The effect of varying head tilt on the perceived color from composite resin and porcelain restorations: Simulating the effect of altering torque

This study aimed to assess the effect of changes in tooth torque on the perceived color of composite and porcelain restorations. A total of 30 patients with previous composite restorations and 30 patients with porcelain restorations on lateral and central incisors were selected. To simulate the effect of dental torque change, we asked the patients to tilt their heads upwards and downwards to represent buccal and palatal crown torque, respectively. Photographs were taken in 3 different positions (natural head position, 15° upward tilt, and 15° downward tilt). A laser alignment tool was used to help with head positioning. Color was measured on the 3 principal axes of the Commission Internationale de L'Eclairage, L∗, a∗, and b∗ color space using Photoshop software (Adobe, San Jose, Calif), and color differences were calculated. The midpoint of the clinical crown, both mesiodistally and incisogingival, was selected as the point of measurement. A general linear model was used to analyze the significance of changes in each value of different tooth torques. A t test was used to compare color changes of 2 different incisors (central and lateral) and overall color differences in the 2 types of restoration. Significant changes of the L∗ and a∗ values were found as a result of the change in head inclination, whereas b∗ values remained unchanged. It was found that buccal crown torque resulted in lighter and greener porcelain restorations. Composite restorations behaved similarly with the only difference being that the central incisors appeared bluer. Palatal crown torque resulted in a darker and redder porcelain restoration and a darker, redder, and yellower composite restoration. No significant differences were found between color changes in the central and lateral incisors. Furthermore, porcelain and composite restorations had similar color changes with alteration of head inclination. Orthodontic changes of tooth torque alter the color perceived from composite and porcelain restorations. •Changing tooth torque led to an alteration in perceived color from esthetic restorations.•The change in color was similar between the central and lateral incisors.•Composite resins and porcelain veneers behaved similarly with altering torque.