Evaluating the ability of dental technician

students and graduate dentists to match

tooth color
Gulden Sinmazisik, DDS, PhD,a Goksu Trakyali, DDS, PhD,b and
Bilge Tarcin, DDS, PhDc
Marmara University, Istanbul, Turkey
Statement of problem. The ability of dental technician students to match tooth shade with the Vita 3D-Master shade
guide and Toothguide Training Box has not been investigated.

Purpose. The purpose of this study was to evaluate and compare the shade-matching ability of dental technician students
and graduate dentists using the Vita 3D-Master shade guide.

Material and methods. Twenty-nine dental technician students (DTS group) and 30 graduate dentists (GD group)
participated in this study. The Toothguide Training Box (TTB) was used to train the participants and test their shade-
matching abilities. Shade-matching ability was evaluated with 3 exercises and a final test, all of which are components of
the TTB. The number of mistakes for each participant for value (L), chroma (c), and hue (h) were recorded during the
exercises and the final test, and the mistake ratios were calculated. Color difference (DE) values for each shade were
calculated from the L*, a*, and b* values of the Vita 3D-Master shade guide for each participant in both groups. The
Mann-Whitney U test was used to determine statistically significant differences between the L, c, and h mistake ratios of
the 2 groups, and the Student t test was used to determine statistically significant differences between the final test scores and
the DE values of the groups (a¼.05).

Results. The mistake ratio for L in the GD group was significantly higher than that of the DTS group (P<.05), whereas the
mistake ratio for h in the DTS group was higher (P<.001). No significant differences were observed between the groups
regarding the mistake ratios for c (P>.05). With regard to the final test scores and the DE values, no significant differences
were found between the groups (P<.001), and the DTS group received higher scores than the GD group (912 and 851).
The mean DE values for the DTS and GD groups were 1.72 and 2.92.

Conclusions. DTSs made more mistakes in the h parameter than GDs, and GDs made more mistakes in the L parameter
than DTSs. With regard to the final test scores and the DE values, DTSs were more successful in shade matching
than GDs. (J Prosthet Dent 2014;112:1559-1566)

Clinical Implications
Shade-matching ability is not dependent on being an experienced
dentist. Dental technician students provided with a theoretical education
on proper shade selection can systematically develop the ability to
perform shade selection successfully.

Esthetic success depends on a close
shade match between a dental resto-
ration and the adjacent teeth and the
adaptation of the restoration to the
surrounding tissues.1,2 Shade selection
and shade duplication are the 2 phases
of shade matching in clinical dentistry.3
Both visual and instrumental methods
can be used for shade selection.4
Although other methods using color-
imeters and spectrophotometers are
available, these new devices cannot
replace shade guides.5,6
Among the various shade guides,
the Vita Toothguide 3D-Master (VMG)
(Vita Zahnfabrik) enables the user to
systematically select tooth shades by
determining their value, chroma, and
hue in accordance with color science
and human color perception.7 Value
denotes the lightness of a shade (the
range from black to white, including
all shades of gray) but provides no in-
formation on color. Chroma provides

a
Associate Professor, Department of Dental Prosthetics Technology, Vocational School of Health Services, Marmara University.
b
Private practice, Istanbul, Turkey.
c
Assistant Professor, Department of Restorative Dentistry, Faculty of Dentistry, Marmara University.

Sinmazisik et al
1560
information about the intensity of a
shade. Hue indicates whether the color
is red, blue, green, and so on. The hu-
man eye is most sensitive to differences
in lightness and significantly less sensi-
tive to changes in hue.7,8
The VMG comprises 26 tabs and an
additional bleaching kit consisting of
3 tabs. The 26 tabs are divided into 5
lightness groups. The tabs within each
group have the same lightness and are
systematically arranged according to
the chroma (vertically) and hue (hori-
zontally). The VMG is used to mark the
shades as follows: The numbers (1, 2,
3, 4, and 5) preceding the letters indi-
cate the lightness level (value group),
such that lighter shades are indicated
by lower numbers and darker shades
are indicated by higher numbers. The
numbers following the letters designate
the chroma level (1, 1.5, 2, 2.5, and 3),
with more chromatic tabs assigned
higher numbers. Finally, the letters cor-
respond to the hue of the shade: M
signifies the middle hue in the group,
and L signifies yellowish (left) hues,
whereas R signifies reddish (right) hues
in comparison with the M tab.
Understanding the color difference
(DE) perceptible by the human eye is
essential for effective shade matching,
whether through visual or instrumental
methods.9 The CIELAB-based color
difference formula recommended by
the International Commission on Illu-
mination defines the color space as L*
a* b*.10 In this system, L* represents
lightness, a* represents the chroma-
ticity coordinate for red-green, and b*
represents the chromaticity coordinate
for yellow-blue.11 To calculate the DE
value between 2 objects, the CIELAB
colorimetric system uses the combina-
tion of the differences between the in-
dividual coordinates. The DE is
calculated according to the following
formula: DE ¼ ½ðL  x  1
=
L  yÞ2 þ ða  x
a  yÞ2 þ ðb  x  b  yÞ2  2 , where the
initial (x) and final (y) are color de-
scriptors. The formula enables the
measurement of minor color differences
and is therefore used extensively in
dental research.12,13 The results of
many studies performed on color
The Journal of Prosthetic Dentistry
discrimination thresholds, most of
which are conducted under in vitro
conditions, vary widely depending on
the individual methodology.13-16 How-
ever, color differences of less than 2.6
were accepted as a match, and the
threshold for a restoration color
mismatch was set at 5.5 under in vivo
conditions by Douglas et al.14
Because of the subjective nature of
perceptual shade matching, the ability
to match shades is acquired through
knowledge of basic color principles and
clinical experience.11,17 Experts have
emphasized the need for training in
vision physiology and color science in
dental education.18 Toothguide Trainer
(TT) software and the Toothguide
Training Box (TTB) developed by Jakt-
stat (University of Leipzig) in collabora-
tion with Vita (Vita Zahnfabrik) provide
an innovative training tool for color
discrimination. In addition, online color
education and training systems such as
Dental Color Matcher (hosted by the
Society for Color and Appearance in
Dentistry website, http://www.scadent.
org) and Toothguide Trainer Web (hos-
ted by Vita, http://www.toothguide.de)
are available.
TTB is an electromechanical device
that helps students and practitioners
practice shade determination with the
VMG system.19,20 The TTB presents a
real shade tab under daylight lamp
conditions (Dialite Color System) with
diffuse light from 2 angled 5 W lamps
of 5500 K and 1000 lux at a distance of
approximately 25 cm. TTB training is
structured in 3 different successive ex-
ercises and a final test in shade
matching. The exercise modus con-
tinues until the participant reaches a
specific performance level, which is
ensured by computed feedback. After
the participants successfully complete
the exercise modus, they undertake the
test modus of the TTB. This procedure
ensures that all participants achieve a
standardized level of knowledge and
equal minimum ability in color
discrimination.20,21 The TTB is consid-
ered to be an effective teaching method
and is also useful in the evaluation of
shade-selection ability.
Volume 112 Issue 6
Success in shade matching depends
on accurate communication between
the clinician and the dental laboratory
technician. If a clinician does not have
the knowledge to discuss hue, chroma,
and value with a laboratory technician,
he or she is not able to supply the
laboratory with the necessary informa-
tion to create an esthetic restoration
that matches the patient’s remaining
natural teeth. Dental technicians
should understand the color informa-
tion provided by the dentist properly
and apply it to the restorations accu-
rately.22 Because technicians fabricate
the restorations, clinicians sometimes
delegate shade selection to them.23
Therefore, in the Dental Prosthetics
Technology Department of Vocational
School of Health Services of Marmara
University, second-year students take a
porcelain prostheses course for 2 se-
mesters, and this course covers the
topics of “color dimensions and
metamerism, ceiling lights and color
temperature, communication on color
by using written instructions and color
selection, shade guides, dental ceramics
and composite resins.” The principal
objective of the Dental Prosthetics
Technology Department is to enable
the dental technician students (DTSs)
to discuss color issues at the level of the
dentist and to shade match the resto-
rations according to the dentist’s
wishes.
The authors have not found any
study that evaluates the shade-
matching ability of graduating DTSs
with VMG. This study aims to eval-
uate and compare the tooth-shade-
matching abilities and DE values of
second-year DTSs at the Dental Pros-
thetics Technology Department of the
Vocational School of Health Services of
Marmara University and those of
graduate dentists (GDs) through the
use of VMG. In addition, with the TTB,
the percentage of correct selection of
each color in VMG was calculated for
both the DTS and the GD groups. The
null hypothesis of this study is that no
difference exists between the tooth-
shade-matching abilities of the DTS
and GD groups.
Sinmazisik et al
December 2014
MATERIAL AND METHODS
Participants
The design of this study was approved
by the ethics committee of the Marmara
University Institute of Health Sciences
(16.01.2014-13). The participants were
divided into 2 groups of 30. The partici-
pants of one group were second-year
DTSs 1 week before graduation in their
last year of training and between the ages
of 19 and 22 years (the DTS group). The
other group was GDs between the ages of
25 and 30 years with 3 to 5 years of
clinical experience (the GD group). The
DTS group consisted of 13 women and
16 men, whereas the GD group consisted
of 16 women and 14 men. After the
participants provided informed consent
for their participation in the study, they
took part in a color vision test. The Ishi-
hara test of 24 plates was given to both
groups, and a data projector was used
during the test.24 For a diagnosis of
normal color vision, no more than 2 er-
rors were allowed. All participants in this
study passed the Ishihara test, meaning
that they had normal visual acuity, either
naturally or with corrective lenses. After
the Ishihara test, a 1-hour lecture on color
theory, VMG, and the use of the TTB was
given to the DTS and the GD groups by a
trained prosthodontist. Although the
DTSs had received theoretical informa-
tion about color and shading determi-
nation throughout their education, they
had not previously made shade selec-
tions. However, the GDs had used
different shade guides during their edu-
cation and had begun using VMG in their
clinical practice. To determine the quality
of their shade selection, all participants
were asked to complete the TTB training
program. One participant from the DTS
group did not finish step 3 of the TTB
training, and data from this participant
were therefore excluded from the study.
The conditions of each viewing session
were standardized. The task was per-
formed in a spacious room with multi-
ple windows in late spring around
midday to avoid fatigue and to allow
for optimal lighting conditions. An
artificial daylight light source (5500 K)
was used in the room where the exper-
iments were performed. The partici-
pants viewed shade tabs from a
distance of approximately 25 cm. Step
1 training exercises were related to the
selection of the appropriate value
group, and participants had to make
4 correct value selections to pass to the
next level. Step 2 exercises guided the
DTSs through value and chroma selec-
tion, and 8 correct value and chroma
selections were required to pass to the
Sex:
Exercise 3
Correct Wrong
1 Specially designed table used to record number of L, c,
and h mistakes of participants in step 3.
Group:
Number:
Sex:
Final test
Selected Shade Actual Shade
1561
next level. Step 3 exercises required the
participants to correctly select the
value, chroma, and hue for 15 teeth,
simulating the complete 3-step shade-
matching procedure. Participants were
required to successfully complete all
3 steps of the guided training exercises
of increasing difficulty to qualify for the
final test. If participants needed to rest
their eyes, they looked at a blue plaque
situated on one corner of the table.
These exercises were performed daily.
The numbers of L, c, and h mistakes for
each participant in step 3 were recor-
ded in a specially designed table
(Fig. 1), and the mistake ratios were
calculated from the data collected.
The final test comprised a set of
15 artificial teeth that had to be
Wrong Parameter
L c h
Total Score

Exercises

The exercises were designed to

simulate the 3-step shade-matching 2 Specially designed table used to record data (value,
procedure recommended for the VMG. chroma, and hue) during shade matching in final test.
Sinmazisik et al
1562
matched to the corresponding shade
guide tab.25 In the final test, the
selected and actual shades were dis-
played on the screen after the shade
selection process had been completed,
and each participant received a score
reflecting the percentage of his/her
correct shade matching. Participants
received the highest possible score
(1000) when they correctly matched
all 15 sample teeth with the shade
guide. During the final test, each
wrong answer (an error in value and/
or chroma and/or hue) was recorded
Volume 112 Issue 6
in a specially designed data table
(Fig. 2), and the DE values were
calculated by using the L*, a*, and
b* values of the VMG as determined
by Bayindir et al.26 During calcula-
tion, correctly selected shades were
recorded as DE¼0.

Table I. Number of total, correct, and incorrect matches for L, c, and h in DTS and GD groups in step 3
No. of No. of
Shades Shades
Total Selected Selected No. of Mismatches
Selection Correctly Incorrectly L c h
Participant DTS GD DTS GD DTS GD DTS GD DTS GD DTS GD

1 42 32 15 15 27 17 13 9 7 8 37 4
2 42 30 15 15 27 15 14 14 2 3 28 1
3 32 23 15 15 17 8 10 7 2 1 12 2
4 39 29 15 15 24 14 11 11 2 3 12 4
5 28 28 15 15 13 13 6 12 1 3 6 3
6 31 29 15 15 16 14 11 11 1 2 8 5
7 29 31 15 15 14 16 8 11 2 5 8 3
8 28 31 15 15 13 16 7 9 2 7 7 3
9 22 36 15 15 7 21 4 12 9 8 9 5
10 20 30 15 15 5 15 12 14 0 5 14 3
11 31 27 15 15 16 12 9 11 8 2 13 4
12 26 32 15 15 11 17 15 21 1 3 19 1
13 29 27 15 15 14 12 13 13 4 3 4 5
14 16 19 15 15 1 4 6 5 1 1 4 2
15 23 28 15 15 8 13 5 8 0 2 5 4
16* - 33 - 15 - 18 - 14 - 0 - 6
17 26 22 15 15 11 7 21 4 0 1 23 2
18 22 20 15 15 7 5 6 4 0 0 10 1
19 27 22 15 15 12 7 5 5 5 2 8 3
20 29 36 15 15 14 21 9 8 0 0 6 12
21 39 22 15 15 24 7 22 7 0 0 13 2
22 31 22 15 15 16 7 4 5 1 2 13 2
23 21 23 15 15 6 8 2 8 1 0 12 4
24 21 24 15 15 6 9 3 8 0 2 6 1
25 19 23 15 15 4 8 2 10 0 2 3 4
26 29 27 15 15 14 12 9 8 0 1 15 4
27 28 21 15 15 13 6 11 7 1 6 9 3
28 28 27 15 15 13 12 9 7 2 3 7 3
29 29 22 15 15 14 7 6 6 4 1 23 4
30 20 25 15 15 5 10 3 8 1 1 9 2
Total 807 801 435 450 372 351 256 277 57 77 343 102

DTS, dental technician student; GD, graduate dentist.

*Participant 16 of DTS group did not finish step 3 of Toothguide Training Box training, and data were therefore excluded from study.

The Journal of Prosthetic Dentistry Sinmazisik et al

December 2014 1563
Table II. Mistake and success ratios for parameters L, c, and h in DTS and GD A Mann-Whitney U test was used to
groups in step 3 compare the mistake ratios for L, c, and
h calculated for the groups in step 3,
Total Correct Incorrect No. of Mismatches
and the Student t test was used to
Characteristic Selection Selection Selection L c H compare the final test scores and the
DE values of the groups (a¼.05).
DTS 807 435* 372 256 57 343
GD 801 450 351 277 77 102 RESULTS
Mistake ratios for L, c, and h with regard DTS 68.8% 15.3% 92.2%
to wrong selected shade number GD 78.9% 21.9% 29.1% The number of total and incorrect
selections of L, c, and h in both groups
Mistake ratios for L, c, and h with regard DTS 31.7% 7.1% 42.5%
to total selected shade number
in step 3 are presented in Table I, and
GD 34.6% 9.6% 12.7% the ratios of mistakes and successful
Success ratios for L, c, and h with regard DTS 68.3% 92.9% 57.5% selections for parameters L, c, and h in
to total selected shade number GD 65.4% 90.4% 87.3% both groups in step 3 are presented in
Table II. The mistake ratios for each
DTS, dental technician student; GD, graduate dentist.
*One participant did not finish step 3 of Toothguide Training Box training, and data were therefore
shade in the VMG for both groups are
excluded from study. presented in Table III.
Although the mistake ratios for h
were significantly higher (P<.001) in
Table III. Mistake ratios for each shade in DTS and GD groups
the DTS group and the mistake ratios
Value DTS Group GD Group for L were significantly higher (P<.001)
in the GD group, no significant differ-
Group Shade L c h L c h
ences were observed between the
1 1M1 6.9% - - 9.4% 9.4% - groups regarding the mistake ratios for
1M2 37.1% - - 3.6% 3.6% - c (P>.05) (Table IV).
Significant differences were ob-
2 2L1.5 32.4% 23.5% 82.4% 34.5% - 3.4%
served in the mean, minimum, and
2L2.5 27.3% 3.0% 21.2% 22.2% 7.4% 7.4% maximum final test scores of the par-
2M1 18.5% 3.7% 11.1% 30.0% 5.0% 5.0% ticipants between the groups (P<.001)
2M2 20.0% 42.9% 71.4% 30.0% 10.0% 17.5% (Table V). When the mean values of the
2M3 36.4% 3.0% 90.9% 25.0% 7.1% 21.4% final test scores were considered, par-
2R1.5 45.9% 13.5% 78.4% 23.5% 8.8% 26.5% ticipants in the DTS group received
2R2.5 87.5% 12.5% 117.5% 27.3% 15.2% 30.3% higher scores compared with the GD
group (912 and 851). With regard to
3 3L1.5 34.3% 8.6% 82.9% 93.5% 9.7% 12.9%
the DE values, participants in the DTS
3L2.5 32.1% 10.7% 28.6% 48.0% - 4.0%
group received significantly lower DE
3M1 24.0% 16.0% 44.0% 30.3% 6.1% 18.2% values than those in the GD group
3M2 24.2% 9.1% 45.5% 14.3% 17.9% 32.1% (P<.001) (Table VI). The mean DE
3M3 51.7% - 10.3% 54.2% 27.1% 22.9% values calculated for the DTS and GD
3R1.5 10.0% - 16.7% 36.8% 10.5% 23.7% groups were 1.72 and 2.92 (Fig. 3).
3R2.5 59.0% - 35.9% 41.7% 12.5% 25.0%
DISCUSSION
4 4L1.5 47.1% 8.8% 38.2% 51.7% 6.9% 10.3%
4L2.5 12.5% 3.1% 78.1% 44.4% 3.7% 14.8%
The null hypothesis of this study was
4M1 32.1% - 7.1% 35.4% 8.3% 4.2%
rejected, as differences in the L and h
4M2 18.5% - 44.4% 55.2% 6.9% 6.9% parameters, the final test scores, and
4M3 41.9% - 32.3% 19.0% 4.8% 14.3% the DE values were observed between
4R1.5 37.8% 8.1% 32.4% 44.0% 32.0% 12.0% the DTS and GD groups. Significant
4R2.5 20.7% 3.4% 51.7% 41.7% 8.3% 8.3% differences were found in L selection
5 5M1 - - - 12.5% - - between the DTS and GD groups. The
GD group performed significantly
5M2 8.0% - - 33.3% 14.3% -
worse with regard to the L parameter.
5M3 - - - 25.7% 5.7% -
However, the DTS group performed
DTS, dental technician student; GD, graduate dentist. significantly worse with regard to the h
Sinmazisik et al
1564 Volume 112 Issue 6
Table IV. Comparison of incorrect matching ratios of parameters L, c, and h Bergen27 recommended that students
among incorrectly selected shades in step 3 between DTS and GD groups begin shade selection with value com-
parison. In a study performed with the
DTS GD
TTB by Llena et al,21 participants
Mistake Mean ±SD Mean ±SD Test (dental students) obtained a greater
Selection Ratio (median) (median) Value P percentage of correct answers for the L
parameter than for the c and h pa-
Incorrect selection L 0.91 1.08 (0.59) 0.83 0.23 (0.8) Z: 2.594 .009**
rameters during the training modus.
c 0.19 0.3 (0.08) 0.22 0.19 (0.21) Z: 1.924 .054 The results of these previous studies
h 1.13 0.82 (0.81) 0.31 0.14 (0.29) Z: 5.957 .001** partially support the findings for the
DTS group of the present study as L
DTS, dental technician student; GD, graduate dentist.
**P<.01, Mann-Whitney U test. was determined more easily than h but
are not in accord with those of the GD
group, who made more L mistakes than
Table V. Comparison of scores achieved in final test for both groups
h mistakes. Llena et al21 evaluated the
Final Test Test Value mean success rate for each of the color
Groups Mean ±SD (median) t: 5.787 parameters, and the greatest identifi-
cation difficulties were observed for
DTS 912.6 32.41 df: 58 hue, with only 62.23% correct answers
GD 851.03 48.43 P¼.001* (72.40% for chroma and 79.86% for
value). In the present study, when the
DTS, dental technician student; GD, graduate dentist.
*P<.01, Student t test.
total number of shade selections were
considered, the mean percentage of
correct answers obtained by the DTSs
Table VI. Distribution and comparison of DE values for both groups for color parameters in step 3 were 68.3
DE Test Value
for L, 92.9 for c, and 57.5 for h,
whereas the mean percentages ob-
Group DE‡2.6 (n) DE<2.6 (n) Min-Max Mean ±SD t: L5.752 tained by the GDs were 65.4, 90.4, and
87.3 for L, c, and h. Additionally,
DTS 5 24 0.46-3.17 1.72 0.73 df: 54
studies by Curd et al28 and Jasinevicius
GD 22 8 0.98-4.38 2.92 0.81 P¼.001*
et al23 reported that when dental tech-
DTS, dental technician student; GD, graduate dentist. nicians and dental students chose an
*P<.01, Student t test. incorrect shade tab, the incorrect
choice often had the same value or
chroma as the correct tab but was of a
6.00
different hue.
Although the DTSs made more
5.00
mistakes in step 3, including many
more hue mistakes, they scored signifi-
4.00
cantly higher on the final test compared
to the GDs. The mean scores obtained
ΔE

3.00
2.00
1.00
0.00
DTS
3 DE values of DTS and GD groups.
parameter. Furthermore, although this
finding was not statistically significant,
parameter c was determined more
easily than L and h by both groups. This
The Journal of Prosthetic Dentistry
GD
finding is consistent with the work of
Winkler et al,22 who found that stu-
dents have more difficulty in deter-
mining the correct hue. Preston and
by the DTS and the GD groups in the
final test were 912 and 851. This result
can be explained by the fact that DTSs,
who had received necessary theoretical
knowledge but had no experience in
shade selection, had systematically
learned shade selection after 3 exercises
with the TTB. In their study evaluating
the effects of the TTB on the shade
selection abilities of dental students by
using VMG, Llena et al21 reported that
the average score of dental students on
the TTB final test was 890.83. Students
who scored 895 points or higher on the
Sinmazisik et al
December 2014
4 Vita Toothguide 3D-Master shade guide.
final test with the TTB obtained a
significantly higher mean success rate
with VMG than those with lower
scores.21 Xu et al29 obtained a similar
average score among professionals with
1 to 5 years of experience in the first
training module of their study (900.29
51.68). In the present study, the
mean final test score of the DTS group
was higher than those reported by Llena
et al21 and Xu et al,29 whereas the mean
score of the GD group was lower.
Previous investigations have indi-
cated that the TTB is an effective
method for teaching and learning
dental color differentiation, and
training with the TTB is known to
improve students’ abilities to accurately
match shades.20 The percentage of
correct answers obtained with the VMG
before and after the training showed a
positive correlation, as high TTB scores
were associated with a greater number
of correct answers.21
The average DE values of the DTS
and GD groups in the final test were
1.72 and 2.92. Participants in the DTS
group received significantly lower DE
values than those in the GD group.
Because there is no gold standard for
the DE threshold for clinical shade
matching, in this study, color differ-
ences of less than 2.6 DE units were
accepted as a match (perceptibility
threshold). The threshold for a resto-
ration color mismatch was set at 5.5
DE units (acceptability threshold), as
recommended by Douglas et al,14 who
simulated an intraoral scenario in
Sinmazisik et al
contrast to other studies performed in
nonclinical in vitro conditions.
The VMG comprises 5 different
value groups with different chroma and
hue (Fig. 4). The mistake ratios for both
groups for each shade are given in
Table V. Participants in the DTS group
made no errors in selecting the 5M1
and 5M3 shades. The lowest L mistake
ratios were detected in shades 1M1 and
5M2, and the highest L mistake ratio
was detected in 2R2.5. No mistakes in c
and h were detected in selecting any of
the shades listed above except 2R2.5. L
mistakes were detected in all shades in
the GD group, with the lowest error
level in selecting 1M2 and 1M1 and the
highest in 3L1.5. Considering the c
mistakes, participants in the DTS group
made no mistakes in the first and the
fifth value groups, whereas the shade
with highest number of c mistakes was
2M2. C mistakes in all shades except
2L1.5, 3L2.5, and 5M1 were observed
in the GD group, with the highest
mismatch in 4R1.5. The lowest and the
highest h mistakes were detected in
4M1 and 2R2.5 in the DTS group and
in 2L1.5 and 3M2 in the GD group.
In the first (1M) and fifth (5M)
VMG groups, no hue selection was
necessary. Therefore, as shown in
Table III, in both groups, few or no
mistakes were observed in the first
(1M1, 1M2) and fifth value groups
(5M1, 5M2, 5M3). Capa et al30 eval-
uated the tooth-shade-matching ability
of different dental occupational groups,
and they used 2L1.5, 1M2, and 2R1.5
1565
as the test shades. These test shades
were similar, but they had different
hues, requiring the participant to pay
considerable attention to distinguishing
the shades. The success rate in selecting
1M2 was significantly higher among the
dental professionals, although 1M2
might have been more challenging
because it is a whitish shade that re-
quires restorative experience and edu-
cation in shade matching.30 In the
present study, shade 1M2 was matched
easily by both groups, and shade 2R1.5
was distinguished more easily by the
GD group than the DTS group.
In this study, shade selections were
conducted with TTB; therefore, an
objective and quantitative comparison
was possible between the DTSs and
GDs. Additionally, the DTSs enrolled in
this study had a satisfactory theoretical
knowledge of systematic shade selec-
tion with VMG, which will be of use in
their professional careers.
CONCLUSIONS
Within the limitations of this study,
it can be concluded that significant
differences exist in the L and h param-
eters between dental technician stu-
dents and graduate dentists. Dental
technician students made more mis-
takes with the h parameter than grad-
uate dentists, and graduate dentists
made more mistakes with the L pa-
rameters than dental technician stu-
dents. With regard to the final test
scores and DE values, dental technician
students achieved more successful
shade matching than graduate dentists.
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Corresponding author:
Dr Gulden Sinmazisik
Department of Dental Prosthetics Technology
Vocational School of Health Services
Marmara University, Buyukciftlik Sok, No. 6
34365 Nisantasi-Sisli/Istanbul
TURKEY
E-mail: gsinmazisik@marmara.edu.tr
Copyright ª 2014 by the Editorial Council for
The Journal of Prosthetic Dentistry.
Sinmazisik et al