Department of Prosthetic Dentistry, University Medical Center, Mainz, 55131, Germany.
Department of Optics, Faculty of Science, University of Granada Office 126, Granada, Granada, Spain.
J Esthet Restor Dent. 2017 Sep;29(5):303-308. doi: 10.1111/jerd.12321. Epub 2017 Jul 25.
The aim of this investigation was to evaluate intra-rater and inter-rater reliability of visual and instrumental shade matching.
Forty individuals with normal color perception participated in this study. The right maxillary central incisor of a teaching model was prepared and restored with 10 feldspathic all-ceramic crowns of different shades. A shade matching session consisted of the observer (rater) visually selecting the best match by using VITA classical A1-D4 (VC) and VITA Toothguide 3D Master (3D) shade guides and the VITA Easyshade Advance intraoral spectrophotometer (ES) to obtain both VC and 3D matches. Three shade matching sessions were held with 4 to 6 weeks between sessions. Intra-rater reliability was assessed based on the percentage of agreement for the three sessions for the same observer, whereas the inter-rater reliability was calculated as mean percentage of agreement between different observers. The Fleiss' Kappa statistical analysis was used to evaluate visual inter-rater reliability.
The mean intra-rater reliability for the visual shade selection was 64(11) for VC and 48(10) for 3D. The corresponding ES values were 96(4) for both VC and 3D. The percentages of observers who matched the same shade with VC and 3D were 55(10) and 43(12), respectively, while corresponding ES values were 88(8) for VC and 92(4) for 3D.
The results for visual shade matching exhibited a high to moderate level of inconsistency for both intra-rater and inter-rater comparisons. The VITA Easyshade Advance intraoral spectrophotometer exhibited significantly better reliability compared with visual shade selection.
This study evaluates the ability of observers to consistently match the same shade visually and with a dental spectrophotometer in different sessions. The intra-rater and inter-rater reliability (agreement of repeated shade matching) of visual and instrumental tooth color matching strongly suggest the use of color matching instruments as a supplementary tool in everyday dental practice to enhance the esthetic outcome.
本研究旨在评估视觉比色和仪器比色的组内和组间可靠性。
本研究共纳入 40 名具有正常颜色感知能力的个体。对教学模型的右上中切牙进行预备，并使用 10 个不同颜色的长石质全瓷冠进行修复。比色过程包括观察者（评估者）通过 VITA 经典比色板 A1-D4（VC）和 VITA Toothguide 3D Master（3D）比色指南以及 VITA Easyshade Advance 口内分光光度计（ES）进行视觉选择最佳匹配，以获得 VC 和 3D 匹配。三次比色过程，每次之间间隔 4 至 6 周。同一位观察者的三次比色过程的一致性百分比评估组内可靠性，而不同观察者之间的平均一致性百分比评估组间可靠性。Fleiss' Kappa 统计分析用于评估视觉组间可靠性。
VC 视觉比色选择的平均组内可靠性为 64(11)，3D 为 48(10)。相应的 ES 值分别为 VC 和 3D 的 96(4)。VC 和 3D 匹配同一颜色的观察者比例分别为 55(10)和 43(12)，相应的 ES 值分别为 VC 的 88(8)和 3D 的 92(4)。
视觉比色匹配的结果显示，组内和组间比较均存在高度到中度的不一致性。VITA Easyshade Advance 口内分光光度计的可靠性明显优于视觉比色选择。
本研究评估了观察者在不同时间段内通过视觉和口腔分光光度计一致匹配相同颜色的能力。视觉和仪器比色的组内和组间可靠性（重复比色匹配的一致性）强烈建议在日常牙科实践中使用比色仪器作为补充工具，以提高美观效果。
