Effects of air-polishing powders on color stability of composite resins

The Effect of Usage of Antiasthmatic Inhalers on Color Stability and Surface Roughness of Dental Restorative Materials: An In Vitro Study

OBJECTIVES

 Increased demand for esthetics by parents and children has resulted in the use of tooth-colored restorative materials. Children with chronic respiratory conditions like asthma use inhalers which have shown to affect the surface of restorative materials. Hence, the aim of the present study was to evaluate the effect of antiasthmatic inhalers on color stability and surface roughness of three restorative materials.

MATERIALS AND METHODS

 Forty samples each of three dental restorative materials: group A: glass ionomer cement (GIC), group B: alkasite restorative material, and group C: composite resins were prepared. Each group was further divided into two subgroups of 20 samples each according to the inhaler used. All the specimens were polished using polishing discs and stored in artificial saliva in order to simulate the oral environment. The baseline color value and surface roughness of all the samples were measured using a spectrophotometer and a profilometer, respectively. Group 1 and group 2 were exposed to 0.31 mg of salbutamol sulfate and 20 mg formoterol fumarate in combination with budesonide, respectively, for every 12 hours, for a period of 15 days following which the samples were evaluated for color changes and surface roughness.

STATISTICAL ANALYSIS

 The data obtained was subjected to statistical analysis and level of significance was set at p < 0.05.

RESULTS

 Exposure to both the inhalers caused a change in color and surface roughness in all three restorative materials. There was a significant change in the color of GIC and composite resin (ΔE > 3.3), following exposure to both the inhalers (p < 0.05). The change in color of alkasite restorative material was not significant. A significant increase in the surface roughness of composite resin from 0.56 ± 0.14 to 0.67 ± 0.19 was seen following 15 days' exposure to formoterol in combination with budesonide inhaler (p < 0.05).

CONCLUSION

 Following exposure, both the inhalers had an equal effect on color and surface roughness of all three restorative materials. Alkasite restorative material showed greater resistance to change in color and surface roughness when exposed to antiasthmatic inhalers, compared to GIC and composite resin. Thus, children who use inhalers and nebulizers should be advised to implement more precautionary oral hygiene measures and periodic dental visits.

The Evaluation of Different Polishing Techniques' Effects on the Post-operative External Staining of Enamel in Primary and Permanent Tooth

Objective This study aimed to examine patient complaints on recoloration development after polishing applications in primary and permanent teeth that differed in enamel composition and to determine the ideal polishing method. Methods A total of 30 permanent upper incisors and 30 primary molars were randomly divided into three groups of 10 using three different polishing techniques. Each polishing method (rubber, brush, and air polishing) was applied to the test surface of its own group. Milk and coffee were used in the coloring processes. A spectrophotometer was used for color measurements. Color change (∆E) was calculated between control and test surfaces and between the three measurement points. Results In the primary teeth's test surfaces, the rubber and brush groups were significantly more colored than the air-polishing group, when compared between after polishing and after coloration (p ˂ 0.05). Furthermore, the color difference of the permanent teeth between the initial measurements and after coloration was significantly higher in the rubber group's test surface compared to the air-polished group (p ˂ 0.05). The average ∆E values in both primary and permanent teeth were as follows: rubber > brush > air polishing. Conclusions Compared to rubber or brush polishing, air polishing seems safer to avoid predisposition to postoperative enamel discoloration. Primary teeth are more colored than permanent teeth. The effect of polishing on postoperative coloring should always be considered, and air polishing should be preferred whenever possible.

The effect of bleaching applications on stained bulk-fill resin composites

Background

The structure of bulk-fill resin composites differs from that of their conventional counterparts, but how this difference affects the color stability of the former after staining and bleaching is unclear. Accordingly, this study was aimed at investigating color change in nine bulk-fill resin composites and one nanohybrid resin composite treated with hydrogen peroxide and carbamide peroxide after staining with tea, coffee, and red wine.

Methods

Eighty specimens were prepared from each resins [Clearfil Majesty Posterior (CMP), SDR flow⁺ (SDR), Filtek^TMBulk-Fill Flowable Restorative (FBF), Reveal HD Bulk (RHD), Beautifil-Bulk Restorative (BBR), Tetric EvoCeram® Bulk Fill (TEC), SonicFill™2 (SF2), everX Posterior™ (eXP), X-tra base (XB), and Venus® Bulk Fill (VBF)]. Following baseline color measurements, the specimens were randomly divided into 4 groups according to immersion solutions and distilled water as the control. At the end of a 30-day test period, color measurements were repeated, and color change values (∆E₀₀) were calculated. Each resin group was then divided into 2 subgroups (with 10 specimens per group) on the basis of bleaching agent (Opalescence Boost 40%, Opalescence PF 16%). Following bleaching application, ∆E₀₀ and changes of whiteness (∆WI_D1 = WI_Dbleaching-WI_Dbaseline, ΔWI_D2 = WI_Dbleaching-WI_Dstaining) values were recorded. Two- and three-way analyses of variance and Tukey’s post hoc test were performed, with a P < 0.05 regarded as indicative of significance.

Results

After immersion in distilled water, tea, and red wine, the highest ΔE₀₀ values were observed in eXP (P < 0.05). Resin materials immersed in coffee and tea exhibited statistically higher ∆E₀₀ values than those immersed in red wine except for eXP, TEC, and FBF (P < 0.05). For eXP, the highest ∆E₀₀ values were recorded in distilled water. For TEC and FBF, there was no statistically significant difference among the immersion solutions and distilled water (P > 0.05). For all the resins and staining beverages, no statistically significant difference in ∆WI_D1 and ∆WI_D2 values were detected between bleaching agents (P > 0.05). All the ΔWI_D1 values were above the whiteness perceptibility threshold.

Conclusion

The bulk-fill materials were more resistant to discoloration and bleaching procedures than the conventional resin composites. Coffee and tea caused more staining than distilled water and red wine generally. The type of bleaching procedure had no effect on the whiteness of the tested materials.

Effect of natural and commercially produced juices on colour stability of microhybrid and nanohybrid composites

Objective

This study aims to evaluate the discoloration rate of two types of composites, microhybrid and nanohybrid, after exposure to natural and commercially-produced juices.

Materials and methods

In this experimental study, 90 disc-shaped specimens with a thickness of 2 mm and a diameter of 10 mm were taken from two composites, microhybrid P₄ (Kerr-ITALY) and nanohybrid Filtek Z250XT (3M-ESPE-USA) (two groups of 45). Then, the samples of each group were divided into five subgroups of nine and were immersed for 10 days for 4 h in five solutions of commercially-produced orange juice, natural orange juice, commercially-produced pomegranate juice, natural pomegranate juice, and distilled water (control group). The colour of the samples was measured by a reflective spectrophotometer using the CLEl*a*b colour space at baseline and after discoloration.

Result

The independent t-test showed that the mean discoloration rate (∆E) of nanohybrid composite exposed to commercially-produced orange juice, natural pomegranate juice, and commercially-produced pomegranate juice was significantly higher than microhybrid composite (P < 0.01). In addition, the test found that the highest discoloration rate of the nanohybrid composite was related to the effect of commercially-produced orange juice (∆E = 13.03) and the highest discoloration rate of microhybrid composite was related to the effect of natural pomegranate juice (∆E = 4.79).

Conclusion

According to the results, it seems that microhybrid composites are more resistant to discoloration than nanohybrid composites. According to the results, consumption of dyed drinks, particularly natural pomegranate juice, commercially-produced orange juice, and commercially-produced pomegranate juice, is not recommended in the first few days after composite restoration.

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.

Mass change of a sodium bicarbonate air-polished nanocomposite exposed to cigarette smoke, coffee, and red wine

Resumo Introdução As resinas compostas estão sujeitas à desafios na cavidade oral relacionados aos hábitos dos pacientes, que podem comprometer a integridade e longevidade das restaurações. As consequências da associação do consumo de bebidas e o uso de cigarros à profilaxia profissional precisam ser estudadas. Objetivo O objetivo desse estudo foi avaliar como o jateamento com bicarbonato de sódio afeta a mudança de massa (sorção e solubilidade) de uma resina composta exposta à fumaça de cigarro, vinho tinto e café. Material e método Oitenta corpos-de-prova de resina composta (FiltekZ350 XT - 3M/ESPE) foram preparados e distribuídos em 8 grupos (n=10): G1 (jateamento + água destilada), G2 (jateamento + café), G3 (jateamento + vinho tinto), G4 (jateamento + fumaça de cigarro), G5 (água destilada), G6 (café), G7 (vinho tinto) e G8 (fumaça de cigarro). Os corpos-de-prova de resina composta foram pesados em três tempos diferentes para obter M1 (massa inicial), M2 (massa após 30 dias de armazenamento nas soluções testadas e exposição ao agente) e M3 (após dessecação). Os valores de sorção e solubilidade foram calculados e analisados usando ANOVA 2-fatores e teste Tukey (5%). Resultado Os grupos experimentais tiveram maior sorção e solubilidade comparado ao grupo controle, independentemente do uso do jateamento. Não houve diferença estatística na sorção para o fator jateamento. Porém, a solubilidade foi maior nos grupos jateados. Conclusão: O jateamento com bicarbonato de sódio foi capaz de intensificar a solubilidade da resina testada, embora não tenha aumentado significativamente os valores de sorção.

Degradation Potential of Bulk Versus Incrementally Applied and Indirect Composites: Color, Microhardness, and Surface Deterioration

This study investigated the color stability and microhardness of five composites exposed to four beverages with different pH values. Composite discs were produced (n=10); Filtek Z250 (3M ESPE) and Filtek P90 (3M ESPE) were applied in two layers (2 mm, 20 seconds), and Tetric N-Ceram Bulk Fill (TetricBF, Ivoclar Vivadent) and SonicFill (Kerr) were applied in bulk (4 mm) and then light cured (40 seconds, Ortholux-LED, 1600 mW/cm²). Indirect composite Sinfony (3M ESPE) was applied in two layers (2 mm) and cured (Visio system, 3M ESPE). The specimens were polished and tested for color stability; ΔE was calculated using spectrophotometer readings. Vickers microhardness (50 g, dwell time=45 seconds) was assessed on the top and bottom surfaces at baseline, 40 days of storage, subsequent repolishing, and 60 days of immersion in distilled water (pH=7.0), Coca-Cola (pH=2.3), orange juice (pH=3.75), or anise (pH=8.5) using scanning electron microscopy (SEM). The materials had similar ΔE values (40 days, p>0.05), but TetricBF had a significantly greater ΔE than P90 or SF (40 days). The ΔE was less for P90 and TetricBF than for Z250, SonicFill, and Sinfony (60 days). Repolishing and further immersion significantly affected the ΔE (p<0.05) except for P90. All composites had significantly different top vs bottom baseline microhardnesses. This was insignificant for the Z250/water, P90/orange juice (40 days), and Sinfony groups (40 and 60 days). Immersion produced variable time-dependent deterioration of microhardness in all groups. Multivariate repeated measures analysis of variance with post hoc Bonferroni tests were used to compare the results. ΔE and microhardness changes were significantly inversely correlated at 40 days, but this relationship was insignificant at 60 days (Pearson test). SEM showed degradation (40 days) that worsened (60 days). Bulk-fill composites differ regarding color-stability and top-to-bottom microhardness changes compared with those of other composites. P90 showed better surface degradation resistance. In conclusion, bulk-fill composites are not promising alternatives to incremental and indirect composites regarding biodegradation.

Customized SmartPeg for measurement of resonance frequency of mini dental implants

Background

One-piece narrow diameter implants (NDIs) have been recommended as “Single-tooth replacements in the anterior zones, single posterior, multiple-unit fixed dental prosthesis (FDP), edentulous jaws to be rehabilitated with FDP, and edentulous jaws rehabilitation with overdentures in situations with reduced mesiodistal space or reduced ridge width.” (ITI consensus 2013). Since NDIs can be immediately loaded, it is important to be able to carry out stability testing. We developed and validated a customized SmartPeg for this type of implant to measure the Implant Stability Quotient (ISQ). The ISQ of mini dental implants (MDIs) was measured and compared with the stability of standard and in a rabbit model.

Objective

The aim of the study is to test the feasibility of a customized SmartPeg for resonance frequency measurement of single-piece mini dental implants and to compare primary stability of a standard and the mini dental implant (3M™ESPE™ MDI) in a rabbit model after 6 weeks of healing.

Methods

Eight New Zealand white rabbits were used for the study. The protocol was approved by the McGill University Animal Ethics Review Board. Sixteen 3M™ESPE™ MDI and equal number of standard implants (Ankylos® Friadent, Dentsply) were inserted into the tibia/femur of the rabbits and compared. Each rabbit randomly received two 3M™ESPE™ MDI and two Ankylos® implants in each leg. ISQ values were measured with the help of an Osstell ISQ device using custom-made SmartPegs for the MDIs and implant-specific SmartPegs™ (Osstell) for the Ankylos®. Measurements were obtained both immediately following implant placement surgery and after a 6-week healing period. Each reading was taken thrice and their average compared using Wilcoxon matched pairs signed-rank tests.

Results

The median ISQ and interquartile range (IQR) values were 53.3 (8.3) at insertion and 60.5 (5.5) at 6 weeks for the 3M™ESPE™MDI and, respectively, 58.5 (4.75) and 65.5 (9.3) for the Ankylos® implant. These values also indicate that both types of implants achieved primary and secondary stability, and this is supported by histological data. ISQ values of both 3M™ESPE™ MDI and Ankylos® increased significantly from the time of insertion to 6 weeks post-insertion (p < 0.05).

Conclusions

The new custom-made SmartPeg is suitable for measuring the Implant Stability Quotient of 3M™ESPE™MDIs. The primary stability of 3M™ESPE™MDIs is similar to the primary stability attained by standard implants in the rabbit tibia.

Discoloration of PMMA, composite, and PEEK

INTRODUCTION

To assess the discoloration and stain removal potential of different cleaning methods relevant to individual/professional prophylaxis and laboratory cleaning on polyetheretherketone (PEEK), poly(methyl methacrylate) (PMMA)-based, and composite (COMP) materials after storage in different media for 7 days.

METHODS

One thousand three hundred twenty specimens of PEEK, PMMA, and COMP (N = 440 of each group) were prepared and stored in four different media for 7 days to cause stain. Samples were divided into three cleaning groups (n = 10): (i) individual prophylaxis, (ii) laboratory protocols, and (iii) professional prophylaxis. Color was determined by a portable spectrophotometer and calculated between different time points (∆E). The data was statistically evaluated using univariate analyses, Kruskal-Wallis H and Mann-Whitney U tests (p < 0.05).

RESULTS

The significantly (p < 0.001) lowest discoloration was found when specimens were stored in distilled water and chlorhexidine (CHX), followed by red wine. Curry solution caused the highest discoloration. PEEK showed the significantly (p < 0.001) lowest color changes, while COMP showed the highest changes. Ultrasonic bath and Air Flow Plus (AFP) were the significantly (p < 0.001) most effective methods to remove staining. The least cleaning effect was found using a soft toothbrush (ST), a medium-hard toothbrush (MT), and SunSparkle (SS) cleaning system.

CONCLUSIONS

PEEK seems more stable against discolorations than other denture resin materials. Regarding the cleaning potential, individual prophylaxis can be conducted with toothbrushes. For professional prophylaxis, air-abrasion devices using gentle powders are effective. Laboratory protocols should include gentle cleaning methods like ultrasonic bath.

CLINICAL RELEVANCE

Clinicians and dental technicians should inform their patients about the discoloration potential of certain foods/beverages and recommend the most efficient cleaning, but preventive methods.

The influence of polymerization conditions on color stability of three indirect composite materials

The aim of the present study was to evaluate color change and color stability against aqueous media of three indirect composite materials (Epricord, Estenia, and Twiny) that were polymerized with different systems. Disk-shaped specimens were prepared with their proprietary polymerization systems or with a metal halide light polymerization unit (Twinkle X). The specimens were then immersed in water or tea. Change in color from baseline (24 h) to 4 weeks was determined with a chromameter (ShadeEye NCC) using a white background. The L*, a*, and b* values for both states were determined, and ΔE*(ab) values were calculated. The Estenia specimens immersed in tea had significantly lower ΔL* (-7.0 to -5.6) and significantly higher ΔE*(ab) values (6.5 to 8.6) than did the Epricord and Twiny specimens, under all polymerization conditions. The results indicate that after tea immersion the Estenia material was less stable against color change than were the other two materials. The Twinkle X metal halide unit was suitable for polymerization of the three composite materials, using an exposure period of 60 s or longer.