One of my favorite things right now: Custom composite shade tabs

Ever sweat your way through an anterior composite restoration, only for it not to match perfectly after? I certainly have, and it can be extremely frustrating for both dentists and patients. Matching composite to natural tooth structure can be particularly challenging for a few reasons:

1. Many conventional shade guides are ceramic. Ceramic and composite have very different optical properties, so don’t rely on a ceramic shade tab to match your composite.
2. There is a lot of variation in shade for composites. Don’t believe me? Take a few different brands of A2, dispense them on a glass slab, cure, and see for yourself!
3. It is important to know the classification of the composite you are using. Different classifications of composite have different filler content and different physical and optical properties. For example, a heavily filled hybrid composite offers more opacity and strength than a nanofilled composite that is intended for an enamel replacement.
4. It is extremely common for composite to appear different after it is completely cured.

One thing that has helped me create more predictable outcomes with composite is to fabricate custom shade tabs. It’s not as cumbersome as you may think to fabricate a custom shade tab. Some manufacturers facilitate the process, such as Tokuyama Dental (figure 1) and 3M (figure 2).

If you don’t have a kit to fabricate them, this can be easily done by indexing an existing shade tab into putty. Once the putty is set, you can use that as a template for custom shade tabs, and they can be affixed to a handle (I use coffee stirrers!). I fabricate a custom shade tab for every composite (figure 3) I have and color code them so I can easily identify my dentin shades, enamel shades, and value shades.

Here’s another tip for getting a perfect shade match: when you narrow down your composite selection, apply a small amount of composite to the tooth before etching and bonding, and then cure. The final shade of the composite after curing will be established, and it will help you finalize your composite selection. It is easily removable and worth the time!

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Editor’s note: This article first appeared in Through the Loupes newsletter, a publication of the Endeavor Business Media Dental Group. Read more articles at this link and subscribe here.

Pamela Maragliano-Muniz, DMD, is the chief editor of DentistryIQ and editorial co-director of Through the Loupes. Based in Salem, Massachusetts, Dr. Maragliano-Muniz began her clinical career as a dental hygienist. She went on to attend Tufts University School of Dental Medicine, where she earned her doctorate in dental medicine. She then attended the University of California, Los Angeles, School of Dental Medicine, where she became board-certified in prosthodontics. Dr. Maragliano-Muniz owns a private practice, Salem Dental Arts, and lectures on a variety of clinical topics. You may contact her at [email protected].