Comparison of the color stability of ten new-generation composites: an in vitro study

The color stability of artificial white spot lesions treated with resin infiltration after exposure to staining beverages

BACKGROUND

To evaluate the effect of staining beverages on the color-changing of resin-infiltrated artificial white spot lesions (WSLs).

METHODS

Thirty-five artificial WSLs were created by pH cycling on flat bovine teeth specimens. The WSLs were treated with resin infiltration and were divided into five groups based on staining beverages: artificial saliva, coffee, wine, green tea, and Coca-Cola. These specimens were subjected to a 28-day exposure to the respective beverages. Color stability was assessed using a spectrophotometer at different time points: baseline, after 7, 14, 21, and 28 days of exposure, and repolishing. The color difference (∆E) between each time point and the baseline was calculated. Statistical analysis was performed using two-way measures ANOVA with a significance level of p = 0.05.

RESULTS

All resin-infiltrated specimens exposed to staining beverages for 7 days exhibited more significant color changes than those exposed to artificial saliva. The color change patterns varied based on the type of beverage. The color alterations intensified with extended immersion in the wine and Coca-Cola groups, while there were no significant differences in the color of specimens after 28 days of immersion in the coffee and green tea groups. However, after cleaning with pumice powder, all specimens showed significantly reduced color changes compared to those observed after 28 days of immersion, except those immersed in coffee.

CONCLUSIONS

Exposure of resin-infiltrated bovine tooth specimens to staining beverages resulted in a significant color alteration as the immersion time increased. However, the staining effect could be minimized by cleaning with pumice powder, except for the coffee group.

CLINICAL RELEVANCE

After resin infiltration treatment, patients should be advised to minimize the consumption of colored beverages to prevent staining that could impact esthetic appearance.

Effect of repeated preheating on color stability of three types of composite resins and a giomer: An in vitro study

Background

This study assessed the effect of repeated preheating of three types of composite resins and a giomer on their color stability.

Methods

In this in vitro study, 128 composite resin and giomer specimens with a 10-mm diameter and a 2-mm height were evaluated in eight groups (n=16) of Heliomolar microfilled, Brilliant Enamel microhybrid, and Tetric N-Ceram nanohybrid composite resins, and Beautifil II giomer used at room temperature and also after preheating of the tube in a water bath at 55‒60 °C for 40 times. After preparing the specimens, their color parameters were measured by a spectrophotometer. The specimens were immersed in a tea solution for 3 hours/day for 40 days and underwent spectrophotometric color assessment again. The color change (∆E) was calculated and analyzed by two-way ANOVA (α=0.05).

Results

The effects of composite resin type (P<0.001) and preheating (P<0.001) and their interaction effect (P<0.001) were significant on ∆E. Immersion in a tea solution caused a significantly greater color change in giomer (P<0.05). The ∆E of the microfilled composite resin was significantly higher than that of nanohybrid (P=0.003) and microhybrid composite resin (P=0.004).

Conclusion

Repeated preheating of giomer, microhybrid, and nanohybrid composite resin specimens to 55‒60 °C for 40 times adversely affected their color stability in the tea solution. The color change was significantly greater for giomer.

Evaluation of Long-term colour resistance of composite materials used in aligner treatments: A comparative study

AIM

The aim of this study is to evaluate the discolouration resistance of attachments made of composites having different physical properties, filler ratios and viscosity through the simulated environment and conditions.

MATERIALS AND METHODS

Seventy-two extracted human teeth were aligned to simulate upper and lower dental arches. The attachments were prepared according to the guides determined by ClearCorrect. Three different composite groups were used for attachments preparation: Aligner Connect, G-Aenial Universal Injectable, and Tetric Prime and Tetric Evoflow combination. Dental models and aligners were kept in artificial saliva throughout the experiment of 96 weeks. The aligners were also subjected to 2308 thermal cycles and insertion and removing procedures 840 times for each period of 12 weeks. Afterwards, the models were kept in coffee and red wine solutions. Colour measurements were made with Vita Easy Shade 4.0 at 12th, 24th, 48th and 96th simulated weeks.

RESULTS

No significant difference in discolouration was observed during thermal cycle application of 12th and 24th week experimental periods. In the later periods, discolouration was observed in the composite materials, and G-Aenial Universal Injectable was less coloured than the other samples. The composite samples were more coloured in proportion to their residence time. The G-Aenial Universal Injectable was more affected by wine solution, and Tetric Prime and Tetric Evoflow combination were more affected by coffee solution.

CONCLUSIONS

Viscosity, resin matrix content and nature of inorganic filler particles of the composite materials significantly affect the colour changing properties of them due to the long-term ageing and exposure to colouring agents.

Evaluating color stability and enamel surface roughness following resin infiltration treatment

OBJECTIVE

To assess the impact of resin infiltration treatment on enamel color stability and surface roughness after simulating daily exposure to coffee stains and regular toothbrushing with standard toothpaste.

MATERIALS AND METHODS

In this in vitro study, we utilized 47 caries-free human enamel specimens, which were divided into two distinct groups. The teeth in the study group underwent artificial demineralization, Icon resin infiltration, and polishing, while the control group received only polishing. Following this, all teeth from both groups were regularly immersed in freshly brewed coffee for 15 min, twice daily, over a span of 30 days. After each staining session, the teeth underwent 10 heavy circular strokes using a soft toothbrush and standard toothpaste. Color changes were measured on Days 1 and 30 using a spectrophotometer. The L*, a*, b* color system defined by the International Commission on Illumination was used to assess the changes. Surface roughness was evaluated at baseline and after 30 days using a 3D surface Metrology Microscope.

RESULTS

After 30 days of immersion in coffee, both the study and control groups showed significant changes in color. However, differences were statistically significant between groups for "L" and "a" parameter but not for "b." The overall color change in the study group was higher than the control group. There were no significant differences in surface roughness within or between the groups before and after staining and brushing.

CONCLUSIONS

Resin infiltration leads to a significant increase in staining compared to untreated enamel. These staining properties should be taken into account when making clinical decisions regarding the treatment of white spot lesions.

Spectrophotometric evaluation of color stability of composite resin after exposure to cold drinks: An in vitro study

Objectives

The aim of this study was to evaluate the color stability of two composite resins after exposure to beverages such as Cola, Pepsi, Red Bull, and distilled water after 15 days.

Materials and Methods

The color stability of a microhybrid and nanohybrid composite was evaluated after storage in distilled water, Coca-Cola, Pepsi, and Red Bull for 15 days. Color measurement was done using a reflectance spectrophotometer based on the CIE L*a*b* color scale.

Results

All tested resin composites showed color change after a period of 15 days. One-way analysis of variance and Tukey post hoc were done to assess the significance of color change within the group and an independent t-test was done to assess the change between micro and nanohybrid composite. Among the resin composites studied, microhybrid composite was found to be more color stable. The microhybrid and nanohybrid composite discolored most in Coca-Cola and Pepsi. In both groups, distilled water showed very less color change.

Conclusion

Every endeavor should be undertaken to minimize the potential for discoloration in composite restorations by employing meticulous polishing techniques and also to use newer composite material with submicron particles. Furthermore, it is imperative to educate patients about the likelihood of the restoration being susceptible to staining from various beverages.

Effect of Commercial Mouth Rinses on Physical Properties of Conventional and Bulk-fill Resin Composites

OBJECTIVE

To evaluate the effects of commercial mouth rinses on color, roughness, sorption (SR), and solubility (SL) of resin composites.

METHODS AND MATERIALS

Disc-shaped specimens (stage I: 6 mm × 2 mm; stage II: 10 mm × 1.5 mm) were made from the following resin composites (n=10): conventional nanofilled (Filtek Z350XT, 3M Oral Care), conventional nanohybrid (Luna, SDI), bulk-fill nanofilled (Filtek One Bulk-Fill, 3M Oral Care), and bulk-fill nanohybrid (Aura Bulk-Fill, SDI) exposed to distilled water (control), blue mouth rinse without alcohol (Colgate Total 12 Clean Mint, Colgate-Palmolive), or blue mouth rinse with alcohol and essential oil (Listerine Tartar Control, Johnson & Johnson). In stage I, tests were performed at the baseline, and after the immersion in solution time points to evaluate coordinates of the CIEL*a*b* system (ΔL*, Δa*, Δb*), general color change (ΔEab, ΔE00, and ΔSGU), and surface roughness (Ra). In stage II, SR and SL were evaluated (ISO 4049:2019) after immersion in the solutions for 7 days. The results were evaluated by generalized linear models (Ra, SR), Kruskal-Wallis, and Dunn tests (color, SL), with α = 0.05.

RESULTS

There were no significative differences for Ra between the solutions. Both mouth rinses promoted significantly negative ΔL* (Luna), Δa* (Filtek One Bulk-fill), and Δb* (all materials except conventional nanofilled resin composite). Mouth rinse without alcohol promoted significantly negative Δa* on all resin composites tested. Both mouth rinses promoted higher ΔEab and ΔE00 for bulk-fill resin composites compared to control. Mouth rinse with alcohol caused higher ΔSGU for bulk-fill nanofilled resin composite. It also promoted greater SR in all the resin composites compared with mouth rinse without alcohol and higher SR in nanohybrid resin composites compared with control. Both mouth rinses promoted higher SL values in Luna and differed significantly from control.

CONCLUSIONS

The physical properties were manufacturer dependent and mediated by mouth rinses. The mouth rinses promoted color changes in the resin composites, pointing out that bulk-fill resin composites were more affected by these effects, especially when the mouth rinse contained essential oil and alcohol.

"Enamel layering" using double-layered enamel-shade resin composites: The strategy to simulate the optical characteristics of human enamel

OBJECTIVE

To evaluate the optical match between enamel and resin composites fabricated using mono-layered and double-layered techniques.

MATERIALS AND METHODS

Enamel slabs were prepared from human upper incisors and canines. Mono-layered composite replicas were prepared from seven Filtek Z350XT and Estelite Sigma shades using silicone molds prepared from the respective enamel surfaces. Translucent and enamel shades (A2 or A3) of the two materials were produced from incisor molds for double-layered replicas, and the groups with the best results underwent accelerated aging. Spectrophotometric evaluation was performed using CIE color system. The differences in translucency (ΔTP) and color (ΔE00 ) between the enamel and paired composite replicas were calculated and analyzed using parametric statistics (α = 0.05).

RESULTS

For the mono-layered composites, white enamel and translucent shades of Filtek yielded the lowest ΔTP for canines (4.6) and incisors (8.9), respectively. The ΔE00 of mono-layered replicas ranged from 5.1 to 11.8. Double-layered Filtek replicas displayed a better 1-day optical match with the lowest ΔTP (3.4-4.0) and ΔE00 (4.2-4.6), irrespective of each layer's thickness.

CONCLUSIONS

For canines, the lowest ΔTP of Filtek white enamel was close to the acceptable threshold (4.43). For incisors, the thicker translucent double-layered Filtek composites demonstrated the greatest optical match before and after aging.

CLINICAL SIGNIFICANCE

Upper incisors and canines have distinct enamel optical properties. Enamel layering using specific double-layered resin composites could achieve a better optical match with upper incisor enamel.

Effects of Surface Preparation Methods on the Color Stability of 3D-Printed Dental Restorations

BACKGROUND

Color stability is a crucial performance parameter for dental restorations, and limited research exists on how surface preparation methods affect it. The purpose of this study was to test the color stability of three resins intended for 3D printing, which can be used to make dentures or crowns in A2 and A3 colors.

MATERIALS AND METHODS

Samples were prepared in the form of incisors; the first group was not subjected to any treatment after curing and washing with alcohol, the second was covered with light-curing varnish, and the third was polished in a standard way. Then, the samples were placed in solutions of coffee, red wine, and distilled water and stored in the laboratory. After 14, 30, and 60 days, color changes were measured (presented as Delta E) compared to material stored in the dark.

RESULTS

The greatest changes were observed for samples that were not polished, then were placed in red wine dilutions (ΔE = 18.19 ± 0.16). Regarding the samples covered with varnish, during storage, some parts detached, and the dyes penetrated inside.

CONCLUSIONS

3D-printed material should be polished as thoroughly as possible to limit the adhesion of dyes from food to their surface. Applying varnish may be a temporary solution.

Long-Term Chromatic Durability of White Spot Lesions through Employment of Infiltration Resin Treatment

Background and Objectives: White spot lesions (WSLs) denote regions of subsurface demineralization on the enamel that manifest as opaque and milky-white regions. Treatment for WSLs is essential for both clinical and aesthetic reasons. Resin infiltration has been identified as the most efficacious solution for alleviating WSLs, but studies with long-term monitoring are scarce. The aim of this clinical study is to assess the color change stability of the lesion after four years of implementing the resin infiltration technique. Materials and Methods: Forty non-cavity and unrestored white spot lesions (WSLs) were treated with the resin infiltration technique. The color of the WSLs and adjacent healthy enamel (SAE) was assessed using a spectrophotometer at T0 (baseline), T1 (after treatment), T2 (1 year after) and T3 (4 years after). The Wilcoxon test was utilized to determine the significance of the variation of color (ΔE) between WSLs and SAE over the observed time periods. Results: When comparing the color difference ΔE (WSLs-SAE) at T0-T1, the Wilcoxon test demonstarated a statistically significant difference (p < 0.05). For ΔE (WSLs-SAE) at T1-T2 and T1-T3, the color variation was not statistically significant (p = 0.305 and p = 0.337). Conclusions: The study's findings indicate that the resin infiltration technique is an effective solution for resolving the appearance of WSLs, and the results have demonstrated stability for a minimum of four years.

Effects of in vitro erosion on surface texture, microhardness, and color stability of resin composite with S-PRG fillers

OBJECTIVES

To evaluate the effect of acid erosion on different physical properties of resin composite with S-PRG (surface pre-reacted glass) fillers, by conducting simulations of intrinsic and extrinsic sources.

MATERIALS AND METHODS

Cylindrical samples (Ø6 vs. 2 mm) of a conventional nanohybrid resin composite (Forma, Ultradent) and of a nanohybrid resin composite with S-PRG filler (Beautifil II, Shofu) were exposed to erosive cycling (5 days), based on (n=12) remineralizing solution (control); 0.3% citric acid (pH=2.6); or 0.01 M hydrochloric acid (pH=2). Roughness (Ra), microhardness (KHN), and color (CIEL*a*b*, CIEDE2000, and Vita scale (SGU)) factors were analyzed at the initial and final time points, and the general color changes (ΔE_ab, ΔE₀₀, ΔSGU) were calculated. Final images were obtained using scanning electron microscopy (SEM). The data were evaluated by generalized models, Mann-Whitney, Wilcoxon, Kruskal-Wallis, and Dunn tests (α=0.05).

RESULTS

Regarding KHN, there was no difference between the groups or the time periods (p = 0.74). As for Ra, there was a significant increase in the Ra of both composites after cycling with hydrochloric acid, but only the resin composite with S-PRG filler showed a change in Ra after cycling with citric acid (p = 0.003). After cycling with citric and hydrochloric acid, the highest Ra values were found for the resin composite with S-PRG filler (p < 0.0001), corroborating the result of images (SEM) indicating loss of filler and porosities in this material. The resin composite with S-PRG filler showed higher ΔE_ab and ΔE₀₀, in addition to more negative ΔSGU values and lower L* values after exposure to both acids, compared to the control (p < 0.05).

CONCLUSION

The acidic conditions altered the roughness and color stability of the materials tested, pointing out that the resin composite containing S-PRG filler showed greater degradation of its physical properties than the conventional resin composite.

CLINICAL RELEVANCE

Bioactive materials are relevant, considering that their properties interact with dental hard tissues; however, the S-PRG-based resin composite showed greater degradation under acidic conditions than the conventional resin composite.

Comparative Evaluation of Colour Stability and Surface Roughness of Nanohybrid Composite Resins in Mouth Rinse and Colouring Beverages

Objectives An ideal restorative material should be capable of supplanting the biological, functional, and aesthetic qualities of a healthy tooth structure. There has always been a search for optimal and aesthetically pleasing restorative materials. This study aims to evaluate the surface roughness and colour stability of three nanohybrid composite resins post-exposure to mouth rinse and colouring beverages. Methods One hundred and twenty specimens of dimension 10 mm x 8 mm x 1 mm were randomly allocated into three equal-sized groups and fabricated using three different nanohybrid composites (Group A: Filtek Z250 XT, Group B: Tetric N-Ceram, and Group C: Solare Sculpt). Sixty samples, comprising 20 from each group, were examined for colour stability and 60 for surface roughness after exposure to chlorhexidine and coffee. Baseline and post-exposure readings of the surface roughness and colour absorbance of the specimens were obtained by atomic force microscopy and spectrophotometer, respectively. A one-way analysis of variance (ANOVA) test followed by a post hoc Tukey's test and an independent t-test were used for data analysis, considering a p-value<0.05 as significant. Results Irrespective of the composite, the surface roughness and colour change were substantially higher in the samples exposed to coffee (p-value<0.01). Filtek Z 250XT showed significantly minor changes in colour and surface roughness, followed by Solare Sculpt and Tetric N-Ceram (p-value<0.05). Conclusion Coffee caused more surface roughness and colour changes compared to chlorhexidine. Filtek 250 XT showed minor changes in colour and surface roughness on exposure to both solutions.

Discoloration of fiber-reinforced composite resin disc for computer-aided design/computer-aided manufacturing after immersion in coffee and curry solutions

The purpose of this study was to clarify the discoloration of fiber-reinforced composite resin (FRC) disc materials. The color differences (ΔEs) of three CAD/CAM disc materials, FRC with different fiber orientations, composite resin, and polyether-ether-ketones were evaluated after month-long immersion in water, coffee, and curry. The ΔEs of all materials after coffee and curry immersion increased with increasing immersion periods, while those after water immersion barely increased. FRC exhibited a smaller color difference and water sorption value than composite resin and a greater color difference and water sorption value than polyether-ether-ketones. The ΔEs after coffee immersion were significantly correlated with the water sorption value. The ΔE of FRC with fiber orientations perpendicular to the surface was greater than that of FRC with fiber orientations parallel to the surface, likely due to greater exposure of the matrix-fiber interface. This result suggested that the fiber orientations of FRC affected the discoloration.

Effects of heat-treatment methods on cytocompatibility and mechanical properties of dental products 3D-printed using photopolymerized resin

PURPOSE

The purpose of this study was to test heat-treatment methods for improving the cytocompatibility of dental 3D printable photopolymer resins.

METHODS

Nextdent C&B resin and a digital light processing 3D printer were used to print all specimens, which were divided into seven groups as follows: 1-month storage at controlled room temperature, 20 to 25 °C (RT), 24-hour storage at RT, 24-hour storage in RT water, 1-min immersion in 80 °C water, 1-min immersion in 100 °C water, 5-min immersion in 100 °C water, and autoclaving. Cell viability tests, cytotoxicity tests, and confocal laser scanning microscopy were performed to analyze the cytocompatibility of the 3D-printed resin. Fourier-transform infrared spectroscopy was performed after heat-treatment to determine the degree of conversion (DC).

RESULTS

Immersing printed resin samples in 100 °C water for 1 or 5 min after the curing process was an effective method for increasing cytocompatibility by inducing the preleaching of toxic substances such as unpolymerized monomers, photoinitiators, and additives. Moreover, the DC can be increased by additional polymerization without affecting the mechanical properties of the material.

CONCLUSIONS

Immersing the printed photosensitive dental resins in 100 °C water for 5 min is a suitable method for increasing cytocompatibility and the DC.

Color stability of aligner materials on exposure to indigenous food products: An in-vitro study

Background

In the recent day, there has been an exponential growth in the usage of clear aligners for orthodontic treatment. As with any removable appliance, the compliance of patients to remove it during ingestion of food is, at times, poor. Thus, the stability of the clear aligner to be "clear" becomes questionable. This in-vitro study examined how the clear aligners changed colour on exposure to various indigenous food products used in everyday life.

Methods

Aligners from 5 different companies (K Line, Clearbite Aligners, The Aligner Company, iAligners and MaxDent CA Digital) were exposed for 12 hours and 24 hours to various indigenous substances (tea, green tea, coffee, turmeric, saffron and Kashmiri red chili powder) and a control solution (distilled water) in-vitro. The color change was assessed with the help of VITA Easyshade compact colorimeter based on Commission Internationale de I'Eclairage L*a*b* color system. Values were then modified to NBS units for clinical relevance.

Results

The hue of the transparent aligners was noticed to change in a statistically meaningful way when exposed to turmeric, saffron, Kashmiri red chili powder and coffee in decreasing order and mild color change in tea and green tea at both 12 hours and 24 hours intervals.

Conclusion

Aligners are prone to color change when exposed to indigenous foods that contain staining properties.

Comparison and Effect of Common Beverages on Color Stability of Different Esthetic Restorative Materials: An In Vitro Study

AIM

The aim of this in vitro study is to assess the color stability of different esthetic veneer restorative materials (feldspathic ceramic, hybrid ceramic, zirconia-reinforced lithium silicate glass ceramic, and composite resin) after being exposed to commonly consumed beverages that have staining potential.

MATERIALS AND METHODS

Sixty specimens were prepared into rectangular blocks with fixed dimensions of 10 × 12 × 2.5 mm. Machinable feldspathic ceramic (FC), zirconia-reinforced lithium silicate glass ceramic (LS), and a hybrid ceramic (HC) were milled using CAD/CAM (n = 15), and specimens of microparticle composite resin (MPC) were manually prepared by with the same dimensions (n = 15). All specimens were randomly divided into three subgroups (= 5) according to immersing solutions used (coffee, black tea, and red wine). All specimens were immersed for a period of 72 hours. A colorimetric evaluation was done for each specimen before and after immersion using a spectrophotometer and the difference in color was calculated according to the CIE-Lab system. To analyze the data, two-way ANOVA and one-way ANOVA tests of significance were used to compare between the different study groups, followed by pairwise comparisons using post hoc test (Tukey).

RESULTS

Different restorative materials showed statistical significance regarding color change after staining (p < 0.001); however, no statistical significance in color change (p > 0.05) was found between the different beverages used.

CONCLUSION

All tested ceramic materials had better color stability compared with composite resin. All the staining beverages used in the current study might cause a significant color change in the tested restorative materials.

CLINICAL SIGNIFICANCE

The color stability of esthetic restorative materials affects their clinical performance in the oral cavity, where the restorative materials are usually exposed to staining beverages that are frequently consumed by patients. Therefore, it is important to understand the staining effect of the different beverages on esthetic restorative materials.

The Effect of Additional Finishing and Polishing Sequences on Hardness and Roughness of Two Different Dental Composites: An In Vitro Study

Aim:

The aim of this study was to evaluate the effect of additional finishing and polishing sequences on a new structural colored (Omnichroma) and a conventional dental composite (Estelite Sigma Quick).

Materials and Method:

Forty disk-shaped dental composite specimens were prepared from each dental composite and assigned to four groups in terms of additional finishing polishing sequences. Group 1: Mylar strip (control). Group 2: Abrasive disks. Group 3: After abrasive disks, application of a felt brush with abrasive paste. Group 4: After abrasive disks, application of a felt brush with abrasive paste. Then, a single-bottle adhesive was applied as a surface sealer. Hardness and surface roughness were measured using the Vickers hardness test and a profilometer, respectively. SEM images of one of each group were captured at 500x, 1500x, and 3500x magnifications. Two-way analysis of variance, Tukey HSD, and Shapiro–Wilk tests were used for the statistical analysis.

Results:

Mean hardness values differ in terms of finishing-polishing sequences ( P < .001), dental composites ( P < .001), and interaction of finishing-polishing sequences-dental composites ( P < .001). Mean roughness values differ in terms of finishing-polishing ( P = .002). The main effect of composites on roughness values was not found statistically significant ( P = .990). Also, there is no difference between the mean roughness values in terms of the interactions of finishing-polishing and composites ( P = .967).

Conclusion:

Finishing-polishing with abrasive disks and abrasive paste are important steps for these dental composites. However, the application of a single-bottle adhesive as a surface sealant on these composites decreases the hardness of the materials.

Assessment of Enamel Color Stability of Resins Infiltration Treatment in Human Teeth: A Systematic Review

(1) The evolution of techniques and materials used in dentistry has led to the introduction of a technique known as micro-infiltration, using ICON infiltrating resin. The purpose of this study was to evaluate whether the resin infiltrant can remain stable in the enamel color of human teeth over time or if it causes discoloration and review current knowledge on color stability based on the literature selected solely on studies performed on human teeth and to provide a perspective on the methods proposed by clinicians in the infiltration procedure; (2) Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement; (3) Results: Twelve studies were selected for this review. The study results suggest that the device content is sufficiently comprehensive. The reviewers expressed strong support for the device's content for assessing the quality of reviews. The paper summarizes current reports regarding the color stability assessment of enamel treated by in- filtration resin confirmed in in vitro and in vivo studies; (4) Conclusions: Based on these considerations, the resin infiltration method can be recommended to improve the appearance of enamel lesions. The infiltrated lesions remained chromatically stable, showing no significant color changes in the long term.

Effects of conventional and heated tobacco product smoking on discoloration of artificial denture teeth

STATEMENT OF PROBLEM

Cigarette smoke can cause discoloration of artificial denture teeth. However, studies on the effects of heated tobacco product smoke on artificial denture teeth are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of conventional cigarette and heated tobacco product smoke on the color stability of artificial denture teeth.

MATERIAL AND METHODS

Ninety maxillary central incisor denture teeth (Endura Anterior HC5 A3; Shofu) were randomly divided into 3 groups (n=30). Teeth in the control group were exposed to air; those in group CC were exposed to conventional cigarette (Marlboro Medium; Philip Morris) smoke, and those in group HT were exposed to heated tobacco product (IQOS 2.4 plus holder, Marlboro Heets Silver; Philip Morris) smoke. Before the experiment, the shade of the artificial denture teeth was evaluated in accordance with the Commission International de I'Eclairage (CIELab) color system by using a spectrophotometer (Shadepilot; DeguDent GmbH). The average CIELab value was estimated by scanning the entire labial surface of each specimen. To simulate smoking, standard conditions described by the Coresta Recommended Method N°22 were used-the puff duration was 2 seconds, with a 60-second interval between puffs. For each cigarette, 6 puffs and 6 intervals were simulated across 372 seconds. A total of 105 cigarettes were used based on a smoking simulation of 15 cigarettes each day for 7 days. The teeth in the control group were stored in fresh air in the smoke chamber for the same period as those in the experimental groups. After the experiment, L∗, a∗, and b∗ values were measured, and ΔE was calculated to evaluate the color change. All statistical analyses were performed with a statistical software program using a paired t test to determine discoloration after exposure to cigarette smoke. One-way ANOVA and the Tukey test were used to evaluate the significant differences between groups (α=.05).

RESULTS

Lightness was significantly lower in the CC and HT groups (P<.001). All CIELab values showed statistically significant differences in the CC group. The greatest color change was observed in the CC group (ΔE=6.93 ±0.59), whereas the HT group showed a clinically imperceptible color change (ΔE=0.79 ±0.21). Discoloration was minimal in the CC group (ΔE=0.34 ±0.13).

CONCLUSIONS

Conventional cigarette and heated tobacco product smoke can change the color of denture teeth. Heated tobacco product smoke causes less discoloration of denture teeth.

Effects of Charcoal Toothpaste on the Surface Roughness, Color Stability, and Marginal Staining of Resin Composites

OBJECTIVE

This study was designed to evaluate the effects of charcoal toothpaste on the surface roughness, color stability, and marginal staining of resin composite restorations.

METHODS

A total of 100 bovine incisors was collected. The crowns were sectioned and randomly divided into 10 groups (n=10) according to two study factors: toothpaste groups and nanoparticle resin composite groups. Five toothpastes-Bianco Pro Clinical (Bianco Oral Care, Uberlândia, MG, Brazil) - Control group; Bianco Carbon (Bianco Oral Care); NAT, Natural Suavetex Carvão Ativado (Suavetex, Uberlândia, MG, Brazil); Nano Action Black Be Emotion (Polishop, Jundiaí, SP, Brazil); and BIW, Black is White (Curaprox, Curaden AG, Kriens, Switzerland)-and two resin composites-Z350XT, Filtek Z350XT (3M Oral Care) and Vittra, Vittra APS (FGM, Joinville, SC, Brazil)-were used. Circular cavities with a diameter of 4 mm and a depth of 1 mm were prepared on the buccal face of the tooth crowns and restored with resin composites. The specimens were subjected to three months of simulated toothbrushing. The surface roughness (right angle [Ra], in micrometers [μm]) of the resin composites was measured before and after toothbrushing in five areas per specimen. The resin composite color and luminosity changes (ΔE and ΔL, respectively) were measured using reflectance spectroscopy (Vita EasyShade). Macro photographs were taken before and after toothbrushing to qualitatively analyze the marginal staining (MSt) of the resin composite restorations. Scanning electron microscopy (SEM) was performed before and after the simulated toothbrushing. Ra data were analyzed using two-way analysis of variance with repeated measures and the Tukey HSD test; MSt was analyzed using Kruskal-Wallis and Dunn tests (α=0.05), and the resin composite color change was analyzed using the clinically unacceptable level of ΔE > 3.3.

RESULTS

Simulated brushing increased Ra irrespective of the resin composite or toothpaste used. No significant differences were found in Ra between the control group and all groups on which the charcoal toothpastes were tested. A clinically unacceptable level of resin composite color change (ΔE>3.3) was found after the use of most charcoal toothpastes. Use of Bianco Carbon resulted in marginal staining similar to that of the control group and was lower than that of the other charcoal toothpastes. Vittra brushed with black toothpaste showed the highest marginal staining.

CONCLUSION

Use of charcoal toothpaste resulted in Ra values of resin composites similar to those found with conventional toothpastes. Charcoal toothpaste generally resulted in clinical resin composite color changes (ΔE). All charcoal toothpastes, except Bianco Carbon, caused marginal staining of the resin composite restorations.

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.

Effect of Different Solutions on the Colour Stability of Nanoparticles or Fibre Reinforced PMMA

This study aimed to evaluate the colour stability of polymethyl methacrylate (PMMA) denture base reinforced with ZrO2 nanoparticles, E-glass fibres, and TiO2 nanoparticles at various concentrations over 180-day storage in Steradent™ (STD) denture cleaner or coffee (CF). A total of 130 disc-shaped specimens were fabricated at various filler concentrations and divided into four main groups to measure the colour changes. Groups Z, T, and E consisted of PMMA reinforced with ZrO2 nanoparticles, TiO2 nanoparticles, or E-glass fibre, respectively, while Group C consisted of PMMA specimens without filler served as the control group (n = 10). The three reinforced groups were further subdivided according to the filler content (n = 10) added to the PMMA (1.5%, 3.0%, 5.0%, and 7.0% wt.%). Half of the specimens were stored in STD, while the other half was stored in CF for 180 days. A Minolta Chroma Meter was used to measure the colour changes (ΔE) at 7, 30, 90 and then 180 days. The results were assessed using two-way repeated-measures analysis of variance (RM-ANOVA) along with Bonferroni post hoc tests at a p ≤ 0.05 significance level. Significant different colour changes (ΔΕ) were observed between all tested groups and across different time points. TiO2-reinforced PMMA in coffee showed the lowest colour stability, while the E-glass fibre-reinforced PMMA in STD/CF showed the highest colour stability. Furthermore, coffee appeared to have the greatest impact on the CF change in comparison to the STD/CF. The results indicated that the filler type and concentration, type of solution, and length of storage all affected the colour stability of the tested specimens.

Impact of Smokeless Tobacco on the Color Stability of Zirconia, Zirconia-Reinforced Lithium Silicate and Feldspathic CAD/CAM Restorative Materials: An In-Vitro Study

WHO estimates that the global number of tobacco users exceeds 1.3 billion people. Few studies have examined the effect of locally made smokeless tobacco (ST) products on the color changes of material used in dental prosthetics. Bearing the recent advances in CAD/CAM ceramic restorations material in mind, this study aimed to assess ST influence on mean color change (∆E*) values among selected CAD/CAM ceramic types: multilayer zirconia (Ceramill Zolid PS), zirconia-reinforced lithium silicate ceramic (Vita Suprinity), and feldspathic (Vita TriLuxe) restorative materials. The color changes of the ceramics were compared to VITA classical and VITA 3D-MASTER shade guides. Sixty CAD/CAM ceramic specimens (20 samples each) were fabricated from Ceramill Zolid PS, Vita TriLuxe Forte, and VITA Suprinity. Specimens were prepared and divided into two groups according to the ST type and immersed for two weeks. Basic VITA classical and VITA 3D-MASTER colors were recorded at a baseline of one week and two weeks. The highest ∆E* values were recorded in the black ST for Vita Suprinity (4.77) in the first week, followed by Vita TriLuxe (4.07) in the second week. For white ST, Vita TriLuxe (4.87), and Vita Suprinity (4.42) showed extensive color change after two weeks and one week, respectively. The color change was least in zirconia for black and white ST after one week. CAD/CAM ceramic materials showed no significant difference after 1 and 2 weeks for the tested ST types. The effects of ST on CAD/CAM ceramic material (∆E* values) were high but did not reach clinically unacceptable values. Zirconia showed the least amount of color change among all the tested materials.

Effects of storage and toothbrush simulation on color, gloss, and roughness of CAD/CAM, hand-cast, thermoforming, and 3D-printed splint materials

Objectives

The aim was to investigate color, gloss, or roughness of splint materials after storage in liquids and toothbrush simulation.

Materials and methods

A total of 58 × 8 (n = 10 per material and group) specimens were fabricated (hand-cast, thermoforming, CAD/CAM-milled, 3D-printed materials); stored in air, water, coffee, red wine, and cleaning tablets; and investigated after fabrication, 24 h, two-, and four-week storage or toothbrushing. Color values (L*, a*, b*; ISO 11664–4:2008; CM–3500d, Konica-Minolta), gloss (ISO 2813:2014), and roughness values were determined (3D laser-scanning-microscope, KJ 3D, Keyence) before and after simulation or storage. Statistics: Levene-test, one-way ANOVA, Bonferroni post hoc test, between-subjects effects, Pearson correlation (α = 0.05).

Results

Color, gloss, and roughness altered due to contact with staining solutions/toothbrush simulation. Highest impact on color, gloss, and roughness presented the material followed by storage time (ΔE material (η2 = 0.239/p < 0.001), storage time (η2 = 0.179/p < 0.001); gloss (η2 = 0.751/p < 0.001) (η2 = 0.401/p < 0.001); Ra/Rz (η2 ≥ 0.801/p < 0.001) (η2 ≥ 0.416/p < 0.001)). Correlations were found between Rz and Ra (Pearson 0.887/p ≤ 0.001) or Rz and ΔE (0.517/p ≤ 0.001) or Ra and ΔE (0.460/p ≤ 0.001).

Conclusions

Storage and toothbrushing were accompanied by a change in color, gloss, and roughness. Almost all materials showed visible discoloration after 4 weeks of storage. Gloss values decreased as storage time increased. The initial roughness and polishability were better with harder materials.

Clinical relevance.

Milled and 3D printed splints show good color, gloss, and roughness resistance after 4-week storage or toothbrush application.

Color stability of resin composites for orthodontic attachments: an in vitro study

Objective:

The aim of the present study was to evaluate the color stability of Filtek Z350 XT, Filtek Z250 XT, Z100 resin composites and Transbond XT orthodontic resin, all used in orthodontic attachments, when immersed in popular beverages.

Methods:

Thirty disk-shaped specimens of each resin composite (2 x 5mm) were manufactured and randomly divided into six groups according to immersion solutions: coffee, red wine, white wine, regular beer, dark beer and deionized water (control). The specimens were fully immersed in each of the solutions for six days at 37°C, representing approximately six months of consumption. The color measurements were evaluated by a reflection spectrophotometer, at baseline (before immersion) and after staining. L*a*b* coordinates were measured and the color change (ΔE₀₀) was calculated using the CIEDE2000 formula. The data were analyzed by ANOVA/Tukey tests at a significance level of 0.05.

Results:

The resin composites immersed in white wine and regular beer showed either imperceptible or clinically acceptable ΔE₀₀, and no difference from the control group (p= 0.4449 and p= 0.467 respectively). Immersion in coffee and red wine were considered clinically unacceptable and were significantly different from the control group (p= 0.0028 and p= 0.0475 respectively).

Conclusion:

Based on the results of the present study, the consumption of coffee and red wine may cause color change of the resin composite attachments above the visual acceptability threshold, and impair aesthetics during treatment.

Spectrophotometric evaluation of staining of different types of light-cure composite resins after exposure with different light-cure intensities: An in vitro study

Context

Relation between the adequate intensity output of curing lights on color stability of composite resin is well accepted.

Aims

To investigate the effect of different light-curing intensities and its relation to color stability of different polymerized composite resin materials using the spectophotometric analysis.

Settings and Design

Comparative in vitro study done on composite resin discs.

Subjects and Methods

A total of 180 discs comprising sixty discs prepared from three different composite resins, namely microhybrid composite resin (Filtek Z100,3M ESPE), nanohybrid composite resin (Filtek Z250 XT, 3M ESPE), and nanofilled composite resin (Filtek Z350 XT,3M ESPE) using three different light curing intensities, viz., 325-425 mW/cm², 750-850 mW/cm², and 1000-1100 mW/cm². Later these discs were stained with 2% methylene blue followed by re-absorption in absolute alcohol for supernatant solution preparation which is used for the spectrophotometric analysis.

Statistical Analysis Used

Spectrophotometric absorption values were analyzed using the one-way ANOVA test for intergroup analysis.

Results

Mean stain absorption was the highest with nanofilled composite resin (Filtek Z350 XT,3M ESPE) after exposure with light-curing intensity of 325-425 mW/cm² and least with microhybrid composite resin (Filtek Z100, 3M ESPE) after exposure with light-curing intensity of 750-850 mW/cm² and this difference found was highly significant statistically (P < 0.001).

Conclusions

Microhybrid composite resin (Filtek Z100, 3M ESPE) cured with intensity of 750-850 mW/cm² showed least stain absorption indication most color stability and esthetic function.

The Effect of Brilliant Blue-Based Plaque-Staining Agents on Aesthetic Orthodontic Appliances

Orthodontic appliances discolour over treatment time, and a yellowish plaque builds up on the contact area of the brackets, adhesive and teeth. Brilliant Blue-based plaque-staining agents (BBPSAs), which increase tooth brushing efficiency, have the potential to support the maintenance of proper oral hygiene during orthodontic treatment. However, they exhibit strong colouring properties, and their impact on the aesthetics of braces remains unclear. Therefore, the aim of this study was to investigate the influence of commercially available BBPSAs on the colour of aesthetic orthodontic materials. A light-cured, colour-changing orthodontic adhesive and new-generation, monocrystalline, sapphire brackets were chosen for the experiments. The effect of the staining agent on the tested materials was investigated in terms of the reaction temperature and time, as well as the presence of black tea-induced impurities on the materials. The CIELAB (Commission Internationale de L'éclairage L* a* b*) colour system parameters were measured, and the colour differences (ΔE*ab and ΔE00-the Commission Internationale de L'éclairage 2000 colour-difference) were determined for the materials under several experimental conditions. The braces' green-red colour expression was positively affected by the BBPSA. Under in vitro conditions, the regular use of the BBPSA for 90 days visibly improved the unfavourable colour change caused by the black tea.

Color Match of Composite Resin and Remaining Tooth Structure over a Period of 28 Days Using Spectrophotometer-A Randomized Clinical Trial

OBJECTIVES

The tooth and the composite restoration can undergo a change in color after the restorative procedure over time. The purpose of this randomized clinical trial was to evaluate the color difference (ΔE) of two types of composite resins and remaining tooth structure over a period of 28 days.

METHODS AND MATERIALS

A total of 40 teeth in 30 patients with Class IV caries or EllisClass II fracture in maxillary incisors were randomized into two groups based on the type of composite resin used for restoration: IPS Empress (n=20 teeth) and Filtek Z250 (n=20 teeth). Shade selection was done using a spectrophotometer. Restorations were performed using an anatomical layering technique, and finishing and polishing was done after 48 hours. Baseline spectrophotometer color values for the remaining tooth structure were measured before isolation and for composite restorations, 10 minutes after light cure. Further color evaluations using a spectrophotometer for the remaining tooth structure and composite restorations were done at 48 hours (both before and immediately after finishing and polishing), 7days, 14 days, and 28 days, and color difference (ΔE) from baseline values for remaining tooth structure and restorations and ΔE between remaining tooth structure and restorations were calculated. Descriptive statistics including mean, standard deviation, and frequencies were computed. Mann-Whitney U test was done to compare spectrophotometer values.

RESULTS

There was a significant reduction in mean color difference (ΔE) from baseline values for both tooth (p<0.05) and composite restoration (p<0.05) at all evaluation periods in both groups. Filtek Z250 showed significantly lower mean ΔE between the tooth and the composite resin restoration than IPS Empress at 48 hours (before and after finishing and polishing), 7 days and 14 days (p<0.05). At the 28 day recall, mean ΔE value of IPS Empress restorations to tooth structure was 3.5, while the mean ΔE value of Filtek Z250 restorations to tooth structure was 3.6, which was not statistically different (p>0.05).

CONCLUSION

The remaining tooth structure as well as the composite restorations showed color changes at all evaluation periods, compared to baseline values in both the composite resin groups. Filtek Z250 exhibited less ΔE with remaining tooth structure at 48 hours, 7 days, and 14 days, when compared to IPS Empress. The composite restorations of both the groups reached clinically acceptable color match (mean ΔE<3.7) with the remaining tooth structure 28 days after the procedure.

Effects of Artificial Tooth Brushing and Hydrothermal Aging on the Mechanical Properties and Color Stability of Dental 3D Printed and CAD/CAM Materials

This study analyzed the surface roughness and waviness, Vickers hardness (VHN), and color changes of six types of 3D printed resins and computer-aided design/computer-aided manufacturing (CAD/CAM) materials after artificial toothbrushing. The average surface roughness height (Ra) change of Formlabs denture teeth A2 resin (FMLB) was not significant between after artificial toothbrushing (0.17 ± 0.02 μm and 0.17 ± 0.05 μm, respectively; mean ± standard deviation). However, the Ra value increased significantly in all remaining groups. Regarding waviness, polymethylmethacrylate (PMMA) had the largest increases in average waviness height (Wa) and maximum surface waviness height (Wz) between, before (0.43 ± 0.23 μm and 0.08 ± 0.02 μm), and after (8.67 ± 4.03 μm, 1.30 ± 0.58 μm) toothbrushing. There were no significant changes in Wa for Formlabs denture teeth A2 resin (FMLB) and NextDent C&B (NXT). After artificial toothbrushing, the dispersed-filler composite (DFC) group had the largest color difference (ΔE, of 2.4 ± 0.9), and the remaining materials had smaller changes than the clinical acceptance threshold of ΔE = 2.25. The VHN of FMLB and NXT were 9.1 ± 0.4 and 15.5 ± 0.4, respectively, and were not affected by artificial toothbrushing. The flexural strengths of the 3D printed materials were 139.4 ± 40.5 MPa and 163.9 ± 14.0 MPa for FMLB and NXT, respectively, which were similar to those of the polycarbonate and PMMA groups (155.2 ± 23.6 MPa and 108.0 ± 8.1 MPa, respectively). This study found that the evaluated 3D printed materials had mechanical and optical properties comparable to those of CAD/CAM materials and were stable even after artificial toothbrushing and hydrothermal aging.

Effects of tooth bleaching protocols assisted by Er,Cr:YSGG and diode (980 nm) lasers on color change of resin-based restoratives

OBJECTIVE

To evaluate color change of three resin-based restorative materials after two laser-assisted in-office tooth bleaching protocols using Er,Cr:YSGG and diode (980 nm) lasers.

MATERIALS AND METHODS

A nanohybrid composite resin (EP), a Bis-GMA free composite resin (EPBio) and a resin-matrix CAD-CAM ceramic (HC) were tested. Ninety specimens were prepared and stored in artificial saliva. Group 1 received an in-office bleaching treatment using 40% H₂ O_2. The same bleaching procedure was assisted by Er,Cr:YSGG laser in Group 2 and by a diode laser (980 nm) in Group 3. Color measurements were performed using a double-beam UV-Vis spectrophotometer at four time intervals (before, 24 h, 15 and 30 days), converted to L*, a*, and b* units of the CIELAB color space and assessed on the basis of 50:50% acceptability (ΔΕ_ab * = 2.7 and ΔΕ₀₀  = 1.77) and 50:50% perceptibility (ΔΕ_ab * = 1.2 and ΔΕ₀₀  = 0.81) thresholds. Three-way ANOVA with repeated measurements was used for statistical analysis of the data.

RESULTS

Color and whiteness changes did not exceed the established 50:50% acceptability thresholds. EP presented the highest color change after the bleaching followed by EPBio and HC (p ≤ 0.05). Three-way ANOVA revealed that type of material and time interval significantly affected color change (p ≤ 0.001).

CONCLUSIONS

The tested bleaching treatments assisted by Er,Cr:YSGG and diode (980 nm) lasers did not induce unacceptable color and whiteness changes in the resin-based restorative materials.

CLINICAL SIGNIFICANCE

The tested Er,Cr:YSGG and diode (980 nm) laser-assisted tooth bleaching protocols which may be recommended to accelerate the clinical procedures cannot affect the color of the existing resin-based restorations in case they are accidentally exposed on the bleaching gel and laser irradiation.

Systematic Review on White Spot Lesions Treatments

The difference in refractive index between the healthy enamel and the demineralized area generates a lesion with a milky white opaque appearance, clearly distinguishable from the surrounding healthy enamel. The aim of this systematic review was to evaluate if the infiltration technique is the most efficient treatment to resolve a white spot lesion when compared with remineralization and microabrasion techniques. The Population/Intervention/Comparison/Outcome question investigated: “in enamel WS lesion, the infiltration treatment compared to remineralization or microabrasion treatments is more or less effective in the camouflage effect?.” The research was performed on electronic databases, including Ovid MEDLINE, PubMed, and web of science. The search was conducted up to April 1, 2020. The scientific search engines produced 324 results. Only 14 were screened after screening. Based on the articles analyzed in this systematic review, the resin infiltration technique seems to be the most effective and predictable treatment for the aesthetic resolution of WSLs.

Knowledge and attitude of dental students in Riyadh City toward the effect of mouthwashes on surface roughness and color stability of some esthetic restorations

Objective

To evaluate the knowledge and attitude of dental students in Riyadh city toward the effect of mouthwash on surface roughness and color stability of some esthetic restorations.

Materials and methods

This cross-sectional study is directed toward dental students in Riyadh city. The inclusion criteria include both undergraduate students and interns. The exclusion criteria include postgraduate dentist and those in the preparatory year. Also, dental students outside Riyadh are excluded, A questionnaire in English language was distributed through randomized selected participants in both social media (WhatsApp, Twitter) via link in a google sheet. The survey items were divided into two sections that include socio- demographic data and knowledge subscales.

Results

A total of 455 dental students have filled the survey, among them 168 were excluded because they did not meet the inclusion criteria (they were preparatory year students), making the number of included responses 287. There was a significant difference between males in females when answering the questions related to 1) indication of mouthwash prescription (P = 0.044), 2) if mouthwashes increase surface roughness of esthetic restorations (P= 0.007) and 3) the type of toothbrush used with esthetic restoration (P= 0.016).

conclusion

there is high awareness and using of mouthwashes among dental students in Riyadh the correlation between mouthwashes and restorative materials needs more spot lightening in the dental education process.

Effect of finishing and polishing systems on the surface roughness and color change of composite resins

Background

This study is to examine the surface roughness and color changes occurring on composite resins following the application of different finishing and polishing systems.

Material and Methods

In our study, a total of 200 samples were prepared from composites resin (6×2 mm) containing supra-nano, submicron hybrid, nanohybrid, nano-ceramic and microhybrid filler. They were polished with diamond, aluminum oxide, silicon carbide finishing and polishing systems. The initial color values of composite samples were measured with a spectrophotometer and surface roughness values with a profilometer. After that, samples were immersed of coffee solution and color measurements were repeated on the 1st and 7th day. The differences between surface roughness (Ra) and color change values (∆Eab) were evaluated using two-way analysis of variance (ANOVA) test (p<0.05).

Results

Finishing and polishing systems produced a statistically significant difference between the surface roughness values of nano-ceramic, submicron hybrid and microhybrid composite resin samples (p<0.05). Supra nano composite, which showed the lowest surface roughness after all finishing and polishing systems, showed the least color change after 7 days compared to other composite groups (p<0.05). The microhybrid composite with the highest surface roughness was the most color changing composite group (p<0.5).

Conclusions

The spiral finishing and polishing system containing diamond particles was the system to provide the least color difference on all composite groups. However, color differences of all composite resin groups were found to exceed the perceptibility threshold (PT) and acceptability threshold (AT).

Key words:Composite resin, color stability, surface roughness.

Color Stability of Dental Reinforced CAD/CAM Hybrid Composite Blocks Compared to Regular Blocks

This study compares the color stability of dental reinforced computer-aided design/computer-aided manufacturing (CAD/CAM) hybrid composite blocks to that of regular blocks. One hundred fifty disc-type specimens (n = 15) were prepared from five sets of hybrid composite blocks (Cerasmart-200/Cerasmart-300, KZR-CAD HR/KZR-CAD HR3, Estelite Block/ Estelite-P Block, Avencia Block/Avencia-P Block, Mazic Duro/Duro Ace). The specimen color and translucency parameter (TP) were assessed using a spectrophotometer before and after immersion in staining solutions (water, 10% ethanol, simulated red wine). Changes in color (ΔE) and translucency (ΔTP) of specimens were calculated. The data were analyzed using the analysis of variance (ANOVA) and Tukey’s post hoc test (p < 0.05). Microstructural features of the hybrid composite blocks were also examined using FE-SEM. Immersion in deionized water or 10% ethanol made no significant color or translucency changes (except for Avencia-P Block); however, the simulated red wine caused significant changes to the color and translucency of almost all specimens, especially after 4 weeks of immersion. The reinforced hybrid blocks (except for Estelite-P Block and Duro Ace) showed lower color stability than corresponding regular blocks. Avencia-P Block showed significantly reduced color stability compared to Avencia Block. Even in deionized water and 10% ethanol, Avencia-P Block showed perceptible ΔE and decreased translucency. Estelite Block/ Estelite-P Block and Mazic Duro/Duro Ace showed better color stability than the other materials tested.

[Clinical performance of rensin-bonded composite strip crowns in primary incisors]

OBJECTIVE

To evaluate the clinical success of the treatment of maxillary anterior primary incisors caries with composite resin strip crowns.

METHODS

Children who presented with severe early childhood caries and were treated comprehensive caries under general anesthesia from January to December 2016 were enrolled in this study. Composite crowns using preformed celluloid crown (3M ESPE, USA) called as "strip crown technique" were applied to treat vital primary incisors with two or multiple surface cavities. Selective etchings of enamel, Universal Bond adhesive and 3M Z350 resin were used to make strip crowns. The patients returned at the end of 6, 12 and 18 months and received clinical and radiologic examinations. Dentists who did not attend the treatment evaluated the strip crowns clinically by modified United States Public Health Service (USPHS) criteria.

RESULTS

Four hundred eighteen restorations, placed in 127 children aged 1.17-5.75 years (average of 3.22), were evaluated. The overall retention rate was 97.8% at the end of 6 months, 93.6% at 12 months and 89.2% at 18 months. After 18 months, 28 restorations (6.7%) were totally lost and 4.1% were rated as having lost some resin material. Only four teeth (1.0%) had secondary caries at the end of 18 months and 1.4% teeth had pulpal pathology requiring root canal treatment. Composite crowns had good performance in contour and adjacent contact and improved aesthetics significantly. Twenty-nine teeth (6.9%) showed mild gingivitis and 93.1% showed healthy gingival. 11.2% of the teeth demonstrated color change because plaque accumulation and the polish could remove the stains. The complete loss of strip crowns was mainly related to eating bites.

CONCLUSION

Strip crowns performed well for restoring primary incisors with large or multisurface caries for periods of over 18 months. The strip crowns can be a durable and aesthetic restoration for vital carious primary incisors with adequate tooth structure after caries removal. Functional movement is an important cause of complete loss. Because of the high technical sensitivity and its requirement of the cooperation of children, strip crowns are more suitable for older and cooperative children as well as children receiving dental treatment under sedation or general anesthesia.

Influence of Neuroticism on the Prognosis of Nanoceramic and Microhybrid Composite Restoration: A Comparative 1-year Clinical Study

AIM

This study aimed to compare the clinical performance of nanoceramic and microhybrid-based composite restorations in adult patients with different personality traits.

MATERIALS AND METHODS

Patients in accordance with the inclusion and exclusion criteria were asked to complete the BFI (Big Five Inventory) questionnaire. Of a total of 323 patients, 124 (67 males and 57 females) patients were categorized into agreeableness and neuroticism traits and were included in the study. The patients were randomly divided into two subgroups: SG I A (n = 31) and II A (n = 31) for microhybrid composite (Spectrum TPH 3, Dentsply/DeTrey, Konstanz, Germany), SG I B (n = 31) and II B (n = 32) for nanoceramic composite restorations (Ceram X mono, Dentsply/DeTrey, Germany). At baseline, 6 and 12 months, the restorations were evaluated using the Modified USPHS (United States Public Health Service) evaluation criteria. The Pearson chi-square and the Fisher's exact test were used to assess the difference between the personality traits and restorative material groups where a probability value of P < 0.05 was considered to be statistically significant.

RESULT

Most of the restorations scored alfa (A), whereas very few scored bravo (B) in all the subgroups. However, there were no charlie (C) or delta (D) scores. Overall, Spectrum TPH and Ceram x mono displayed superior performances in retention and postoperative sensitivity than all the other clinical parameters. Furthermore, Ceram x mono restorations showed more surface roughness than Spectrum TPH. No statistical differences in the restoration performance were found between both personalities and restorative material types.

CONCLUSION

Although neuroticism has an effect on various health outcomes, its impact on the clinical performance of composite restorations during the follow-up period was not observed. In addition, there was no difference between the performance of nanohybrid and microhybrid composite.

The Influence of Dental Occlusion on Spectrophotometric Tooth Color Determinations

Background:

Shade matching is a significant treatment step and a challenge for the clinical team with potentially high costs for color correction. Currently, in the United States, the majority of private dental practitioners use visual color matching, but a recent study has reported a high rate of mistakes of subjective color determination among graduate dentists.

Objective:

The aim of this retrospective study is to analyze whether a change in the oral background due to dental occlusion can influence tooth color determination.

Methods:

Volunteer dental students underwent spectrophotometric color assessment using the SpectroShade device. Two measurements were carried out (with the individuals’ occlusion closed and with the occlusion open) on 43 upper central and 58 lateral incisors. Association between colorimetric variables L*, a*, b* and ΔE00 and tooth width, length and tobacco usage were examined.

Results:

Slight changes in the CIELAB values between closed and open occlusions were found for both the gingival and the central sections as for the overall tooth area, with mean ΔL*=-1.24, Δa*=-1.77, Δb*=-1.42 and ΔE00=1,84. A larger difference was detected in the incisal area, with mean ΔL*=-2.99, Δa*=-1.76, Δb*=-2.83 and ΔE00=3.65.

Conclusion:

In conclusion, our study showed that dental occlusion does not play a significant role in tooth color matching determinations, even though attention to avoid overbite due to a maximum intercuspation should be made.

Effects of Khat on Surface Roughness and Color of Feldspathic and Zirconia Porcelain Materials under Simulated Oral Cavity Conditions

Background and Objectives: Khat chewing is considered as a daily habit that is practiced by more than five million people globally. The effect of khat chewing on the surface roughness and the color stability of natural teeth and the material used in the fabrication of dental prosthesis remains unknown. This study was conducted to explore and compare the effect of khat homogenate (KH) on the surface roughness (Ra) and the average color changes (ΔE*) amongst natural teeth and selected shades from different porcelain types, namely, feldspathic metal ceramic (MC) VM13, computer-aided design/computer assisted manufacture (CAD/CAM) feldspathic (Vitablocs Mark II), and multilayer zirconia (Ceramill Zolid PS) porcelains. Materials and Methods: Seventy samples were prepared from natural teeth, feldspathic MC, CAD/CAM Vitablocs Mark II, and zirconia porcelain. The Ra values were measured using a profilometer and expressed in micrometers, whereas the ΔE* values were measured using VITA Easyshade® V spectrophotometer for all samples before and after frequent immersion and thermocycling in KH for 30 days. The surface topography was used to assess the materials surfaces (glazed or polished) after KH immersion by using a white light interferometry machine. Results: Results revealed that the Ra and the ΔE* values of the different types of tested porcelain were influenced by KH. The order of surface roughness values was glazed or polished MC > polished Zircon > polished Vitablocs Mark II > natural teeth. The lowest ΔE* values were recorded for glazed Vitablocs Mark II and MC, and the values could be arranged as polished zircon > natural teeth > glazed zircon > polished MC > polished Vitablocs Mark II. P values were significantly varied (< 0.001) among all the tested groups, except the zircon group (>0.05) for both Ra and ΔE*. Conclusion: KH significantly affected both surface parameter and color of glazed or polished porcelain materials and natural teeth.

Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up

The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.

Physical Properties of Nanohybrid and Microhybrid Resin Composites Subjected to an Acidic Environment: A Laboratory Study

BACKGROUND

This study investigated the hardness and color stability of five resin composites subjected to different polishing methods following immersion in distilled water or lactic acid for up to three months.

METHODS AND MATERIALS

Three nanohybrid, Paradigm (3M ESPE), Estelite Sigma Quick (Tokuyama), Ice (SDI), and two microhybrid, Filtek P60 and Filtek Z250, composites were examined. Disc-shaped specimens (10×1.5 mm) were prepared and immersed in distilled water for 24 hours then polished using either silicon carbide paper, the Shofu polishing system or were left unpolished (control). The CIE values and microhardness were determined using a spectrophotometer and digital Vickers hardness tester, respectively (n=10) after one, 45, and 90 days of storage in distilled water or lactic acid. Data were analyzed using analysis of variance, Tukey test, and Pearson correlation coefficient.

RESULTS

Ice exhibited the greatest color change, yet Paradigm and Filtek P60 demonstrated the least. Overall, discoloration of tested materials was multifactorial and the effect of storage media depended on the material, polishing method and time interval. The greatest hardness was obtained for Paradigm and the lowest for Estelite. Hardness was found to be significantly higher in lactic acid after 45 days (p=0.014) and even higher after 90 days (p<0.001) compared with distilled water.

CONCLUSIONS

An acidic environment did not adversely affect color stability or microhardness of the resin composites. There was a significantly mild reverse correlation between hardness and color change in both storage media.

Color changes of polyetheretherketone (PEEK) and polyoxymethelene (POM) denture resins on single and combined staining/cleansing action by CIELab and CIEDE2000 formulas

PURPOSE

The purpose of study was to investigate the long-term effect of staining and/or cleansing solutions on the color stability of two non-metal removable partial denture materials.

METHODS

One hundred disks (25×3mm) of polyoxymethylene (POM) and polyetheretherketone (PEEK) were immersed in water, wine, coffee, cleanser and combo bath, simulating normal daily use. Color parameters in the CIELAB system was measured every 30 cycles up to 240 using a contact colorimeter and color differences estimated using ΔE_ab and ΔE₀₀ formulas. Two-way repeated measures ANOVAs and regression analyses were performed at α=0.05.

RESULTS

Regression analysis indicated a strong R² between color changes and number of cycles, for both materials. Tests of within-subjects effects for the ΔE_ab revealed significant differences among cycles and between the materials in the wine and coffee baths (p<0.001). Significant materialXcycles interactions were also recorded with all staining baths. ΔE₀₀ values were lower than ΔE_ab up to 63.6%. Tests within and between-subjects effects for the ΔE₀₀ gave similar but not the same with ΔE_ab results.

CONCLUSIONS

ΔE₀₀ found to correlate well with ΔE_ab. Long term exposure of both materials showed a progressive discoloration in all except control baths. POM discolored more than PEEK in coffee, and combo baths but not in cleanser. Discoloration was smaller in combo bath (where a cleanser was also used) indicating the effectiveness of a cleanser to prevent long term discoloration of both materials.

Color stability of nanohybrid composite resins in drinks

Aim: The objective of this study was to evaluate the effects of solutions on the color stability of nanohybrid composite resins. Methods: The experimental sample consisted of 90 composite specimens (Beautifil II; Z350XT; Premisa), divided into three subgroups (n=10) according to the solutions (matte tea; lemon flavor isotonic drink; artificial saliva). The specimens were immersed in the solutions (5 mL/specimen) while stirring for 5 minutes, four times a day, with 1-hour intervals, repeated for 15 days. The color of the specimens was analyzed before (baseline) and after the 15th day of cycling using the CIELAB system. Data were analyzed using the two-way analysis of variance (ANOVA) and Tukey’s test (α=5%). Results: Different behaviors were observed among resins. Beautifil II presented the highest color change (∆E=4.18) and less color stability, statistically different from the others (p<.05). The solutions also presented different behaviors. The lemon flavor isotonic drink (∆E=3.95) promoted the highest color change, statistically different from saliva (∆E=2.75; p<.05). The interaction between Beautifil II and isotonic drink became even more evident and significant (p<.05). Conclusion: The isotonic drink is the solution that most affected the resins, and Beautifil II presents the worst color stability.

Discoloration of different esthetic restorative materials: A spectrophotometric evaluation

Objective:

A crucial property of esthetic restorative materials is their long-term color stability. The aim of this in vitro study was to evaluate the color stability of esthetic restorative materials (one microfilled flowable composite, one nanofilled composite, one nanoybrid composite, one microfilled composite, and one nanoybrid ormocer-based composite) after surface roughening with cola and exposure to different staining solutions (coffee and red wine).

Materials and Methods:

All materials were polymerized into silicone rubber rings (2 mm × 6 mm × 8 mm) to obtain 150 specimens identical in size. Seventy-five specimens of Group A were first exposed to cola for 24 h, and then samples were immersed in coffee or red wine over a 28-day test period. A colorimetric evaluation, according to the CIE L*a*b* system, was performed at 7, 14, 21, 28 days. Shapiro–Wilk test and Kruskal–Wallis analysis of variance were applied to assess significant differences among restorative materials. Means were compared with Scheffe's multiple comparison test at the 0.05 level of significance.

Results:

Specimens of Group A showed higher variations when compared with Group B's specimens (P < 0.05). After 28 days, the immersion protocols caused a clinically perceivable color change for all materials tested (P < 0.05). CeramX Universal and Admira Fusion showed the lowest ΔE variations (P < 0.05).

Conclusions:

Staining beverages caused significant discolorations for all the materials tested. The first exposure to cola enhanced the subsequent staining with coffee or red wine. Nanohybrid composites reported the lowest color variations.