreases; they
are inversely related.3
The chroma of a natural tooth comes mainly from the dentin, and the thickness and
opacity of the overlying enamel determines how much chromatic influence the dentin
has.4 When the enamel is thin at the gingival third but thick incisally, a chroma
gradient is created. Increasing opacity of the enamel, as seen with dehydration and
bleaching, can exaggerate the chroma gradient.

Value
The words value and brightness are synonymous. Value is the sum total amount of
light that is returned from an illuminated object. Lowering value means diminished
light returns from the illuminated object; thus, more light is absorbed, scattered
elsewhere, or transmitted through and away from the object. Using porcelain with less
chroma and less translucency can increase a dental restorations brightness.
The characteristics of brightness and translucency work counter to each other. As
tooth bleaching becomes even more popular, dentistry will continue to search for
porcelain that is both bright and translucent. Choosing porcelains with higher
opalescence,5 optical density, and fluorescence will manifest brighter qualities.

Translucency
In the dental context, translucency can be described as the gradient between
transparent and opaque. Enamel and dentin have varying degrees of translucency.
Areas within a tooth or a restoration with higher translucency will have a lower value
because light transilluminates through and away from the viewer. When evaluating
enamel translucency, the observer will often focus on the opalescent blue areas
(Figure 2). Translucent enamel displays the characteristic of opalescence. Opalescence
causes tooth enamel to reflect blue light back to the observer. Blue light tends to
bend/refract more or to scatter within the enamel body. Longer red-yellow
wavelengths do not bend as much in the enamel; therefore, a higher percentage will
trans-illuminate the tooth. The blue accumulates within the enamel, giving it a bluish
appearance from a frontal view even though it is intrinsically colorless. 6-9

Opalescence
This optical phenomenon is named after the appearance of opals. Natural opals are
aqueous disilicates that break light down into its component spectrum of wavelengths
by refraction. Opals act like prisms and refract or bend different wavelengths to
varying degrees. Enamel has a primary mineral makeup of hydroxyapatite, which is
crystalline calcium phosphate. Hydroxyapatite crystals align in organized, tightly
packed masses to form prismatic enamel rods. 10 Refraction will occur as light passes
through each enamel rod and also at the internal (eg, cracks) and external surfaces of
the tooth. An example of an internal surface within a porcelain-bonded restoration is
the interface between a pressed coping and the superficial veneering porcelain. The
natural halo effect in teeth is a byproduct of opalescent bending of transilluminating
light at the lingualincisal external enamel surface (Figure 3). In dental ceramics, the
appearance of the tooth is successfully imitated as a sum of all its visual dimensions.
It is better to build restorations with porcelain with the same opalescent characteristics
as enamel rather than to create an artificial incisal halo, for example, with opaque
yellow stains.

Optical Density and Fiber-Optic Properties


When light enters a natural tooth it gets bounced around the enamel like a fiber-optic
cable. If one side of a tooth is illuminated with a curing light, the entire crown is lit.
When light travels from one translucent material to another, light will be either
reflected at the surface, or it will pass through the surface but bends (refracts) as it
passes. The more optically dense a translucent material is, the more light will enter
and stay within its body rather than transilluminating. Enamel is an optically dense
material bordered on either side by air or dentin, both with significantly lower optical
densities. For light to escape an optically dense material, such as enamel, the light
must hit the external surface at an incident angle close to perpendicular, otherwise it
will be reflected back into the enamel body. If the incident angle is not close enough
to perpendicular to escape, it is said to lack the critical angle of incidence to escape.
This means that any light rays closer to parallel to the external surface of the enamel
will not cross that surface, and will stay within and be completely reflected back
internally. This effect is exploited with fiber-optic cable, which confines the light
within the fibers. Light travels along the fiber, bouncing off the external walls.
Because the light must strike the external boundaries at an angle greater than the

critical angle to escape, once the light enters the fiber at a low angle virtually parallel
to its walls, it will travel down the fiber without leaking out. By increasing the optical
density of the ceramics used to build the enamel layer, the fiber-optic properties of
natural enamel can be replicated, resulting in a prosthetic crown that is brighter and
more translucent at the same time.

Optical Anisotrophy
The opalescent effects of enamel brighten the tooth and give it optical depth and
vitality.11 The property of opalescence will cause a tooth to appear to be one color
when light is reflected from it and another color when light is transmitted through
it.5 The more opalescent a tooth or porcelain is, the more anisotropic light qualities it
has. Optical anisotropy is the change of visual appearance depending on the angle of
view or the angle of illumination. An example of this can be seen in the change of
width, chroma, and hue of the incisal halo depending on the angles of illumination
(Figure 4).
A percentage of the red-yellows fail to escape the lingual surface of the tooth and can
be trapped by the fiber-optic properties of the enamel. This increases the anistropy of
the enamel. These longer wavelengths will travel around the circumference of the
tooth and can manifest themselves as an ever-changing light show at the incisal edge.
The anisotrophic properties of natural teeth will yield infinite opalescent optical
effects depending on ambient lighting conditions. What appears to be a good match in
static chairside photographs taken with a macro flash next to the lens and at the same
perpendicular buccal view will not necessarily match in the real world.

Metamerism
Metamerism is the unfortunate characteristic of restorations matching well in
operatory lighting or in photographs but then displaying differently when the patient
smiles in other light conditions.12 Perhaps you have matched clothing under one
lighting type and were shocked to find the mismatch under different lighting. One
object may have the ability to reflect more blue than another. However, if there is no
blue range in the lighting source, they will appear the same; then, when viewed under
a light source containing blue, the differences will appear. The perceived color
depends on the nature of the light source illuminating the object and what
wavelengths are reflected. The closer the sum is of the reflecting wavelengths of the
two materials to be matched, the more successful the color match will be. 13 Using
opaque surface stains to correct mismatches will increase metamerism. When
reconstructing the dentin and enamel layers with dental porcelain, selecting porcelains
with the same optical properties will minimize metamerism.

Fluorescence
Fluorescence might be categorized as a type of reflection by opaque material.
Fluorescence by definition is the absorption of light by a substance and the
spontaneous re-emission of lower-energy light of a longer wavelength. 14 Fluorescence
in a natural tooth occurs primarily in the dentin because of the higher amount of
organic material present.7,14-16 Ambient, non-visible, near-ultraviolet (UV) light is
absorbed and then fluoresced back as visible light primarily in the blue end of the
spectrum. Why this is noteworthy in dentistry is that the more the dentin fluoresces,
the higher the value of the tooth.17To increase the fluorescence in stacked dental

porcelains, opaque metallic-oxide powders with fluorescent qualities can be added to


increase the quantity of light returned back to the viewer, to block out discolorations,
and to decrease chroma.17 Unfortunately, these powders will reduce the perceived
translucency if not kept to the deeper dentin layers or to the coping. The porcelains
commonly used today all vary in their natural fluorescent qualities. Zirconium
exhibits little or no fluorescence.
The brightness of natural teeth changes significantly when illuminated with UV light,
which can have a dramatic affect on the level of perceived vitality exhibited by
porcelain restorations. Imagine how a crown made of porcelain with low fluorescent
qualities will stand out in bright sunlight.

Light Sources and Color Rendering


If a wavelength is not part of the ambient light spectrum, it is not there to reflect off
the tooth. To properly assess chroma and hue, a full-spectrum light source is needed.
Dental unit lights are commonly used for color rendering. Most are incandescent
lights that emit light high in the red-yellow spectrum and low at the blue end (Figure
5). The ambient light quality of the operatory must be maintained with artificial
lighting (natural light conditions vary). There are ceiling fluorescent bulbs that have
full color content and render color more accurately. The quality of ambient light is
commonly measured by the color temperature and the color-rendering index (CRI),
which measures the percentage of the near-UV and visible light spectrum that a light
emits. Any light source over 91 is adequate for dentistry. Quality SLR macro-flash
systems have excellent CRIs greater than 93, and are the best way to document color
to the laboratory. Ideally, both the dentist and the laboratory technician should have
balanced, full-spectrum lighting conditions. Color temperature is an inadequate
measure of light quality for shade rendering.

Surface Morphology
All teeth have surfaces with morphological variations. Surface morphology affects
how light will reflect. When light hits a surface perpendicular to your eyes, a
significant portion of that light can reflect back to your eyes. Anterior teeth have
surfaces perpendicular to a viewer; thus, these reflections have a significant influence
on appearance. The perceived shape, length, and width of an anterior tooth is
significantly influenced by the specular reflections coming off the heights of contour
of the buccal surfaces.17 Documenting the surface morphology of posterior teeth is of
less importance.

Surface Texture and Luster


The surface textures of maxillary incisors can be described as vertical, horizontal, and
varied.18 Vertical surface textures are primarily composed of the heights of contour of
the marginal ridges and the developmental lobes. Fine, transverse, wavelike grooves
called perichymata or the striae of retzius 16,19 create most of the horizontal textures.
These horizontal undulations never cross each other, and they go circumferentially
(Figure 6). These horizontal textures are formed on top of vertical textures, meaning
the horizontal patterns follow into the concavities formed by the vertical textures but
the vertical textures are not affected by the horizontal textures. The varied textures are
cracks, chips, and other surface aberrations or patterns such as orange peel (Figure
7).

At eruption, teeth have their roughest surface texture. A roughened surface texture
will not yield as well defined an image and will scatter the light. 20 With age, these
surface features gradually wear. As the wear process continues into the later years of
life, usually all signs of the perikymata are lost and even the definition of the
developmental lobes is obliterated (Figure 8).
Luster is often described as surface polish. Reducing the surface luster of window
glass by sand blasting will produce a frosty white look. As light hits the surface of the
roughened glass surface, it scatters or bends irregularly. This scattering of the light at
the surface causes an increase in opacity. The light does not pass the surface but is
reflected, causing an increase in brightness (Figure 9 through Figure 11). As the glass
becomes less translucent, the value goes up. The net effect is that more light returns to
the viewer as the luster/polish goes down. Polishing a porcelain restoration is a subtle
way to lower value by making the porcelain clearer and more translucent. 19,21

Conclusion
Matching a natural tooth with an artificial restoration will always remain an artistic
challenge. The dentist/technician team is responsible for artfully re-creating the
natural tooth anatomy, alignment, and wear patterns of the lost tooth structure while
also matching the optical parameters that generate the overall visual appearance of the
tooth. Beyond talent, the ultimate likelihood of faithfully re-creating nature is limited
only by how complete the communication process is. Knowing the language of color
as well as understanding how the optical properties of the human dentition are
displayed will improve the outcomes of our restorative endeavors.
- See more at: https://www.dentalaegis.com/id/2012/11/the-optical-characteristics-ofnatural-teeth#sthash.5bKnToee.dpuf