CLINICAL RESEARCH

Effects of ceramic layer thickness,

cement color, and abutment tooth
color on color reproduction
of feldspathic veneers
Christopher Igiel, DMD
Assistant Professor, Department of Prosthetic Dentistry, University Medical Center,
Mainz, Germany

Michael Weyhrauch, DMD

Assistant Professor, Department of Prosthetic Dentistry, University Medical Center,
Mainz, Germany

Barbara Mayer, DMD

Assistant Professor, Department of Prosthetic Dentistry, University Medical Center,
Mainz, Germany

Herbert Scheller, DMD, PhD, Univ-Prof

Professor, Department of Prosthetic Dentistry, University Medical Center, Mainz, Germany

Karl Martin Lehmann, DMD, PhD, Priv-Doz

Professor, Department of Prosthetic Dentistry, University Medical Center, Mainz, Germany

Correspondence to: Dr Christopher Igiel

Department of Prosthetic Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany;

Tel: +49 6131 17 2871, Fax: +49 6131 17 5517; Email: christopher.igiel@unimedizin-mainz.de

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Abstract
Aim: To optimize the esthetics of ceramic
restorations, it is important to determine
accurately the effects of various para-
meters on the final color of the restor-
ation. However, there is a lack of infor-

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mation on what determines the color of
translucent feldspathic veneers formed
using ceramics such as Vita Mark II. The
aim of this study was to evaluate the ef-
fects of the ceramic layer thickness, ce-
ment color, and abutment tooth color on
the color of the feldspathic ceramic ve-
neer restoration.
Material and methods: A total of 30 all-
ceramic monolithic veneers (Vita Mark II)
were fabricated using a CAD/CAM sys-
tem. The crowns were divided into three
groups of differing ceramic thickness
(0.4-, 0.7-, and 1.0-mm thick). Each
type of crown was seated on six differ-
ent-colored abutment teeth (1M1 [refer-
ence], 1M2, 2M2, 3M2, 4M2, and 5M2)
using seven different try-in paste colors.
The color of the resulting restoration was
evaluated using spectrophotometry with
IGIEL ET AL
a spot-measurement device (Vita Easy-
shade Advance 4.0). Color data are
expressed in CIE L*a*b* system coordi-
nates, and color differences ΔE relative
to the reference tooth were calculated
and analyzed using one-way analysis of
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post hoc test at α = 0.05.
Results: The color difference ΔE of the
feldspathic all-ceramic veneer system
was significantly affected by the thick-
ness of the ceramic layer, the cement
color, and the abutment tooth color
(P < 0.05). The smallest values of ΔE
compared with the reference color were
found when try-in pastes shade -3 was
used. As the thickness of the ceramic
layer increased, a significant decrease
in ΔE was found. As the color of the abut-
ment tooth varied from light to dark, a
significant increase was found in ΔE.
Conclusion: The thickness of the ceram-
ic layer, the cement color, and the abut-
ment tooth color significantly affected
the color of the resulting CAD/CAM feld-
spathic ceramic veneer restoration.
(Int J Esthet Dent 2018;13:110–119)
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Introduction
There has been much interest recently
in metal-free, biocompatible restorative
materials for application in dental res-
torations. New all-ceramic systems are
continuously being introduced and im-
plemented into dental processes. This
has led to a significant increase in the
number of different monolithic recon-
structions that are currently available.1
Choosing the appropriate materials to
achieve satisfactory esthetics requires
the consideration of a number of bio-
logical factors. There has been a trend
toward less-invasive restorations using
esthetically pleasing ceramic material
systems.2,3 Edelhoff and Sorensen2 re-
ported an in vitro study showing that
the removal of tooth structure for veneer
restorations is factor 4.3 less invasive
compared with a conventional crown
preparation. Adhesively fixed veneers
exhibit good clinical long-term suc-
cess, are minimally invasive, and offer
superior esthetics compared to con-
ventional metal-ceramic crowns, and
should hence be considered an alter-
native treatment.3,4 The veneer prepar-
ation process requires significant skill
on the part of the dentist for both the
temporary restoration and the adhesive
incorporation.
Successful reproduction of the natu-
ral tooth shape and color remains a
significant challenge for dentists and
dental technicians. In particular, when
thin monolithic ceramics are used with
a computer-aided design/computer-
aided manufacturing (CAD/CAM) ap-
proach, the user must choose among
a large number of resin cement shades
and ceramic materials. Determining the
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optimal combination of ceramic and ce-
ment color requires a sound knowledge
of the various factors that affect the re-
sulting color of the restoration. Previous
studies have shown that the structure of
the ceramic material is important in this
respect, as the thickness and translu-
cency of the ceramic layer determine
the amount of light that is scattered or
absorbed. The interaction between the
light and the ceramic substructures
means that the colors of both the abut-
ment tooth and the cement are impor-
tant, as these optical characteristics af-
fect the esthetics of the restoration.
The thickness of the ceramic layer is
critical with regard to the masking effect
of ceramic restorations. The ceramic
should be at least 2-mm thick for the re-
sulting color of the restoration not to be
affected by the underlying tooth struc-
ture.5,6 Using spectrophotometric meth-
ods, the abutment tooth color and the
color of the cement have been shown to
affect the color of the restoration when
the ceramic layer was 1.5-mm thick, po-
tentially leading to clinically unaccept-
able color differences. A further reduc-
tion in the thickness of the ceramic layer
to 1 mm almost always leads to clini-
cally detectable differences in color.7,8
The abutment tooth color is particularly
significant for veneer restorations. The
thickness of veneers is commonly in
the range of 0.4 to 1 mm.2 Dozic et al9
reported an in vitro study showing that
ceramic veneers that were 0.6-mm thick
could not mask the color of the under-
lying abutment tooth, regardless of the
color of the resin cement. Vichi et al7
found that the color of the resin cement
had a smaller impact on the final color of
the restoration than did the color of the

abutment tooth.7 However, the diversity
of adhesive cement systems appears to
be significant, especially when slightly
discolored teeth should be masked with
thin ceramic restorations.
The influence of various factors on the
final color of ceramic restorations can be
described using the color difference ΔE:
ΔEab = (ΔL2 + Δa2 + Δb2)0.5
where the CIE system color coordinates
L*, a*, and b* are numerical descriptions
of the color in a three-dimensional (3D)
color space; ie, L* is a measure of light-
ness (0 ≤ L* ≤ 100), a* is a measure of
the redness minus the greenness, and
b* is a measure of the yellowness minus
the blueness.10 The perceptibility and
acceptability of color differences is an
active topic in dentistry, and a number of
studies have indicated different thresh-
old levels.11-15 Recent trends in the de-
mands of patients, dentists, and dental
technicians mean that the esthetics of
restorations is becoming increasingly
important. The 50:50% perceptibility
threshold (PT) is defined as ΔEab = 1.2,
meaning that 50% of examiners could
not perceive a color difference between
two specimens. Color differences are
rated as acceptable by 50% of observ-
ers for ΔEab = 2.7 (50:50% acceptability
threshold [AT]).16
The aim of this study was to evaluate
the effects of the thickness of the ce-
ramic layer, the cement color, and the
abutment tooth color on the final color
of the ceramic veneers. The null hypoth-
esis was that the veneer thickness, the
cement color, and the abutment tooth
color would not significantly affect the
color of the resulting ceramic veneer.
IGIEL ET AL
Materials and method
ANA-4 composite abutment teeth (Frasa-
co) were used to simulate the clinical sit-
uation. The maxillary right central incisor
was prepared for a veneer restoration. To
define a reproducible position of the ce-
ramic veneer for color analysis, a cham-
fer was prepared at the incisal third of
the palatal side of the resin tooth. The
preparation was optically scanned us-
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Dental). The images were analyzed us-
ing the Cerec version 4.0 CAD software
package (Sirona Dental) to create a digi-
tal model to design the final veneer, with
a cement thickness of 0.1 mm. Three
different thicknesses of the ceramic ve-
neer were chosen (0.4, 0.7, and 1 mm)
and were designed digitally. The area for
subsequent spectrophotometric analys-
is was fully supported by the abutment
tooth and was almost planar. Following
completion of the design of the veneer,
feldspathic monolithic blocs (Vita Mark II,
Vita Zahnfabrik) were placed in the mill-
ing unit (Cerec MC XL, Sirona Dental) us-
ing the milling mode for Vita Mark II. Five
veneers of each thickness were milled
with the color A2. Following milling, each
veneer was adapted to the resin stump
to provide optimal fitting. The restor-
ations were then prepared for glazing
(Vita AP Glaze Paste, Vita Zahnfabrik). A
ceramic furnace (Vita Vacumat 6000 M,
Vita Zahnfabrik) was used, according to
the manufacturer’s instructions.
The initial preparation was used to
fabricate a glass mold that provided an
accurate reproduction of the abutment
tooth. To simulate the clinical situation
and to comply with the Vita 3D-Master
(Vita Zahnfabrik) color organization
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 CLINICAL RESEARCH
system, an optically polymerized com-
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Zahnfabrik) was used. Identical resin
abutment teeth were fabricated in six
different colors (1M1 [reference], 1M2,
2M2, 3M2, 4M2, and 5M2) to replicate
natural variations in the appearance of
dentin.
The feldspathic restorations were
seated using different-colored trail in-
sertion pastes based on glycerin gel
(Variolink Veneer Try-in, shades +3, +2,
+1, 0, -1, -2, and -3, Ivoclar Vivadent).
Thus, there were three thickness groups,
seven try-in paste color groups, and six
abutment color groups. Each combi-
nation was measured three times non-
consecutively, and the CIE color coor-
dinates were recorded using a dental
spectrophotometer (Vita Easyshade
Advance, Vita Zahnfabrik). A single op-
erator performed all the measurements
under standardized test conditions. The
calibrated operator was blinded to the
aim of the research. The spectrophotom-
eter was calibrated prior to each meas-
urement by placing the probe tip on the
calibration port aperture. The target was
measured by holding the probe tip at 90
degrees to the surface of the middle third
of the veneer. The CIE coordinates were
analyzed using the Easyshade Helper
Software package (Vita Zahnfabrik).
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ferences compared with the reference
used for the statistical analysis. The
color differences ΔEab were calculated,
and the effects of the ceramic thickness,
color of the try-in paste, and color of the
abutment tooth were analyzed using
one-way analysis of variance (ANOVA)
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that did not satisfy the AT for abutment
where statistical significance was con-
sidered as P = 0.05.
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Results
Table 1 lists the mean color differences
ΔE and standard deviations between the
reference abutment tooth color 1M1 and
abutment tooth colors 1M2, 2M2, 3M2,
4M2, and 5M2. Data are subdivided in-
to ceramic thicknesses and try-in paste
colors. The results show an increase
in the color difference as the abutment
tooth color became darker. A reduction
in the thickness of the ceramic layer from
1 to 0.4 mm also resulted in an increase
in ΔE.
Figure 1 shows the mean value of ΔE
as functions of the ceramic thickness
and the color of the try-in paste. The
horizontal green and red lines show the
PT and AT, respectively. The data reveal
an increase in ΔE as the thickness of
the ceramic layer decreased and as
the abutment tooth color became dark-
er. The only color difference below the
PT was found between the reference
color 1M1 and abutment tooth colors
1M2 and 2M2 (thickness: 1 mm; try-in
paste shade: -3). Clinically acceptable
color differences (ΔE ≤ 2.8) were found
between the reference abutment tooth
color 1M1 and 1M2, independent of the
thickness of the ceramic or the try-in
paste. The abutment tooth color 2M2
exhibited clinically acceptable color dif-
abutment tooth color 1M1 when the ce-
ramic thickness was ≥ 0.7 mm (except
for try-in paste shades +1 and 0). In-
creasing the thickness of the ceramic
layer to 1 mm and using try-in paste
shade -3 resulted in color differences ΔE
tooth colors 3M2 and 4M2. Clinically
unacceptable color differences were
 IGIEL ET AL

Table 1 Mean color difference (ΔE) and standard deviation (SD) between reference abutment tooth color
1M1 and abutment tooth colors 1M2, 2M2, 3M2, 4M2, and 5M2

Mean ΔE (SD): Reference abutment tooth color 1M1

Color Ceramic Abutment tooth color

of try-in thickness
paste (mm) 1M2 2M2 3M2 4M2 5M2

0.4 2.28 (1.04)Aa 


#B 4.94 (0.32)Ca 7.48 (0.42)Da 10.25 (0.43)Ea

Value -3 0.7 1.71 (0.25)Aab 


#C 3.7 (0.26)Cb 5.28 (0.4)Db 7.05 (0.57)Eb

1 1.44 (0.23)Ab 1.52 (0.33)Ac 


#D 3.52 (0.44)Cc 4.71 (0.46)Dc

0.4 2.13 (0.14)Aa 


#B 5.61 (0.4)Ca 8.5 (0.64)Da 11.32 (0.76)Ea

Value -2 0.7 1.72 (0.23)Aab 


#C 3.85 (0.43)Cb 5.56 (0.52)Db 7.24 (0.79)Eb

1 1.61 (0.64)Ab 1.66 (0.34)Ac 


#D 3.7 (0.52)Cc 5.04 (0.48)Dc

0.4 2.4 (0.23)Aa 


#B 6.44 (0.47)Ca 9.87 (0.6)Da 13.29 (0.73)Ea

Value -1 0.7 1.71 (0.15)Ab 


#C 4.22 (0.4)Cb 6.26 (0.88)Db 8.15 (0.73)Eb

1 1.24 (0.34)Ac 


#D 3.21 (0.47)Cc 4.18 (0.57)Dc 5.31 (0.64)Ec

0.4 2.38 (0.4)Aa 


#B 

#B 11.17 (2.62)Ca 15 (2.75)Da

Value 0 0.7 1.96 (0.24)Ab 


#C 4.88 (0.66)Cb 8.03 (1.39)Db 10.78 (0.17)Eb

1 1.53 (0.3)Ac 2.21 (0.4)Ac 


#D 5.27 (0.82)Cc 6.99 (0.98)Dc

0.4 2.57 (0.28)Aa 


#B 6.96 (1.42)Ca 10.63 (1.45)Da 14.67 (1.72)Ea

Value +1 0.7 1.68 (0.31)Ab 2.56 (0.72)Ab 


#C 6.56 (0.99)Cb 9.08 (1.0)Db

1 1.51 (0.6)Ab 1.8 (0.42)Ac 


#C 4.61 (0.63)Cc 5.83 (0.58)Dc

0.4 2.44 (0.36)Aa 


#B 6.44 (0.52)Ca 9.82 (0.82)Da 13.31 (0.93)Ea

Value +2 0.7 1.79 (0.22)Ab 


#C 4.48 (0.54)Cb 6.41 (0.4)Db 8.61 (0.62)Eb

1 1.51 (0.35)Ab 2.04 (0.53)Ab 


#D 4.60 (0.6)Cc 5.96 (0.66)Dc

0.4 1.52 (0.38)Aa 


#B 4.2 (0.43)Ca 5.86 (0.67)Da 7.72 (0.77)Ea

Value +3 0.7 1.3 (0.31)Aab 1.73 (0.4)Ab 


#C 3.72 (0.4)Cb 4.75 (0.4)Db

1 0.99 (0.33)Ab 0.99 (0.27)Ac 


#D 2.54 (0.4)Cc 3.16 (0.38)Dc

Different uppercase letters within lines represent significant differences (P < 0.05) between abutment tooth colors. Respectively,
different lowercase letters within columns represent significant differences (P < 0.05) between ceramic thicknesses.

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16
Value +3 Value +2 Value +1 Value 0 Value -1 Value -2 Value -3

14

12

10
1M2

2M2
8 3M2

4M2

5M2
6

AT ΔE = 2.7
2

PT ΔE = 1.2

0
0.4 / 0.7 / 1 mm 0.4 / 0.7 / 1 mm 0.4 / 0.7 / 1 mm 0.4 / 0.7 / 1 mm 0.4 / 0.7 / 1 mm 0.4 / 0.7 / 1 mm 0.4 / 0.7 / 1 mm

Fig 1 Graph showing the mean values of ΔE as functions of the ceramic thickness and color of the try-in
paste. The horizontal green and red lines show the PT and AT, respectively.

observed for color differences between
1M1 and abutment tooth color 5M2.
Discussion
Fifteen feldspathic ceramic
were fabricated and analyzed using a
spectrophotometer. The application of
feldspathic monolithic all-ceramic restor-
ations for the anterior teeth was justified
due to satisfactory survival
color of both the try-in paste and the
abutment teeth significantly affected the
final color of the ceramic veneers, there-
fore the null hypothesis was rejected.
The influence of the abutment tooth
color on the color of the final ceramic
restoration was investigated using com-
posite abutment teeth to simulate the
clinical situation.18 Optically polymer-
ized composites were used to provide
colors in accordance with the Vita 3D-
Master system, allowing systematic cov-
veneers erage of natural tooth colors.19 Color dif-
ferences ΔE were analyzed between the
reference abutment tooth color 1M1 and
the abutment tooth colors 1M2, 2M2,
3M2, 4M2, and 5M2. Consistent with the
rates.17 The findings of other studies,9,18 the change
in abutment tooth color from lighter to
darker resulted in an increase in ΔE.
Independent of the thickness of the
ceramic layer, darker abutment colors
always resulted in perceptible color dif-
ferences (ΔE ≥ 1.2).13,20 It was found

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that ΔE decreased as the thickness of
the ceramic restoration increased.7,21 A
reduction in the thickness of the ceramic
layer reduced the masking ability of the
restoration, revealing the color of the un-
derlying tooth structure.7 Choosing the
correct thickness of the ceramic is an
important factor in achieving optimal es-
thetics.5,18,22-24
The masking ability of the veneer de-
pends primarily on the characteristics
of the material. The amount of light that
is reflected, scattered, or transmitted
through the ceramic layer determines
the appearance of the restoration. The
relative translucency varies among the
all-ceramic systems.25,26 Studies on this
have focused on the thickness of the ce-
ramic layer as the main criterion for the
masking ability, showing that a thickness
of 2 mm sufficiently masks discolored
abutment teeth.7,18,22,24,27,28 The optical
properties of the ceramic material vary
with the thickness of the ceramic layer,7
and the absorption coefficient and re-
fractive index of the material determine
the masking effect.29 An increase in the
thickness of the ceramic layer results in
greater absorption of light in the ceramic
layer, and less in the underlying struc-
tures. It is clear that color differences
can be measured, and that the color and
thickness of the ceramic material affect
the CIE color coordinates.30 The rela-
tionship between color difference and
ceramic thickness was particularly evi-
dent for thin ceramic veneers. Changing
the color of the abutment tooth always
affected ΔE by more than the PT com-
pared with the reference abutment tooth
color, and 3M2, 4M2, and 5M2 resulted
in ΔE values above the AT (except for
try-in paste shade -3).
IGIEL ET AL
It was found that the final color of the
veneer restorations was affected by the
abutment tooth color. This is consistent
with the findings of Azer et al23 and Tur-
gut et al31 on 0.5- to 1-mm-thick ceram-
ic specimens. Dozic et al9 cemented
0.6-mm-thick ceramic veneers on nine
different-colored resin stumps using
seven different-colored resin cements.
They found that no combinations were
able to sufficiently mask the color of the
underlying structures.
The effects of the Variolink veneer
system were investigated with different-
colored try-in pastes. Opaque try-in
pastes are more effective at masking
discolored or dark abutment teeth than
transparent pastes.9,32,33 White and yel-
low try-in pastes with low opacity are ef-
fective, and an increase in the opacity
or the amount of pigment reduces the
influence of the abutment tooth color,33
especially when translucent ceramic
materials are used.31,34-36 Investigations
of the color of feldspathic veneers have
focused primarily on a ceramic thick-
ness ≥ 1 mm.18,35,37 The cement color
increase becomes more important as
the thickness of the ceramic layer de-
creases,18,34 which is consistent with the
results of the present study. Dozic et al9
showed that ceramic veneers were not
able to mask the color of abutment teeth
independently of the color of the resin
cement.
The translucency of monolithic ce-
ramic restorations complicates the task
of determining the color of the resulting
restoration, resulting in new challenges
compared with conventional ceramic
systems.31 This is because more light
can pass through the material, and
the color of the underlying structures
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influences the appearance of the res- Conclusion

toration.18 Accurately determining the
color of the prepared tooth and com-
municating this to the dental technician
can enable the laboratory to fabricate
a resin abutment of the same color as
the prepared tooth, making it possible
to adapt the restoration more accurately
to the clinical situation. Information on
the color of the abutment tooth is es-
sential for the fabrication of thin ceramic
veneers; however, the ceramic systems
exhibit differences, which must be con-
sidered. Further studies are planned to
deliver systematic guidance for the use
of CAD/CAM materials.
Feldspathic all-ceramic veneer systems
are suitable for restorations due to their
excellent longevity and esthetics; how-
ever, due to their translucency, color
management is challenging. The major
results of this study were:
1. The color difference ΔE relative to the
reference abutment tooth increased
as the abutment tooth became darker.
2. A reduction in the thickness of the ce-
ramic resulted in an increase in ΔE.
3. An increase in opacity due to an in-
crease in the amount of pigment re-
sulted in a reduction in the color dif-
ference ΔE.

the colour of heat-pressed 10. McDonald R. Colour Physics

References

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+3
5IF

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and Colorists, 1997.
clinical success of all-ceram-
ic restorations. J Am Dent
Assoc 2008;139(suppl):8S–
13S.
2. Edelhoff D, Sorensen JA.
Tooth structure removal
associated with various
preparation designs for
anterior teeth. J Prosthet
Dent 2002;87:503–509.
3. Peumans M, Van Meerbeek
#

-BNCSFDIUT
1

7BOIFSMF
(
of opaque posts. J Prosthet

,BP
&$

Porcelain veneers: a review
of the literature. J Dent
2000;28:163–177.
4. Scherrer SS, de Rijk WG. The
fracture resistance of all-
ceramic crowns on support-
ing structures with different

5TBHLBSJ
.

,IBTI- for discriminating mismatch
elastic moduli. Int J Prostho-
dont 1993;6:462–467.
5. Nakamura T, Saito O, Fuyi-
kawa J, Ishigaki S. Influ-
ence of abutment substrate
and ceramic thickness on
ceramic crowns. J Oral
Rehabil 2002;29:805–809.
effect of ceramic thickness
and number of firings on the
color of a zirconium oxide
based all ceramic system
fabricated using CAD/CAM
technology. J Adv Prostho-
dont 2011;3:57–62.
7. Vichi A, Ferrari M, Davidson
CL. Influence of ceramic
and cement thickness on
the masking of various types

+PIOTUPO
8.
Dent 2000;83:412–417.
8. Paravina RD, Majkic G, Imai
FH, Powers JM. Optimiza-
tion of tooth color and shade
guide design. J Prosthodont
2007;16:269–276.

%P[JD
"
ayar G, Aboushelib M. Color
management of porcelain
veneers: influence of dentin
and resin cement colors.
Quintessence Int 2010;41:
567–573.
GPS
*OEVTUSZ
6,
5IF
4PDJFUZ
PG
%ZFST

11. Ghinea R, Pérez MM, Herrera
LJ, Rivas MJ, Yebra A, Para-
vina RD. Color difference
thresholds in dental ceram-
ics. J Dent 2010;38(suppl
2):e57–e64.
12. Lindsey DT, Wee AG. Per-
ceptibility and acceptability
PG
$*&-"#
DPMPS
EJGGFSFODFT

in computer-simulated teeth.
J Dent 2007;35:593–599.
Assessment of appearance
match by visual observation
and clinical colorimetry.
J Dent Res 1989;68:819–822.
14. Ragain JC Jr, Johnston WM.
Minimum color differences
between composite and
tooth color. J Esthet Restor
Dent 2001;13:41–48.
15. Da Silva JD, Park SE, Weber
HP, Ishikawa-Nagai S. Clin-
ical performance of a newly

118
THE INTERNATIONAL JOURNAL OF ESTHETIC DENTISTRY
70-6.&

t
/6.#&3

t
SPRING 2018

developed spectrophoto-
metric system on tooth color
reproduction. J Prosthet Dent
2008;99:361–368.
16. Paravina RD, Ghinea R,
Herrera LJ, et al. Color dif-
ference thresholds in den-
tistry. J Esthet Restor Dent
2015;27(suppl 1):S1–S9.
17. Sailer I, Makarov NA, Thoma
DS, Zwahlen M, Pjetursson
#&
"MMDFSBNJD
PS
NFUBM
ceramic tooth-supported

#BHJT
#
&GGFDU
PG

fixed dental prostheses
(FDPs)? A systematic review
of the survival and compli-
cation rates. Part I: Single
crowns (SCs). Dent Mater
2015;31:603–623.

$IBJZBCVUS
:

,PJT
+$

-F#- mal for anterior esthet-

,SJTUJBOTFO
+

*TIJLBXB
eau D, Nunokawa G. Effect
of abutment tooth color,
cement color, and ceramic
thickness on the result-
ing optical color of a CAD/
CAM glass-ceramic lithium

+BSBE
'%

4NJUI

disilicate-reinforced crown.
J Prosthet Dent 2011;105:
83–90.
19. Chu SJ, Trushkowsky RD,
Paravina RD. Dental color
matching instruments and

*CCFUTPO
3
torations: an in vitro study.
systems. Review of clinical
and research aspects.
J Dent 2010;38(suppl 2):e2–
e16.
20. Seghi RR, Johnston WM,
0#SJFO
8+
1FSGPSNBODF

assessment of colorimetric
devices on dental porce-
lains. J Dent Res 1989;68:
1755–1759.
21. Dozi˂
"

,MFWFSMBBO
$+

porcelain fused to metal. Int J
Meegdes M, van der Zel J,
Feilzer AJ. The influence of
porcelain layer thickness on
the final shade of ceramic
restorations. J Prosthet Dent

FE

#SBEGPSE


2003;90:563–570.
22. Denissen H, Dozic A, van
Waas M, Feilzer A. Effects of

#BHJT
#

"ZB[
&"

5 manipulative variables on
the color of ceramics used
for computer-generated res-
torations. Quintessence Int
2007;38:401–408.
23. Azer SS, Rosenstiel SF,
Seghi RR, Johnston WM.
Effect of substrate shades on
the color of ceramic laminate
veneers. J Prosthet Dent
2011;106:179–183.
24. Douglas RD, Przybylska M.
Predicting porcelain thick-
ness required for dental
shade matches. J Prosthet
Dent 1999;82:143–149.
25. Conrad HJ, Seong WJ,
Pesun IJ. Current ceramic
materials and systems with
clinical recommendations: a
systematic review. J Prosthet
Dent 2007;98:389–404.
26. Spear F, Holloway J. Which
all-ceramic system is opti-
.
ics? J Am Dent Assoc
2008;139(suppl):19S–24S.
27. Carossa S, Lombardo S,
Pera P, Corsalini M, Rastello
ML, Preti PG. Influence of
posts and cores on light
transmission through dif-
ferent all-ceramic crowns:
spectrophotometric and clin-
ical evaluation. Int J Prostho-
dont 2001;14:9–14.

4UFWFOTPO
#
The effect of the substructure
on the colour of samples/
restorations veneered with
ceramic: a literature review.
J Dent 2010;38:361–368.
29. Terada Y, Maeyama S,
Hirayasu R. The influence
of different thicknesses of
dentin porcelain on the color
reflected from thin opaque
Prosthodont 1989;2:352–356.
30. Nobbs JH. Colour-Match
Prediction for Pigmented
Materials. In: Colour Physics
GPS
*OEVTUSZ
6,
5IF
4PDJFUZ
PG
%ZFST

and Colorists, 1997:292–372.

5VSHVU
4
Achieving the desired colour
in discoloured teeth, using
leucite-based CAD-CAM
laminate systems. J Dent
2014;42:68–74.
THE INTERNATIONAL JOURNAL OF ESTHETIC DENTISTRY
IGIEL ET AL
32. Ge J, Wang XZ, Feng
HL. Influence of differ-
ent post core materials on
the color of Empress 2 full
ceramic crowns. Chin Med J
2006;119:1715–1720.
33. Niu E, Agustin M, Douglas
RD. Color match of machin-
able lithium disilicate ceram-
ics: Effects of cement color
and thickness. J Prosthet
Dent 2014;111:42–50.

5VSHVU
4
resin cement and ceramic
thickness on final color of
laminate veneers: an in
vitro study. J Prosthet Dent
2013;109:179–186.
35. Chang J, Da Silva JD, Sakai
Nagai S. The optical effect of
composite luting cement on
all ceramic crowns. J Dent
2009;37:937–943.
36. ALGhazali N, Laukner J,
#VSOTJEF
(
PW, Preston AJ. An investi-
gation into the effect of try-in
pastes, uncured and cured
resin cements on the overall
color of ceramic veneer res-
J Dent 2010;38(suppl
2):e78–e86.
37. Shokry TE, Shen C, Elhosary
MM, Elkhodary AM. Effect of
core and veneer thicknesses
on the color parameters of
two all-ceramic systems.
J Prosthet Dent 2006;95:
124–129.
119
70-6.&

t
/6.#&3

t
SPRING 2018