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procedures, goal and final result in a patient-
friendly way, but also visual ones, such as wax-ups
and composite mock-ups in the patient’s mouth,
and lately, more digital, such as various software
solutions that offer graphic, 3D simulations of
the future appearance of the patient.
In this sense, a special group of our patients
are those who have an indication for teeth
whitening procedures due to the unsatisfactory
existing shade of the tooth structure. Namely,
in such patients, and most often in the younger
population with completely healthy and intact
teeth, we are not able to show them the final shade
Fig 3: Digital connection of the mobile device and the VITA Easyshade V spectrophoto- of their teeth by making wax-ups or mock-ups.
meter for the purpose of transmitting the measured values to the mobile application. The Previous digital programs offered an excellent
new module works on iOS and Android mobile devices.
graphic level simulation of change in shape, size
and position of the teeth, but not a satisfactory
shade change. The only thing we have used
thus far for this purpose, are different, typically
unsatisfactory shade tabs for the everyday shade
assessment in dental offices. For the shade change
during a bleaching procedure these shade tabs in
generally do not have a sufficient range of shades,
proper shade distribution or ability to display
and monitor tooth discoloration. So far, only
oneappropriateshade guide has been developed:
The VITA Bleachedguide 3D-Master (BG, Vita
Zahnfabrik, Bad Säckingen, Germany) has a
logical sequence, uniform shade distribution
and brighter shade options. The development of
Fig 4a-d: Digital protocol for photo input and clinical measurement in a mobile application. the shade guide offerstabs thathave the correct
and always uniform change in lightness and
saturation, and therefore serves to monitor
shade changes during all bleaching processes. It
should be emphasized that during the whitening
process, it is important to know that it changes
the shade by lightening, and at the same time,
desaturating the tooth structure (reduces the
intensity or chroma in a shade), and that these
parameters can be visually monitored only with
a shade guide that satisfies the above. This is
impossible with other shade guides and, most
importantly, leads to inaccurate determination.
However, it is not good to rely solely on the
individual assessment of the dental professional
and the patient to monitor and evaluate the
Fig 5a-d: Digital calibration and adjustment of the entered photo in the mobile application
and marking the area where the shade change will be simulated. success of whitening, because the patient is
often unable to properly assess the change, due
to frequent observation of their teeth during the
our patient can understand and accept the same. Many years of clinical experience have procedure. For this purpose, a large number of
taught us that the disparity in understanding the results achieved by dental procedures, dentists photograph the initial situation so that
ultimately ends in patient dissatisfaction and a number of other complications, including the photo can later be compared with the result,
potential legal challenges. but it should be noted that the change in tooth
In this sense, the dental profession has advanced with the development of various shade in the photos can be properly assessed only
communication skills and tools, not only verbal ones that attempt to explain the purpose, if the photos are always taken in the same patient

Dental Practice i July-August 2023 i Vol 19 No 4 51