The use of a standardized gray reference card in dental photography to correct the effects of five commonly used diffusers on the color of 40 extracted human teeth.

The aim of this in vitro study was to investigate the color changes of human teeth caused by five different diffuser materials commonly used in dental photography, as well as software influence, and to confirm whether the use of a standardized gray reference card is effective in correcting these color changes during digital postproduction.Forty extracted human teeth were obtained from a specialized oral surgery practice in Cham, Germany. Five commonly used diffuser materials were chosen to be investigated, which included: polyethylene (PET), White Frost photographic paper, LumiQuest polyamide (nylon) material, 80 gsm white printing paper, and 3M linear polarizing filter sheet used for cross polarization. A digital single-lens reflex camera (Canon EOS 5D MKII) was used, together with a twin flash suitable for macrophotography (Canon MT-24EX Macro Twin Lite). Images were tethered into Adobe Lightroom CC using the RAW format. A standardized gray reference card (WhiBal, Michael Tapes Design) was used for exposure calibration and white balancing. Classic Color Me- ter software (Ricci Adams, version 1.6 (122)) was used to obtain CIE L*a*b* values of the specimens before and after white balancing and exposure correction.All diffusers caused visually perceivable color changes on the extracted teeth: White Frost (ΔE* 1.24; sd 0.47), 80 gsm printing paper (ΔE* 2.94; sd 0.35), LumiQuest polyamide (ΔE* 3.68; sd 0.54), PET (ΔE* 6.55; sd 0.41), and 3M linear polarizing filter sheet (ΔE* 7.58; sd 1.00). The use of a standardized gray reference card (WhiBal) could correct these values below the visually perceivable threshold: White Frost (ΔE* 0.58; sd 0.36), 80 gsm printing paper (ΔE* 0.93; sd 0.54), LumiQuest polyamide (ΔE* 0.66; sd 0.58), PET (ΔE* 0.59; sd 0.33), and 3M linear polarizing filter sheet (ΔE* 0.53; sd 0.42).The use of a standardized gray reference card with specified CIE L*a*b* values should be considered when diffusers are used in dental photography in order to reveal the color of preoperative situations (ie, shade documentation) and document postoperative results accurately.