Prosthodontics & Occlusion · patient case question
When should the shade be selected?
Patient case: Shade selection for an anterior restoration
Patient: Adult requiring an anterior indirect restoration
Chief complaint: Concerned about the appearance of the definitive crown.
Background: No relevant medical history reported.
Current findings: Shade selection is being carried out against a prepared tooth, using a shade guide.
Show answer and explanation
Correct answer: D. At the start of the appointment, before the teeth are isolated and allowed to dry
- A. This is the very error described. Dehydrated teeth appear falsely light.
- B. Intense direct light bleaches perception and obscures the subtleties of value and translucency.
- C. By the end of the appointment the tooth is fully dehydrated and the reference tooth may be gone.
- D. CORRECT. Shade must be taken FIRST, before isolation and dehydration. Teeth dehydrate rapidly once isolated, becoming lighter and more opaque as enamel loses water and its refractive index changes. A shade taken from a dehydrated tooth will be too light, and the restoration will look conspicuously dark once the tooth rehydrates.
Note: Take the shade at the start, on hydrated teeth, under neutral light, at eye level, in short glances of 5–7 seconds.
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