Porosity and color of maxillofacial silicone elastomer

In situ study of the effect of endogenous and exogenous agents on color stability, hardness, and surface roughness of an elastomer for facial prostheses

PURPOSE

To evaluate in situ the influence of sweat, oil, sunscreen, and disinfectant solution on the color stability, hardness, and roughness of elastomer for facial prostheses.

MATERIALS AND METHODS

Standardized and intrinsically pigmented specimens remained in contact with human skin from the same person for 30 days, considering exposures (n = 36 per group), absent of exposition (Control, C); sweat and oiliness contact (SO); sweat and oiliness associated with sunscreen (SOS); 0.12% chlorhexidine digluconate immersion (CD0.12%); and all agents exposed (SOSCD). The main variables were color change (CIELab and National Standard Bureau system, NBS), Shore A hardness, and surface roughness, measured at baseline and 30 days. Qualitative analyses were performed by atomic force microscopy (AFM) and scanning electron microscopy (SEM). The data were analyzed by Kruskal-Wallis tests (color) and two-way ANOVA (hardness and roughness) with Sidak post-test (α = 0.05).

RESULTS

CD0.12% (1.54 ± 0.49) and SOSCD (2.10 ± 1.03) had similar effects and caused the smallest color changes, considered mild and noticeable (NBS), respectively. SOS promoted the greatest color change (6.99 ± 1.43, NBS: large) and hardness (17.97 ± 0.56); SOS promoted intermediate roughness (3.48 ± 1.05) between SOSCD (2.25 ± 0.53), and two similar groups: C (4.46 ± 0.95), and CD0.12% (4.39 ± 1.26). The qualitative analysis showed an irregular, dense, dry, and whitish layer on the surface of the specimens exposed to sunscreen, which was reduced when in contact with 0.12% chlorhexidine digluconate.

CONCLUSIONS

Endogenous and exogenous factors are capable of altering elastomer properties. The 0.12% chlorhexidine digluconate minimized the changes caused by sweat, oil, and sunscreen.

The impact of zirconium dioxide nanoparticles on the color stability of artificially aged heat-polymerized maxillofacial silicone elastomer

The limited service life of craniofacial prostheses due to degradation and color instability is a significant challenge. This in vitro study aimed to determine how zirconium dioxide (ZrO2) nanoparticles affect the color stability of M511 heat temperature vulcanizing (HTV) maxillofacial silicone elastomers after artificial aging. ZrO2 nanoparticles were added at concentrations of 1, 2, and 3 wt% to M511 HTV silicone elastomer. Two intrinsic silicone pigments were used (red and mocha). Silicone with pigment and without ZrO2 nanoparticles were used as the control. Eighty disk-shaped specimens were fabricated and divided into eight experimental groups, each containing ten specimens (n = 10). All specimens were subjected to artificial aging, and color changes were recorded at 252, 504, and 1008 h intervals. The L*a *b * values were measured using a colorimeter and the CIE-Lab system. To interpret the recorded color differences, a 50:50 percent perceptibility threshold (ΔE* = 1.1) and acceptability threshold (ΔE* = 3.0) were implemented. A one-way analysis of variance and Tukey's post hoc test at a significance level of 0.05 were used for the statistical analysis. We found that every evaluated specimen group exhibited a chromatic change (ΔE* > 0). The ΔE* values for the mocha pigments with and without ZrO2 nanoparticles were below the perceptible threshold (1.1 units). The ΔE* values of the red pigment with and without ZrO2 nanoparticles were significantly higher than the acceptable threshold (P < 0.000). According to the findings of this in vitro study, all the specimens underwent color changes (ΔE* > 0). The red pigment exhibited highly significant chromatic alterations. In contrast, mocha pigments with and without ZrO2 nanoparticles exhibited the least color change and were below the perceptible threshold. ZrO2 nanoparticles provided important protection and showed a reduction in color change.

Digitization in Skin Shade Matching for Maxillofacial Prostheses: A Systematic Review

Color matching of maxillofacial prostheses for the restoration of maxillofacial defects is an important factor for esthetic results. Various methods have been introduced for the accurate and reliable color matching of prostheses with the skin color of patients. A systematic review was conducted to search the existing literature on color-matching digital techniques for maxillofacial prostheses. An electronic literature search was conducted in PubMed/Medline, Scopus, and Web of Science from January 2000 to December 2022 using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Two independent reviewers conducted the search. Eight articles that fulfilled the inclusion criteria after a full-text evaluation were included in this review. Most of these studies were published in prosthodontics journals and conducted in various countries around the world. A computerized color formulation system was used in three studies; a non-contact spectroradiometer (PR 705; Photo Research Inc., Chatsworth, CA) with a Xenon arc lamp was used in two studies; a mobile phone colorimeter was used in one study; additive manufacturing of 3D facial skin with a spectrophotometer was used in one study; and a recently introduced computerized method known as e-skin (Spectromatch, Bath, UK) was used in two studies. Most of these methods were accurate in color matching, except for the additive manufacturing system, which showed less accuracy, but good repeatability. Owing to a lack of sufficient studies, no method can be labeled as the best method for color-matching maxillofacial prostheses. The latest computerized method, the e-skin, can be used to achieve better accuracy and good color matching. However, further studies are required to validate the use of e-skin for precise color matching.

Fungicidal Effect of Lemongrass Essential Oil on Candida albicans Biofilm Pre-established on Maxillofacial Silicone Specimens

Aims:

This in-vitro study aimed to evaluate the efficacy of lemongrass (Cymbopogon citratus) essential oil in eradicating Candida albicans biofilm pre-established on the maxillofacial silicone specimens.

Materials and Methods:

Two maxillofacial silicones, namely, MDX4-4210 and Multisil Epithetik, were used for the fabrication of 6 mm diameter disks (n = 21 for each brand of silicone). A 48-h mature C. albicans ATCC 10231 biofilm was pre-established on sterile silicone specimen. These disks were then exposed to various concentrations of lemongrass essential oil ranging from 0.31% to 5% (v/v), 20% (v/v) nystatin, and RPMI-1640 medium for 18–20 h. After exposure, the remaining viable fungal biofilm was examined by the XTT [2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide]-reduction assay. All data were analyzed by using a regression coefficient and a post hoc Tukey HSD multiple comparisons test (α = 0.05).

Results:

Different brands of silicone used for fabrication did not significantly affect the formation of mature C. albicans biofilm (P =0.302). A 5% (v/v) lemongrass essential oil significantly eliminated fungal biofilm by approximately 95% (P =0.031). However, less than 50% of the fungal biofilm was eliminated by the tested oil at a concentration as low as 0.31% (v/v). Furthermore, the fungicidal efficacy against C. albicans biofilm of lemongrass essential oil at 2.5% (v/v) was as potent as that of 20% (v/v) nystatin suspension (P = 0.99).

Conclusion:

Lemongrass essential oil expressed fungicidal effect on C. albicans biofilm pre-established on the disks fabricated from different brands of silicone. Additionally, the fungicidal effectiveness of the oil against the mature fungal biofilm was dose-dependent.

The color stability of maxillofacial silicones: A systematic review and meta analysis

Aim

This systematic review aims to identify and interpret results of studies that evaluated the changes in the color stability of maxillofacial prosthetic materials due to chemical instability of silicones and pigments and the effect of exposure to environmental conditions and aging factors on the same.

Settings and Design

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA).

Materials and Methods

Relevant articles written in English only, before November 15, 2019, were identified using an electronic search in the PubMed/Medline conducted to identify pertinent articles. The relevancy of the articles was verified by screening the title, abstract, and full text, if they met the inclusion criteria. A total of 42 articles satisfied the criteria, from which data were extracted for qualitative synthesis. This review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number CRD42019124562).

Statistical Analysis Used

Since considerable data heterogenicity was present in all studies except the ones on incorporation of TiO2 for which meta-analysis using random effects model was performed.

Results

The database search resulted in 234 studies, of which 202 articles were excluded due to lack of relevance, duplication, and unavailability of data. The remaining 32 fulltext articles were assessed for eligibility, out of which 2 articles were excluded. Twelve articles were yielded by manual search. A total of 42 studies were included in the present systematic review. Due to heterogeneous data, meta-analysis could be only carried out with the effect of TiO2 nano particle on color stability.

Conclusions

Although there has been extensive amount of research in this field, an ideal maxillofacial silicone exhibiting good color stability in various human and environmental aging conditions is yet to be identified. Human and environmental aging conditions have an adverse effect on the color stability and addition of TiO2 nano particle seems to improve the same.

Effect of nano-oxides on the color stability of maxillofacial silicone elastomers

STATEMENT OF PROBLEM

A significant challenge of craniofacial prostheses is their limited service life because of degradation and color instability. In spite of improvements in the materials and techniques used for the fabrication of silicone maxillofacial prostheses, undesirable color change over time remains a challenge. Zn and Ti nano-oxides (nano-TiO₂) have been reported to impart an ultraviolet- (UV) shielding property to silicone elastomers. However, studies examining the effects of nanopigments on the color stability of craniofacial prostheses are sparse.

PURPOSE

The purpose of this in vitro study was to evaluate the color stability of a room-temperature vulcanizing (RTV) silicone elastomer with the addition of iron oxide and titanium dioxide nanopigments under accelerated artificial aging.

MATERIAL AND METHODS

Sixty disks (Ø15×2 mm) were fabricated from RTV silicone 4408 Q. The specimens were divided into 5 groups containing iron oxide nanopigment, iron oxide nanopigment and rutile nano-TiO₂ (as an opacifier), burnt sienna pigment, burnt sienna and nano-TiO₂, and silicone without pigment or opacifier. The specimens were subjected to accelerated aging in a Xenotest chamber for 1000 hours. CIELab color coordinates and the total color difference (ΔE∗) values were determined before and after aging. ΔE∗ values were compared between the groups by using 1-way ANOVA and Tamhane multiple comparisons (α=.05), and a standard deviation of 1.09 was considered.

RESULTS

ANOVA showed that the values of ΔE∗ differed among all groups (P<.05). The minimum amount of a color change perceived (ΔE∗ approximately =1.1) by the visual system as the threshold was observed in the specimens treated with burnt sienna and nano TiO₂. The greatest color change occurred in the specimens treated with iron oxide nanopigment. As per the acceptable clinical threshold, the color change was satisfactory in all groups.

CONCLUSIONS

Nano-TiO₂ with burnt sienna groups had a lower color change than the other groups. The color change in all groups was within a clinically acceptable range.

Influence of Different Pigment Incorporation Methods on the Sorption and Solubility of Medical Silicones

Objective  The aim of this study is to verify the influence of three pigment incorporation methods (conventional, mechanical, and industrial) on the sorption and solubility of the MDX4-4210 and A-2186 silicones.

Materials and Methods  The groups formed were based on the silicones used (A-2186 and MDX4-4210), intrinsic pigments (pink, bronze, and black), and pigment incorporation methods (conventional, mechanical, and industrial). The dimensions of all samples were 45-mm diameter (ø) × 1-mm thickness. Readings were taken initially and after 1,008 hours of aging.

Statistical Analysis  Three-way analysis of variance and the Tukey's test were performed (α = 0.05).

Results  For sorption and solubility, there was no difference between the incorporation methods for the A-2186 silicone, regardless of the pigment used ( p  > 0.05). For pink MDX4-4210, the industrial and mechanical methods showed higher values of sorption compared with the conventional method ( p  < 0.05). For bronze MDX4-4210, the industrial method showed a higher sorption value compared with the conventional and mechanical methods ( p  < 0.05). For black MDX4-4210, there was no difference between incorporation methods based on sorption ( p  > 0.05). For pink MDX4-4210, the mechanical method showed a higher solubility value compared with the industrial and conventional methods ( p  < 0.05). For black MDX4-4210 and bronze MDX4-4210, there was no statistically significant difference between incorporation methods based on solubility (p > 0.05).

Conclusion  Based on sorption and solubility, for the A-2186 silicone, the conventional, mechanical, and industrial methods of pigment incorporation were equivalent. For the MDX4-4210 silicone, its results of sorption and solubility were varied, and further studies are recommended.

Tear Strength Analysis of MDX4-4210 and A-2186 Silicones with Different Intrinsic Pigments Incorporated by Mechanical and Industrial Methods

Objective

The aim of this study was to evaluate the tear strength of MDX4-4210 and A-2186 silicones with different intrinsic pigments incorporated by mechanical and industrial methods, comparing nonaged and aged groups.

Materials and Methods

Twenty-four groups were created according to the American Society for Testing and Materials D-624/type C, half nonaged and half aged (n = 10): bronze mechanical MDX4-4210, bronze industrial MDX4-4210, black mechanical MDX4-4210, black industrial MDX4-4210, pink mechanical MDX4-4210, pink industrial MDX4-4210, bronze mechanical A-2186, bronze industrial A-2186, black mechanical A-2186, black industrial A-2186, pink mechanical A-2186, and pink industrial A-2186. All specimens were submitted to tear strength analysis. Data were submitted to the ANOVA and Tukey test (p < 0.05).

Results

An increase in the tear strength values was observed only for the bronze and black MDX4-4210, comparing nonaged and aged silicones (p < 0.05), regardless of the manufacturing method. There was a difference in all comparisons between MDX4-4210 and A-2186 silicones with the same pigment type (p < 0.05), regardless of the manufacturing method. In all cases, there was no difference in the manufacturing method comparing the MDX4-4210 or A-2186 groups with the same pigment.

Conclusion

Accelerated aging did not influence the tear strength in all aged A-2186 silicones and in aged pink industrial and mechanical MDX4-4210 silicones. The other MDX4-4210 groups had an increase in the results after aging. In all cases compared, the A-2186 groups had higher tear strength values than the MDX4-4210 groups. Mechanical and industrial methods can be used for silicone preparation, without changing the tear strength.

Influence of Different Pigment Incorporation Methods on Color, Dimensional Stability, and Detail Reproduction of Silicones

Objective  To analyze the influence of three pigment incorporation methods on color change, dimensional stability, and detail reproduction of the MDX4–4210 and A-2186 silicones.

Materials and Methods  The A-2186 and MDX4–4210 silicones were used for preparation of samples, with the incorporation of bronze, black and pink pigments, usingconventional, mechanical, and industrial incorporation methods. Samples were submitted to the initial readings of color ( n = 10; 22-mm diameter × 2-mm thickness), detail reproduction, and dimensional stability ( n = 10; 30-mm diameter × 3-mm thickness). Readings were also taken at the end of 252, 504 and 1,008 hours of aging cycles.

Results  Quantitative data were evaluated by ANOVA and Tukey test, with a level of significance of 5%. The mechanical and industrial methods caused smaller color changes of all samples compared with the conventional method ( p < 0.05). In most cases, the mechanical and industrial methods caused less samples’ contraction than the conventional method after aging ( p < 0.05). The color change values increased progressively in each aging period for all samples ( p < 0.05). The contraction values increased progressively in each aging period for all samples ( p < 0.05). In the qualitative analysis of detail reproduction, all samples presented full reproduction of the three grooves, with accurate angles, initially and after the aging periods.

Conclusions  The industrial and mechanical methods showed the best results for color and dimensional stability. Despite the statistical differences, all pigment incorporation methods generated acceptable dimensional and color changes of the MDX4-4210 and A-2186 silicones, regardless of the pigment and aging. In addition, the detail reproduction was satisfactory after aging periods in all cases of this study, showing the excellent quality of the A-2186 and MDX4–4210 silicones.

In vitro evaluation of color and translucency reproduction of maxillofacial prostheses using a computerized system

PURPOSE

Accurate color matching of maxillofacial prostheses to skin is important for esthetics. A computerized color matching system specific to human skin has recently been developed. The purpose of this study was to evaluate the accuracy in color and translucency matching of the computerized color matching system across different skin colors.

MATERIALS AND METHODS

The silicone was colored to simulate 28 different skin colors (n=5) to serve as “target skin colors”. Using a spectrocolorometer (e-skin), color codes were determined for “replicate skin color” fabrication. CIELAB Delta-E between target skin color-replicate skin color pairs and translucency parameter were calculated. CIELAB Delta-E values were compared with one-way ANOVA and Tukey multiple-comparison. The agreement between L*, a*, b* and translucency parameter of target skin colors and replicate skin color were calculated by a two-way mixed average measures intraclass correlation coefficient. Translucency parameter of target skin color-replicate skin color pairs were compared with Paired t-test (α=.05).

RESULTS

The mean CIELAB Delta-E value was 3.83 and significant differences were found among colors. The intraclass correlation coefficient showed excellent reliability for L*, a*, b* and good reliability for translucency parameter (P<.001). The mean translucency parameter of replicate skin colors was significantly higher than that of translucency parameter.

CONCLUSION

The computerized color matching system specific to human skin was found to be reliable in terms of color and translucency between target skin colors and replicate skin color.

A spectrophotometric analysis of extraoral aging conditions on the color stability of maxillofacial silicone

Context:

Surveys have reported color fading as the most frequent reasons patients given for disliking their prostheses.

Aim:

The aim of the study is to compare the color variation between two maxillofacial silicone elastomers after subjecting them to extraoral aging conditions.

Subjects and Methods:

A total of 80 samples were made from M511 Maxillofacial Rubber (Part A: Part B = 10:1) and Z004 Platinum Silicone Rubber (Part A: Part B = 1:1) and divided into two main Groups A and B (40 each). These main groups were then subdivided into five subgroups (A₁B₁, A₂B₂, A₃B₃, A₄B₄, and A₅B₅) (n = 8); outdoor weathering, acidic perspiration, sebum (for 6 months), and neutral soap and disinfectant (for 30 h), respectively. Baseline L*a*b* values were recorded. The samples were subjected to the extraoral aging conditions, and the L* a*b* values were recorded after the aging period using a spectrophotometer.

Statistical Analysis:

The intergroup comparison was done by Kruskal–Wallis test, whereas the intragroup comparison was done by Mann–Whitney test.

Results

All groups exhibited visually detectable, mean color differences that ranged from 3.06–5.21, except for A₄B₄. There was no statistical significance between the two materials when subjected to extraoral aging conditions.

Conclusions:

Visually perceptible and clinically unacceptable color changes occur when exposed to various extraoral aging conditions except for neutral soap solution immersion, for which values of Δ E* were clinically acceptable (ΔE < 3). It can be said for all practical purposes, clinically, the choice between M511 Maxillofacial Rubber (Part A: Part B = 10:1) and Z004 Platinum Silicone Rubber (Part A: Part B = 1:1) would yield more or less the same results, with unacceptable norms in terms of color stability under extraoral aging conditions.

Porosity of maxillofacial silicone elastomers and microleakage pattern of the commercially pure Ti-silicone elastomer interface after hydrothermal cycling

STATEMENT OF PROBLEM

Delamination of the maxillofacial silicone elastomer away from the commercially pure titanium (cpTi)-encapsulated magnets affects the long-term performance of the facial restoration.

PURPOSE

The purposes of this in vitro study were to investigate the interfacial microleakage patterns of 2 maxillofacial silicone elastomers with cpTi when 3 different primers were used and to evaluate the porosity of the 2 elastomers tested.

MATERIAL AND METHODS

To test the interfacial microleakage patterns of the 2 elastomers MDX4-4210 (EL1) and A-2006 (EL2) with cpTi when 3 metal primers, A-304 (PR1), A-320 bonding enhancer (PR2), Super-Bond C&B monomer (PR3), and ethyl-cyanoacrylate (Super Glue) were used, the bonded interfaces were observed using reflected light microscopy, and the percentage of the linear extent of leakage along the interface (%microleakage) was measured. High-resolution x-ray computed microtomography scanning was used to investigate the percentage of void volume fraction (%VF) for both silicone EL1 and EL2. The data were analyzed with 2-way ANOVA and post hoc tests (α=.05).

RESULTS

No statistically significant differences were found among the percentages of PR1, PR2, and PR3 microleakage, whereas ethyl-cyanoacrylate showed a statistically significant higher percentage of microleakage than either of the silicone elastomers (P<.001). EL1 medical grade elastomer groups have always had a statistically significantly higher percentage of microleakage than the EL2 platinum silicone elastomer groups (P<.001). For both elastomers, no statistically significant differences were found in %VF (P=.056).

CONCLUSIONS

Differences in mechanical properties, chemical composition, and manipulations during handling of the maxillofacial silicone elastomers can affect the linear microleakage along the cpTi-silicone elastomer bonding interface and the porosity of the silicone elastomer.

Outdoor weathering of facial prosthetic elastomers differing in Durometer hardness

STATEMENT OF PROBLEM

Facial prosthetic elastomers with wide ranges in hardness are available, yet material weatherability is unknown.

PURPOSE

The purpose of this study was to assess color, Durometer hardness, and tensile property changes after 3000 hours of outdoor weathering.

MATERIAL AND METHODS

Unpigmented elastomers with Durometer hardness 5, 30, 50, 70, and A-2186 were polymerized into dumbbells (ASTM D412) and disks, 34 mm in diameter by 6 mm thick. Materials were subjected to outdoor or time passage environments for 3000 hours. CIELab color (n=5), Durometer hardness (n=5), and tensile mechanical properties (n=10) were measured at 0 and 3000 hours, and group differences were assessed by material and weathering condition (ANOVA/Tukey, α=.05).

RESULTS

Except for A-2186, the mean Durometer changes for all materials were 1 unit or less, with no significant differences observed between time passage and weathered groups (P≥.05). Three-thousand-hour tensile mechanical property results demonstrated nonsignificant differences between time passage and weathered materials but significantly changed properties from immediately tested materials (P<.001). Outdoor weathering induced perceptible but acceptable color changes (1.7≤ΔE*≤2.6) for elastomers with Durometer hardness 5 and 30 and A-2186.

CONCLUSIONS

With a few exceptions, outdoor weathering produced relatively small changes in color, Durometer hardness, or tensile properties compared with time passage.

An in vitro assessment of gutta-percha coating of new carrier-based root canal fillings

The first aim of this paper was to evaluate the push-out bond strength of the gutta-percha coating of Thermafil and GuttaCore and compare it with that of gutta-percha used to coat an experimental hydroxyapatite/polyethylene (HA/PE) obturator. The second aim was to assess the thickness of gutta-percha around the carriers of GuttaCore and HA/PE obturators using microcomputed tomography (μCT). Ten (size 30) 1 mm thick samples of each group (Thermafil, GuttaCore, and HA/PE) were prepared. An orthodontic wire with a diameter of 0.5 mm was attached to the plunger of an Instron machine in order to allow the push-out testing of the gutta-percha coating. Five samples of (GuttaCore and HA/PE) were scanned using μCT. The data obtained were analysed with one-way analysis of variance and Tukey post hoc test. HA/PE obturators exhibited significantly higher push-out bond strength (P < 0.001) determined at 6.84 ± 0.96 than those of Guttacore around 3.75 ± 0.75 and Thermafil at 1.5 ± 0.63. GuttaCore demonstrated significantly higher bond strength than Thermafil (P < 0.001). μCT imaging revealed that the thickness of gutta-percha around the experimental HA/PE carrier was homogeneously distributed. The bondability and thickness of gutta-percha coating around HA/PE carriers were superior to those of GuttaCore and Thermafil obturators.

Effect of different disinfecting procedures on the hardness and color stability of two maxillofacial elastomers over time

OBJECTIVE

Disinfection procedures often cause deterioration in a maxillofacial prosthesis. Color and hardness alterations could lead to a replacement of the prosthesis.

MATERIAL AND METHODS

An experimental chlorinated polyethylene (CPE) and a commercial polydimethyl siloxane (PDMS) sample were treated with four different disinfection procedures for a period which simulates 1 year of clinical service. The applied disinfection procedures included microwave exposure and immersion in three solutions, sodium hypochlorite, neutral soap and a commercial disinfecting soap. Shore A hardness (∆H) and color differences (∆E) were determined before and after each procedure. All data were analyzed by Two Way Analysis of Variance (ANOVA) and Tukey's post hoc tests at a level of α=0.05.

RESULTS

The samples presented significant alterations in color and hardness after the different disinfection treatments. The color differences (∆E) were at least eye detectable in all cases and clinically unacceptable in most of the cases, with values ranging from 1.51 to 4.15 and from 1.54 to 5.92 for the PDMS and CPE material, respectively. Hardness was decreased after all the disinfection procedures in the PDMS, while for the CPE, a decrement was observed after disinfection with sodium hypochlorite and neutral soap and an increment after microwave exposure and the disinfection with a commercial antimicrobial agent. The PDMS samples presented greater alterations in color and hardness after disinfection with sodium hypochlorite solution, while the microwave exposure caused negligible effects. The CPE samples were affected most after disinfection when treated with neutral soap, and more slightly when disinfected with sodium hypochlorite solution.

CONCLUSIONS

The disinfection procedures caused alterations in color and hardness of the examined materials. The most suitable disinfection procedure for the PDMS material is microwave exposure, while disinfection with sodium hypochlorite solution is not recommended. The CPE material is suggested to be disinfected with sodium hypochlorite solution and the use of neutral soap is not recommended. Comparing the two materials, the PDMS material is most color stable, while the CPE material presented fewer changes in hardness.

Influence of pigments and pigmenting methods on color stability of different silicone maxillofacial elastomers after 1-year dark storage

PURPOSE

The purpose of this study was to measure spectrophotometrically the color changes of pigmented maxillofacial silicone elastomers with different pigments and pigmenting methods after storing 1 year in the dark environment.

METHODS

Three maxillofacial silicones, Cosmesil M511 (CosM511), Cosmesil M522 (CosM522), and Multisil-Epithetic (Mult-Epit), were selected for this study. A total of 240 specimens were fabricated; 80 of each of the 3 elastomers (n = 5) (18 mm in diameter and 2 mm in thickness) were prepared in 6 colorant categories (5 colorant and 1 with no colorant). Specimens were stored in a black box representing a condition of total darkness and placed in a dark environment at ambient room temperature (22°C ± 10°C) and humidity (50% ± 10%) for 1 year. A color spectrophotometer was used to measure the ΔE* values of the test specimens to determine the color changes.

RESULTS

The lowest color changes were observed in CosM511 in white color (ΔE* = 1.31) and in Mult-Epit in white color (ΔE* = 1.82) in extrinsic coloration group. The highest color changes were observed in yellow color in CosM511 (ΔE*= 21.61) and CosM522 (ΔE*= 23.78) in silicone pigmented intrinsic coloration method. In coloration methods, intrinsic silicone pigmented groups in all colors except brown in Mult-Epit had the highest ΔE* values.

CONCLUSIONS

Significant color changes were observed in both pigmented and unpigmented specimens, which were stored in dark environment and not exposed to sunlight.

A micro-computed tomography evaluation of mineral trioxide aggregate root canal fillings

INTRODUCTION

The aim of this study was to assess the effect of indirect ultrasonic activation on the incidence of voids within mineral trioxide aggregate (MTA) root canal fillings and at their interface with the canal walls by using a nondestructive 3-dimensional (3D) micro-computed tomography (micro-CT) analysis.

METHODS

Extracted human teeth with single canals and minimal curvatures were decoronated, instrumented to size 50/05 apically, and randomly allocated into 4 groups (n = 12). MTA was compacted manually by using hand pluggers in group A (MC). Indirect ultrasonic activation was applied to each increment of manually compacted MTA for 1 second in group B (1 sec-UC), 5 seconds in group C (5 sec-UC), and 10 seconds in group D (10 sec-UC). Filled roots were scanned with a micro-CT device, and 3D analysis of void incidence was carried out by using the SkyScan software.

RESULTS

Statistical analysis showed a significantly lower incidence of voids (P < .05) in the manual compaction (MC) group (0.7%) compared with the ultrasonic activation for 1 second (3.8%), 5 seconds (1.7%), and 10 seconds (1.6%) groups.

CONCLUSIONS

Manual compaction produced significantly denser root fillings than those achieved with ultrasonic activation.