Analysis of color differences in stained contemporary esthetic dental materials

Color alteration of CAD/CAM 3D-printed, milled resin-ceramic hybrid material compared to enamel

To assess color and translucency change (∆E00 and ∆TP) of 3D-printed (Varseosmile crown plus, VS) and milled resin-ceramic hybrid material (Cerasmart, CS) compared to enamel (E) when immersed in distilled water (DW) and coffee (C). Sixty VS, CS, and E specimens were immersed in DW and C for 30 days. Statistics analysis using t-test and one-way ANOVA at p≤0.05. ∆E00 of VS, CS, and E significantly increased when immersed in coffee (p<0.001, p<0.001 and p=0.01, respectively). E has more ∆E00 than VS and CS (p<0.001). The translucency of VS and CS was reduced after water and coffee immersion. The translucency of E was increased after immersion in water and coffee. ∆TP of VS, CS, and E were not different between immersion in water and coffee at p=0.08, p=0.43 and p=0.72, respectively. Therefore, DW and C have distinct effects on the ∆E00 and ∆TP among VS, CS and E.

Color stability of two different resin matrix ceramics: randomized clinical trial

BACKGROUND

One of the most common causes of aesthetic failure and restoration replacement is the tooth restorations color mismatch specifically after aging.

METHODS

One hundred and two participants with endodontically treated first molar were selected clinically. The patients were randomly splited into two groups and restored either with Cerasmart hybrid ceramic or Vita Enamic polymer infiltrated ceramic network (PICN) crowns and cemented using dual cure adhesive cement. The color difference (ΔE) values after cementation at 0 (Baseline), 6, and 12 months of use were obtained by quantification of L*, a*, and b* values with a digital spectrophotometer. Mann-Whitney test used to compare between tested groups at each time point and between (α = 0.05).

RESULTS

At 6 months follow-up intervals, Vita Enamic group showed the highest significant ∆L* (p = 0.035) and ∆a* (p < 0.001) compared to Cerasmart group. ∆b* and ∆E showed no significant difference between both groups (p > 0.05). Furthermore, all color parameters of both groups showed statistically significant difference at 12 months follow-up intervals. After 12 months, Vita Enamic restorations presented higher color change compared to Cerasmart restorations with a (p-value of 0.0120). When comparing the total color difference ∆Et through-out the follow-up intervals of Vita Enamic & Cerasmart groups, there were insignificant difference (p = 0.263).

CONCLUSION

Both hybrid materials demonstrated comparable color stability after 1 year of clinical service within clinical acceptance range. However, Cerasmart demonstrated a better colour stability after 1 year.

TRIAL REGISTRATION

ClinicalTrials.gov (ID: NCT05501808) 15/8/ 2022- 'retrospectively registered'.

Effect of monomer composition and filler fraction on surface microhardness and depth of cure of experimental resin composites

This study evaluated microhardness profiles and calculated depths of cure at 80% of the surface microhardness of experimental dental resin composites having different base monomer compositions and different filler fractions. Composites were prepared using four different base monomers (bisphenol A-glycidyl methacrylate [Bis-GMA], urethane dimethacrylate [UDMA], ethoxylated bisphenol-A dimethacrylate [Bis-EMA], and Fit-852) with triethylene glycol dimethacrylate (TEGDMA) used as a co-monomer at three filler:resin matrix weight percent fractions (50:50, 60:40, and 70:30). Uncured material was placed in 3D printed molds and light cured for 40 s from the top surface only. Knoop microhardness was measured at the top of the specimen, and at every 0.5 mm up to 4 mm in depth. Microhardness at the surface increased in all experimental composites as the filler fraction increased. When comparing base monomers, microhardness was the highest in UDMA-based composites, while Bis-GMA-based composites showed the lowest values. When comparing depth of cure as a function of base monomer type, both Bis-GMA and Bis-EMA showed significantly lower values than UDMA or Fit-852. Composites having 50 wt% filler showed a significantly higher depth of cure than those with 60 and 70 wt% filler. Base monomer and filler fraction significantly influence microhardness and depth of cure in these experimental composites.

Color Stability of Polymer-Based Composite CAD/CAM Blocks: A Systematic Review

BACKGROUND

This systematic review aims to evaluate the color stability of resin composite CAD/CAM blocks (CCB) when submitted to staining solutions.

METHODS

A systematic search was performed on different databases (Embase, Medline, Scopus, Web of Science). Search terms were: 'polymer infiltrated', 'polymer-based', 'resin nanoceramic', 'resin ceramic', 'hybrid composite', 'hybrid ceramic', 'composite ceramic', 'resin infiltrated', 'CAD-CAM', 'CAD/CAM', 'color stability', 'staining', 'staining susceptibility', 'color change', 'color difference'.

INCLUSION CRITERIA

in vitro articles published in the English language until 18 September 2022 without initial time restriction evaluating the color stability of CCB when submitted to staining solutions.

EXCLUSION CRITERIA

studies investigating color change induced by smoke or whitening treatments; studies not including a clinical evaluation of the results using the thresholds for color perceptibility and acceptability. Risk of bias assessment using the QUIN tool.

FINDINGS

Out of the 378 initially retrieved articles, 19 were included in this review. They investigated 17 different CCBs and different artificial staining by liquid protocols, including coffee, red wine, tea, and cola. CCBs exceeded clinical acceptability thresholds for color shift in 18 out of 19 studies, with a significantly higher color stability than conventional hybrid resin-based composites (RBCs), and a significantly lower color stability than ceramic materials. The identified differences in CCBs in color stability can be attributed to the material's composition, but also to the heterogeneity of staining procedures. Interpretation and clinical implication: Clinicians should be aware that, although to a lower degree when compared to RBCs used in direct or indirect procedures, CCBs undergo color changes to a higher degree in comparison to ceramic materials.

The effect of bleaching applications on stained bulk-fill resin composites

Background

The structure of bulk-fill resin composites differs from that of their conventional counterparts, but how this difference affects the color stability of the former after staining and bleaching is unclear. Accordingly, this study was aimed at investigating color change in nine bulk-fill resin composites and one nanohybrid resin composite treated with hydrogen peroxide and carbamide peroxide after staining with tea, coffee, and red wine.

Methods

Eighty specimens were prepared from each resins [Clearfil Majesty Posterior (CMP), SDR flow⁺ (SDR), Filtek^TMBulk-Fill Flowable Restorative (FBF), Reveal HD Bulk (RHD), Beautifil-Bulk Restorative (BBR), Tetric EvoCeram® Bulk Fill (TEC), SonicFill™2 (SF2), everX Posterior™ (eXP), X-tra base (XB), and Venus® Bulk Fill (VBF)]. Following baseline color measurements, the specimens were randomly divided into 4 groups according to immersion solutions and distilled water as the control. At the end of a 30-day test period, color measurements were repeated, and color change values (∆E₀₀) were calculated. Each resin group was then divided into 2 subgroups (with 10 specimens per group) on the basis of bleaching agent (Opalescence Boost 40%, Opalescence PF 16%). Following bleaching application, ∆E₀₀ and changes of whiteness (∆WI_D1 = WI_Dbleaching-WI_Dbaseline, ΔWI_D2 = WI_Dbleaching-WI_Dstaining) values were recorded. Two- and three-way analyses of variance and Tukey’s post hoc test were performed, with a P < 0.05 regarded as indicative of significance.

Results

After immersion in distilled water, tea, and red wine, the highest ΔE₀₀ values were observed in eXP (P < 0.05). Resin materials immersed in coffee and tea exhibited statistically higher ∆E₀₀ values than those immersed in red wine except for eXP, TEC, and FBF (P < 0.05). For eXP, the highest ∆E₀₀ values were recorded in distilled water. For TEC and FBF, there was no statistically significant difference among the immersion solutions and distilled water (P > 0.05). For all the resins and staining beverages, no statistically significant difference in ∆WI_D1 and ∆WI_D2 values were detected between bleaching agents (P > 0.05). All the ΔWI_D1 values were above the whiteness perceptibility threshold.

Conclusion

The bulk-fill materials were more resistant to discoloration and bleaching procedures than the conventional resin composites. Coffee and tea caused more staining than distilled water and red wine generally. The type of bleaching procedure had no effect on the whiteness of the tested materials.

Mechanical Properties of Bisacryl-, Composite-, and Ceramic-resin Restorative Materials

OBJECTIVE

Resin-based materials used in restorative dentistry are introduced at a fast pace with limited knowledge about their properties. Comparing properties of these materials from different restorative categories is lacking but can help the clinician in material selection. This study aimed to compare mechanical properties and wear resistance of bis-acryl-, composite-, and ceramic-resin restorative materials.

METHODS AND MATERIALS

Bisacryl-resin (Bis-R, LuxaCrown, DMG), composite-resin (Com-R, Filtek Supreme Ultra, 3M Oral Care), and ceramic-resin (Cer-R, Enamic, VITA Zahnfabrik) specimens were prepared for mechanical tests: fracture toughness (FT) with and without initial thermomechanical loading using a mastication simulator, flexural strength (FS), and flexural modulus (FM), compressive strength (CS), and volumetric wear loss measurement. The datasets for FT and wear resistance were each analyzed using two-way ANOVA followed by pairwise comparisons or Tukey testing as appropriate. The datasets for FS, FM, and CS were analyzed using one-way ANOVA followed by the Tukey test.

RESULTS

Analysis of FS, FM, and CS showed significant differences between materials, with all pairwise comparisons between materials showing significance. Analysis of FT resulted in a significant interaction between the material and treatment, with analysis of wear loss showing a significant interaction between the material and the number of cycles.

CONCLUSIONS

Cer-R demonstrated superior FT, CS, and wear resistance compared to Bis-R and Comp-R materials. Fracture toughness of Bis-R increased after thermomechanical loading.