There are no previous studies validating the accuracy and repeatability of ClearMatch photographic shade analysis system. The purpose of this study was to compare the shade matches performed by a photographic shade analysis system (ClearMatch) with conventional visual shade matching method under simulated clinical conditions. Three shade matching methods were used to match twelve shade tabs under simulated clinical conditions using a Vita Classical shade guide: conventional visual shade matching using 3 human raters (VM – Visual method), photographic shade analysis system (CM - ClearMatch) using two different ways of normalizing the image (CM-A2 and CM-ref respectively). Shade matching for all methods was completed at two separate sessions. The Kappa statistic was used to determine the intra-rater and inter-rater agreement. CIELAB values of the shade results were used to produce scatter plots as well as to calculate the color difference (delta E) between VM and CM groups. There was no inter-rater agreement between VM and CM-A2 (k=0.000 and k=0.015 for the first and second sessions respectively) while VM and CM-ref showed weak agreement (k=0.244 and k=0.091 respectively). Intra-rater agreement was strong in all groups VM, CM-A2 and CM-ref (0.705, 0.803 and 0.681 respectively). CM-A2 had 2 (8.3%) shade matches with a delta E of less than 2.6 (clinically imperceptible), while CM-ref had 12 (50.0%) imperceptible matches. CM-A2 had an additional 16 (66.6%) shade matches with delta E of less than 5.5 (clinically acceptable), while CM-ref had 23 (95.8%) additional acceptable matches. There was poor agreement in exact shade matches between conventional visual shade matching method and the photographic shade analysis system. The repeatability of the photographic shade analysis system was shown to be comparable to conventional visual shade matching. Using conventional shade matching as the gold standard, the capability of this photographic shade analysis system to accurately shade match has not been achieved.

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