Agreement and Consistency of Visual and Digital Tooth Shade Selection: An In Vivo Comparison of Expert Practitioners and Senior Dental Students

Background: Accurate shade selection is essential in restorative and prosthetic dentistry, but visual matching is subjective and influenced by lighting, clinical experience, and color perception. Digital spectrophotometers offer objective, reproducible measurements. Objective: The aim of this study was to compare visual shade selection using the VITA 3D-Master guide by expert practitioners and senior dental students against a digital spectrophotometer (Rayplicker Handy), and to assess inter-examiner consistency within each group. Methods: Five expert practitioners and five senior dental students selected shades (cervical, middle, and incisal thirds) on the maxillary right central incisor in 40 participants, followed by digital measurement. Shade values were converted to CIE Lab* coordinates to compare groups, evaluate inter-examiner consistency, and calculate intraclass correlation coefficients (ICC). Results: Expert–student agreement was close, with small mean ΔE (2.1–2.5 across regions), above the perceptibility threshold (1.2) but within the acceptability threshold and no significant difference (Friedman test, Dunn’s post hoc, p > 0.05 in all regions). Both groups differed markedly from the Rayplicker (mean ΔE 11.9–16.2), exceeding the 50:50% acceptability threshold (ΔE*ab = 2.7) and significantly greater than the expert–student difference (p < 0.001); expert–Rayplicker and student–Rayplicker differences did not differ from each other (p > 0.05). Inter-examiner within-group dispersion was significantly lower (better agreement) among experts than students in the incisal (p < 0.001) and cervical (p = 0.049) thirds, with no difference in the middle third (p = 0.116); intraclass correlation coefficients were directionally higher for experts in all nine region-by-component comparisons, though confidence intervals overlapped between groups and absolute reliability was poor-to-moderate for both. Conclusions: Visual and digital shade selections differed substantially in this study, exceeding the clinically acceptable 50:50% threshold, while expert practitioners and senior students chose comparably close shades to one another using the visual method. However, experts were more internally consistent than students in most regions, suggesting that clinical experience was associated with greater reproducibility, though not necessarily accuracy, of visual shade selection.