Measuring color change of tooth enamel by in vitro remineralization of white spot lesion.

Betina Raquel Tolcachir, Luis Crohare, Raquel Vivian Gallará


Introduction: Objective colour determination is based on calculating the colorimetric distance (ΔE) within a colour space. So far, the most used colour space in dentistry is CIE L*a*b (Comission Internationale de l´Éclairage). CIE L*C*h* has been recently developed, showing a better correlation with the perception of the human eye. Objective: To determine the ability of an in vitro remineralisation substance to mimic the colour of white spot lesions (WSL) with sound enamel, determining ΔE by using the CIE L*C*h* colour space. Methods: In vitro WSL was generated by immersing 10 samples obtained from human third molars in a demineralization solution for 72 h. Amorphous calcium phosphate stabilized by casein phosphopeptide (CPP-ACP) was then applied for 60 days while maintaining the samples in artificial saliva at 37º C. To evaluate the colour of enamel, images were taken from the samples placed in specifically designed silicone moulds after generating the WSL (pre stage) and after remineralisation by scanning, applying the colorimetric distance equation (ΔE*CMC) according to the Color Measurement Committee. Results: Treatment with CPP-ACP caused a significant ΔE decrease with respect to the pre stage (p <0.001), while the analysis of parameters that make up the colour showed a reduction in the difference of hue (∆H) (p< 0,001) and brightness (∆L) (p< 0,01) after applying CPP-ACP. Discussion: CPP-ACP penetrated to the depth of the white spot lesion, making its appearance similar to that of the sound enamel, probably because of the formation of different mineral phases than that of the original structure, although pores were not completely filled.


Bordoni N, Escobar A, Castillo R. Odontología Pediátrica la Salud Bucal del Niño y el Adolescente en el Mundo Actual. Buenos Aires: Ed. Panamericana; 2010

Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan V, Eden E. Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group. Int Dent J. 2012; 62(5): 223–43.

Knösel M, Reus M, Rosenberger A, Ziebolz D. A novel method for testing the veridicality of dental colour assessments. Eur J Orthod. 2012;34(1):19-24.

Ou XY, Zhao YH, Ci XK, Zeng LW. Masking white spots of enamel in caries lesions with a non-invasive infiltration technique in vitro. Genet Mol Res. 2014; 13(3): 6912-19.

Gómez C, Gómez M, Celemin A, Martínez JA. A clinical study relating CIELCH coodinates to the color dimentions of the 3D-Master System in a Spanish population. J Prosthet Dent. 2015; 113(3): 185-90.

CIE (Commission Internationale de l’Éclairage). Improvement to industrial color-difference evaluation. CIE Technical Report 142. Vienna: CIE Central Bureau; 2001.

Rooij JF, Nancollas GH. The formation and remineralization of artificial white spot lesions: a constant composition approach. J Dent Res. 1984; 63(6): 864-67.

Fejerskov O. Changing Paradigms in Concepts on Dental Caries: Consequences for Oral Health Care. Caries Res. 2004; 38(3): 182-89.

Braly A, Darnell LA, Mann AB, Teaford MF, Weihs TP. The Effect of Prism Orientation in the Indentation Testing of Human Molar Enamel. Arch Oral Biol. 2007; 52(9): 856–60.

Kidd EA, Fejerskov O. What Constitutes Dental Caries? Histopathology of Carious Enamel and Dentine Related to the Action of Cariogenic Biofilms. J Dent Res. 2004; 83(Spec No C):C35-8.

Karlsson L. Caries detection methods based on changes in optical properties between healthy and carious tissue. Int J Dent. 2010: 270729.

Yetkiner E, Wegehaupt F, Wiegand A, Attin R, Attin T Colour improvement and stability of white spot lesions following infiltration, micro-abrasion, or fluoride treatments in vitro. Eur J Orthod. 2014; 36(5): 595-602.

Gómez C, Gómez M, Montero J, Martínez JA, Celemin A. Correlation of natural tooth colour with aging in the Spanish population. Int Dent J. 2015; 65(5): 227-34.

Cochrane NJ, Zero DT, Reynolds EC. Remineralization models. Adv Dent Res. 2012; 24(2): 129–32.

Yuan H, Li J, Chen L, Cheng L, Cannon RD, Mei L. Esthetic comparison of white-spot lesion treatment modalities using spectrometry and fluorescence. Angle Orthod. 2014; 84(2): 343-49.

Rocha Gomes Torres C, Borges AB, Torres LM, Gomes IS, de Oliveira RS. Effect of caries infiltration technique and fluoride therapy on colour masking of White spot lesions. J Dent. 2011; 39(3): 202-7.

Kim Y, Son HH, Yi K, Kim HY, Ahn J, Chang J. The colour change in artificial white spot lesions measured using a spectroradiometer. Clin Oral Investig. 2013; 17(1): 139-46.

Cochrane NJ, Cai F, Huq NL, Burrow MF, Reynolds EC. New approaches to enhanced remineralization of tooth enamel. J Dent Res. 2010; 89: 1187–97.

Full Text: PDF


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.

Corresponding: Facultad de Odontología, Universidad de Concepción, Chile. Roosevelt 1550, Concepción, Chile. Phone +56-41-2204232 - E-mail