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Updated: Jul 6, 2026

Accuracy in Dental Medicine, A New Way to Measure Trueness and Precision
Published on: April 29, 2014
Reliability of Dental Shade Selection Methods: Agreement Among Spectrophotometer, Intraoral Scanner, and
Jose Alfredo Gonzalez-Chavez1, Uriel Soto-Barreras1, Brenda Perez-Aguirre1
1Faculty of Dentistry, Autonomous University of Chihuahua, Chihuahua, Mexico.
Objective:
The study aimed to evaluate the reliability and agreement of dental shade selection methods-spectrophotometry, intraoral scanning, and cross-polarized digital photography (CP photography)-using VITA Classical (VC) and VITA 3D-MASTER (V3M) shade guides.
Materials And Methods:
The shade of the central area of the right maxillary central incisor was assessed in 56 subjects using three methods: SpectroShade spectrophotometer, 3Shape TRIOS intraoral scanner, and CP photography. All measurements were standardized, performed in triplicate, and conducted under controlled conditions. Fleiss' Kappa was used to evaluate intra-instrument reliability, while Cohen's weighted Kappa assessed inter-instrument agreement. CIEDE2000 (ΔE 00) values were calculated to evaluate the magnitude of color differences between methods.
Results:
Intra-instrument reliability was highest for the spectrophotometer across both shade guides, followed by CP photography and the intraoral scanner. Inter-instrument agreement revealed substantial agreement between CP photography and the spectrophotometer for the VC guide (κ = 0.736) and moderate agreement for the V3M guide (κ = 0.553). The intraoral scanner showed moderate to substantial agreement with the spectrophotometer for the V3M guide (κ = 0.607). Additionally, CP photography yielded fewer cases exceeding the acceptability threshold than the intraoral scanner.
Conclusions:
CP photography demonstrated high intra-instrument reliability and substantial agreement with the spectrophotometer, particularly when using the VC guide.
Clinical Significance:
This study supports the use of accessible methods, such as CP photography, for accurate shade selection, which could potentially enhance clinical outcomes and patient satisfaction in restorative dentistry.

