Investigating the color changes on resin‐based CAD/CAM Blocks

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

OBJECTIVE

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

MATERIALS AND METHODS

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

RESULTS

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

CONCLUSIONS

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

CLINICAL SIGNIFICANCE

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

Assessment of color stability and translucency of various CAD/CAM ceramics of different compositions and Thicknesses: An in vitro study

Background

Translucency and optical characteristics significantly affect the aesthetics of ceramic restorations. The introduction of new virgilite crystals to novel ceramic advanced lithium disilicate through a matrix firing process enhances the material's strength and aesthetic quality according to the manufacturer.

Materials and Methods

Four types of CAD/CAM ceramics; lithium disilicate (LD), leucite reinforced (LR), advanced lithium disilicate (ALD), and zirconia-reinforced lithium silicate (ZLS) exposed to different staining solutions (tea, cola, coffee, and distilled water). Each ceramic type had 120 specimens, divided into subgroups based on thickness (0.5 mm, 1 mm, and 1.5 mm). Color changes (ΔE00) and translucency parameters (TP00) were measured after thermocycling, and spectrophotometry was employed to evaluate ΔE00 and TP00 after 1, 7, and 30 days of exposure to the staining solutions.

Results

ZLS exhibited the lowest color stability, while lithium LD and ALD displayed the highest. Thickness significantly affected color stability, with 0.5 mm thickness showing the least change. The duration of exposure also impacted color changes, with 30 days causing the most significant shift. LD demonstrated the highest translucency. Coffee and tea induced more pronounced reductions in translucency and color stability compared to the control group.

Conclusions

Material structure, thickness, staining solution, and exposure duration significantly influenced the color stability and translucency of CAD/CAM ceramics, with LD and ALD demonstrating superior color stability and LD exhibiting the highest translucency.

Effect of coffee thermocycling on the color and translucency of milled and 3D printed definitive restoration materials

STATEMENT OF PROBLEM

Research on the color and translucency properties of 3-dimensionally (3D) printed definitive resins and the effect of coffee thermocycling on these properties is lacking.

PURPOSE

The purpose of this in vitro study was to investigate the effect of coffee thermocycling on the color and translucency parameters of the milled and 3D printed materials used for definitive restorations.

MATERIAL AND METHODS

Plate-shaped specimens (12×12×1 mm) of 3 milled (IPS e.max CAD (LDS), Vita Enamic (PICN), Cerasmart (RNC)) and two 3D printed (VarseoSmile Crownplus (VSP), Permanent Crown (PC)) were fabricated (n=12). The brightness (L*), red-green (a*), and yellow-blue (b*) parameters were measured with a spectrophotometer before and after 10 000 coffee thermocycles. The relative translucency parameters (RTP00) and color change were calculated using the CIEDE2000 formula. Stainability (ΔE00) and translucency differences (ΔRTP00) were evaluated. Data were analyzed with the Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests. The Spearman correlation test was used to analyze the ΔE00 and ΔRTP00 values (α=.05).

RESULTS

The type of material and coffee thermocycling significantly affected the evaluated parameters at both measurement periods (P=.001). Coffee thermocycling decreased the L* and RTP00 values while increasing the a* and b* values (P=.001). The highest ΔE00 values were found in VSP and PC, which were statistically similar (P=.291), while the highest | ΔRTP00 | values were observed for VSP (P=.001). The lowest ΔE00 and | ΔRTP00 | values were found in LDS (P=.001). A positive relationship was found between the ΔE00 and | ΔRTP00| values (R=.590, P=.01).

CONCLUSIONS

After coffee thermocycling, all tested materials exhibited a darkened, yellowish, and opaque appearance, although the alterations in color and translucency remained within clinically acceptable thresholds (AT00=1.81) for these materials.

Effect of different beverages and polishing techniques on colour stability of CAD/CAM composite restorative materials

Objectives

The aim of this article was to compare the colour stability of short fibre-reinforced computer-assisted design/computer-assisted manufacturing (CAD/CAM) composite (SFRC CAD) to commercially available CAD/CAM materials following prolonged immersion in a variety of beverages. Furthermore, the influence of the polishing technique was evaluated.

Materials and methods

A total of 120 rectangular specimens (10 mm length × 14 mm width × 2 mm thickness) were prepared from SFRC CAD, IPS e-max, Cerasmart 270, Celtra Duo, Enamic, and Brilliant Crios. The specimens underwent polishing through either a laboratory polishing machine equipped with 4000-grit silicon carbide paper or chairside polishing using Sof-Lex spiral. Twenty specimens of each tested CAD/CAM material were randomly divided into four groups (n = 5) based on the staining solution used in order to evaluate the colour stability of the materials. Group 1: distilled water, Group 2: coffee, Group 3: red wine, Group 4: coke. Using a spectrophotometer, the colour changes (∆E) of all CAD/CAM materials were assessed at baseline, and after 1 and 12 weeks of staining. Three-way analysis of variance was used to analyse the data (α = 0.05).

Results

The staining solution and material type showed a significant influence on the CAD/CAM specimens' colour stability (p < 0.05), while polishing method had no significant influence (p > 0.05). The average ∆E values for specimens submerged in wine were considerably higher (p < 0.05) than those for the other solutions. SFRC CAD, Cerasmart 270, and Enamic displayed the highest ∆E values in wine (p < 0.05).

Conclusions

The colour stability of tested SFRC CAD was comparable to other composite-based CAD/CAM materials, while IPS e.max exhibited the highest level of colour stability.

Effect of various staining beverages on the color stability of CAD/CAM PMMA denture teeth: An in vitro study

OBJECTIVE

This study aimed to compare the color change of computer-aided design (CAD)/computer-aided manufacturing (CAM) polymethyl methacrylate (PMMA) denture teeth and conventional acrylic teeth after immersion in three staining beverages (coffee, red tea, and cola) for a day, 7 days, and 30 days.

MATERIALS AND METHODS

Group 1: Conventional acrylic teeth (n = 32). Group 2: Milled CAD/CAM teeth out of PMMA disc (n = 32). The specimens of each material were further divided into four subgroups: (1) Control group, distilled water (n = 16). (2) Red tea solution (n = 16). (3) Coffee solution (n = 16). (4) Cola (n = 16). The color change (∆ E $\unicode{x02206}E$ ) was assessed using a spectrophotometer at four time points: at the baseline (t0 ), on the 1st day (t1 ), on the 7th day (t2 ), and the 30th day (t3 ) of immersion. Kolmogorov-Smirnov test was applied, followed by performing independent samples t test, one-way analysis of variance and post-hoc Tukey tests to compare the color change values at different time points.

RESULTS

The mean score of NBS values of the coffee solution indicates perceivable color change at the end of the 30th day in the conventional acrylic teeth group. It was 0.843 ± 0.395 at t1 , then increased to 1.017 ± 0.477 at t2 and to 2.259 ± 1.059 at t3 . There is a statistically significant difference (p < 0.05) in color change values between both tooth types at the end of the 30th day of immersion in red tea solution and a statistically significant difference at the end of the 7th day (p < 0.05) and the 30th day (p < 0.05) of immersion in coffee solution.

CONCLUSIONS

CAD/CAM PMMA teeth are more color stable than conventional acrylic teeth after 30 days of immersion in coffee and red tea solution.

Effect of smokeless tobacco on color stability and surface roughness of CAD/CAM milled, 3D printed, and conventional provisional crown and fixed dental prosthesis materials: An in vitro study

BACKGROUND

Provisional fixed dental prosthesis (FDP) plays an important role during fixed prosthodontic therapy till the definitive. Discoloration of materials used for provisional FDPs can cause patient dissatisfaction and may create doubt about the color stability of the definitive FDP. Surface roughness is the other major property to be taken into consideration for provisional FDP materials. Smokeless tobacco is reported to affect the color stability and surface roughness of different prosthetic materials.

OBJECTIVE

The aim of the current study was to evaluate the effect of two types of smokeless tobacco (black and white) on color stability and surface roughness of 3D printed, CAD/CAM milled, and conventional provisional FDP resin materials.

METHODS

A total of 144 disc-shaped specimens were fabricated using four techniques CAD/CAM subtractive technique (milling), CAD/CAM additive technique (3D Printing), and conventional technique using autopolymerized PMMA, and autopolymerized Bis-acrylic resins. Each group was subdivided into three subgroups of twelve specimens each, and were submerged into three solutions (artificial salivary substitute, black smokeless tobacco, white smokeless tobacco). The change in color and surface roughness was evaluated and the data collected were statistically analyzed.

RESULTS

It was observed that black smokeless tobacco caused the maximum color change and the effect was highest in autopolymerized PMMA resin specimens (ΔE = 9.343 ± 0.489), followed by 3D printed (ΔE = 7.187 ± 0.391), autopolymerized Bis-acryl (ΔE = 6.464 ± 0.453) and milled (ΔE = 4.978 ± 0.227). White smokeless tobacco was found to cause a maximum change in surface roughness and the effect was highest in autopolymerized Bis-acryl specimens (ΔRa = 0.321 ± 0.015 μm), followed by autopolymerized PMMA (ΔRa = 0.297± 0.015 μm), 3D printed (ΔRa = 0.191 ± 0.019 μm), and milled (ΔRa = 0.168 ± 0.014 μm). Statistically significant (p-value < 0.05) differences were observed among all techniques and solutions.

CONCLUSIONS

The change in color and surface roughness were maximum in the case of FDPs prepared using autopolymerizing resins, followed by 3D printed, and CAD/CAM milled reins.

Comparing the physical and mechanical properties of different biocompatible three-dimensional resin materials in possible use of dental appliances: An in vitro study

OBJECTIVE

This study aimed to assess the colour stability, water sorption, microhardness and water contact angle of two different 3D printing systems (SLA and DLP) in a possible use of producing paediatric and orthodontic dental appliances.

MATERIALS AND METHODS

SLA and DLP printer systems produced a total of 160 disk samples with a diameter of 15.00 mm and a height of 2.00 mm. Colour changes of 64 samples were assessed in distilled water, coffee, coke and cherry juice and Vicker's microhardness tests were also conducted. Solubility and water sorption were held following the water contact angle assessment. Statistical analyses were performed using the SPSS software. Mann-Whitney-U test, Friedman test and Bonferroni post hoc Multiple Comparison Test were performed.

RESULTS

In DLP and SLA groups, coffee had a statistically significant colouring effect regarding the assessment periods (P = .001, 20.09 ± 2.96, 22.09 ± 3.51, respectively), and the discolouration effect of coffee was higher in the SLA group at all endpoints (P < .05). At the same time, DLP was more affected by coke solution in T0-T1 and T0-T7 (P < .05). The values of water sorption showed statistically significant differences in the group of DLP compared to the SLA (P = .01, 121.11 ± 10.54, 92.78 ± 8.70, respectively). No statistical significance was detected between the solubility values and water contact angle of SLA and DLP groups. The SLA printer's microhardness values revealed statistically significantly higher values than the DLP group (P = .001) and a decrease was detected following the immersion period in the microhardness values of the SLA group (P = .022).

CONCLUSION

The compared groups exposed to staining solutions revealed colour changes above the clinically acceptable values at all periods (ΔE00  = 2.25).

Comparison of the Surface Properties of 3D-printed Permanent Restorative Resins and Resin-based CAD/CAM Blocks

OBJECTIVE

This study aimed to investigate the surface roughness, microhardness, and color changes of resin-based computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printed permanent resins in different beverages.

METHODS AND MATERIALS

Resin-based CAD/CAM blocks (Cerasmart 270 and Grandio Blocs) and 3D-printed permanent restorative resins (Crowntec and Permanent Crown) were used in this study. A total of 96 specimens were prepared from CAD/CAM blocks and 3D-printed permanent resins. The initial surface roughness, microhardness, and shade value of the specimens were measured. Then, the specimens prepared from each material were divided into three subgroups (n=8) and immersed in tea, coffee, and distilled water for 30 days. After the specimens were immersed in the beverages, the surface roughness, microhardness, and tone values were measured again. The data were statistically analyzed using a two-way analysis of variance test (p<0.05).

RESULTS

No statistically significant difference was found in the surface roughness values of the resin-based CAD/CAM blocks and 3D-printed resins (p<0.05). Resin-based CAD/CAM blocks showed statistically significantly higher microhardness than 3D-printed permanent resins (p<0.05). Although the color changes in 3D-printed resins in tea and coffee were similar to those in resin-based CAD/CAM blocks on the first and seventh days, more color changes appeared in the 3D-printed resins after 30 days. The surface roughness and microhardness values of the specimens submerged in tea, coffee, and distilled water showed no statistically significant changes (p<0.05).

CONCLUSIONS

Although the surface roughness of 3D-printed permanent resins was similar to that of resin-based CAD/CAM blocks, they had a lower microhardness value. Moreover, 3D-printed permanent resins showed more color changes in tea and coffee.

Effect of Various Beverages on Adhesion of Repaired CAD/CAM Restorative Materials

(1) Background: The purpose of this study was to determine the effect of commonly consumed beverages on the bond strength of three different computer-aided design-computer-aided manufacturing (CAD/CAM) resin-ceramic hybrid materials repaired with resin-based composite (RBC) materials. (2) Materials and Methods: Rectangular prism specimens (N = 138) measuring 6 mm × 5 mm × 2 mm were obtained from GC Cerasmart (GC), Lava Ultimate (LU), and Vita Enamic (VE) blocks. These blocks were polished and then subjected to thermal cycling (10,000 cycles, 5 °C to 55 °C). After the surface treatment was applied, the average surface roughness value was measured. All the surfaces were repaired with RBC. Thermal cycling was performed for the second time. Each group was then distributed into three subgroups according to the beverage used: tea (t), cola (c), and distilled water (0) (n = 15). The specimens were stored in these solutions for 28 days and then subjected to the shear bond strength (SBS) test. Statistical analysis was performed using a two-way ANOVA test with Bonferroni adjustment. (3) Results: The surface roughness of the materials presented no significant difference after different surface treatments (p > 0.05). No significant difference was observed among the materials (p > 0.05). Tea and cola presented similar SBS values (p > 0.05). Both were significantly lower than distilled water (p < 0.001, p < 0.001, respectively). (4) Conclusions: Consumption of beverages reduces the bond strength in surfaces repaired with RBC to CAD/CAM resin-ceramic hybrid materials. (5) Clinical Significance: Repairing damaged resin matrix dental restorations with RBC is advantageous in terms of time and cost by achieving adequate bond strengths. Frequently consumed beverages reduce the bond strength of repaired CAD/CAM resin-ceramic hybrid materials.

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.

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

BACKGROUND

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

METHODS

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

INCLUSION CRITERIA

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

EXCLUSION CRITERIA

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

FINDINGS

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

Determination of Water Content in Direct Resin Composites Using Coulometric Karl Fischer Titration

This study evaluated the water content and sorption of direct composites over 60 days using coulometric Karl Fischer titration (KFT). Plate-shaped specimens (10 × 10 × 1 mm³ of thickness) were built up using the composites Clearfil Majesty Posterior (CM), Grandio SO (GS), and Filtek Supreme XT (FS). Water contents were determined in non-stored specimens (control) or after storage in distilled water for up to 60 days (n = 5). The amount of water transferred from the specimens heated at 200 °C (isothermal mode) was measured in the Coulometer. The water content of non-stored specimens ranged from 0.28 to 1.69 wt% (5.6 to 31.2 μg/mm³) for GS and FS, respectively. The highest values of water sorption were observed for FS (25.3 μg/mm³ after 60 days). GS and CM showed similar water sorption after 60 days (≈9 μg/mm³), but an ultimate higher water content was observed for CM (0.9 wt%; 22.0 μg/mm³) than GS (0.7 wt%; 14.8 μg/mm³). Except for CM, no significant water sorption was observed between 21 and 60 days of storage. Since all composites presented some base water content, water sorption data alone do not account for the ultimate water content in direct resin-based composites.

Smart Monochromatic Composite: A Literature Review

Over the previous years of the 20th and 21st centuries, there has been a progression in the field of bonded esthetic restorations. At the present time, the inclination of dentists toward the smart monochromatic shade of composite is flourishing owing to the fact that it decreases the requirement of a range of composite shades, curtails the waste of unconsumed composite shades, lessens chair side interval, abolishes the shade selection, and decreases dependency on shade-selecting methods. Smart monochromatic composite is known to obtain the color of the adjacent tooth structure in which it is placed. Therefore, the current literature elucidates the several features of innovative and revolutionary monochromatic composites including color stability, mechanical and optical properties, and shade-matching capability that could have a positive impact potentially over other resin composites.

Effects of At-Home and In-Office Bleaching Agents on the Color Recovery of Esthetic CAD-CAM Restorations after Red Wine Immersion

The aim of this study was to evaluate the effects of at-home and in-office bleaching agents on esthetic CAD-CAM materials after red wine immersion by measuring their optical properties. Sixty specimens were prepared out of three esthetic CAD-CAM materials: Vita Enamic, Celtra Duo, and Ceresmart (n = 20). All specimens were immersed in a red wine solution, and color measurements were performed. Specimens were randomly divided (n = 10) according to the bleaching procedure (in office, at home), bleaching durations were set to 3 time points, and color measurements were performed. According to the Commission Internationale de l’Eclairage (CIE) L* a* b* parameters, CIEDE2000 color differences (ΔE00), translucency parameters (TP00), and whiteness index values (ΔWID) after wine staining and after bleaching were calculated. Data were analyzed using the Mann−Whitney U-test, the Kruskal−Wallis test, and a two-way analysis of variance (ANOVA) (α = 0.05). ΔE00, ΔTP00, and ΔWID decreased with an increase in bleaching treatment. ΔE00 after the final bleaching treatment of in-office bleaching ranged from 1.7 to 2.0, whereas those of in-office treatment ranged from 0.4 to 1.1. All ΔTP00 and ΔWID after the final treatment were below the 50:50% perceptibility thresholds (ΔTP00 < 0.6, and ΔWID < 0.7). Significant differences in ΔE00, ΔTP00, and ΔWID among esthetic CAD-CAM materials were found between CD and CE. In the present study, color recovery after at-home and in-office bleaching appeared to be material-dependent. In-office bleaching showed more effective recovery comparing to at-home bleaching.

Effect of Wet and Dry Polishing Conditions by Two Finishing and Polishing Systems on the Surface Roughness and Color Changes of Two Composite Resin Restoratives: An In Vitro Comparative Study

Purpose:

The study aimed at evaluating the effect of wet and dry polishing systems on the resin composites’ surface roughness and color change.

Materials and Methods:

In the study, samples were prepared using nanoceramic (Ceram.x one) and nanohybrid (GrandioSO) resin composites. Two different finishing and polishing systems were used in the polishing of resin composites. Resin composite surfaces were finished and polished under wet and dry conditions. The initial surface roughness values (Ra) of the samples were measured using a profilometer, whereas the color changes were measured using a spectrophotometer. Then, the colors of the samples kept in coffee were measured on the 7th and 30th days. Surface roughness and color change values (ΔE00) were measured and statistically analyzed using the one-way analysis of variance (ANOVA) test ( P < .05).

Results:

Wet or dry use of polishing systems did not show a statistically significant difference between the surface roughness values of the resin composite ( P < .05). Wet and dry use of polishing systems showed similar color changes on the composite resins ( P < .05). Diamond-containing spirals on composite resins showed statistically less color change than aluminum-oxide-containing discs ( P < .05). Wet or dry use of polishing systems did not reduce the color change of the composite resins below the acceptability threshold (AT).

Conclusion:

Wet or dry use of polishing systems on composite resins did not affect surface roughness and color change. The use of diamond-containing polishing spirals that cause less color change can increase clinical success.

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.

Effect of post-curing time on the color stability and related properties of a tooth-colored 3D-printed resin material

This study investigated the effect of post-curing time on the color stability and related properties, such as degree of conversion (DC), surface roughness, water contact angle, water sorption (W_sp), and water solubility (W_sl) of 3D-printed resin for dental restorations. The 3D-printed specimens were divided into four groups according to the post-curing time (0, 5, 10, and 20 min). Color changes (ΔE₀₀) of the specimens immersed in aging media were measured using a spectrophotometer at different aging times. The DC of the resin was measured using a FTIR. The surface roughness (Ra) of the resin immersed in coffee was measured at different aging times. Water contact angle was evaluated using the sessile drop method, and W_sp and W_sl were tested according to the ISO 4049:2019. The ΔE₀₀ values of the specimens immersed in coffee and red wine decreased with increasing post-curing time. As the post-curing time increased up to 10 min, the DC increased and water contact angle decreased. The Ra value of the group without post-curing (0 min) increased gradually for 30 days, except between 7 and 15 days. However, when the post-curing time increased to greater than 10 min, no apparent change in Ra value was detected. The W_sp and W_sl of the group without post-curing were significantly lower and larger than that of the other groups, respectively. The longer the post-curing time of the tooth-colored 3D-printed resin, the better the color stability. The post-curing time of the 3D-printed resin affected the DC, surface roughness after aging in the staining media, water contact angle, water sorption, and water solubility.

Assessment of Color Stainability of Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) Ceramic Materials After Hot and Cold Coffee Immersion at Different Time Intervals

BACKGROUND This spectrophotometric study assessed the color stability of CAD/CAM restorative materials with different exposed surfaces following staining by hot Arabic Qahwa and cold coffee. MATERIAL AND METHODS Ninety-six specimens were fabricated from 3 different CAD/CAM ceramic materials: Vita Suprinity (Vita-S), Vita Enamic (Vita-E), and Vitablocs Mark II (Vitablocs-MII). We divided 32 specimens for each group into glazed or polished surfaces, with 16 specimens in each group, then subdivided them according to staining materials: Arabic Qahwa and Frappuccino Cold Coffee. Color of specimens was measured during immersion in staining materials (BEFORE) as baseline with (Vita classic) and (L, a, b), for average color changes (ΔE₀₀), then remeasured after 2, 4, and 12 weeks, and described as 1st, 2nd, and 3rd measurements for VITAPAN Classic shade and T1, T2, and T3 for ΔE00 values using the CIE L*a*b* equation. We performed ANOVA and then post hoc testing. RESULTS We found significant differences in ΔE₀₀ values during immersing in hot Arabic Qahwa and cold coffee for tested materials in glazed or polished specimens. Polished specimens of Vita-S and Vita-E had the highest color changing and staining compared to glazed surfaces. Vitablocs-MII had the best color stability through immersion periods. Moreover, there were changes in relation to VITAPAN Classic shade guide for both Vita-S and Vita-E specimens during different immersion periods. CONCLUSIONS Coffee caused staining and contamination of ceramic material. Values of ΔE₀₀ for tested ceramic materials were significantly different but were within the clinically acceptable range. Polished specimens showed higher staining; therefore, we highly recommend re-glazing of ceramic restorations to maintain color stability.

Optical behaviors, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate (ZLS): A narrative review

OBJECTIVES

The present narrative review was focused on the optical properties, surface treatment, adhesion, and clinical indications of zirconia-reinforced lithium silicate ceramics (ZLS) for Computer-aided design / Computer-aided manufacturing (CAD/CAM) technologies.

DATA/SOURCES

A literature search was performed by 3 calibrated independent researchers on PubMed, Scopus, Embase, Google Scholar, Dynamed, and Open Grey. The criteria for inclusion were: 1) papers addressing at least one of the following variables about ZLS: optical properties, surface treatment, adhesion, and clinical indications; 2) in vitro, in silico, or in vivo studies; 3) case reports; 4) systematic reviews. The exclusion criteria were: 1) animal studies; 2) non-dental studies; 3) studies only focusing on ZLS used in the heat-pressed process.

STUDY SELECTION

98 records among in vitro studies and case reports were included.

CONCLUSIONS

Despite the promising microstructure characteristics of ZLS, increased translucency compared to lithium disilicate ceramics (LS₂) was not proven, but acceptable color changes and stability were reported. Mechanical polishing was the most effective method to reduce surface roughness. Moreover, machinability and handling of ZLS resulted harder than LS₂. Conventional acid etching procedures seemed effective in conditioning ZLS surface, but no protocol has been established yet. Besides, silane-coupling and dual-curing resin cements were recommended.

CLINICAL SIGNIFICANCE

ZLSs can be used for anterior and posterior fixed single-unit CAD/CAM restorations onto both natural teeth and implants, but do not seem to represent a viable treatment option for endocrowns onto posterior teeth or fixed dental prostheses.

Effects of Artificial Staining and Bleaching Protocols on the Surface Roughness, Color, and Whiteness Changes of an Aged Nanofilled Composite

This study evaluated the surface roughness and color alteration of an aged nanofilled composite exposed to different staining solutions and bleaching agents. Ninety nanofilled composite (Filtek Z350XT, 3M/Oral Care) specimens were submitted to 5,000 thermal cycles and immersed in (n = 30): red wine, coffee, and artificial saliva at 37°C for 48 h. Groups were subdivided according to the bleaching protocol (n = 10) with 20% carbamide peroxide, 38% hydrogen peroxide, or without bleaching - control. Mean surface roughness values (Ra - μm) and color parameters (L*, a*, b*) were measured at baseline (T0), after thermal cycling aging and staining (TS), and after bleaching (TB). Color (ΔE00) and whiteness index (ΔWID) changes were determined after aging and staining (Ts-T0) and after bleaching (TB-TS). The adopted perceptibility and acceptability thresholds of the nanofilled composite were 0.81 and 1.71 ΔE00 units and 0.61 and 2.90 ΔWID units, respectively. Ra was analyzed using mixed models for repeated measurements and L* by the Tukey-Kramer test. The a* and b* values were evaluated by generalized linear models for repeated measures. ΔE00 was tested using two-way ANOVA and Tukey tests, and ΔWID by Kruskal-Wallis and Dunn tests (α = 5%). Ra of all groups decreased after aging and staining (TS, p &lt; 0.05), but increased after bleaching only for groups stained with red wine (TB). Aging and staining decreased the luminosity of the composites, but L* increased after bleaching (p &lt; 0.05). Aging and staining increased a* and b* values, but after bleaching, b* values decreased (p &lt; 0.05). After bleaching, ΔE00 and ΔWID were greater in stained groups at both time intervals, regardless of the bleaching protocol. Stained resin composites exhibited perceptible but unacceptable color (ΔE00 &gt; 1.71) and whiteness (ΔWID &gt; 2.90) changes, regardless of the bleaching treatment performed. Therefore, red wine affected the surface roughness of the aged nanofilled resin submitted to bleaching. Bleaching was unable to reverse the color changes promoted by red wine and coffee on the aged nanofilled composite.

Evaluation of the Color Stability of 3D-Printed Crown and Bridge Materials against Various Sources of Discoloration: An In Vitro Study

Recent advances in three-dimensional (3D) printing have introduced new materials that can be utilized for dental restorations. Nonetheless, there are limited studies on the color stability of restorations using 3D-printed crowns and bridge resins. Herein, the color stability of conventional computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printing resins was evaluated and assessed for their degrees of discoloration based on material type, colorant types (grape juice, coffee, curry, and distilled water (control group)), and storage duration (2, 7, and 30 days) in the colorants. Water sorption, solubility, and scanning electron microscope (SEM) analyses were conducted. A three-way ANOVA analysis showed that all three factors significantly affected the color change of the materials. Notably, the discoloration (ΔE₀₀) was significantly higher in all 3D printing resins (4.74–22.85 over the 30 days) than in CAD/CAM blocks (0.64–4.12 over the 30 days) following immersion in all colorants. 3D-printing resins showed color differences above the clinical limit (2.25) following storage for 7 days or longer in all experimental groups. Curry was the most prominent colorant, and discoloration increased in almost all groups as the storage duration increased. This study suggests that discoloration must be considered when using 3D printing resins for restorations.

Investigation the effects of whitening toothpastes on color change of resin-based CAD/CAM blocks

INTRODUCTION

Some colorant foods and beverages cause undesired discoloration on dental restorations. The aim of this study was to investigate the effect of whitening kinds of toothpaste with different active ingredients on the color change of resin-based CAD/CAM blocks.

MATERIAL AND METHODS

In the study, resin-based CAD/CAM block samples sized 1.5 × 7 × 12 mm, were prepared. Then, to simulate the time-dependent color change, the samples were immersed in coffee (Nescafe Classic, Nestlé) for 14 days. After the color change values of the samples colored in coffee were measured by spectrophotometer, the samples were brushed with different types of whitening toothpastes for 4 minutes. Statistical analysis of the color change (ΔE₀₀ ) was performed using the one-way analysis of variance (ANOVA).

RESULTS

Color differences occurring on all resin-based CAD/CAM blocks immersed in coffee for 14 days exceeded the 50%:50% perceptibility threshold (PT) (ΔE₀₀ :0.8). There was no statistical significant difference between the whitening toothpastes containing activated charcoal, hydrogen peroxide (HP), blue covarine pigment, and microparticles in color improvement on resin-based CAD/CAM blocks (P > .05).

CONCLUSION

It has been verified that the discoloration on resin-based CAD/CAM blocks exhibiting color difference above the PT after coffee immersion can be reduced by utilizing toothpastes containing whiteners.

CLINICAL SIGNIFICANCE

Color changes that occur over time in resin-based CAD/CAM blocks can be a clinical problem. These color changes in the materials can be reduced below the PT level using whitening toothpastes.

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.

Repolishing in situ eroded CAD/CAM restorative materials and human enamel

This study aimed to evaluate the effects of repolishing on the surface microhardness (SMH), color change (ΔE), and translucency parameter (TP) of previously in situ eroded computer-aided design/computer-aided manufacturing (CAD/CAM) restorative materials and human enamel. Each of 8 volunteers wore an intraoral appliance containing 3 CAD/CAM restorative material specimens (IPS e.max CAD lithium disilicate ceramic, Lava Ultimate hybrid ceramic, and poly (methyl methacrylate) (PMMA) block) and 1 human enamel specimen. The specimens were subjected to in situ erosion cycles by rinsing with a cola drink (4 × 5 min/day) for 14 days. After erosion, the specimens were polished with a silicone polishing system (Ceramister, Shofu Inc, Kyoto, Japan). The SMH and color of the specimens were determined at baseline (T1), after erosion (T2), and after repolishing (T3). The ΔE and TP values of the specimens were further calculated. The data were statistically analyzed using repeated-measures analysis of variance (ANOVA) and Bonferroni's test (α = 0.05). After erosion, a decrease in the SMH of the restorative materials and enamel was observed (all P < 0.001), and a decrease in the TP of the enamel was observed (P = 0.016). The ΔE values of the enamel (ΔE = 7.32) and Lava Ultimate (ΔE = 3.19) exceeded the clinically unacceptable threshold after erosion. After repolishing, the SMH of the restorative materials and enamel at T3 was significantly higher than that at T2 (all P < 0.001). No significant difference was found in the TP and ΔE values of the restorative materials and enamel between T2 and T3. In conclusion, erosion negatively affected the surface properties and appearance of the CAD/CAM restorative materials and human enamel. Repolishing contributed to restoring the compromised SMH of the eroded restorative materials and enamel to a certain extent. However, repolishing did not restore the color of the eroded restorative materials and enamel.