Wayakanon Kornchanok, Kamiam Chanathip, Khamlue Ratchaneekorn, Daengla Apinya, Naorungroj Supawadee
Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Thailand.
Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Thailand.
J Dent. 2025 Aug 16;162:106038. doi: 10.1016/j.jdent.2025.106038.
This study evaluated how ceramic translucency, resin cement shade, and tooth substrate color influence the masking ability of lithium disilicate veneers, aiming to support evidence-based clinical decision-making.
IPS e.max CAD ceramics (high, medium, and low translucency) and Variolink Esthetic LC resin cements (four shades) were paired in all combinations and bonded to either A3Dentin (natural dentin, control) or C4Dentin (discolored dentin, experimental) resin composite substrates. Standardized procedures were used for specimen preparation, including hydrofluoric acid etching, silanization, and universal adhesive bonding. Color parameters (L*, a*, b*) were measured using a spectrophotometer, and CIEDE2000 (ΔE) values were calculated. Data were analyzed via ANOVA, regression, and dominance analysis.
Ceramic thickness affected color outcomes. Substrate shade significantly influenced final color, with Light Plus cement increasing lightness (L*) and blue chroma (b*) values in high-translucency ceramics. Yellow chroma (b*) was more influenced by ceramic translucency. All experimental groups showed ΔE values above the clinical acceptability threshold (ΔE > 1.8). Substrate shade was the dominant factor affecting color outcomes (87.82 %), followed by ceramic translucency (9.15 %) and cement shade (3.03 %).
No tested combination achieved clinically acceptable masking of severe discoloration. Substrate shade overwhelmingly influenced final color, surpassing ceramic translucency and cement shade. These results emphasize that material selection alone is insufficient and highlight the necessity of substrate modification for optimal esthetic outcomes.
This study provides clinically applicable guidance for managing the often-unpredictable esthetic outcomes in veneer cases involving tooth discoloration. By quantifying the influence of each variable through dominance analysis within a regression model, the underlying tooth shade was found to contribute approximately 87.82 % to the explained variance in color outcome-emphasizing the importance of substrate modification as a key step toward achieving consistent and natural-looking results. This statistical contribution should be interpreted within the context of the model and not as a clinical absolute.
本研究评估了陶瓷半透明度、树脂水门汀颜色和牙齿基底颜色如何影响二硅酸锂贴面的遮色能力，旨在为循证临床决策提供依据。
将IPS e.max CAD陶瓷（高、中、低半透明度）和Variolink Esthetic LC树脂水门汀（四种颜色）进行所有组合配对，并粘结到A3牙本质（天然牙本质，对照）或C4牙本质（变色牙本质，实验）树脂复合材料基底上。采用标准化程序制备标本，包括氢氟酸蚀刻、硅烷化和通用粘结剂粘结。使用分光光度计测量颜色参数（L*、a*、b*），并计算CIEDE2000（ΔE）值。通过方差分析、回归分析和优势分析对数据进行分析。
陶瓷厚度影响颜色结果。基底颜色显著影响最终颜色，Light Plus水门汀增加了高半透明度陶瓷的亮度（L*）和蓝色色度（b*）值。黄色色度（b*）受陶瓷半透明度的影响更大。所有实验组的ΔE值均高于临床可接受阈值（ΔE>1.8）。基底颜色是影响颜色结果的主要因素（87.82%），其次是陶瓷半透明度（9.15%）和水门汀颜色（3.03%）。
没有测试组合能在临床上实现对严重变色的可接受遮色效果。基底颜色对最终颜色的影响极大，超过了陶瓷半透明度和水门汀颜色。这些结果强调仅靠材料选择是不够的，并突出了为获得最佳美学效果而对基底进行处理的必要性。
本研究为处理涉及牙齿变色的贴面病例中常常不可预测的美学效果提供了临床适用的指导。通过在回归模型中通过优势分析量化每个变量的影响，发现潜在的牙齿颜色对颜色结果的解释方差贡献约为87.82%，强调了基底处理作为实现一致和自然外观效果的关键步骤的重要性。这种统计贡献应在模型背景下进行解释，而不是作为临床绝对值。
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