Quantifying enamel luster

When the pH of the oral cavity drops below 5.5, the hydroxyapatite crystalline lattice is damaged and the tooth surface becomes rough. Consequently, specular reflection is decreased and results, clinically, in a loss of tooth luster. The aim of this study was to develop a digital image capture and processing algorithm to quantify enamel luster.

Extracted human teeth (n = 25) containing no restorations and with no clinical evidence of caries were used in this study. The teeth were sectioned longitudinally in a mesial-to-distal orientation to provide experimental and control groups. The experimental group was treated with six consecutive 60-minute exposures to an acidic soft drink, separated by tap water rinses; the control group was similarly treated with just the tap water. Standardized photographs were made before and after application of the treatment or control conditions. Images were converted to eight-bit monochrome digital format. The clinical crown was identified using a standard digital masking technique. Luster in the crown was quantified by determining pixels with luminescence values that were 65% above background.

Overall, there was an average 53.6% change in luster in the experimental group, and a nominal 2.10% change in luster in the control group. Analysis of variance revealed a significant loss in luster as measured by this algorithm in the experimental group (p < 0.001), while no significant change in luster was found in the control group. The method reliably identified luster with a repeatability coefficient of 0.992.

Our digital processing algorithm consistently quantified loss of enamel luster associated with exposure to an acidic beverage. This digit photographic technique may be valuable for evaluating changes in the esthetic chacteristics of teeth when they are exposed to a variety of adverse environments.