Effect of toothbrushing on color changes of esthetic restorative materials

Changes in optical properties of aesthetic paediatric restorative materials following exposure to beverages: In-vitro study

PURPOSE

Optical properties of recent aesthetic restorative materials must maintain an acceptable appearance throughout their functional lifetime. This study aimed to assess the changes in translucency and colour of recent resin-based restorative materials after exposure to beverages commonly consumed by children.

METHODS

An experimental in-vitro study on 48 discs specimens prepared from; Group I: Filtek Z250 XT (Nanohybrid), Group II: Cention N (Alkasite bulkfill), and Group III: SDR flow Plus (Flowable bulkfill). The prepared disc specimens were randomly assigned into 4 subgroups (n = 12) according to the immersion solution: Subgroup A (control): distilled water, B: Coca-Cola, C: chocolate milk, and D: Orange juice. Translucency and colour measurements were done before immersion (baseline) and on day 30 of exposure. Statistical analysis involved Two Way Repeated Measures ANOVA and Kruskal-Wallis test.

RESULTS

The statistical analysis revealed that the restorative material, immersion time, and immersion solution had a significant effect on the change in translucency (p < 0.0001*, p < 0.0001*, p = 0.001*, respectively). Regarding colour changes, different immersion solutions had a statistically significant effect on Filtek Z250 XT and Cention N (p < 0.0001*). Distilled water and Coca-Cola were found to have a significant effect on colour change for all restorative materials investigated (p < 0.0001*, p = 0.003*).

CONCLUSION

the optical properties of resin-based restorative materials used in paediatric dentistry were notably affected by prolonged exposure to beverages commonly consumed by children.

Effect of Orange Juice on the Properties of Heat-Polymerized and 3D-Printed Denture Materials

This study evaluated the color stability, surface roughness, and hardness of 3D-printed and heat-polymerized denture materials. A total of 90 samples were prepared, with equal numbers of 3D-printed and heat-polymerized disks. The initial hardness, surface roughness, and color values of the samples were measured. After 14 days of immersion in distilled water, natural orange juice, or commercial orange juice, the measurements were repeated. Based on the findings, 3D-printed samples exhibited a greater reduction in Vickers hardness (56.24 ± 15.81%) compared to heat-polymerized samples (18.93 ± 11.41%). Materials immersed in commercial orange juice exhibited a greater reduction in hardness compared to those in other solutions (43.13 ± 23.66). Surface roughness increased by 46.66 ± 26.8% in heat-polymerized samples and by 26.16 ± 20.78% in 3D-printed samples, with the highest increase observed in commercial orange juice (50.73 ± 28.8%) (p < 0.001). The color change (ΔE) was significantly higher in heat-polymerized samples (ΔE = 5.05 ± 0.28) than in 3D-printed samples (ΔE = 3.9 ± 0.26) (p < 0.001). This study demonstrates that the material type and immersion solutions play a critical role in determining the mechanical and optical properties of denture materials, with commercial orange juice having the most pronounced effect on surface roughness and hardness.

Evaluation of the color stability of resin composites subjected to artificial aging procedures: immersion in different solutions, brushing, and thermal cycling

The aim of this in vitro study was to evaluate the color change of resin composites with different filler contents subjected to immersion in different solutions, brushing, and thermal aging procedures. A total of 320 samples were prepared using 4 different flowable and 4 different conventional resin composites (n = 40). The samples were separated into 4 subgroups according to the solution to be used (wine, coffee, tea, or distilled water) and then immersed in the solutions for 12 days. All samples were subjected to 10,000 cycles of brushing and 10,000 cycles of thermal cycling procedures. ∆E values were calculated according to CIEDE2000 and CIELab color systems. For statistical analysis, the 3-way analysis of variance, the Tukey test, and the intraclass correlation coefficient were used. The significance level was taken as P < 0.05. Mean color change values differed significantly according to the solution, type of resin composite, and their interactions (P < 0.001). The values of the highest color change were obtained in wine, according to solutions, and conventional according to type. The filler content, viscosity, solutions to which they are subjected and their interactions with each other are effective factors in the color stability of restorative materials. The most effective factor in the color change of resin composites was the solution.

Effect of coffee staining and simulated oral hygiene methods on the color and translucency of a nanoceramic resin

OBJECTIVE

Evaluate the color and translucency of a nanoceramic resin subjected to hygiene practices and immersion in coffee over time.

MATERIALS AND METHODS

Specimens (n = 80, HT and LT, 0.5-mm thick) of a nanoceramic resin were obtained and were divided in groups according to the simulated oral hygiene: no intervention (NT), brushing with an electric brush and water (BN), brushing with an electric brush and toothpaste for 10 s (BT), and immersion in mouthwash for 30 s (MW). Oral hygiene practices were repeated after staining in coffee solution for 15, 48, 336, 1440, 8640, and 35,040 min. Spectral wavelengths were recorded with a spectrophotometer at each time. ∆E00, ∆L', ∆C', ∆H', and TP00 were calculated by CIEDE2000 and were evaluated by 2-way ANOVA, repeated measures ANOVA, and Tukey's HSD test (α = 0.05).

RESULTS

ANOVA showed significance among factors for ΔE00 (p < 0.05), with higher ΔE00 for NT-HT (11.7) and NT-LT (11.2). After T6 (2-year simulation), the lowest values were found for BT-HT (5.3) and BT-LT (4.9). All groups showed a reduction in lightness and translucency and increased chroma and hue. However, the smallest variations were found in the BT groups (p < 0.05).

CONCLUSIONS

Brushing with toothpaste effectively minimized the color change of NCRs caused by coffee staining.

CLINICAL SIGNIFICANCE

Oral hygiene practices, such as brushing with toothpaste, might be important to minimize staining of nanoceramic resin restorations, especially in patients who frequently consume coffee.

Quantification of Color Variation of Various Esthetic Restorative Materials in Pediatric Dentistry

Aim of study

The goal of this paper is to find an association between the staining capacity of dental restorations used in pediatric patients and food items and to develop an optimum model to predict the most informative factor that causes the highest amount of color change through machine learning algorithms.

Background

Color changes in restorative materials occur as a result of intrinsic and extrinsic factors, such as the type of restorative material, food items used, polished status of the material, and time interval.

Materials and methods

This was an "in vitro study" conducted at Aligarh Muslim University, Aligarh, Uttar Pradesh, India. The study included 200 specimens, that is, 40 in each group A (orange juice), group B (Amul Kool Café), group C (Pepsi), group D (Amul Kesar Milk), and group E (artificial saliva). The materials were glass ionomer cement (GIC), resin-modified glass ionomer cement (RMGIC), microhybrid composite resin, and nanohybrid composite resin. These were further divided into polished and unpolished groups. The optimum modeling of the prediction of color change in materials by different effective factors was done by machine learning decision tree. We applied two algorithms: Chi-square automatic interaction detector (CHAID) and classification and regression tree (CART). In prediction modeling in the decision tree by CHAID and CART, color change is taken as the dependent variable, and group (type of restorative material), food items, time interval, and polished status are taken as independent variables.

Results

The various beverages caused significant color variation due to different pigmentation agents. The agent that caused the highest color change was Kool Café. The Kesar Milk had the lowest pigmentation capacity. The greatest color variation was found on Glasionomer FX-II submerged in Pepsi and the least on Ivoclar Te-Econom Plus in Kesar Milk. The mean absolute error for the training dataset in the CART model and CHAID model is 0.379 and 0.332, and for the testing data set, it is 0.398 and 0.333, respectively. Therefore, the prediction of color change by the CHAID model is optimum, and we found that the restorative materials have a maximum predictor importance of 0.86 (86%), time interval 0.07 (7%), food items 0.04 (4%), and polished status has the least importance, that is, 0.03 (3%).

Conclusion

The staining capacity of restorative material highly depends on the material itself, the initial time interval, and least on the food items used.

Clinical significance

The clinical performance of dental restorations could be affected by various beverages consumed by children. This study thus provides important clinical insights into esthetic dentistry by offering valuable information on long-term color stability and the effect of polishing on common esthetic restorative materials used in pediatric dentistry.

How to cite this article

Varshney P, Khan SY, Jindal MK, et al. Quantification of Color Variation of Various Esthetic Restorative Materials in Pediatric Dentistry. Int J Clin Pediatr Dent 2024;17(7):754-765.

Effect of the Different Dietary Supplements on the Average Surface Roughness and Color Stability of Direct Restorative Materials Used in Pediatric Dentistry

Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children's oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial to predict the properties of restorative materials when exposed to dietary supplements to maintain the dental care of children. Thus, this study aimed to investigate the effect of various syrup-formed dietary supplements on the average surface roughness and color stability of current restorative materials used in pediatric dentistry. Seven different restorative materials (conventional glass ionomer [Fuji IX GP], resin-modified glass ionomer, [Fuji II LC], zirconia-reinforced glass ionomer [Zirconomer Improved], polyacid-modified composite resin [Dyract®XTRA], bulk-fill glass hybrid restorative [Equia Forte HT Fill], conventional resin composite [Charisma Smart], and resin composite with reactive glass fillers [Cention N]) were tested. The specimens prepared from each type of restorative material were divided into five subgroups according to dietary supplements (Sambucol Kids, Resverol, Imunol, Umca, and Microfer). These specimens were immersed daily in supplement solution over a period of 28 days. Surface roughness and color difference measurements were performed at baseline and at the 7th and 28th days. The color difference and Ra values showed that there was an interaction among the type of restorative material, type of dietary supplement, and immersion time factors (p < 0.05). Whereas lower Ra values were found in the composite resin group, the highest Ra values were found in the conventional glass ionomer group. All supplements caused increasing color difference values, and Resverol and Umca showed higher discoloration values above the clinically acceptable threshold. The intake of dietary supplement type, the immersion time of the dietary supplement, and the restorative material type affected the surface roughness and color stability of the tested direct restorative materials. All of the experimental groups showed higher Ra values than clinically acceptable surface roughness values (0.2 µm). The color difference values also increased with the immersion time.

Effects of Different Anti-Epileptic Drug Groups and Brushing on the Color Stability of Restorative Materials Used in Pedodontics: An In Vitro Evaluation

OBJECTIVES

This study will evaluate the effects of anti-epileptic drugs and brushing used in children on the color change of three restorative materials by creating an in vitro study model.

METHODS

Forty samples of polyacid-modified composite resin (compomer), glass ionomer cement (GIC), and composite resin (CR) were prepared. Samples were split into four groups (n = 10) and soaked in three anti-epileptic drugs (Tegretol, Depakine, Keppra) and distilled water. For each group (n = 5), two subgroups (brushing and non-brushing) were created. Discolorations [CIEDE2000 (ΔE00)] were determined initially and on days 7 and 14. The data were analyzed with a four-factor repeated measures ANOVA analysis, and a post hoc analysis Bonferroni test was used.

RESULTS

After the second week, the highest ΔE00 value was seen in the non-brushed compomer material in the Tegretol drug group (8.59 ± 0.43). In contrast, the lowest value was seen in GIC filling material-brushing-Depakine drug (3.45 ± 2.14). ΔE00 values in the brushing groups were statistically significantly lower than those in the no brushing groups (p < 0.05).

CONCLUSIONS

It has been determined that the color stability of aesthetic restorative dental materials used in pediatric dentistry is affected by antiepileptic drugs. In addition, it has been determined that tooth brushing positively affects the color stability of restorative materials. Therefore, pediatric dentists should advise their patients and their relatives about this issue and take precautions.

Change in surface properties of two different dental resin composites after using various beverages and brushing

BACKGROUND

The study aimed to evaluate the influence of various beverages; with and without brushing; on the surface mechanical properties of two resin composites.

METHODS

A total of 160 disc-shaped specimens were prepared for each of the following dental composites; nanohybrid ormocer (Admira fusion, VOCO GmbH, Cuxhaven, Germany) and nanohybrid resin composite (Grandio, VOCO GmbH, Cuxhaven, Germany). The baseline surface hardness and roughness measurements were carried out after 24 h. The composite samples were randomly distributed into one of the two groups; brushing and non-brushing, which were further divided into one of the four subgroups (n = 10); artificial saliva as control, coffee, red wine, and soft drink. In the non-brushing group, the specimens were immersed in the different beverages for five minutes three times daily for 30 days. The same procedure was done for the brushing group, in addition to brushing the specimens for five seconds. The surface hardness and roughness measurements were repeated after 30 days. One-way ANOVA and independent t-tests were used for statistical analysis.

RESULTS

The soft drink had the most deteriorating effect and artificial saliva had the least. The change in surface properties was higher in the brushing subgroups. Grandio exhibited a higher change in surface microhardness while Admira fusion exhibited a higher change in surface roughness.

CONCLUSIONS

The surface properties of both dental resin composites were negatively affected by using beverages and brushing.

The Effect of Salbutamol and Budesonide Pediatric Doses on Dental Enamel and Packable and Flowable Composites: Microhardness, Surface Roughness and Color

OBJECTIVE

To assess and compare the effects of two pediatric anti-asthmatic medication doses on the microhardness of enamel and microhardness, surface roughness and color of restorative materials.

METHODS

Human enamel samples and packable and flowable composite restorations were used. The samples were exposed to Salbutamol (0.6 mL/6 mL saline) and Budesonide (2 mL/2 mL saline) via a custom-made chamber connected to a nebulizer. Medication administration was conducted for 10 days. The samples were brushed with an electronic brush in a continuous and circular mode for 10 s after 10 min of medication administration. Assessments of microhardness, surface roughness and color were carried out at three different time intervals: baseline (T0), 5 days (T1) and 10 days (T2). One-way analysis of variance (ANOVA), a two-sample t-test and a Bonferroni multiple comparison test were used to analyze the data and compare between the groups.

RESULTS

Both medications significantly (p < 0.05) decreased the microhardness of the enamel and composite samples after 10 days. Both medications lowered the surface roughness of both types of composite with a greater effect observed after 10 days of Budesonide administration (p < 0.05). Both medications had comparable detectable color change on both types of composite with a greater effect observed after 10 days of Budesonide administration (p < 0.05).

CONCLUSION

Salbutamol and Budesonide significantly decreased microhardness in the enamel samples. Both medications affected the properties of packable and flowable composites. The packable composite showed more resistance to microhardness changes. Both medications showed a clinically detectable change in the color of packable and flowable composites.

Color behavior of composite resin enhanced with different shapes of new antimicrobial polymer coated nanoparticles

BACKGROUND

Zein-coated magnesium oxide nanoparticles (zMgO NPs) demonstrate a potent antimicrobial effect, endorsing it as a compelling additive to dental materials formulations for oral health care advances. However, currently there is no data on the imprint of zMgO NPs on the color permanence of dental composites. The objective of this study is to evaluate the color stability of different types of composite enhanced with antimicrobial zein-coated magnesium oxide nanoparticles (zMgO NPs) of different shapes before and after thermocycling.

METHODS

Two hundred composite samples were divided into four groups: Gp1: Tetric N-Flow with zMgO nanowires, Gp2: Tetric N-Flow with zMgO nanospheres, Gp3: Tetric N-Ceram with zMgO nanowires; Gp4: Tetric N-Ceram with zMgO nanospheres. Each group was subdivided into 5 subgroups (n = 10) with concentrations of zMgO NPs 0%, 0.3%, 0.5%, 1% and 2%. The characterization of the modified composite containing the zMgO was done via X-ray Diffraction, Field Emission Scanning Electron Microscopy (FESEM), and Fourier Transform Infrared Spectroscopy (FTIR). Colorimetric evaluation was performed through spectrophotometry with a white background. Samples underwent color assessment using a spectrophotometer, followed by thermocycling, and then another color assessment.

RESULTS

FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. However, the XRD spectra exhibited an amorphous pattern in the composite enhanced with zMgO NPs. There was no compelling discrepancy in color variation ΔE among the different groups before and after thermocycling (p > 0.05). A statistically notable variation in ΔL was found amid the control and N-Flow and N-Ceram with 2% zMgO nanospheres before and after thermocycling respectively (p < 0.05). While after thermocycling, there was a statistically significant difference in Δa in N-Flow and N-Ceram wires amid the control and the different groups (p < 0.05). Additionally, after thermocycling there was a statistically significant difference in Δb in N-Flow and N-Ceram wires between the control and the different groups (p < 0.05). The Tukey test exhibited no variation among the groups with different zMgO concentrations (p > 0.05).

CONCLUSION

Enhancing N-Flow and N-Ceram composite with antimicrobial zMgO nanowires and nanospheres did not alter the total color stability of the materials before and after thermocycling.

The Effect of Whitening Toothpastes on the Color Stability of a Smart Monochromatic Composite Resin

OBJECTIVE

The aim of this study was to evaluate the color stability of smart monochromatic composite resin after coloring with coffee solution, thermal aging and brushing with four different kinds of toothpaste.

MATERIALS AND METHODS

According to the manufacturer's instructions, 40 smart monochromatic composite resin (Omnichroma, Tokuyama Dental, Japan) specimens were prepared with a thickness of 2 mm and a diameter of 10 mm. The samples were divided into four groups. The first group (SFM) was brushed with Sensodyne Fresh Mint (Sensodyne GSK, UK), the second group (CW) with Colgate 2 in 1 Whitening (Colgate Palmolive, USA), the third group (OW) with Opalescence Whitening (Ultradent Products, Inc., USA), the fourth group (COW) with Colgate Optic White With Charcoal (Colgate Palmolive, USA). At time point t0, no brushing and thermal cycles were performed. For time point t1, simulations corresponding to 10 days of staining, thermal aging and brushing were performed. For time point t2, simulations corresponding to one year of staining, thermal aging and brushing were performed. The color of all specimens was measured at t0, t1 and t2 with a spectrophotometer. To examine the color change, ΔE00 values were calculated with the CIEDE 2000 color system. Shapiro Wilk, Kolmogorov Smirnov, Wilcoxon Signed Rank, Kruskal Wallis, and Mann-Whitney U tests were used to analyze the data.

RESULTS

According to the results of the intergroup comparison, there is no statistically significant difference between the groups in ΔE00(t0-t1) values in terms of t0-t1 time period measurement (p>0.05). There is a statistically significant difference between the groups in ΔE00(t1-t2)values in terms of t1-t2 time period measurement (p<0.05). The COW group had the lowest ΔE00(t1-t2) value and the OW group had the highest ΔE00(t1-t2) value. There is a statistically significant difference between the groups in ΔE00 (t0-t2) values in terms of t0-t2 time period measurement (p<0.05). The COW group had the lowest ΔE00(t0-t2) value and the OW group had the highest ΔE00(t0-t2) value.

CONCLUSION

The whitening efficacy of different kinds of toothpaste whitening mechanisms may differ from each other. Toothpastes also show whitening on composite resins. The lowest discoloration was observed in the group brushed with toothpaste containing activated charcoal and blue covarine. The efficacy of whitening toothpastes should be supported by in vivo studies.

In Vitro evaluation of the effects of whitening toothpastes on the color and surface roughness of different composite resin materials

BACKGROUND

The aim of this study was to evaluate the effects of traditional and whitening toothpastes on the color and surface roughness of different composite resin materials.

METHODS

Eighty disc-shaped samples were prepared for each of the following composite resins: nano-hybrid (Filtek Ultimate Universal; 3 M/ESPE, Saint Paul, USA), micro-hybrid (Charisma Smart; Kulzer, Hanau, Germany) and supra-nano-filled (Omnichroma; Tokuyama, Tokyo, Japan). Each composite-resin sample was randomly divided into the following four subgroups (n = 20 per group): Group 1, control; Group 2, traditional toothpaste (Colgate Total 12; Colgate Palmolive, New York, USA); Group 3, peroxide-based toothpaste (Colgate Optic White; Colgate-Palmolive, New York, USA); and Group 4, blue covarine-based toothpaste (Meridol Gentle White; CP-GABA, Hamburg, Germany). The samples for the toothpaste subgroups were immersed in a coffee solution for 10 min and washed twice a day before each brushing cycle. The specimens were brushed for 30 days. Color analyses were performed using a spectrophotometer (SpectroShade Micro, MHT, Italy). Surface roughness analyses were conducted using a profilometer (Surftest SJ-210 Mitutoyo, Tokyo, Japon). The color and surface roughness analyses were performed at baseline and 1, 7 and 30 days after each treatment. Furthermore, surface topography analysis was performed using Scanning Electron Microscopy (FEG 250-FeiQuanta, the Netherlands). The data were analysed with a three-way robust ANOVA and Bonferroni post-hoc correction (p < 0.05).

RESULTS

The smallest color change was observed for the micro-hybrid composite resin, and the greatest color change was observed for the nano-hybrid composite resin. Based on the tested composite resin samples, the greatest color change was obtained after using blue covarine-based toothpaste, while the smallest color change was observed after using peroxide-based toothpaste. Moreover, the supra-nano-filled composite resin samples exhibited the lowest roughness values (robust ANOVA test, p < 0.001). There was no statistically significant difference between the mean values of roughness for the composite, group and time interaction (p = 0.937).

CONCLUSION

Charisma Smart composite resin exhibited significantly lower staining than all the other composite resins tested after using all toothpastes included in the study. Further laboratory and clinical studies are needed to fully understand the long-term effectiveness of whitening toothpaste on composite resin materials.

Deterioration of direct restorative materials under erosive conditions with impact of abrasion and attrition in vitro

Objective

To compare the cumulative impact of sequential wear on mechanical properties and appearance of a composite resin (CR), Filtek Z250^®, a glass ionomer GI, Fuji IX GP^®, and a glass hybrid (GH), Equia Forte^®.

Material and Methods

Six equally sized specimens of each material were subjected to wear tests, i.e., simulation of brushing, chewing and acidic liquid exposure, mimicking at least 6 months of clinical exposure. Surface roughness, hardness, substance loss and degree of shade lightness were determined.

Results

Following wear tests, significant increase in surface roughness and decrease in hardness values were observed for all materials (p < .05). Significantly larger substance loss was found in Equia Forte^® specimens compared to Filtek Z250^® (p < .05), while that of Fuji IX^® exceeded the measurement capacity of the instrument. Opposite to the two other materials, the shade of Filtek Z250^® became darker.

Conclusions

Sequential wear exposure mimicking abrasion, erosion and attrition to products representing CR, GI and GH, caused weakening and change in appearance of the materials. The composite resin was the most mechanically resistant to the sequential wear.

Effect of Different Artificial Staining Procedures on the Color Stability and Translucency of a Nano-Hybrid Resin-Based Composite

BACKGROUND

To evaluate the effect of different experimental staining procedures on color stability and translucency of a nano-hybrid resin-based composite (RBC).

METHODS

Forty-eight cylindrical-shaped specimens (10 × 2 mm) were prepared with a nano-hybrid RBC (Clearfil Majesty ES-2) and randomly divided in four groups according to the experimental staining procedure: G1) static immersion in a staining solution (coffee) (44 ± 1 °C); G2) staining cycling between coffee (44 ± 1°C) and distilled water (37 ± 1°C) with an experimental staining machine based on Arduino, an Open Source hardware development platform; G3) staining cycles as in G2 + brushing with a low abrasive toothpaste (Relative Dentin Abrasion RDA = 30) (Elmex Sensitive Professional); G4) staining cycles as in G3, with brushing performed with a very strong abrasive toothpaste (RDA = 90) (Lacult Active). Color parameters were recorded at the baseline (T0) after staining procedures (T1) and repolishing (T2) using a spectrophotometer. Color change (∆E00) and translucency (TP, CR) were evaluated. Data were statistically analyzed (p < 0.05).

RESULTS

For ∆E00 after staining, Group 1 showed the highest color change and Group 3 the lowest. All groups were significantly different (p < 0.001) except for Group 2 vs. Group 4; after repolishing, Group 1 was significantly higher than Group 3 (p < 0.001), Group 2 (p < 0.001), and Group 4 (p = 0.003); Group 2 was higher than Group 3 (p < 0.001). For TP variable, after staining procedures, Group 2 was significantly higher than all other groups (p < 0.001), and Group 1 was significantly higher than Group 3 (p < 0.001) and Group 4 (p = 0.007). After repolishing, Group 4 was significantly lower than Group 3 (p = 0.008) and Group 2 (p = 0.027). Repolishing procedure significantly reduced color parameters.

CONCLUSIONS

The investigated staining procedure induced significant differences in color stability and translucency. The use of a very strong abrasive toothpaste (RDA = 90) induced higher color change than a low abrasive one (RDA = 30). Repolishing procedures are able to partially reduce color change induced by artificial staining procedures.

The Effects of Different Pediatric Drugs and Brushing on the Color Stability of Esthetic Restorative Materials Used in Pediatric Dentistry: An In Vitro Study

The aim of the current study is to observe how different pediatric drugs and tooth brushing affect the color stability of different esthetic restorative materials. Three restorative materials (composite, compomer, and glass ionomer cement (GIC)) were each used to produce 72 specimens (10 mm × 2 mm). The specimens were divided into six groups and immersed in distilled water and five different pediatric drugs (amoxicillin, ibuprofen, ventolin, paracetamol, and multivitamins). Each group was divided into two subgroups (brushed and non-brushed). Over the course of two weeks, the specimens were agitated for one minute every eight hours. Color changes in all the specimens were evaluated using a spectrophotometer at 1 and 2 weeks. GIC showed a change in color that was significantly greater than that in all the other materials in each solution, except for those in amoxicillin. After a period of 1 to 2 weeks, the most noticeable change in color was detected in the amoxicillin composite and amoxicillin GIC unbrushed groups, and after 2 weeks, a significant difference was found in the ventolin GIC unbrushed group. The color stability of the restorative materials used in pediatric dentistry can be influenced by using popular liquid pediatric medications. GIC was the least color-stable material when subjected to liquid medications.

Color stability of resin-based composites: Staining procedures with liquids-A narrative review

OBJECTIVE

The objective of this study was to review the experimental staining procedures performed in in-vitro studies for evaluating color stability of resin-based composites used for direct restorations.

OVERVIEW

A review was performed with the purpose to identify in vitro procedures carried out to establish staining and color stability of resin-based composites used for direct restorations. A literature search was performed on four online databases (PubMed, Scopus, Embase and Web of Science) for articles published from January 1st 2001 till March 20th 2021, using a combination of free words and Medical Subject Headings (MESH) terms: "Composite Resins" AND "Color Stability" OR "Staining." Two reviewers screened titles and/or abstracts of 1728 unique studies. In total, 208 studies were selected for full-text reading, from which 178 were included in the review. The assessed variables were specimen dimensions, shape, and surface finishing; time before immersion; staining media type, dwell time, temperature and renewal interval; type of composite; color and translucency assessment parameters and measuring system. One hundred and seventy-eight articles analyzed color stability with staining liquids. Coffee was the most used staining medium (n = 102), followed by tea (n = 61), and red wine (n = 55). A disc-shaped specimen was used in most studies (n = 170) with a 2 mm thickness (n = 116). Spectrophotometers were the most used color assessment devices (n = 154), followed by colorimeters (n = 17). Color differences were quantified with ΔE (n = 154), ΔE00 (n = 23). Acceptability and or perceptibility thresholds were also taken into consideration (n = 126).

CONCLUSIONS

The large variety of staining procedure suggests the need for standardization.

CLINICAL SIGNIFICANCE

Aesthetic failure due to discoloration is a relevant clinical problem. Evaluating benefits and drawbacks of resin based composites artificial staining procedures will improve to predict materials clinical performances.

Comparison the effect of charcoal-containing, hydrogen peroxide-containing, and abrasive whitening toothpastes on color stability of a resin composite; an in vitro study

Background

This study aimed to compare the effects of charcoal-containing, hydrogen peroxide-containing, and abrasive whitening toothpastes on color stability of a resin composite.

Methods

Forty-five specimens were fabricated of spectrum TPH3 composite resin and stored in artificial saliva for 24 h. Baseline color assessment was performed using a spectrophotometer device. Then, the specimens were randomly assigned into 5 experimental groups, namely distilled water (GC), Bencer (GB), colgate optic white (GO), perfect white black (GP) and colgate total whitening (GT) toothpastes. The specimens immersed in coffee solution for 10 min and brushed for 1 min with respective toothpaste and then stored in artificial saliva until the next day. This cycle was repeated for 30 days. After 30 days, the final color assessment was performed using the spectrophotometer. Data were analyzed using one-way ANOVA and Tukey tests.

Results

Experimental groups were not significantly different in terms of Δa and ΔE values. However, ΔL and Δb values showed significant difference among the groups. Regarding Δa, GT and GC groups showed red color shift while the other groups showed green color shift. Regarding Δb, all groups showed blue color shift except GT group which showed yellow color shift.

Conclusion

None of the whitening toothpastes could decrease discoloration caused by the coffee solution to the level below the perceptibility threshold except Colgate Optic White which reduced discoloration within the clinically acceptable perceptibility range.

An experimental study on the effect of four pediatric drug types on color stability in different tooth-colored restorative materials

Background

One of the drawbacks of tooth-colored dental restorations is their discoloration over time. The present study aimed to determine the effect of four categories of pediatric medications, including analgesics, antibiotics, anticonvulsants, and multivitamins, on two types of tooth-colored dental materials, namely, composite resins and glass ionomer cements.

Materials and Methods

In this in vitro study, a total of 40 specimens with disc shapes (with a diameter of 5 mm and thickness of 2 mm) were prepared from each material and immersed in eight different drugs for 2 min three times a day for 1 week. The values of the baseline color were calculated based on the CIE (International Commission on Illumination) L*a*b* system. After 7 days, ΔE values were calculated. Two-way analysis of variance was employed for statistical analysis. Statistical significance was defined at 0.05.

Results

Statistical analysis showed that there were significant differences between ΔE and different restorative materials as well as ΔE and drug types (P < 0.001).

Conclusion

According to the results of this in vitro study, all the four types of drugs caused the discoloration in all the restorative materials, and the color change values were affected by the type of used drug and restorative material.

Color Stability and Translucency of Polymer-Infiltrated Ceramic-Network Materials—A Systematic Review of the Literature

This systematic review aimed to compile information and report the color stability and translucency of polymer-infiltrated ceramic-network (PICN) materials for suitable clinical applications in dentistry. Original peer-reviewed articles in electronic databases including PubMed, MEDLINE, Scopus, and Web of Science were searched to identify relevant papers published between January 2013 and August 2020. The published papers were only in the English language and limited to in vitro studies, and experimental reports were considered. The data from nine studies were considered when reviewing the color stability and translucency of PICN in comparison to other commonly used restorative materials. Among the included studies, color stability assessment was performed in five studies, and the other four studies were involved in the combined assessment of both color stability and translucency. PICN materials are a comparatively newer class of restorative materials and are recommended to overcome the drawbacks of ceramics and resin composites. The outcomes of previous laboratory studies still do not provide convincing results regarding the optical properties of PICN materials. However, with existing sources and evidence, PICN materials exhibit less color stability than ceramics do but better color stability compared to that of resin nanoceramics (RNC) and resin composites. The translucency of PICN materials is low compared to that of ceramics, nanoceramics, and resin composites.

Effects of whitening toothpastes on the esthetic properties and surface roughness of a composite resin

PURPOSE

The aim of this study was to investigate and compare the effects of some whitening toothpastes on the surface roughness and coloration susceptibility of a composite resin, as well as their whitening effectiveness.

METHODS

This study was carried out in two different stages. In experiment A, samples were divided into 7 subgroups to compare the surface roughness and coloration susceptibility of the composite resin: distilled water, conventional toothpaste, and 5 different whitening toothpastes. In experiment B, samples were divided into 8 subgroups to compare the whitening effectiveness of the whitening toothpastes: conventional toothpaste, 5 other whitening toothpastes, and two bleaching groups. After toothbrushing simulation, the color and surface roughness of the samples were measured. Data were subjected to one-way analysis of variance, paired t-test and Tukey post-hoc test (α = 0.05).

RESULTS

There were no statistically significant differences among the surface roughness values for the groups for any period before and after brushing (P > 0.05). In terms of the coloration susceptibility of the composite resin and the whitening effects of the toothpastes, no statistically significant differences were evident among the groups for any period before and after brushing (P > 0.05).

CONCLUSION

The results of this study indicate that effective toothbrushing is more important than the type of toothpaste employed.

Color stability of 3D-printed denture resins: effect of aging, mechanical brushing and immersion in staining medium

PURPOSE

This in-vitro study evaluated and compared the color stability of 3D-printed and conventional heat-polymerized acrylic resins following aging, mechanical brushing, and immersion in staining medium.

MATERIALS AND METHODS

Forty disc-shaped specimens (10 mm in diameter and 3 mm thick) were prepared from two 3D-printed [DentaBASE (DB) and Denture 3D+ (D3D)] and one conventional polymethylmethacrylate (PMMA) denture materials. The specimens were thermo-cycled, subjected to mechanical brushing, and were immersed in either coffee, lemon juice, coke, or artificial saliva (AS) to simulate one and two years of oral use. Color measurements of the specimens were recorded by a spectrophotometer at baseline (T0), and after one (T1) and two years (T2) of simulation. The color changes (∆E) were determined and also quantified according to the National Bureau of Standards (NBS) units. Descriptive statistics, followed by factorial ANOVA and Bonferroni post-hoc test (α=.05), were applied for data analysis.

RESULTS

The independent factors, namely material, staining medium, and immersion time, and interaction among these factors significantly influenced ∆E (P<.009). Irrespective of the materials, treatments, and time, the highest and the lowest mean ∆Es were observed for PMMA in lemon juice (4.58 ± 1.30) and DB in AS (0.41 ± 0.18), respectively. Regarding the material type, PMMA demonstrated the highest mean ∆E (2.31 ± 1.37), followed by D3D (1.67 ± 0.66), and DB (0.85 ± 0.52), and the difference in ∆E between the materials were statistically significant (P<.001). All the specimens demonstrated a decreased color changes at T2 compared to T1, and this difference in mean ∆E was statistically significant (P<.001).

CONCLUSION

The color changes of 3D-printed denture resins were low compared to conventional heat polymerized PMMA. All the tested materials, irrespective of the staining medium used, demonstrated a significant decrease in ∆E values over time.

Mechanical and optical properties of conventional restorative glass-ionomer cements - a systematic review

Objectives

To perform a systematic review of test methodologies on conventional restorative glass-ionomer cement (GIC) materials for mechanical and optical properties to compare the results between different GICs.

Material and Methods

Screening of titles and abstracts, data extraction, and quality assessments of full-texts were conducted in search for in vitro studies on conventional GICs that follow the relevant specifications of ISO standards regarding the following mechanical and optical properties: compressive strength, flexural strength, color, opacity and radiopacity.

Sources

The Latin American and Caribbean Health Sciences (LILACS), Brazilian Bibliography of Dentistry (BBO) databases from Latin-American and Caribbean System on Health Sciences Information (BIREME) and PubMed/Medline (US National Library of Medicine - National Institutes of Health) databases were searched regardless of language. Altogether, 1146 in vitro studies were selected. Two reviewers independently selected and assessed the articles according to pre-established inclusion/exclusion criteria. Among all the properties investigated, only one study was classified as being of fair quality that tested compressive strength and was included. It was observed that many authors had not strictly followed ISO recommendations and that, for some properties (diametral tensile strength and microhardness), there are no guidelines provided.

Conclusions

It was not possible to compare the results for the mechanical and optical properties of conventional restorative GICs due to the lack of standardization of studies.

Color stability of different composite resins after polishing

The goals of the present study were to evaluate, in vitro, the staining of different composite resins submitted to different common beverages, and to compare the staining effect of each of these solutions. A total of 288 specimens were randomly divided into six groups and immersed for 4 weeks in five staining solutions represented by red wine, orange juice, coke, tea and coffee or in artificial saliva as a control group. When analyzed over a black background, mean ΔE00 values varied from 0.8 for Venus Diamond, Saremco Microhybrid and ELS in saliva and Estelite Posterior in coke to 37.6 for Filtek Supreme in red wine. When analyzed over a white background, mean ΔE00 values varied from 0.5 for Saremco Microhybrid in saliva to 51.1 for Filtek Supreme in red wine. All materials showed significant changes in color after 4 weeks of immersion in staining solutions. Significant differences were found between the tested composite resins and also between the staining solutions.

In vitro evaluation of a silica whitening toothpaste containing blue covarine on the colour of teeth containing anterior restoration materials

OBJECTIVES

To investigate the effects of a silica-based whitening toothpaste containing blue covarine on the colour of restorations in extracted human teeth.

METHODS

Human extracted teeth were mounted in acrylic resin. A cavity was cut into the enamel surface and the specimen restored with either glass ionomer or composite dental materials. Following 4 weeks storage in water, specimens were treated with either water, red wine or a toothpaste containing blue covarine (n=10) for 24h followed by brushing with a silica-based toothpaste. Specimens were imaged with a digital imaging system at baseline, after 24h treatment and after brushing with a silica-based toothpaste. CIELAB colour parameters were determined for the restoration and the whole specimen and overall mean colour changes calculated (ΔE). Baseline and post-brushing images were compared subjectively for overall stain and staining around the restoration margin.

RESULTS

Red wine produced the largest ΔE values for whole specimens and for all restoration materials and the largest subjective stain scores for whole specimens and restoration margins. The red wine stain was not completely removed by brushing with a silica-based toothpaste. Comparisons of the red wine group with either the blue covarine toothpaste group or the water group were of statistical significance for all parameters (ANOVA, Tukey-Kramer, p<0.05). Following brushing with the silica-based toothpaste, specimens from the blue covarine toothpaste group were not significantly different (p>0.05) to the water group, for all restoration material types.

CONCLUSIONS

Exaggerated treatment with a blue covarine containing toothpaste does not significantly affect the colour of the restoration or the restoration margin of the dental materials tested versus a water alone treatment.

CLINICAL SIGNIFICANCE

The silica-based blue covarine containing toothpaste does not permanently stain the restorative materials tested or their margins.

Effects of Different Pediatric Drugs on the Color Stability of Various Restorative Materials Applicable in Pediatric Dentistry

Background. The chronic recommendation of pediatric drugs could exhibit erosive and cariogenic problems. Objective. To evaluate the effects of different pediatric drugs on the color stability of various restorative materials. Methods. Five specimens (1 mm × 3 mm) were prepared and immersed in ten different pediatric drugs and agitated every 8 hours daily for 2 min up to 1 week. Between immersion periods, the samples were stored in artificial saliva. After 1-week period, ΔE^⁎ values were calculated. Two-way ANOVA and Fisher's LSD test were used for statistical analysis at a level of p < 0.05. Results. ΔE^⁎ values were only significantly influenced by restorative material factor (p < 0.001) and varied in the range of 2.08 and 6.55 units for all drugs/restorative materials. The highest ΔE^⁎ was found in Ferrosanol B-composite (6.55 ± 1.38) and the lowest one was found in Dolven-glass ionomer (2.08 ± 0.40) pairwise. The most prominent ΔE^⁎ value elevations were obtained in composite material compared to the compomer and/or glass ionomers in Macrol, Ferrosanol B, and Ventolin (p < 0.001; for all) and also for other drugs (p < 0.05). Dolven exhibited significantly higher values compared to Augmentin (p = 0.021), Macrol (p = 0.018), and Ventolin (p = 0.013) in compomer group. Conclusion. The clinically perceptible color changes for tested composite/pediatric drug pairwise can be more problematic than compomer and glass ionomers in pediatric dentistry.