Color stability of a bulk-fill composite resin light-cured at different distances

Effect of Low pH Dietary Supplements on Discoloration of Resin Composites

AIM

This study aimed to evaluate the impact of the consumption of low pH dietary supplements on the color stability of different resin composites.

MATERIALS AND METHODS

Three different restorative materials were used for this in vitro study: Filtek One Bulk-Fill (FOB), Filtek Z550 (Z550), and Fill-Up (FUP). Samples fabricated from each composite group were divided into four subgroups, and color measurements were performed at baseline. The control subgroup was stored in distilled water, and the other three subgroups were immersed in acidic dietary supplement solutions (Redoxon, Supradyn, and Voonka Collagen Shake) for 2 minutes daily for 28 days. Color measurements were obtained using a digital spectrophotometer. Color change values (ΔE1) were calculated after each color measurement. Next, all samples were immersed in a coffee solution for 7 days and repeat color measurements were taken to determine ΔE2 values. The study groups were compared using the Kruskal-Wallis test (α =0.05).

RESULTS

ΔE1 values were significantly different among the groups (P < 0.05). While Voonka Collagen Shake produced the greatest discoloration in FOB (1.67 ± 1.08) and Filtek Z550 (3.59 ± 1.90) materials, Fill-Up showed the highest discoloration (3.14 ± 0.37) with Supradyn. Analysis of ΔE2 values demonstrated a significant difference only for the Filtek Z550-Redoxon group versus the control group (P < 0.05).

CONCLUSION

Acidic dietary supplements not only produce color alterations in resin composites but also reduce the staining resistance of the composite further, depending on the type of composite and dietary supplement. Consumption of staining food after taking Redoxon effervescent tablets produces greater discoloration in Filtek Z550 restorations compared with other restorative materials.

In Vitro Color Stability Evaluation of Three Polished and Unpolished Nanohybrid Resin Composites Immersed in a 0.12% Chlorhexidine-Based Mouthwash at Different Times

The use of chlorhexidine-based mouthwashes on resin composites with rough surfaces can cause discoloration which compromises the esthetic of patients. The present study aimed to evaluate the in vitro color stability of Forma (Ultradent Products, Inc., South Jordan), Tetric N-Ceram (Ivoclar Vivadent, Schaan, Liechtenstein) and Filtek Z350XT (3M, ESPE, St. Paul, MN, USA) resin composites, with and without polishing, after being immersed in a 0.12% chlorhexidine (CHX)-based mouthwash at different times. The present in vitro experimental and longitudinal study used 96 nanohybrid resin composite blocks (Forma, Tetric N-Ceram and Filtek Z350XT) 8 mm in diameter and 2 mm thick, evenly distributed. Each resin composite group was divided into two subgroups (n = 16) with and without polishing and then immersed in a 0.12% CHX-based mouthwash for 7, 14, 21 and 28 days. Color measurements were performed with a calibrated digital spectrophotometer. Nonparametric tests were used to compare independent (Mann–Whitney U and Kruskal–Wallis) and related (Friedman) measures. In addition, the Bonferroni post hoc correction was used considering a significance level of p < 0.05. All polished and unpolished resin composites presented color variation < 3.3 when immersed for up to 14 days in 0.12% CHX-based mouthwash. The polished resin composite with the lowest color variation (ΔE) values over time was Forma, and the one with the highest values was Tetric N-Ceram. When comparing the color variation (ΔE) over time, it was observed that the three resin composites, with and without polishing, presented a significant change (p < 0.001), although these changes in color variation (ΔE) were evident from 14 days between each color acquisition (p < 0.05). The unpolished Forma and Filtek Z350XT resin composites showed significantly more color variation than the same polished ones at all times when immersed in a 0.12% CHX-based mouthwash for 30 s daily. In addition, every 14 days, all three resin composites with and without polishing showed a significant color change, while, every 7 days, color stability was maintained. All the resin composites showed clinically acceptable color stability when exposed for up to 14 days to the above-mentioned mouthwash.

Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial

OBJECTIVES

This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months.

METHODOLOGY

A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson's Chi-square test were used (α=0.05) for statistical analysis.

RESULTS

After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05).

CONCLUSION

Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations' improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

Effects of different toothpastes on the color and whiteness of stained anterior composite resin

PURPOSE

To evaluate changes in the color of an anterior nanohybrid composite resin and differences in its whitening index after 30 days of brushing with six brands of whitening toothpaste in vitro to simulate the situation in individuals with high coffee consumption.

METHODS

Eighty-four disk-shaped resin specimens were prepared (shade A2). For initial staining, the samples were immersed in coffee solution for 14 days and then divided into eight groups for treatment with various toothpastes. Color was assessed at the baseline, after initial staining, and on days 7, 14, and 30 of the staining-and-brushing cycle. Color stability was evaluated based on the CIEDE2000 color difference (ΔE00), and differences in whiteness were determined using the whitening index for dentistry (WID).

RESULTS

The highest ΔE00 and ΔWID values were obtained with Colgate Herbal, followed by Opalescence Whitening and Crest Baking Soda and Peroxide, whereas the lowest values were obtained with distilled water, followed by Yotuel Pharma B5, on day 30 of the staining-and-brushing cycle.

CONCLUSION

In terms of improving the color and whiteness of coffee-stained anterior nanohybrid composite resin, Colgate Herbal, Opalescence Whitening, and Crest Baking Soda and Peroxide yielded promising results after 30 days of continuous use.

Characterization of whitening toothpastes and their effect on the physical properties of bulk-fill composites

To characterize activated charcoal and 2% hydrogen peroxide-based toothpastes and investigate their effects on roughness, color change, and gloss of bulk-fill composite resin. Composite resin specimens (Aura Bulk Fill, SDI) were subjected to 5,000 brushing cycles with regular toothpaste (Colgate Total 12, [RT]), activated charcoal toothpaste (Bianco Dental Carbon, [AC]), or hydrogen peroxide-containing toothpaste (Colgate Luminous White Advanced, [HP]), with or without coffee exposure. The pH, particle characterization by scanning electron microscopy (SEM), and weight% of solid particles in the toothpaste were assessed. Roughness (Ra) was evaluated using a surface profile-measuring device, color change (∆Eab/∆E00) by reflectance spectrophotometer, and gloss unit (GU) by glossmeter. Kruskal-Wallis, Dunn, Friedman, and Nemenyi tests were used, and the correlation coefficient test was performed between Ra and GU (α=0.05). RT presented a higher Ra after brushing and did not change after staining with coffee; moreover, the ∆Eab/∆E00 values were higher for RT than HP. Regarding gloss, AC and HP obtained higher values compared to RT. A significant negative correlation between gloss and Ra was found for RT exposed to coffee. All toothpastes had a neutral pH; however, RT had the largest percentage of solids by weight. SEM images showed particles of many sizes: irregular shape (RT), more regular particles (AC), and spherical clusters (HP). Although surface roughness, color change, and gloss may compromise the longevity of restorations, the whitening toothpastes tested did not promote more morphology changes than regular toothpastes.

Effects of Sr/F-Bioactive Glass Nanoparticles and Calcium Phosphate on Monomer Conversion, Biaxial Flexural Strength, Surface Microhardness, Mass/Volume Changes, and Color Stability of Dual-Cured Dental Composites for Core Build-Up Materials

This study prepared composites for core build-up containing Sr/F bioactive glass nanoparticles (Sr/F-BGNPs) and monocalcium phosphate monohydrate (MCPM) to prevent dental caries. The effect of the additives on the physical/mechanical properties of the materials was examined. Dual-cured resin composites were prepared using dimethacrylate monomers with added Sr/F-BGNPs (5 or 10 wt%) and MCPM (3 or 6 wt%). The additives reduced the light-activated monomer conversion by ~10%, but their effect on the conversion upon self-curing was negligible. The conversions of light-curing or self-curing polymerization of the experimental materials were greater than that of the commercial material. The additives reduced biaxial flexural strength (191 to 155 MPa), modulus (4.4 to 3.3), and surface microhardness (53 to 45 VHN). These values were comparable to that of the commercial material or within the acceptable range of the standard. The changes in the experimental composites’ mass and volume (~1%) were similar to that of the commercial comparison. The color change of the commercial material (1.0) was lower than that of the experimental composites (1.5–5.8). The addition of Sr/F-BGNPs and MCPM negatively affected the physical/mechanical properties of the composites, but the results were satisfactory except for color stability.

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.